R08-140
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1
2 RESOLUTION NO. R08-/4D
3
4 A RESOLUTION OF THE CITY OF BOYNTON BEACH,
5 FLORIDA, AUTHORIZING EXECUTION OF ATHREE (3)
6 YEAR AGREEMENT BETWEEN THE CITY OF
7 BOYNTON BEACH AND BETHESDA HEALTHCARE
8 SYSTEM, AS THE NEW PROVIDER FOR PHYSICIAN
9 SERVICES FOR ALL NEW EMPLOYEES AND
10 REQUIRED ANNUAL PHYSICALS FOR POLICE
11 OFFICERS AN FIREFIGHTERS; AND PROVIDING AN
12 EFFECTIVE DATE.
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14
15
16
17 WHEREAS, the City Commission of the City of Boynton Beach, upon
18 recommendation of staff, deems it to be in the best interests of the citizens of the City of
19 Boynton Beach to enter into an Agreement between the City of Boynton Beach and Bethesda
20 Health Care System, providing for pre-employment examinations, and required annual
21 physicals for police officers and firefighters;
22 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
23 THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
24 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
25 being true and correct and are hereby made a specific part of this Resolution upon adoption
26 hereof.
27 Section 2. The City Commission of the City of Boynton Beach hereby authorizes
28 and directs the execution of a three (3) year Agreement for physician services between the
29 City of Boynton Beach and Bethesda Health Care System, a copy of which agreement is
30 attached hereto as Exhibit "A".
31 Section 3. This Resolution shall become effective immediately upon passage.
SICA\RESOlAgreements\Bethesda Healthcare System (physician services).doc
II I
1 PASSED AND ADOPTED this .;1.A1L) day of December, 2008.
2
3 CITY OF BOYNTON BEACH, FLORIDA
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5 ~~
6
7
8 {)ayor I Jerry T lor
9 .....,
10 .....,..,~....,.. -~,~.....-.......-",. '
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11 Vice Mayor - Jose Rojffguez
12 ~
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15 Commissioner - Ronald Weiland
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17 ~~L
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19 Commissioner Woodrow
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23 Commissioner - Marlene Ross
24
25 ATTEST:
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27
28 1/ --
29 I /,/'tc: "t
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31
32
33
34
35 (Corporate Seal)
S\CAIRESOlAgreementslBethesda Healthcare System (physician services) doc
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THREE (3) YEAR CONSULTANT AGREEMENT
FOR PHYSICIAN SERVICES
WITH BETHESDA HEAL THCARE SYSTEM
THIS AGREEMENT is entered into between the City of Boynton Beach, hereinafter
referred to as "the City", and Bethesda Healthcare System, hereinafter referred to as "the
Physician", in consideration of the mutual benefits, terms, and conditions hereinafter
specified effective December 2,2008.
1. PROJECT DESIGNA nON. The Physician is retained by the City to perform
Physician services in connection with the project designated.
2. SCOPE OF SERVICES. Physician agrees to perform the services, identified on
Exhibit "A" attached hereto, and incorporated herein by reference, including the
provision of all labor, materials, equipment and supplies. No modifications will be
made to the original scope of work without the written approval of the City Manager
or his designee.
3. TIME FOR PERFORMANCE. Work under this contract shall commence upon the
giving of written notice by the City to the Physician to proceed. Physician shall
perform all services and provide all work product required pursuant to this agreement.
4. TERM: The term of this Agreement shall commence on the date written above and
shall be for a period of three (3) years. The agreement will automatically renew for
an additional two (2) years unless either party is notified by the other at least ninety
(90) days prior to the end of this Agreement.
5. PAYMENT. The Physician shall be paid by the City for completed work and for
services rendered under this agreement as follows:
a. Payment for the work provided by Physician shall be made as provided on Exhibit
"A" attached hereto, on an as needed basis without express written modification
of the agreement signed by the City Manager or his designee.
b. The Physician may submit invoices to the City once per month during the
progress of the work for partial payment for project completed to date. Such
vouchers will be reviewed by the City, and upon approval thereof, payment will
be made to the Physician in the amount approved.
c. Final payment of any balance due the Physician of the total contract price earned
will be made promptly upon its ascertainment and verification by the City after
the completion of the work under this Agreement and its acceptance by the City.
d. Payment as provided in this section by the City shall be full compensation for
work performed, services rendered and for all materials, supplies, equipment and
incidentals necessary to complete the work.
S:\HR\Bethesda\agreement for physician services\Physician Services Agreement Bethesda.doc
e. The Physician records and accounts pertaining to this agreement are to be kept
available for inspection by representatives of the City and State for a period of
three (3) years after the termination of this Agreement. Copies shall be made
available upon request.
6. OWNERSHIP AND USE OF DOCUMENTS. All documents, records, and other
materials produced by the Physician in connection with the services rendered under
this Agreement shall be the property of the City whether the project for which they
are made is executed or not. The Physician shall be permitted to retain copies,
including reproducible copies, of documents, records, and other materials for
information, reference and use in connection with Physician's endeavors.
7. COMPLIANCE WITH LAWS. Physician shall, in performing the servIces
contemplated by this service agreement, faithfully observe and comply with all
federal, state and local laws, ordinances and regulations that are applicable to the
services to be rendered under this agreement.
8. INDEMNIFICA nON. Consultant shall indemnify, defend and hold harmless the
City, its offices, agents and employees, from and against any and all claims, losses or
liability, or any portion thereof, including attorneys fees and costs, arising from injury
or death to persons, including injuries, sickness, disease or death to Physician's own
employees, or damage to property occasioned by a negligent act, omission or failure
of the Physician.
9. INSURANCE. The Physician shall secure and maintain in force throughout the
duration of this agreement Malpractice Insurance along with comprehensive general
liability insurance with a minimum coverage of $1,000,000 per occurrence and
$1,000,000 aggregate for personal injury; and $1,000,000 per occurrence/aggregate
for property damage, and professional liability insurance in the amount of $1,000,000
per occurrence to $2 million aggregate with defense costs in addition to limits.
Said general liability policy shall name the City of Boynton Beach as an additional
named insured and shall include a provision prohibiting cancellation of said policy
except upon thirty (30) days prior written notice to the City. Certificates of coverage
as required by this section shall be delivered to the City within fifteen (15) days of
execution of this agreement.
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10. INDEPENDENT CONTRACTOR. The Physician and the City agree that the
Physician is an independent contractor with respect to the services provided pursuant
to this agreement. Nothing in this agreement shall be considered to create the
relationship of employer and employee between the parties hereto. Neither Physician
nor any employee of Physician shall be entitled to any benefits accorded City
employees by virtue of the services provided under this agreement. The City shall not
be responsible for withholding or otherwise deducting federal income tax or social
security or for contributing to the state industrial insurance program, otherwise
S:\HR\Bethesda\agreement for physician services\Physician Services Agreement Bethesda.doc
assuming the duties of an employer with respect to Physician, or any employee of
Physician.
11. COVENANT AGAINST CONTINGENT FEES. The Physician warrants that he has
not employed or retained any company or person, other than a bonafide employee
working solely for the Physician to solicit or secure this contract, and that he has not
paid or agreed to pay any company or person, other than a bonafide employee
working solely for the Physician, any fee, commission, percentage, brokerage fee,
gifts, or any other consideration contingent upon or resulting from the award or
making of this contract.
For breach or violation of this warranty, the City shall have the right to annul this
contract without liability or, in its discretion to deduct from the contract price or
consideration, or otherwise recover, the full amount of such fee, commission,
percentage, brokerage fee, gift, or contingent fee.
12. DISCRIMINATION PROHIBITED. The Physician, with regard to the work
performed by it under this agreement, will not discriminate on the grounds of race,
color, national origin, religion, creed, age, sex or the presence of any physical or
sensory handicap in the selection and retention of employees or procurement of
materials or supplies.
13. ASSIGNMENT. The Physician shall not sublet or assign any of the services covered
by this agreement without the express written consent of the City.
14. NON-WAIVER. Waiver by the City of any provision of this agreement or any time
limitation provided for in this agreement shall not constitute a waiver of any other
prOVIsIOn.
15. TERMINAnON. This agreement may be terminated as follows:
a. By either Party for Cause (defined for purposes of this Agreement as an incurred
breach of the provisions hereof), if the terminating Party has provided the other
Party with written notice of the matter or matters constituting Cause for
termination and the Party receiving such notice has not cured such matter or
matters within thirty (30) days of receipt.
b. In the event of the death of a member, partner or officer of the Physician, or any
of its supervisory personnel assigned to the project, the surviving members of the
Physician hereby agree to complete the work under the terms of this agreement, if
requested to do so by the City. This section shall not be a bar to renegotiations of
this agreement between surviving members of the Consultant and the City, if the
City so chooses.
S:\HR\Bethesda\agreement for physician services\Physician Services Agreement Bethesda.doc
16. DISPUTES. Any dispute arising out of the terms or conditions of this agreement
shall be adjudicated within the courts of Florida. Further, this agreement shall be
construed under Florida Law.
17. NOnCES. Notices to the City of Boynton Beach shall be sent to the following
address:
Human Resources
Attention: Sharyn M. Goebelt, Human Resources Director
City of Boynton Beach
P.O. Box 310
Boynton Beach, FL 33425-0310
Notices to Consultant shall be sent to the following address:
Bethesda Healthcare System
2815 S. Seacrest Blvd.
Boynton Beach, Florida 33435
S:\HR\Bethesda\agreement for physician services\Physician Services Agreement Bethesda.doc
18. INTEGRATED AGREEMENT. This agreement, together with attachments or
addenda, represents the entire and integrated agreement between the City and the
Physician and supersedes all prior negotiations, representations, or agreements
written or oral. This agreement may be amended only by written instrument signed by
both City and Physician.
DATED this ~ day of A~ ,2008.
CITY OF BOYNTON BEACH
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Title
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City lerk
Attest! Authenticated:
Secretary
S:\HR\Bethesda\agreement for physician services\Physician Services Agreement Bethesda.doc
Exhibit A
SCOPE OF SERVICES
The Physician will provide new hire, annual, and fit for duty exams during normal business
hours and all other duties as listed in the scope of services. The City will schedule services with
the Physician during normal hours of operation. The Physician shall perform the following types
of substance abuse testing: Reasonable Suspicion/Cause, Post Accident testing, Return to Duty
testing and Follow-up, CDL physical and all other service testing within the scope of work.
During periods of absence due to vacation, etc, physician will be required to provide a contact
for back-up physician services.
1: Firefighter Services - Breakdown of Scope
The Proposer for Physician Services, Part 1 Firefie:hter must have a Fire Physician on staff
who meets the standards of NFP A 1582. The Fire Physician must be knowlede:eable of
firefie:htine: and the various tasks that firefie:hters perform.
A. General
1. Conduct pre-employment physicals for all Firefighters including drug and alcohol
screening to be in compliance with the City's Drug Free Workplace Policy
2. Conduct annual physicals for Firefighters.
3. Physician shall coordinate laboratory testing necessary in conjunction with examinations
and testing performed by outside Vendor to comply with the terms of the agreement.
4. Physician and or Staff shall assume all billing responsibilities, including billing for
additional testing, x-rays and laboratory tests related to the exam.
5. Physician shall provide any and all necessary consultation and case review of
examination results for the employee/patient. A written review of the examination results
shall be provided to employee/patient.
6. Physician shall provide flu shots to all City of Boynton Beach Firefighters. Retirees may
be permitted to participate by paying for the shots.
7. Maintain all medical records created during the course of the agreement.
8. Certify that all Physicians as well as any other employees of the Vendor shall have the
appropriate licenses or registrations as required by any local, state or federal law, rule or
regulation.
9. Provide a detailed monthly invoice for all services and fees.
B. Fire Department Annual Physicals:
1. Annual Physical Evaluations for Firefighters shall meet or exceed requirements
established in NFP A 1582 Medical Evaluation of Candidates and Medical Evaluation of
Members. A physician, nurse practitioner, physician assistant or equivalent shall conduct
physicals. The Physician shall inform the appropriate department only as to whether or
not the candidate or current employee is medically certified to perform their duties.
2. The Physician shall be responsible for guiding, directing and advising the employee with
regard to their health, fitness and suitability for various duties. Firefighter's health and
1
fitness will be guided by standards established in NFP A 1500, Fire Department
Occupational Safety and Health Program, Chapter 8, Section 8-6 "Fire department
Physician" as amended.
3. The Physician shall provide immunization(s) as needed.
4. The Physician shall perform a review of all office notes; EKG's and review all cases
achieving abnormal results, deviations from baseline results as determined by comparison
with previous examinations, and positive contagious disease profiles.
5. The Physician shall report patterns of deviation and/or abnormal results identified by
review of the employees physical to the Department Chief in an effort to coordinate
preventative measures to avoid or reduce further deviation.
6. If any requirements should change as a result of changes in the collective bargaining
agreements, the City shall assume responsibility to notify the Physician_of said changes.
This agreement may be amended upon written approval of both parties.
C. Firefighter Annual Exam Components:
Firefighter exam reference NFPA 1582, Chapter 6-7, Periodic Medical Evaluation
1. Establishment of Medical & Occupational History
2. Physical Evaluation including spinal exam
3. Range of motion and neurological reflex exam
4. EKG
5. Pulmonary Function Testing with pulse oximetry
6. Fitness Assessment by Certified Fitness Coordinator
7. Dietary and exercise program recommendations with follow-up as needed
8. Tetanus and Diphtheria as needed
9. Hepatitis B Booster (series as needed) plus titers (quantitative)
10. Tuberculosis Test!Tine, PPD (chest X-ray as needed)
11. Stress Test (Treadmill) (At age 40 and every two years thereafter, or as clinically
indicated)
12. CMP, LP, CBC, RPR, UA, Hep A,B,C and B quantitative, HIV (confirmation on positive
results) TSH (when clinically indicated)
13. PSA (males over 40)
D. Firefighter New Hire Evaluation Components:
1. Components same as annual physical
2. A,B,O and AB Blood Typing
E. Firefighter Testing for Infectious Disease:
1. Confirmation and/or repeat testing for HIV, Hepatitis A, B, C and RPR
F. Fire Rescue Fitness Evaluation (Wellness Program)
1. Body fat evaluation. This will include circumference and skinfold.
2. Grip strength.
2
3. Push ups. Max 45
4. Sit-ups. Max 45
5. Flexibility. (Sit and Reach)
6. 5 minute step test. This evaluates aerobic capacity.
Participants will receive a computer print out of evaluation which will specify areas of
improvement and percentile ranking based on age and gender.
Part 2 Police Officers and Employees (excluding Firefighters) - Breakdown of scope
A. General
1. Conduct pre-employment physicals for all Police Officers and general employees
requested by the City including drug and alcohol screening to be in compliance with the
City's Drug Free Workplace Policy.
2. Administer flu shots to all Police Officers and City of Boynton Beach employees. The
City will determine the number of shots to be given and who may participate. Retirees
may be permitted to participate by paying for the shots.
3. Physician shall coordinate laboratory testing necessary in conjunction with examinations
and testing performed by the Vendor as requested by the City.
4. Physician and or Staff shall assume all billing responsibilities, including billing for
additional testing, x-rays and laboratory tests.
5. Physician shall provide any and all necessary consultation and case review of
examination results for the employee/patient. A written review of the examination results
shall be provided to employee/patient.
6. Maintain all Medical records created during the course of the agreement.
7. Certify that all Physicians as well as any other employees of the Vendor shall have the
appropriate licenses or registrations as required by any local, state or federal law, rule or
regulation.
8. Provide a detailed monthly invoice for all services and fees.
B. Police Officer New Hire Examination Components:
1. Establishment of Medical & Occupational History
2. Physical Examination including spinal exam
3. Range of motion and neurological reflex exam
4. EKG
5. Pulmonary Function Testing with pulse oximetry
6. Fitness Assessment by Certified Fitness Coordinator
7. Dietary and exercise program recommendations with follow-up as needed
8. Tetanus and Diphtheria as needed
9. Hepatitis B Booster (series as needed) plus titers (quantitative)
10. Tuberculosis Test!Tine, PPD (chest X-ray as needed)
11. Stress Test (Treadmill
12. CMP, LP, CBC, RPR, UA, Hep A,B,C and B quantitative, HIV (confirmation on
positive results) TSH (when clinically indicated)
13. PSA (males over 40)
14. Drug Screening
15. Fitness Assessmet
3
C. General Emplovees/New Hire Physical Components:
1. Physical Examination, Visual Acuity and Peripheral Vision testing
2. Tetanus and Diphtheria Booster as needed
3. Tuberculosis Test!Tine, PPD as needed, chest X-ray as needed
4. Drug & Alcohol Screen
D. General Employees - Immunization:
1. Hepatitis B Booster/series as needed
2. Blood titers as necessary
4
CITY OF BOYNTON BEACH
PROFESSIONAL SERVICES AND FEES COMPARISON
Scope of Services Pricing
I PART 1 - FIREFIGHTER SERVICES I Bethesda Medical Assoc.
A Drug and Alcohol Testing - 10 panel $30
B Fire Department Annual Physicals $100
C Fire Department Annual Physicals with Stress Test $232
C1 Fire Department Annual Physicals without Stress Test $100
D Firefighter New Hire Evaluation with Stress Test $378
D1 Firefighter New Hire Evaluation without Stress Test $246
E Firefighter Testing for Infectious Disease $81
F Fire Rescue Fitness Evaluation - Wellness Program $35
Additional Testing Service PPD $4
Chest X-ray as needed $42
Drug Test - 1 0 panel $30
Tetanus as needed $38
Hepatitis B Series as needed after hire $150
Hepatitis B Booster as needed $50
Hepatitis A Series for Technical Rescue and Dive Team $120
Titers - quantitative $12
CRP Blood Test when cardiac risk factors indicate $35
PSA for males over 40 $31
Stress Test $132
Flu Shot $20
PART 2 - POLICE AND GENERAL EMPLOYEE SERVICES I Bethesda Medical Assoc. I
A Drug and Alcohol Testing - 10 panel $30
B Flu Shots $20
C Police Officer New Hire Evaluation $303
D General Employees New Hire Pre-Employment Exam $120
E Police Testing for Infectious Disease $81
Additional Testing Service PPD $4
Chest X-ray as needed $42
Drug Test - 10 panel $30
Tetanus as needed $38
Hepatitis B Series as needed after hire $150
Hepatitis B Booster as needed $50
Hepatitis A Series $120
Titers - quantitative $12
CRP Blood Test when cardiac risk factors indicate $35
Stress Test $132
Flu Shot $20
Lead Testing for Range Instructors Only $12
PSA for males over 40 $31
*three (3) shots
**per shot
* EXHIBIT
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a.
Summary of Request for Information (RFI)
for Physicians Services
~ Willis sent out a Request for Information for pricing for physicians services for the City of Boynton Beach.
~ The RFI included a request for Physician Services pricing for Firefighters, as well as Police and General Employees.
~ Vendors within 15 miles ofthe City of Boynton Beach were contacted, and were asked to provide a breakdown oftheir costs for
Physician services. Responses were due to Willis no later than October 7,2008.
~ Local vendors who were sent the RFI are listed below:
0 Dr. Randall L. Wolff, Clinical Services Unit
0 Bethesda Medical Associates
0 Central Palm Beach Physicians & Urgent Care
0 MedExpress Urgent Care
0 U.S. Healthworks
~ The following vendors did not provide pricing for physicians services:
0 Central Palm Beach Physicians & Urgent Care did not respond.
0 MedExpress Urgent Care responded on the due date with a request for a meeting; no other information was submitted.
~ Dr. Randall Wolff, Bethesda Medical Associates, U.s. Healthworks provided pricing for the Physician Services, which is illustrated on the
attached Revised Professional Services and Fees Comparison spreadsheet. The proposed fees that are lower than the current are
highlighted in green; proposed fees that are higher than current are highlighted in red.
Willis
. EXHIBIT
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CITY OF BOYNTON BEActf
REVISED PROFESSIONAL SERVICES AND FEES COMPARISON
PART 1 - FIREFIGHTER SERVICES Dr. Randall WoIft' s.lhesda Medical Anoc:. US Hulthworks
A Drug and Alcohol Testing - 10 panel $90 $30 S6l
B Fire Department Annual Physicals $415 $100 '34(\(
C Fire Department Annual Physicals with Stress Test $715 $232 S~~/):.
C1 Fire Department Annual Physicals without Stress Test $415 $100 S401
0 Firefighter New Hire Evaluation with Stress Test $745 $378 5'l91
01 Firefighter New Hire Evaluation without Stress Test $445 $246 S44C
E Firefighter Testing for Infectious Disease $250 $81 S18:
F Fire Rescue Fitness Evaluation - Wellness Program $50 $35 $50
Additional Testing Service PPD $15 $4 $15
Chest X-ray as needed $110 $42 SY.
Drug Test - 10 panel $75 $30 S4L
T etan us as needed $40 $38 SJE
Hepatitis B Series as needed after hire $150 $150 $210*
Hepatitis B Booster as needed $50 $50 $70
Hepatitis A Series for Technical Rescue and Dive Team $150 $120 $90*'
Titers ~ quantitative $20 $12 $35
CRP Blood Test when cardiac risk factors indicate $30 $35 $40
PSA for males over 40 $45 $31 S~("
Stress Test $300 $132
Flu Shot $25 $20 S:c
PART 2 - POLICE AND GENERAL EMPLOYEE SERVICES Dr. RandaU Wolft' s.lhelda Medical Anoc:. US H..lthworlcs
A Drug and Alcohol Testing - 10 panel $90 $30 Sb\
B Flu Shots $25 $20 S:c
C Police Officer New Hire Evaluation $750 $303 544,.
0 General Employees New Hire Pre-Employment Exam $130 $120 541
E Police Testing for Infectious Disease $250 $81 516..
Additional Testing Service PPD $15 $4 $15
Chest X-ray as needed $110 $42 532
Drug Test - 10 panel $75 $30 S4[:
Tetanus as needed $40 $38 53c
Hepatitis B Series as needed alter hire $150 $150 $210
Hepatitis B Booster as needed $50 $50 $70
Hepatitis A Series $150 $120 $90"
Titers. quantitative $20 $12 $35
CRP Blood Test when cardiac risk factors indicate $30 $35 $40
Stress Test $300 $132 S 1;:,c
Flu Shot $25 $20 S')f
Lead Testing for Range Instructors Only $30 $12 $30
PSA for males over 40 $45 $31 See
"three (3) shots
"per shot
. EXHIBIT
willi S i 3
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WIWS HRH
EMPLOYEE BENEFITS
720 5th Avenue South, Suite #203
Direct: 239 659 4500
Toll Free: 8665934656
Fax: 239 262 5338
Website: www.willis.com
Executive Summary
Puroose: To identify a vendor to provide physician services, including office space, exam rooms and
equipment, to the City of Boynton Beach. The City desires to establish a strong, sound and mutually beneficial
relationship with a physician or firm.
Badc2round: The City of Boynton Beach has a contract for physician services with Dr. Randall Wolff, M.D. that
ends December 2, 2008. At the request of the Human Resources staff of the City of Boynton Beach, Willis of
Florida developed a Request for Information (RFI) for pricing for a qualified firm or physician to provide
physician services, including office space, exam rooms and equipment, to the City of Boynton Beach.
Local vendors within 15 miles of the City of Boynton Beach were asked to provide a breakdown of their costs
for Physician Services.
Analysis: The RFI was distributed by Willis on September 30, 2008.
Local vendors who were sent the RFI are: Dr. Randall L. Wolff, Clinical Services Unit, Bethesda Healthcare
System (Bethesda Medical Associates), Central Palm Beach Physicians & Urgent Care, MedExpress Urgent Care
and U.S. Healthworks.
Central Palm Beach Physicians and Urgent Care did not respond to our Request. MedExpress Urgent Care
responded with a request for a meeting and followed up with an e-mail advising us that they are not equipped
to provide all services as outlined in the RFL
Dr. Randall Wolff, Bethesda Medical Associates and U.S. Healthworks provided pricing for Physician Services,
which is illustrated on the attached comparison spreadsheet.
Based on these results, Willis facilitated a finalist meeting with Bethesda to verify the terms and conditions
proposed in their analysis.
Recommendation: After careful review of the criteria provided by the City, and the proposals submitted by
the vendors, Bethesda Healthcare System has provided a proposal that most closely meets or exceeds the
requirements outlined in the RFI for physician services.
11/10/2008