Proposal ResponseRFP F-26-1054 Pre-Employment Medical Screening ServicesCity of San Bernardino Submitted by:Loma Linda University Occupational Medicine Center 328 Commercial Road, Suite 101 San Bernardino, CA 92408 Employer Services:909-558-62221. Executive SummaryLoma Linda University Occupational Medicine Center is pleased to submit this proposal to continue providing Pre-Employment Medical Screening Services for the City of San Bernardino under RFP F-26-1054. For close to two years, our team has served the City’s pre-employment medical screening needs. In addition, we have cared for City workers’ compensation patients and have worked with City Human Resources leaders over the years regarding occupational healthneeds affecting the municipal workforce. We are proud to provide the City with full-service occupational medicine, not merely isolated testing services.Our program is led by Akbar Sharip, MD, MPH, FACOEM, Professor of Medicine, Medical Director of the Loma Linda University Occupational Medicine Center, and Past President of the Western Occupational and Environmental Medical Association. He is supported byan experienced occupational medicine team, clinic leadership, administrative personnel, and contract coordination staff. Our physicians include board-certified Occupational and Environmental Medicine physicians with many years of experience in pre-employment evaluations, workers’ compensation care, public safety examinations, respiratory clearance, hearing conservation, drug and alcohol testing, Medical Review Officer services, fitness-for-duty evaluations, and return-to-work planning.Loma Linda University Health describes its Occupational Medicine Center as providing occupational and environmental health services to help protect employee health by addressing workplace hazards and treating work-related illnesses and injuries. The Center also describes customized programs, board-certified physicians, regional leadership, clear communication, whole-person care, workers’ compensation management, pre-employment/post-offer examinations, fitness-for-duty and return-to- 1 work evaluations, drug/alcohol testing, MRO services, radiology, telemedicine, vaccinations, and preventive programs as part of its occupational medicine services. (Loma Linda University Health). The City’s RFP requests a qualified firm to provide post-offer/pre-employment examinations, occupational and environmental health evaluations, respiratory clearance, hearing and vision testing, written clearance reporting, secure medical record maintenance, and timely examinations for City applicants. Loma Linda University Occupational Medicine Center acknowledges these requirements and is fully prepared to continue meeting the City’s needs. We believe our proposal offers the City several important advantages:1.Continuity with an existing City occupational medicine providerWe have already provided pre-employment medical screening services for theCity and have also cared for City workers’ compensation patients.2.Physician-led occupational medicine expertiseOur team includes board-certified Occupational and Environmental Medicinephysicians who understand job demands, public safety requirements, workplacehazards, disability accommodation principles, and regulatory compliance.3.Regional leadership and full-service capabilityWe are one of the region’s leading occupational medicine centers, with the abilityto support the City across pre-employment, workers’ compensation, return-to-work, medical surveillance, respiratory protection, drug testing, and fitness-for-duty needs.4.Reliable communication and administrative supportThe City will have clear points of contact for clinical oversight, clinic operations,contract coordination, invoicing, scheduling, and reporting.5.Minimal transition burdenBecause of our existing relationship with the City and familiarity with City HRneeds, our team can continue services efficiently without the learning curverequired of a new vendor. 2 Table of Contents3
3. Identification of Proposer Legal Name of Proposer: Faculty Physicians and Surgeons of LLUSM Service Location:Loma Linda University Occupational Medicine Center 328 Commercial Road, Suite 101 San Bernardino, CA 92408 Legal Form of Company: 501C3 Parent Company, if applicable: N/A Primary Proposal Contact: Michelle Hawkins Practice Administrator (909) [email protected] Clinical / Medical Lead: Akbar Sharip, MD, MPH, FACOEM Professor of Medicine Medical Director, Loma Linda University Occupational Medicine CenterClinic Operations Contact: Maria Hurtado Clinic ManagerPhone: 909-651-4265 Contract Coordination and Invoicing Support: Michelle Hawkins Contract Coordination / Invoicing Support909-558-6275 [email protected] Employer Services Contact Number:909-558-6222 California Business License Number:957330 4 4. Staffing ResourcesA. Firm Staffing and Key PersonnelLoma Linda University Occupational Medicine Center will assign a physician-led occupational medicine team to support the City of San Bernardino. Our team includes board-certified Occupational and Environmental Medicine physicians, supported by clinic management, nursing, medical assistant, technical, administrative, records, billing, and contract coordination personnel. Loma Linda University Health identifies Akbar Sharip, MD, MPH, FACOEM as Medical Director of the Occupational Medicine Center and identifies Maria Hurtado, Clinic Manager, as the contact for partnership discussions and facility tours. The website lists employer services through the Occupational Medicine Center at 909-558-6222. (Loma Linda University Health) Name Discipline / Title Proposed Role Akbar Sharip, MD, MPH, FACOEMProfessor of Medicine; Medical Director, Loma Linda University Occupational Medicine Center; Past President, Western Occupational and Environmental Medical Association Physician lead, medical oversight, quality assurance, complex case review, City liaison Maria Hurtado Clinic Manager Clinic operations, scheduling workflow, employer partnership coordination, facility coordination Michelle Hawkins Contract Coordination / Invoicing Support Contract coordination, invoicing support, administrative communication Maryam Sanjari, MD, MPH Occupational Medicine PhysicianPre-employment and occupational health evaluationsLeslie Cadet, MD, MPH Occupational Medicine PhysicianPre-employment and occupational health evaluationsDana M. Brockmann, MD, MPH Occupational Medicine PhysicianPre-employment and occupational health evaluationsHaitham Juma, MD, MPH Occupational Medicine PhysicianPre-employment and occupational health evaluations 5 Name Discipline / Title Proposed RoleNasrin Kazemi, MD, PhD, MPH Occupational Medicine PhysicianPre-employment and occupational health evaluationsB. Three Principal Individuals Responsible for Working withthe CityThe following individuals will be principally responsible for working with the City:Name Title Role and ResponsibilityAkbar Sharip, MD, MPH, FACOEMProfessor of Medicine; Medical Director; Past President, Western Occupational and Environmental Medical Association Physician leadership, medical oversight, complex case review, quality assurance, clinical escalation, City liaison Maria Hurtado Clinic Manager Clinic operations, scheduling workflow, applicant flow, employer coordination, operational issue resolution Michelle Hawkins Contract Coordination / Invoicing Support Contract coordination, invoicing support, administrative documentation, communication support If selected as a finalist, these principal individuals or designated institutional representatives will be available for interview and presentation as requested by the City. C. Team OrganizationThe proposed team will operate under physician-led oversight. The City will have clearly defined contacts for: Clinical oversight and medical interpretationScheduling and applicant flowContract coordinationInvoicing and documentationClearance forms and reportingEscalation of delayed, inconclusive, or complex casesMedical clearance decisions will be reviewed by appropriately licensed physicians and clinical professionals experienced in occupational medicine. Administrative and contract-related matters will be coordinated through designated support personnel.D. SubcontractorsLoma Linda University Occupational Medicine Center may coordinate certain ancillary services through qualified internal, affiliated, or external resources, such as laboratory 6 testing, radiology interpretation, or specialized testing when required. All such services will be coordinated through our occupational medicine program and performed in accordance with applicable laws, City-approved protocols, confidentiality requirements, and professional standards. Business Permit/License – Appendix A1Physician Licenses – Appendices A2-ACertificate of Status – Appendix A7
5. Fiscal StabilityLoma Linda University Occupational Medicine Center is part of a stable academic health system with established clinical, administrative, compliance, financial, medical records, and billing infrastructure. Audited Financials FY19-20 – Audited Financials FY21-22 – Audited Financials FY23-24 – 8
6. Experience and TechnicalCompetenceA. ExperienceLoma Linda University Occupational Medicine Center has many years of experience providing occupational medicine services for public agencies, municipalities, healthcare institutions, school districts, public safety employers, and regional employers. Our experience includes:Post-offer/pre-employment medical examinationsPre-placement and job-specific medical evaluationsCalifornia POST-related medical screeningWorkers’ compensation careFitness-for-duty evaluationsReturn-to-work evaluationsRespirator medical clearanceSpirometryN-95 fit testingAudiometry and hearing conservation screeningVision and color vision testingDrug and alcohol testing coordinationMedical Review Officer servicesEKG and radiology coordinationLaboratory testingTuberculosis screeningImmunization and infectious disease screeningOSHA-related medical surveillanceMusculoskeletal screening for physically demanding positionsDisability managementOccupational and environmental health evaluationsThe RFP requires proposers to have at least four years of experience providing the required scope of services for public clients. Loma Linda University Occupational Medicine Center meets and exceeds this requirement through its close to 26 years of occupational medicine practice and its established service to public and safety-sensitive employers.B. ReferencesReference 1: City of San BernardinoCourtney Davis Human Resources Division Manager, Human Resources & Risk Management 9 Direct: 909-998-2069 | x2069Email: [email protected] size/description: LLUH Occupational Medicine has provided pre-employment medical screening services for the City of San Bernardino for close to two years, including post-offer/pre-employment examinations, workers’ compensation examinations, and coordination with City HR/Risk Management. Reference 2: San Bernardino Police Department Captain Adam Affrunti Administrative Services DivisionPhone: 909-384-5604 Email: [email protected] Project size/description: LLUH Occupational Medicine has supported public safety-related occupational medicine needs, including pre-employment/public safety medical evaluations and coordination related to law enforcement candidate screening and fitness for duty. Reference 3: San Bernardino City Unified School District Jeff D. Haynes Risk ManagerPhone: 909-388-6476 Email: [email protected] Project size/description: LLUH Occupational Medicine has provided occupational medicine and workers’ compensation-related services, including evaluation and treatment of injured workers, work-status documentation, return-to-work planning, and coordination with Risk Management. C. Local Experience and Knowledge of the CityLoma Linda University Occupational Medicine Center has been providing pre-employment medical screening services for the City of San Bernardino for close to two years. In addition, our physicians and clinical team have cared for City workers’ compensation patients and have worked with City Human Resources leaders over the years. This gives our team direct familiarity with: City HR communication needsMunicipal hiring timelinesSafety-sensitive job demandsWorkers’ compensation and return-to-work issuesPublic agency documentation expectationsConfidentiality requirements 10 The importance of timely clearance decisionsBecause we already understand the City’s occupational health needs, we can continue services with minimal transition burden and without the learning curve required of a new vendor. D. Physician Leadership and Regional OccupationalMedicine ExperienceLoma Linda University Occupational Medicine Center’s physician leadership reflects both clinical expertise and regional occupational medicine leadership. This leadership background strengthens the Center’s ability to provide high-quality, compliant, employer-responsive occupational medicine services for public agencies such as the City of San Bernardino. The City will benefit from a team that is not only experienced in direct clinical care, but also actively engaged in advancing occupational and environmental medicine across the region. E. Project-Specific ExperienceProject 1: City of San Bernardino - Pre-Employment Medical Screening Services Role of Firm: Occupational medicine provider Duration: Approximately two yearsDescription of Services: Pre-employment medical examinations, occupational health testing, clearance reporting, City communication, and related services. Staffing: Board-certified occupational medicine physicians, clinic manager, clinical support staff, administrative support, and contract coordination personnel. Relationship to Client: Existing occupational medicine provider. Contact: Courtney Davis Human Resources Division Manager, Human Resources & Risk Management City of San Bernardino Direct: 909-998-2069 | x2069 Email: [email protected] Project 2: City of San Bernardino - Workers’ Compensation Care Role of Firm: Occupational medicine and workers’ compensation clinical provider Duration: Ongoing over two years 11 Description of Services:Evaluation and treatment of City workers’ compensation patients, work-status determination, return-to-work planning, coordination with appropriate parties, and occupational medicine consultation. Staffing: Board-certified occupational medicine physicians, clinical support staff, and administrative staff. Relationship to Client: Existing occupational medicine relationship with City employees and City HR leaders. Contact: Insurance Company Coordination Project 3: San Bernardino City Unified School District — Workers’ Compensation / Occupational Medicine Services Role of Firm:Occupational medicine and workers’ compensation clinical providerDuration: More than a decade / ongoing Description of Services: LLUH Occupational Medicine has provided occupational medicine and workers’ compensation-related services, including evaluation and treatment of injured workers, work-status documentation, return-to-work planning, and coordination with Risk Management. Staffing: Board-certified occupational medicine physicians, clinical support staff, and administrative staff. Relationship to Client: Established occupational medicine provider relationship with Risk Management. Contact: Jeff D. Haynes - Risk Manager San Bernardino City Unified School District Phone: 909-388-6476 Email: [email protected] F. Technical CompetenceLoma Linda University Occupational Medicine Center has the clinical and technical infrastructure necessary to perform the services requested in the RFP, including: Secure electronic medical recordsConfidential medical records managementOccupational medicine examination roomsAudiometry capabilityVision testing capabilitySpirometry capabilityRespirator clearance and fit testing capabilityLaboratory testing coordinationImaging and radiology coordinationEKG testing and interpretation coordination 12 Drug and alcohol testing supportMedical Review Officer servicesPhysician review and clearance documentationAdministrative systems for scheduling, reporting, and billingContract coordination and invoicing supportOur multidisciplinary structure allows us to support both routine pre-employment screening and more complex occupational medicine questions. The LLUH Occupational Medicine Center website describes a broad employer-service model that includes preventive programs, health screenings, workers’ compensation management, communication with insurance companies, on-site assessments, specialty clinics, disability management, QME exams, pre-employment/post-offer exams, fitness-for-duty and return-to-work evaluations, drug/alcohol testing and MRO services, radiology, telemedicine, and vaccinations. (Loma Linda University Health) 13
7. Proposed Method to Accomplish the Work Loma Linda University Occupational Medicine Center proposes to continue a structured, physician-led workflow for the City of San Bernardino.A. Referral and Scheduling The City will submit candidate referrals and required job-classification protocols to the designated contact pathway. Our team will schedule applicants promptly and coordinate the appropriate examination components. We acknowledge the RFP requirement that physical examinations must be able to occur within two working days of the City’s request and that applicants should wait no longer than 30 minutes from the actual appointment time before services begin. B. Examination Process Examinations will be performed according to accepted occupational medicine standards and City-approved protocols. Depending on the job classification, services may include: Medical history review Physical examination Blood pressure Pulse Respiration Temperature Height Weight Visual acuity, corrected and/or uncorrected Color vision testing Urinalysis Hearing testing Musculoskeletal screening, including back and knees when required Tuberculosis screening Immunity review or testing Vaccination review EKG Chest X-ray Blood testing, including glucose, blood borne pathogen, kidney and liver function, or other required tests Respirator clearance o Spirometry o N-95 fit testing POST-related medical evaluation components, when applicable 14 The RFP specifically identifies many of these examination components, including physiologic measurements, vision, hearing, urinalysis, chest X-ray, EKG, musculoskeletal screening, TB screening, immunity review, bloodwork, respiratory clearance, spirometry,and N-95 fit testing. C. Public Safety and POST-Related Evaluations For applicable safety personnel, examinations will be performed consistent with City protocols and applicable California POST-related requirements. The medical review will focus on whether the candidate is medically capable of performing job duties and whether any condition may create a hazard to the candidate or others, while respecting ADA and accommodation principles. D. Respirator Clearance and Fit Testing Respirator clearance services may include: Review of the respirator questionnaire Focused occupational and medical history Focused physical examination when indicated Spirometry when required Physician interpretation Written clearance N-95 fit testing when included in the City-approved protocol If the medical review identifies potential risk factors requiring further evaluation, our team will notify the City and obtain approval before proceeding with additional testing outside the approved protocol, unless urgent clinical circumstances require otherwise. E. Additional Testing and Referrals If irregular results, incomplete information, or medical concerns require additional evaluation beyond the City-approved protocol, Loma Linda University Occupational Medicine Center will notify the City and obtain approval before proceeding with additionaltesting or referral, except where urgent clinical circumstances require otherwise. Applicants will be advised when follow-up with their personal physician is recommended. When appropriate, such notification will clarify that follow-up may be the applicant’s responsibility. F. Reporting and Clearance Forms Loma Linda University Occupational Medicine Center will provide written summaries of medical examination and test results in a complete, accurate, and understandable format.We acknowledge the RFP requirement for timely reporting of medical examination and testing summaries, including prompt communication with the City if an examination is delayed, inconclusive, or requires additional time.Reports and clearance documentation will be transmitted through City-approved communication methods and in accordance with applicable confidentiality requirements. 15 G. Medical Records Loma Linda University Occupational Medicine Center will initiate, update, maintain, and securely store medical and health records for City applicants and employees for whom services are provided. Records may include: Health questionnaires Examination findings Test results Proofs of immunityPhysician consultation notes Progress notes Rationale for additional tests or reports when requiredRecords will be maintained confidentially and securely. If the agreement is cancelled or expires, records that are the property of the City will be made available according to contract requirements and applicable law. H. Communication and Escalation The City will have a designated communication pathway for: Scheduling questions Candidate status updates Delayed or incomplete examinations Clarification of clearance forms Contract coordination Invoicing support Operational concerns Clinical escalation I. Quality Assurance Our quality assurance approach includes: Physician-led review of clearance decisions Standardized protocols by job classification Timely communication with City representatives Documentation review for completeness Monitoring of turnaround times Escalation of delayed or complex cases Confidential records handling Ongoing process improvementJ. First-Year Schedule of Tasks, Milestones, and Deliverables Because Loma Linda University Occupational Medicine Center has been providing pre-employment medical screening services for the City of San Bernardino for close to two years, the first-year work plan will focus on continuity, confirmation of existing workflows, 16 ongoing service delivery, and process improvement, rather than new program implementation.Timeframe Task / Milestone Deliverable Contract Start / Month 1Confirm current City protocols, contacts, and any updates from the new agreement Updated workflow and communication pathway Contract Start / Month 1Review and confirm existing report and clearance form process Continued use of City-approved documentation process, with updates as needed Contract Start / Month 1Confirm contract coordination, invoicing contacts, and billing workflow Updated contact list and invoicing pathwayOngoing Schedule candidates according to City-approved protocols Appointments within required timeframe Ongoing Perform examinations and required testing Completed pre-employment medical screening servicesOngoing Provide physician review and medical clearance determinations Accurate and timely clearance decisions Ongoing Report results to the City through approved communication methods Written clearance summaries Ongoing Notify City of delayed, incomplete, or inconclusive examinationsTimely status updates and recommended next stepsMonthly Submit invoices and required supporting documentation Monthly billing package Quarterly as requested Review workflow, turnaround, communication, and service needs with City representatives Process improvement updatesAnnually Review protocols, service needs, pricing, and operational expectations Updated service plan, if needed 17 8. Fee ProposalA separate fee proposal will be submitted using the City’s Vendor Quote Form.Vendor Quote Form – Appendix DescriptionPhysical Exam (POST) $157.50Physical Exam (PROFESSIONAL, DISPATCH) $78.75 Audiogram $52.50 Spirometry $52.50 Respiratory Questionnaire Review by MD $42.00 EKG Resting $52.50 Instant Drug Screen 11 Panel $42.00 Blood Draw $46.20 Titer: CBC With Differential $26.25 Titer: Comprehensive Chem Panel $31.50 Titer: Lipid Panel $31.50 Titer: Hepatitis B Core Antibody, HBcAB $21.00 Titer: Hepatitis B Surface Antibody $36.75 Titer: Hepatitis C $52.50 Titer: Mumps Antibody Screen $42.00 Titer: Rubella Antibody Screen $42.00 Titer: Rubeola Antibody Screen $42.00 Titer: Varicella Antibody Screen $42.00 Vaccine: MMR (Series of 2) $105.00 EachVaccine: Hepatitis B (Series of 3) $94.50 Vaccine: Hepatitis A (Series of 2) $42.00 Vaccine: Tdap $52.50 Vaccine: Varivax (Chickenpox) (Series of 2) $189.00 Each Vaccine: Influenza; Flu (Seasonal) $36.75 TB Skin Test $26.25 QuantiFERON TB Gold $47.25 Urinalysis $21.00 Department of Transportation Physical (DOT) $105.00 Chest X-Ray $105.00 18 9. InsuranceLoma Linda University Occupational Medicine Center acknowledges the City’s insurance requirements and will provide evidence of insurance as required. The RFP requires acknowledgment of minimum insurance requirements, including commercial general liability, automobile liability, employer’s liability, professional liability, and cyber liability if applicable. A Certificate of Insurance will be provided through a copy of the current contract with the City of San Bernardino. A signed Acknowledgement of Insurance Requirements isincluded within this proposal. of Insurance Requirements – Appendix Copy of current contract with the City of San Bernardino documentinginsurance coverage/requirements – Appendix 19 10. Litigation HistoryLoma Linda University Occupational Medicine Center has no litigation history within the past five years related to the provision of the services described in this RFP.20
11. Other Information A. Demonstration of Efficient Staffing and Timely CompletionLoma Linda University Occupational Medicine Center has a demonstrated record of efficiently staffing occupational health services and completing examinations, clearance determinations, and reports in a timely manner. Our established physician-led workflow supports the City’s need for reliable scheduling, timely communication, clear documentation, and appropriate escalation of complex cases. Our current and prior work with the City has allowed us to understand the importance of rapid turnaround in the hiring process. We recognize that delays in medical clearance can affect public agency operations, onboarding, and staffing. Our approach is designed to support the City’s operational timelines while maintaining high medical and regulatory standards. B. Community Involvement As part of Loma Linda University Health, our occupational medicine program is deeply rooted in the Inland Empire and San Bernardino County region. We support workforce health, public safety, injury prevention, disability accommodation, regulatory compliance, and community well-being.Our mission aligns closely with the needs of public agencies. We understand that municipal employees serve the public every day, and our role is to help ensure that candidates and employees are medically supported, safely placed, and appropriately evaluated. C. Previous Involvement with the City Loma Linda University Occupational Medicine Center has worked with City Human Resources leaders over the years, has cared for City workers’ compensation patients, and has provided pre-employment medical screening services for close to two years. This previous involvement is a major strength. It gives our team a practical understanding of the City’s expectations, workforce needs, communication style, and occupational health priorities. We are proud of this relationship and are committed to continuing to support the City with dependable, high-quality occupational medicine services. D. Full-Service Occupational Medicine Partnership The City of San Bernardino benefits from working with a full-service occupational medicine center rather than a limited testing vendor. Pre-employment screening, workers’ compensation care, return-to-work planning, respiratory clearance, hearing conservation, drug testing review, fitness-for-duty evaluations, and medical surveillance are connected parts of workforce health. 21 Loma Linda University Occupational Medicine Center can support these needs through one integrated, physician-led occupational medicine program.E. No Conflict of InterestLoma Linda University Occupational Medicine Center has no conflict of interest in connection with providing the services described in this RFP. 22 “The undersigned hereby submits its proposal and, by doing so, agrees to furnish services to the City in accordance with the Request for Proposal (RFP), and to be bound by the terms and conditions of the RFP . ” 23
13. Statement of No Deviations from RFPLoma Linda University Occupational Medicine Center has reviewed the Request for Proposals, including the proposed Professional Services Agreement, scope of services, insurance requirements, and submittal requirements. Loma Linda University Occupational Medicine Center takes no deviations or exceptions to the RFP or Agreement template, unless otherwise expressly stated in this proposal. 24
14. AppendicesAppendix A: Applicable licenses and certifications Appendix : Vendor Quote Form Appendix : Acknowledgement of Insurance Requirements Appendix : Current contract stating insurance coverage Appendix : Additional service descriptions 25 26 27
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Additional Services Beneficial to the City In addition to pre-employment medical screening services, our team has also provided workers’ compensation care for City employees and has worked with City Human Resources leaders over the years. This existing relationship allows us to support the City across the broader occupational health continuum, not simply during the hiring process. Several of the services listed below are already part of our established work with the City, while others are available as needed to further support workforce health, regulatory compliance, injury prevention, and safe return to work. Medical Review Officer consultationDOT and non-DOT drug and alcohol testing program supportReasonable suspicion consultation and supervisor educationFitness-for-duty evaluationsReturn-to-work evaluationsWork restriction clarificationOSHA medical surveillanceHearing conservation program supportRespiratory protection program supportImmunization and vaccination programsTelemedicine visits when appropriateRadiology and diagnostic imaging coordinationWorkplace hazard assessmentsPreventive health and injury prevention educationDisability management consultationQME and complex occupational medicine evaluations when appropriate 50