Title
Long Term Disability Program Clinical Consulting Services (Ordinance S-46041)
Description
Request authorization for the City Manager, or his designee, to enter into a contract with Managed Medical Review Organization, Inc. (MMRO) to provide long term disability program clinical consulting services beginning Oct. 1, 2019. Further request authorization for the City Controller to disburse all funds related to this item over the life of the contract.
Report
Summary
The contract provides clinical consulting services to assist in determining medical and/or psychological eligibility for newly submitted and ongoing long term disability (LTD) claims. Initial and ongoing LTD eligibility is determined through regular certification from the employee's medical and/or mental health provider specialized in the diagnosis and treatment of the injury or illness. The nature of these contracted services is to provide a clinical opinion of the submitted documentation, when needed. A credentialed clinical, vocational, and/or behavioral health independent expert may conduct an in-person examination and would review medical documents and records, reach out to treating physicians on a peer-to-peer basis, and provide clinical insight about an employee's ability to continue working, to return to work, or to perform other types of work. Some of these services are currently performed on a case-by-case basis by independent medical doctors charging a range of fees for their services. MMRO offers a well coordinated and consistent approach to this need at an overall lower cost.
Procurement Information
The Human Resources Department opened a Request for Proposals (RFP) in August 2017 for LTD Peer Review Services. Proposals did not match the desired services. The Human Resources Department issued a second RFP with expanded, clearer and a more specific scope of work. The second RFP was posted from May 24, 2018 through June 21, 2019. Managed Medical Review Organization, Inc. was the sole vendor to submit a proposal. Managed Medical Review Organization, Inc. already performs similar services for the COPERS Disability Assessment Committee (DAC). The evaluation committee agreed this vendor meets the RFP scope of work for the LTD program.
Contract Term
The contract term will be two years, starting on or about Oct. 1, 2019. Provisions of the contract will include an option to extend the term for up to three years, in one-year increments, which may be exercised by the City Manager, or his designee.
Financial Impact
The aggregate contract value shall not exceed $500,000 over five years. LTD Trust funds are available to support these services. No General Fund dollars are requested for this contract.
Concurrence/Previous Council Action
The Sustainability, Housing, Efficiency and Neighborhoods Subcommittee approved the issuance of the RFP on May 16, 2017. The City Council approved the issuance of the RFP at the June 21, 2017 Formal meeting.
Department
Responsible Department
This item is submitted by Acting Deputy City Manager Toni Maccarone and the Human Resources Department.