HomeMy WebLinkAbout01/18/2011, C10 - AGREEMENT WITH MED+STOP FOR FIREFIGHTERS MEDICAL EXAMS council M °1 e- 11
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C I T Y OF S AN L U IS 0 B I S P 0
FROM: Charlie Hines, Fire Chief
Prepared By: Julie Cox, Administrative Analyst
SUBJECT: AGREEMENT WITH MED+STOP FOR FIREFIGHTERS MEDICAL
EXAMS
RECOMMENDATION
Approve a three-year agreement with Med+Stop Urgent Care Center (Med+Stop) to provide firefighter
medical exams and authorize the Mayor to execute the agreement.
DISCUSSION
Medical examinations for the City's firefighters are required annually by the Memorandum of
Agreement (Fire MOA) between the City of San Luis Obispo and the International Association of
Firefighters, Local 3523. Beginning January 1, 1990, a physical fitness program was implemented to
meet the training requirements of each Fire Department safety employee covered under the Fire
MOA contract. Several changes occurred with regard to firefighter medical examinations from FY
2008-09 to FY 2009-10.
s In FY 2009-10, Fire Department budget reductions included reducing medical examinations
from $37,000 to $5,000. The three-year contract with French Hospital had ended and French
Hospital was not interested in renewing the contract.
• In FY 2009-10 a one-year agreement was approved with Med+Stop for firefighter medical
exams at a cost of$17,190. The additional cost for the medical exams was provided through
Fire Department budget savings in other line items.
• A three-year agreement is now recommended to provide for the medical exams in 2010-11
and allow for budgetary planning for the 2011-13 Financial Plan.
In October 2010 the Fire Department requested concurrence from the Finance Department to sole
source with Med+Stop for the firefighter medical exams for the following reasons:
1. Med+Stop is located in San Luis Obispo and firefighters are able to take the medical during
their shift therefore eliminating potential overtime expenses.
2. Positive response to Med+Stop by the firefighters to the FY 2009-10 medical exams.
3. City currently has an agreement with Med+Stop for Workers Compensation.
4. Med+Stop provides medical examinations to the Cambria, Paso Robles, South Bay Fire, and
SLO County Fire Department. Is aware of requirements for firefighter medicals.
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5. The Fire Department has not been contacted by other potential vendors expressing interest in
a contract for medical exam services; in fact we are not sure we would get any other
proposals to an RFP.
6. Will assist with budget planning for FY 2011-13, we would like to contract with Med+Stop
for 3 years.
Finance Department concurred with the request to sole source the contract.
For the reasons stated above, the Fire Department staff recommends contracting with Med+Stop for
the firefighter medical examinations.
FISCAL IMPACT
There is $17,690 budgeted for firefighter medical exams for FY 2010-11. However, it is estimated
that the cost for the medical examinations will be $19,070. The additional funding required for FY
2010-11 will be realized through cost savings in other line items. There will be no additional cost to
the General Fund for FY 2010-11. The cost estimates for year two and three of the agreement are
$21,110 and $24,110. The increase in cost for year two and three of the contract include an annual
adjustment to the cost per exam according to the Los Angeles-Riverside-Orange County consumer
price index, not to exceed 3% as stated in the agreement, the number of firefighter in each age group,
and vacancies (for year one of the agreement there is one vacant position).
ALTERNATIVES
Do not approve the contract and establish a one year contract which is not recommended due to the
potential for increased cost in future years and increased difficulty in planning for future year expenses
for on Fire Department budget.
ATTACHMENT
Agreement with Med+Stop Urgent Care Center
Electronic File Path: TWouncil Agenda ReportsTire CARTY 2010-11Ned+Stop
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ATTACHMENT
CITY OF SAN LUIS OBISPO
AGREEMENT FOR MEDICAL PROVIDER SERVICES
THIS AGREEMENT, is made and effective as of , ("Effective Date") between the
City of San Luis Obispo Fire Department ("City") and Med+Stop Urgent Care Center, a
professional corporation ("Medical Provider").
RECITALS
WHEREAS,the City has the obligation to verify that its public safety employees
employed by the City Fire Department ("Public Safety Employees") meet the physical standards
necessary to perform the responsibilities as required by their jobs; and
WHEREAS,the Medical Provider is a professional corporation employing duly licensed
physicians, physician assistants, nurse practitioners and other personnel who have the expertise
to perform medical evaluations to determine whether the Public Safety Employees meet the
physical standards necessary to perform their responsibilities as required by their jobs ("Medical
Evaluations"); and
WHEREAS, the City desires to engage the services of the Medical Provider as an
independent contractor to provide such Medical Evaluations, to interpret the results from such
medical evaluations, and to provide medical advice based on the results of those medical
evaluations; and
Therefore, in consideration of the mutual covenants and conditions set forth herein, the
parties agree as follows:
1 TERM
This Agreement shall commence on the effective date and shall remain and continue in
effect for three years.
2. SERVICES TO BE RENDERED BY MEDICAL PROVIDER
(a) Medical Provider shall provide Medical Evaluations as requested by the City.
Medical Evaluations include any of the physical examinations, individual diagnostic studies or
immunizations listed on Exhibit A, attached hereto, and incorporated by reference. Attached as
Exhibit B is Medical Provider's estimate of Medical Evaluations that Medical Provider will
provide based on information provided by the City about its current Public Safety Employees.
(b) Within five (5) business days of the Medical Evaluation being completed,
Medical Provider shall either provide a Clearance for Duty Certificate.or notify the City that a
Clearance for Duty Certificate will not be provided, whichever is applicable in the professional
judgment of the Medical Provider. A Medical Evaluation deemed completed the date that the
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Medical Provider examines the City's Fire Department public safety employee or the date that all
results from diagnostic studies are received by the Medical Provider, whichever date is later.
(c) Subject to federal and state privacy laws, Medical Provider shall take all steps
necessary to facilitate the transfer of the medical records of the Public Safety Employees from
any other medical provider identified by the City as having Public Safety Employees' medical
records to Medical Provider.
3. CITY'S OBLIGATIONS
(a) The City shall provide an Employee Medical Questionnaire ("EMQ") to each City
employee requiring a medical evaluation and shall deliver the EMQ completed by the City
employee in a sealed envelope at least five (5) business days before the scheduled Medical
Evaluation.
(b) The City shall provide a City employee's job description to the Medical Provider
when requested by the Medical Provider.
4. PERFORMANCE STANDARDS
Services rendered under this Agreement by the Medical Provider shall be provided by
duly licensed, certified or otherwise authorized, and accredited personnel who shall provide such
services consistent with the scope of their license, certification or accreditation and in accordance
with generally accepted medical and surgical practices and standards prevailing in the applicable
professional community and all applicable requirements of federal, state and local law.
5. LICENSES
Medical Provider acknowledges that all of its directors, officers, employees or agents
("Medical Provider's Employees") that will participate in delivering a Medical Evaluation,
interpreting a Medical Evaluation or rendering medical advice based on a Medical Evaluation
shall be licensed as required by the laws of the State of California and shall be in good standing
with both the Federal Government of the United States of America and the State of California.
Furthermore, Medical Provider's Employees shall remain fully licensed to practice medicine in
compliance with the applicable law during the term of this Agreement
6. CITY MANAGEMENT
City's Fire Chief shall represent City in all matters pertaining to the administration of this
Agreement, review and approval of all services rendered by Medical Provider, but not including
the authority to enlarge the scope of services rendered or to change the payment due to Medical
Provider.
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7. PAYMENT
(a) The City agrees to pay Medical Provider monthly, in accordance with the
payment rates and terms and the schedule of payment as set forth in Exhibit A, attached hereto
and incorporated herein by this reference as though set forth in full, based upon actual services
rendered. Medical Provider may adjust the payment rates annually effective January 1, 2012 and
annually thereafter in proportion to the change in the Los Angeles-Riverside-Orange County
Consumer Price Index. However, in no event shall the annual increase exceed three percent
(3%). The indexes shall be for All Urban Consumers as published by the Bureau of Labor
Statistics.
(b) Medical Provider shall not be compensated for any services rendered in
connection with its performance of this Agreement which are in addition to those set forth in
Exhibit A or Exhibit B, unless such additional services are authorized in advance and in writing
by the City Manager. Medical Provider shall be compensated for any additional services in the
amounts and in the manner as agreed to by City Manager and Medical Provider at the time City's
written authorization is given to Medical Provider for the performance of said services. The City
Manager may approve additional work not to exceed ten percent (10%) of the amount of the
Agreement, but in no event shall such sum exceed ten-thousand dollars ($10,000.00). Any
additional work in excess of this amount shall be approved by the City Council.
(c) Medical Provider will submit invoices monthly for actual services performed.
Invoices shall be submitted on or about the first business day of each month, or as soon thereafter
as practical, for services provided in the previous month. Payment shall be made within thirty
(30) days of receipt of each invoice as to all non-disputed fees. If the City disputes any of
Medical Provider's fees, it shall give written notice to Medical Provider within thirty (30) days
of receipt of an invoice of any disputed fees set forth on the invoice.
8. SUSPENSION OR TERMINATION OF AGREEMENT WITHOUT CAUSE
(a) The City may at any time, for any reason, with or without cause, suspend or
terminate this Agreement, or any portion hereof, by serving upon the Medical Provider at least
one (1) day prior written notice. Upon receipt of said notice, the Medical Provider shall
immediately cease all work under this Agreement, unless the notice provides otherwise. If the
City suspends or terminates a portion of this Agreement such suspension or termination shall not
make void or invalidate the remainder of this Agreement.
(b) Medical Provider may at any time, for any reason, with or without cause, suspend
or terminate this Agreement, or any portion hereof, by serving upon the Medical Provider at least
sixty days (60) day prior written notice.
(c) In the event this Agreement is terminated pursuant to this Section, the City shall
pay to Medical Provider the actual value of the work performed up to the time termination,
provided that the work performed is of value to the City. Upon termination of the Agreement
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pursuant to this Section, the Medical Provider will submit an invoice to the City pursuant to
Section 7.
9. INDEMNIFICATION
(a) Indemnification for Professional Liability. When the law establishes a
professional standard of care for Medical Provider's Services, to the fullest extent permitted by
law, Medical Provider shall indemnify, protect, defend and hold harmless City and any and all of
its officials, employees and agents ("Indemnified Parties") from and against any and all losses,
liabilities, damages, costs and expenses, including attorney's fees and costs to the extent same
are caused in whole or in part by any negligent or wrongful act; error or omission of Medical
Provider, its officers, agents, employees or sub-contractors (or any entity or individual that
Medical Provider shall bear the legal liability thereof) in the performance of services rendered
under this Agreement.
(b) Indemnification for Other Than Professional Liability. Other than in the
performance of professional services and to the full extent permitted by law, Medical Provider
shall indemnify, defend and hold harmless City, and any and all of its employees, officials and
agents from and against any liability (including liability for claims, suits, actions, arbitration
proceedings, administrative proceedings, regulatory proceedings, losses, expense or costs of any
kind, whether actual, alleged or threatened, including attorneys fees and costs, court costs,
interest, defense costs, and expert witness fees), where the same arise out of, are of a
consequence of, or are in any way attributable to, in whole or in part, the performance of this
Agreement by Medical Provider or by any individual or entity for which Medical Provider is
legally liable, including but not limited to officers, agents, employees or sub-contractors of
Medical Provider.
(c) General Indemnification Provisions. Medical Provider agrees to obtain executed
indemnity agreements with provisions identical to those set forth here in this section from each
and every sub-contractors or any other person or entity involved by, for, with or on behalf of
Medical Provider in the performance of this agreement. In the event Medical Provider fails to
obtain such.indemnity obligations from others as required here, Medical Provider agrees to be
fully responsible according to the terms of this section. Failure of City to monitor compliance
with these requirements imposes no additional obligations on City and will in no way act as a
waiver of any rights hereunder.
(d) This obligation to indemnify and defend City as set forth here is binding on the
successors, assigns or heirs of Medical Provider and shall survive the termination of this
agreement of this section.
10. INSURANCE
Medical Provider shall maintain prior to the beginning of and for the duration of this
Agreement adequate professional liability insurance coverage as required by law, and Medical
Provider further agrees that during the term hereof he shall maintain a policy of malpractice
insurance in the minimum amount of one (1) million per occurrence with an aggregate amount of
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three (3) million. Medical Provider shall, upon execution of this Agreement, provide City with
proof of insurance. Such insurance during the term hereof shall not be changed or terminated
without at least thirty (30) days notice in writing to the City.
11. INDEPENDENT MEDICAL PROVIDER
(a) Medical Provider is and shall at all times remain as to the City a wholly
independent Medical Provider. The personnel performing the services under this Agreement on
behalf of Medical Provider shall at all times be under Medical Provider's exclusive direction and
control. Neither City nor any of its officers, employees, or agents shall have control over the
conduct of Medical Provider or any of Medical Provider's officers, employees, or agents, except
as set forth in this Agreement. Medical Provider shall not at any time or in any manner represent
that it or any of its officers, employees, or agents are in any manner officers, employees, or
agents of the City. Medical Provider shall not incur or have the power to incur any debt,
obligation, or liability whatever against City, or bind City in any manner.
(b) No employee benefits shall be available to Medical Provider in connection with
the performance of this Agreement. Except for the fees paid to Medical Provider as provided in
the Agreement, City shall not pay salaries, wages, or other compensation to Medical Provider for
performing services hereunder for City. City shall not be liable for compensation or
indemnification to Medical Provider for injury or sickness arising out of performing services
hereunder.
12. LEGAL RESPONSIBILITIES
The Medical Provider shall keep itself informed of State and Federal laws and regulations
which in any manner affect those employed by it or in any way affect the performance of its
service pursuant to this Agreement. The Medical Provider shall at all times observe and comply
with all such laws and regulations. The City, and its officers and employees, shall not be liable
at law or in equity occasioned by failure of the Medical Provider to comply with this Section.
13. UNDUE INFLUENCE
Medical Provider declares and warrants that no undue influence or pressure is used
against or in concert with any officer or employee of the City in connection with the award,
terms or implementation of this Agreement, including any method of coercion, confidential
financial arrangement, or financial inducement. No officer or employee of the City will receive
compensation, directly or indirectly, from Medical Provider, or from any officer, employee or
agent of Medical Provider, in connection with the award of this Agreement or any work to be
conducted as a result of this Agreement. Violation of this Section shall be a material breach of
this Agreement entitling the City to any and all remedies at law or in equity.
14. NO BENEFIT TO ARISE TO LOCAL EMPLOYEES
No member, officer, or employee of City, or their designees or agents, and no public
official who exercises authority over or responsibilities with respect to the services rendered
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during his/her tenure or for one year thereafter, shall have any interest, direct or indirect, in any
agreement or sub-agreement, or the proceeds thereof, for work to be performed in connection
with the services rendered under this Agreement.
15. RECORDS
(a) All information gained by Medical Provider in performance of this Agreement
shall be considered confidential and shall not be released by Medical Provider without City's
prior written authorization. Medical Provider, its officers, employees, agents, or sub-contractors,
shall not without written authorization from the City Manager or unless requested by the City
Attorney, voluntarily provide declarations, letters of support, testimony at depositions, response
to interrogatories, or other information concerning the work performed under this Agreement or
relating to any project or property located within the City. Response to a subpoena or court order
shall not be considered "voluntary" provided Medical Provider gives City notice of such court
order or subpoena.
(b) Medical Provider shall promptly notify City should Medical Provider, its officers,
employees, agents, or sub-contractor be served with any summons, complaint, subpoena, notice
of deposition, request for documents, interrogatories, request for admissions, or other discovery
request, court order, or subpoena from any person or party regarding this Agreement and the
work performed thereunder or with respect to any project or property located within the City.
City retains the right, but has no obligation, to represent Medical Provider and/or be present at
any deposition, hearing, or similar proceeding. Medical Provider agrees to cooperate fully with
City and to provide the opportunity to review any response to discovery requests provided by
Medical Provider. However, City's right to review any such response does not imply or mean
the right by City to control, direct, or rewrite said response.
(c) The City hereby acknowledges that information obtained directly from the City's
employee during the course of a Medical Evaluation by Medical Provider is subject to both
federal and California state privacy laws.
(d) Medical Provider shall maintain all patient medical records relating to the
Medical Evaluations provided, in such form and containing such information as required by
federal, state and local law. Medical records shall be maintained in a current manner that is
legible, complete, organized, and shall permit effective patient care and review by any third-
party medical provider. Subject to all applicable patient confidentiality laws, upon written
request, with at least five (5) business days to respond, Medical Provider shall provide to City or
its delegate, the City's respective expenses, copies of the Public Safety Employees' medical
records for the purposes of conducting quality assurance and utilization review, claims
processing, verification and payment, resolving any grievances and appeals, and other activities
reasonably necessary for the proper administration of this Agreement consistent with the law.
Medical records shall be retained by Medical Provider for at least five years following a medical
evaluation and as required by law. This section survives termination of the Agreement.
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16. NOTICES
Any notices which either party may desire to give to the other party under this Agreement
must be in writing and may be given either by (i) personal service, (ii) delivery by a reputable
document delivery service, such as but not limited to, Federal Express, which provides a receipt
showing date and time of delivery, or (iii) mailing in the United States Mail, certified mail,
postage prepaid, return receipt requested, addressed to the address of the party as set forth below
or at any other address as that party may later designate by notice:
To City: City of San Luis Obispo
Attn: Fire Chief
990 Palm Street
San Luis Obispo, California 93401
To Medical Provider: Med+Stop
Attn: Brian Roberts, M.D.
283 Madonna Rd., Suite B
San Luis Obispo, California 93405
17. ASSIGNMENT
The Medical Provider shall not assign the performance of this Agreement, nor any part
thereof, nor any monies due hereunder, without prior written consent of the City. Because of the
personal nature of the services to be rendered pursuant to this Agreement, only Medical Provider
shall perform the services described in this Agreement.
18. NO THIRD PARTY BENEFICIARIES
This Agreement shall not confer or be construed to confer any rights or benefits to any
person or entity other than the Parties.
19. GOVERNING LAW
The City and Medical Provider understand and agree that the laws of the State of
California shall govern the rights, obligations, duties, and liabilities of the parties to this
Agreement and also govern the interpretation of this Agreement. Any litigation concerning this
Agreement shall take place in the municipal, superior, or federal district court with jurisdiction
over the City.
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20. ENTIRE AGREEMENT
This Agreement contains the entire understanding between the parties relating to the
obligations of the parties described in this Agreement. All prior or contemporaneous
agreements, understandings, representations, and statements, oral or written, are merged into this
Agreement and shall be of no further force or effect. Each party is entering into this Agreement
based solely upon the representations set forth herein and upon each party's own independent
investigation of any and all facts such party deems material. Any future modification or
amendment to this Agreement must be in writing. The illegality, invalidity or unenforceability
of any provision, or part any provision, of this Agreement shall not affect any other provisions of
this Agreement, which shall continue in full force and effect.
21. SEVERABILITY
If any provision of this Agreement, in whole or in part, or the application of any
provision in whole or in part, is determined to be illegal, invalid or unenforceable by a court of
competent jurisdiction, such provision, or part of such provision, shall be severed from this
Agreement.
22. AUTHORITY TO EXECUTE THIS AGREEMENT
The person or persons executing this Agreement on behalf of Medical Provider warrants
and represents that he/she has the authority to execute this Agreement on behalf of the Medical
Provider and has the authority to bind Medical Provider to the performance of its obligations
hereunder.
IN WITNESS HEREOF, the parties hereto have caused this Agreement to be executed
the day and year first above written.
CITY OF SAN LUIS OBISPO MEDICAL PROVIDER
By: By:
Katie Lichtig, City Manager (Signature)
Attest: (Name)
Its:
Elaina Cano, City Clerk (Title)
Approves As to Form:
J. Christine Dietrick, City Attorney
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Appendix—A
Price List
Physical Examination Charge Notes
PHYSICAL—Doctor's complete physical exam with review of Employee
LEVEL II EXAM $120.00 Medical Questionnaire(EMQ).If physical exam,history or job description
reveals the need to individual diagnostic studies,notification of those studies
will be made and the cost will not exceed the amount itemized listed below.
REVIEW OF EMQ $50.00 EMQ review charged only on years with no physical exam
DMV PHYSICAL $40.00 When com leted with a scheduled physical.
DMV PHYSICAL $88.00 When com leted without a scheduled physical.
INDIVIDUAL DIAGNOSTIC STUDIES
CHEST X-RAY(2-VIEW) S90
CHEST X-RAY(1-VIEW) $70
PULMONARY FUNCTION, $70
PULSE OX ON ROOM AIR
RESTING EKG $85
TREADMILL $250
AUDIOGRAM $50
TITMUS/VISION ACUITY N/C Includes near,far,color and peripheral testing.
BLOOD DRAW $lo
CBC $25
CMP S25
LIPID PANEL S25
PSA $70
URINE DIP SIO
URINALYSIS W/MICRO $15 If indicated.
FECAL OCCULT BLOOD N/C
TB SKIN TEST $20
2ND TB SKIN TEST Sly 1 For new employees only.
QFT—GOLD TB TEST S" Asper county charges.
IMMUNIZATIONS—NFPA 1852 touches on immunizations with recommendations not requirements.Cal OSHA
however does have re uirements.Ifyou choose to pursue vaccinations I have included them below.
Hepatitis A(2 shot series) $130
Hepatitis B(3 shot series) $240
Hepatitis AB Titers $50
Varicella Zoster titer $25
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APPENDIX-B
SERVICE COST ESTIMATES FOR 2011
Firefighters under age 35
Level I Exam for this age group (Note: Level II Physical Exam done every 3 years)
EMQ Review= $50
Tb Skin Test= $20
EKG= $85
Spirometry = $70
CBC= $25
UA-Dip= $10
CMP= $25
Lipids = 25
Total $310
Level II Physical Exam Cycle= add $120
(Plus $120 for Level II Exam,plus $50 Audiogram, minus $50 for EMQ)
You have 6 firefighters in this age group.
None are due for a Level II Physical Examination in 2011
6 X $310=$1,860
Costs for Firefighters below age 35 = $1,860
Firefighters age 35 -45
Level I Exam for this age group (Note: Level II Physical Exam done every 2 years)
EMQ Review = $50
Tb Skin Test= $20
EKG = $85
Spirometry = $70
CBC = $25
UA-Dip = $10
CMP= $25
Lipids = 25
Total $310
Level II Physical Exam Cycle= add$120
(Plus $120 for Level II Exam,plus $50 Audiogram, minus $50 for EMQ)
You have 24 firefighters in this age group.
Ten are due for the Level I and II Examinations
$310 + 120 = $440 X 10 = $4,400
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Fourteen had their Level H Physical Examinations in 2010
They will only need a Level I Exam
14 X $310 =$4,340
Costs for Firefighters 35—45=$8,740
Firefighters age 46-49
Level I and II examination done every year
Level II Exam= $120
Tb Skin Test= $20
Audiogram= $50
Spirometry = $70
CBC = $25
UA-Dip= $10
CMP= $25
Lipids = $25
EKG= 85
Total $430
You have 4 firefighters in this age group.
Four need Level I and II Examinations this year.
4 X $430 = $1,720
Costs for Firefighters 46-49=$1,720
Firefighters age 50+
Level I and II examination every year
Level II Exam= $120
Tb Skin Test= $20
Spirometry = $70
Hearing test= $50
EKG = $85
PSA= $70
CBC= $25
UA-Dip = $10
CMP = $25
Lipids = 25
Sub-Total $500
Level III Exam=Treadmill =$250
You have 8 firefighters in this age group.
9 X $750 = $69750
Costs for Firefighters 50+= $6,750
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Overall Cost Estimates:
Costs for Firefighters under 35 = $1,860
Costs for Firefighters 35—45 -- $8,740
Costs for Firefighters 46-49 = $1,720
Firefighters 50+ $6,750
$19,070
From the information available to me at this time,and assuming there is no additional testing
required on clinical grounds...
Total Cost Estimate for 2011 = $19,070
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