REQUEST FOR CITY COUNCIL ACTION
SUBMITTED TO: Honorable Mayor and City Council Members
SUBMITTED BY: Al Zelinka, City Manager
PREPARED BY: Travis K. Hopkins, Assistant City Manager
Subject:
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Authorize the City Manager to approve a contract with Paradigm Management Services, LLC (“Paradigm”) to undertake medical management responsibilities related to a workers’ compensation claim
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Statement of Issue:
The City requests authorization for the City Manager to execute a contract with Paradigm to undertake medical management responsibilities, including the payment of all medical costs, related to a workers’ compensation claim.
Financial Impact:
The total amount of this contract with Paradigm is anticipated not to exceed $2.8M.
The City has liability insurance through PRISM, which provides insurance for claims costs exceeding the City’s self-insured retention of $1M. The contract cost exceeding the City’s $1M self-insured retention will be reimbursed by the City’s insurance carrier. Reimbursement is expected to occur in the current fiscal year. Other costs previously incurred that relate to this occurrence are included in the $1M retention limit.
Sufficient budget is available in the City’s Self-Insured Worker’s Compensation Fund (551).
Recommended Action:
recommendation
Authorize the City Manager to approve a contract, approved to form by the City Attorney, with Paradigm Management Services, LLC to undertake medical management responsibilities related to a workers’ compensation claim, in an amount not-to-exceed $2.8M.
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Alternative Action(s):
Do not approve the recommended action, and provide alternate direction.
Analysis:
In response to an ongoing workers’ compensation claim, the City recommends entering into a Revised Outcome Plan Contract with Paradigm to undertake medical management responsibilities for the employee, including the payment of medical costs related to any injuries sustained by the employee, when appropriate, necessary and compensable. Due to HIPAA concerns, the employee’s name cannot be disclosed publicly. Such services will be performed with consultation from the City and in accordance with workers’ compensation laws and regulations.
The estimated contract length is approximately two years, and the total amount payable to Paradigm is anticipated not to exceed $2.8M. Amounts related to this occurrence that exceed the $1M self-insured retention will be reimbursed by the City’s excess liability insurance carrier.
Environmental Status:
Pursuant to CEQA Guidelines Section 15378(b)(5), administrative activities of governments that will not result in direct or indirect physical changes in the environment do not constitute a project.
Strategic Plan Goal:
Non Applicable - Administrative Item