CM-13-10-181ROUND ROCK. TEXAS
PURPOSE. IANOI. PROSPERITY
City of Round Rock
Agenda Item Summary
Agenda Number:
Title: Consider executing a Substance Abuse Testing Services Agreement with
Quest Diagnostics for out of town applicant testing.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 9/13/2013
Dept Director: Valerie Francois
Cost:
Indexes:
Attachments: Substance_Abuse_Testing_Services Agreement.pdf
Text of Legislative File CM -13-10-181
City of Round Rock Page 1 Printed on 9/30/2013
CONTRACT APPROVAL FORM FOR CITY MANAGER ACTION
Required for Submission of Specific City Manager Items
Department Name: Human Resources
Project Mgr/Resource: Valerie Francois
cm
City Manager Approval
CMA Wording
Project Name: Substance Abuse Testing Services Agreement
Contractor/Vendor: Quest Diagnostics
Consider executing a Substance Abuse Testing Services Agreement with Quest Diagnostics for out of town applicant testing.
Approval
X❑Employee EE Bowden Date September 9, 2013
Notes/Comments
Page 1 of 4
SUBSTANCE ABUSE TESTING SERVICES AGREEMENT
This Agreement for company -sponsored substance abuse testing services (the "Agreement") is made effective as of the
9
day of
LSeptember
2013
by and between Quest Diagnostics Incorporated ("Quest Diagnostics") and
CITY OF ROUND ROCK TX
Quest Diagnostics will provide Purchaser.
("Purchaser"), and defines the services that
1. DESCRIPTION OF PROTOCOL.
Quest Diagnostics will provide substance abuse testing of Purchaser's urine, oral fluid, blood, and/or hair specimens at a Quest
Diagnostics laboratory certified by the Substance Abuse and Mental Health Services Administration ("SAMHSA").
2. TEST ORDERS, SPECIMEN COLLECTION AND SPECIMEN TRANSPORTATION.
2.1 TEST ORDERS.
Purchaser will ensure that all substance abuse testing is ordered by a person authorized by Purchaser pursuant to
applicable law.
2.2 SPECIMEN COLLECTION.
Purchaser will and Quest Diagnostics agrees to provide collection of specimens in the following manner:
A) Purchaser may choose to refer applicants/employees to Quest Diagnostics' Patient Service Centers ("PSCs") or
Preferred Third Party Network Sites ("Preferred Collection Sites") for specimen collections at the additional charges outlined
on Exhibit A; or
B) Purchaser may choose to refer applicants/employees to non -preferred, third -party collection facilities, by separate
arrangement and at such third -party collection fees as Purchaser shall negotiate.
(To be used when Quest Diagnostics is responsible for Collection management)
C) Quest Diagnostics assumes full responsibility for selection of non -preferred third -party collection sites and for payment
of non -preferred third -party collection fees. Fees outlined for management of collection services are outlined on Exhibit A of
this Agreement.
2.3 SPECIMEN TRANSPORTATION.
Specimen transportation costs are included in the Fees listed on Exhibit A. If alternate arrangements are made such that
Purchaser assumes responsibility for transportation or shipping of specimens to Quest Diagnostics' laboratory, Purchaser
must ensure that the specimens are placed in containers designed to minimize the possibility of damage during shipment
and must be securely sealed.
3. RESULTS AVAILABILITY AND DELIVERY.
3.1 RESULTS AVAILABILITY.
Quest Diagnostics will release negative test results to the Medical Review Officer ("MRO"), if applicable, or to Purchaser,
usually within twenty-four (24) hours after receipt of the specimen at the testing site. Quest Diagnostics will release non -
negative (e.g. positive) results (or those requiring recheck) to the MRO or authorized contact, if applicable, usually within
forty-eight (48) to seventy-two (72) hours after receipt of the specimen at the testing site. Where Purchaser utilizes the
services of an MRO, Purchaser will provide Quest Diagnostics with written confirmation of the MRO's name, Unique
Physician Identification Number (UPIN) and state license number. Holidays and weekend work schedules may alter the
schedule of results availability described above.
3.2 RESULTS DELIVERY.
Results will be returned to a recipient designated by Purchaser according to a procedure agreed upon by Purchaser and
Quest Diagnostics, including electronic reporting of results. To the extent Quest Diagnostics transmits test results
electronically, using Quest Integrated Solutions (QIS 2), Purchaser agrees to execute a separate Employer Solutions
Service Agreement (QIS 2 Agreement).
4. SUPPLIES.
Quest Diagnostics will provide to Purchaser certain specimen collection supplies as Quest Diagnostics deems proper to be
used exclusively for ordering testing performed by Quest Diagnostics. Quest Diagnostics reserves the right to charge for
these supplies when such orders exceed 120% of tests ordered. Custom forms and custom collection supplies are available
at additional cost as set forth in Exhibit A.
5. CONFIDENTIALITY.
The parties agree that records related to test orders and/or test reports (collectively the "Data") shall be regarded as
confidential, and both parties shall comply with all applicable federal and state laws and regulations regarding the use and
disposition of such Data. Both parties agree to consider the terms of this Agreement confidential and not disclose any
information contained in this Agreement to any outside party unless required by applicable law.
6. FEES AND PAYMENT TERMS.
6.1 FEES AND PAYMENT TERMS.Quest Diagnostics will invoice Purchaser at the fees set forth in Exhibit A in accordance
with the specific needs of Purchaser and applicable federal and state statutes and regulations. Purchaser agrees to
compensate Quest Diagnostics Net fifteen (15) days Due Upon Receipt of the date of Quest Diagnostics' invoice. Quest
Diagnostics reserves the right to charge a finance charge of one and one-half percent (1-1/2%) per month on any thirty (30)
day past due balance or the maximum rate that the law permits.
C M '5-10-1(231
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6.2 LITIGATION ASSISTANCE FEES.Quest Diagnostics is qualified and available to provide litigation assistance for Purchaser
at the fees outlined in Exhibit A of this Agreement.
7. TERM AND TERMINATION.
This Agreement shall continue from the Effective Date until terminated by either party with or without cause upon thirty (30)
days prior written notice to the other party, with the understanding that Quest Diagnostics expressly reserves the right to
increase or decrease its fees upon providing Purchaser with at least thirty (30) days advance written notice. Such increases
or decreases shall apply with respect to all samples received by Quest Diagnostics after the effective date of such price
change.
8. MISCELLANEOUS.
8.1 ASSIGNMENT.
All rights and obligations of either party under this Agreement may be assigned to its subsidiary, successor, or parent
corporation.
8.2 ENTIRE AGREEMENT.
This Agreement constitutes the entire understanding between the parties regarding the subject matter hereof and
supersedes all prior understandings, arrangements and agreements relating to the subject matter hereof.
8.3 INDEPENDENT CONTRACTORS.
It is expressly understood and agreed by the parties hereto that Quest Diagnostics and Purchaser will at all times be and
act as independent contractors.
8.4 PRETESTING.
Quest Diagnostics' sports testing policy forbids any person, including a healthcare provider from using Quest Diagnostics
laboratory services to engage in pre -testing or otherwise aid any athlete in attempting to avoid detection of use of banned
drugs. "Pre -testing" is the analysis for drugs in order to determine the positive or negative status of an individual's urine
prior to the testing of this individual by an athletic governing body or organization, which prohibits or penalizes the use of
these drugs. Furthermore, Purchaser and Purchaser's Client represent and warrant that each specimen forwarded to Quest
Diagnostics for testing is not for "Pre -testing" as defined above or intended to assist an athlete or individual in avoiding the
detection of use of banned drugs, including but not limited to anabolic steroids.
8.5 QUEST DIAGNOSTICS' LOGO/PUBLICITY.
Purchaser shall not use the name or logo of Quest Diagnostics and shall not originate any publicity, news release, or other
public announcement, whether written or oral or via the Internet, relating to Quest Diagnostics, this Agreement, any
amendment hereto, any prices quoted herein or to any performance hereunder without prior written approval of Quest
Diagnostics.
8.6 COMPLIANCE WITH LAWS.
The parties agree to comply with all laws, rules and regulations applicable to their respective obligations related to the
services provided under this agreement.
(Only to be used when an MRO is used)
9. SERVICES PERFORMED BY MEDICAL REVIEW OFFICER.
Purchaser acknowledges that it must comply with regulations which mandate the services of a Medical Review Officer ("MRO").
In the event Purchaser requests Quest Diagnostics to include fees for MRO services in its invoice, Quest Diagnostics will do so
if agreeable to Purchasers MRO. Accordingly, Quest Diagnostics will report its results along with a copy of Purchaser's
requisition (when required by applicable laws or regulations) to the MRO. The MRO will review and verify the test results and it
is the MRO's responsibility to report the results to the appropriate individual designated by Purchaser in accordance with
applicable laws and regulations. Purchaser and Quest Diagnostics acknowledge and understand that MRO services are
provided by third -party, independent contractor physicians. Quest Diagnostics assumes no responsibility for the adequacy of
the performance of MRO services, and Purchaser agrees that it shall have recourse only to the MRO in the event of
dissatisfaction, for any reason, with the MRO services provided in connection with this Agreement. Purchaser is responsible to
reimburse Quest Diagnostics for any and all tests ordered by the MRO on behalf of Purchaser and performed by Quest
Diagnostics pursuant to this Agreement.
(Only to be used where Point of Collection Test Kits are Provided)
10. ON-SITE DRUG/ALCOHOL POINT OF COLLECTION TEST KITS (POCT KITS).
In the event Purchaser desires to purchase POCT products, the provisions included as Exhibit B shall apply.
IN WITNESS WHEREOF, the parties have executed this Agreement through their authorized agents.
QUEST DIAGNOSTICS INCORPORATED
("Quest Diagnostics")
By:
Print Name:
Title
CITY OF ROUND ROCK TX
("Purchaser")
By:
Print Name:
Title:
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Date: Date:
9191/3
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EXHIBIT A FEES
PRICING FOR "LAB BASED" TESTING AND SERVICES
Refer to Exhibit A for testing protocol.
Quest Diagnostics is pleased to offer the following pricing:
Description: Test Code:
SAP 5-50/2000 w/TESTSURE =[35105]
$16.00
COLLECTION FEE - QUEST=[8766N]
$10.00
COLLECTION FEE - PREFERRED =[35499]
$14.00
SET-UP FEE =31257
$75.00
Page 4 of 4
Client Test Code Price:
SUMMARY OF SERVICES INCLUDED IN ABOVE PRICING
• Where bundled testing is provided, the initial screen and confirmation of all positives by GC/MS is included in the Test Code
Price above.
• Transportation of ALL specimens to laboratory (international shipping provided at an additional charge).
• Supplies for specimen collection.
• Handling of rejected specimens or those otherwise unfit for testing.
• Retention of positive specimens in frozen storage for a minimum period of one year.
SUMMARY OF SERVICES AVAILABLE AT AN ADDITIONAL CHARGE
• TestSure TM quantitative adulteration detection panel.
• Custom Requisitions (non-standard requisitions).
• Custom Supplies.
• Reporting of hard -copy results in a method other than faxing or electronic transmission (if delivered by overnight
commercial courier, U.S. Mail, etc.).
LITIGATION ASSISTANCE AS FOLLOWS:
• Litigation Assistance (Witness/Responsible Person to testify about the information contained within a documentation
package, including test data, laboratory policies, procedures, and SOP's)
$1000.00/day
$125.00/hour after eight hours
Plus Travel expenses
■ Deposition (On site at Quest Diagnostics' Lab — including telephone and televised testimony from Quest
Diagnostics' Lab)
• Test Documentation Packet (Litigation Packet)
• Record Retrieval
$125.00/Hour
$250.00/Packet
$50.00/Record
Please note:
• Prices contained within this proposal are offered for 30 days from the proposal date.
■ Bundled pricing is based on positive rate of up to 5%.
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I.1 Quest
er Diagnostics
INTEGRATED SOLUTIONS
On-line Customer Setup Request Form
(PLEASE TYPE OR PRINT CLEARLY)
CLIENT INFORMATION:
Client Name: CITY OF ROUND ROCK TX �ew Client
Attn: 'ialer1 C. Ra,MIC-421S
Addr: 231 E. MAIN ST Primary Account Number:
City: ROUND ROCK
State: TX
Zip: 78664
Phone #: 512-218-5494
Ext:
Fax #: 512-218-5493
USER INFORMATION: (All items are required - One setup form per user)
* User Type:
Page 1 of 1
rj Existing Client
Primary User (*) (*) Person who Signed Service Agreement and is responsible for all other users for this
account
El Additional User
* User's Name: (Last, First):
* User's Work Phone#
* User's E -Mail Address:
P ri s C -o1 DeAore s
X317-) 21 �S- 3 Z.2-1 Ext. —� �''
I -15c o roLIJAArDc 4-e a S . 00V
User would like to receive e-mail notification of results . Yes E No
ours briSc o
Primary User Name:
Primary User Signature:
MRO USER INFORMATION: (All items are required - One setup form per user)
* User Type:
MRO
MRO Assistant
* User's Name: (Last. First):
* User's Work Phone#
* User's E -Mail Address:
Ext.
User would like to receive e-mail notification of results
MRO User Name:
MRO User Signature:
Yes 1 No
(*)MRO SIGNATURE REQUIRED TO VIEW FULL LAB COPY IMAGE
Account number(s) to be accessed/ordered on-Iine:(attach sheet for additional accounts)
Account Number(s)IMnemonic(s) that User is Authorized to Access:
Fax Completed Form to 888.880.2535
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