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2024-224-E-Human Resouces-Select Physical Therapy-Poet-Fit for duty testing job analyes
Revised 01/24 1 [Departmental Use Only] TITLE Select Physical Ther FY 2024 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 5th day of February, 2024, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and Select Physical Therapy, a Delaware Corporation registered in North Carolina with its principal place of business located at 4716 Gettsburg Road, Mechanicsburg PA 17055 for an on behalf of its subsidaries and affiates ("hereinafter, the "Provider"), WorkSTEPS, Inc., a Texas corporation located at University Busines Park, 3019 Alvin Devane, Suite 150, Austin Texas 78741 ("WorkSTEPS"), (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): The services and/or materials to be furnished under this Agreement are as follows: [functional employment testing of job descriptions identified by COUNTY, as further described in Attachment A, Description of Services, which is attached herto and incorporated by refernce herein, except as to those parts that conflict with this Agreement]. WorkSTEPS provides implementing a functional employment testing program as a part of its work injury and disability management program, to, among other reasons, effecuate a reduction of on-the-job injuries by trying to determine if an applicant or employee can safely pefrom the essential functions of the job. To assist Orange County in implenting the WorkSTEPS functional employment-testing program. ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 2 a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional quality, accuracy and timely completion and submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits. vii) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 3 approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): b. WorkSTEPS provides it testing services to the County through a licensed network of independent third-party providers and therefore the County acknowledges each licensed provider utilized to provide County services will be treated as a party to this contract with regard to payment for services rendered. All WorkSTEPS Providers who have provided WorkSTEPS testing services to the County will be compensated within thirty (30) days of receipt of invoices. Basic Services provided in Attachement A. c. Job Analyses. Job Analyses is the foundation of the COUNTY’S functional employment testing program. A job analysis is a measurement of the physical demands and requirements of the essential functions of a specific job. Accurate and current job analyses are the COUNTY’S responsibility. Job Specific Authorization Forms that document essential function requirements must be executed by COUNTY’S representative and provided to WorkSTEPS before testing can begin. COUNTY managers should use professionals experienced in assisting with job analyses or other trained and certified ergonomic assessment specialists to assist in the preparation of job analyses and documentation of essential functions. The job analyses should be based on a close, careful examination of the specific job by an individual trained and competent in making the physical measurements of the essential functions of the specific job. The job analysis provides specific job content validity to COUNTY’s functional employment testing program, which seeks to simulate the specific physical demands necessary to perform essential job functions. Accurate and up-to-date job analyses help ensure that employment decisions are based on objective, sound, individual, and job specific information. Likewise, accurate and up-to-date job analyses helps ensure that no individual or group of individuals is discriminated against. COUNTY agrees to enter into an agreement in the form attached hereto as Exhibit “1” with the Analyst that will perform the job analysis. 4. Duration of Services a. Term. The term of this Agreement shall be from February 5, 2024 to June 30, 2025. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 4 ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be February 5, 2024. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services shall not exceed Fifteen Thousand Dollars ($15,000). Payment for satisfactorily performed Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. c. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by P rovider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Brenda Bartholomew, HR Director) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall consist of (attached - Insurance and Coverage Amounts (if no DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 5 additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days’ prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 6 ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County’s convenience and without penalty to County upon three (3) days’ notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. c. Non-Discrimination. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal non-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each Orange County policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 7 jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider’s performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. Non-Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable or not appropriated for the performance of County’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability or non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. In the event of a change in the County’s statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects County’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County’s legal authority. i. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider’s Name Attention:Brenda Bartholomew Tony Viggiano, WorkStrateg P.O. Box 8181 DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 8 Hillsborough, NC 27278 [SIGNATURE PAGE TO FOLLOW] DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Revised 01/24 9 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: By: _________________________________ Bonnie Hammersley, County Manager By: __________________________________ Tony Viggiano, VP – WorkStrategies (Select Physical Therapy) Printed Name and Title DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 3/27/20244/23/2024 Revised 01/24 10 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Select Physical Therapy Vendor Contact Person: Amy McCartney Phone: 336-765-5664 Address: 120 Charlois Blvd City Winston Salem State: NC Zip: 27103 Department: Human Resouces Amount: $15,000 Purpose: POET/FIT FOR DUTY TESTING/JOB ANALYSES Budget Code(s): 10250020/63000 Vendor # 65168 Vendor Status with NCSOS: Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date End Date Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prio r to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have alread y begun or been completed. Description of the nature of the emergency condition that was addressed: This is a contract renewal because of increased pricing. Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 3/27/2024 4/8/2024 4/11/2024 4/23/2024 Revised 01/24 11 Received for record retention: Office of the Clerk to the Board __________________________________________Date:________ DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 1 AGREEMENT THIS AGREEMENT is by and between WorkSTEPS, Inc., a Texas corporation located at University Business Park, 3019 Alvin Devane, Suite 150, Austin, Texas , 78741 (“WorkSTEPS”), Select Subsidiaries, Inc. on behalf of its subsidiaries and affiliates, with corporate offices located at 4714 Gettysburg Road, Mechanicsburg, PA 17055 (“PROVIDER”) and Orange County, a local political subdivision of the State of North Carolina, located at 200 South Cameron Street, Post Office Box 8181, Hillsborough, North Carolina . (“COMPANY”), collectively (“THE PARTIES”). WHEREAS: COMPANY is desirous of implementing a functional employment testing program as a part of its work injury and disability management program, to, among other reasons, effectuate a reduction of on- the-job injuries by trying to determine if an applicant or employee can safely perform the essential functions of the job. WHEREAS: WorkSTEPS has developed functional employment testing protocols and procedures that COMPANY desires to utilize for its functional employment testing program, and WHEREAS: WorkSTEPS desires to assist COMPANY in implementing the WorkSTEPS functional employment-testing program, THEREFORE, THE PARTIES HERETO DO HEREBY AGREE AS FOLLOWS: Based on the functional employment test(s) and services that have been identified below the price for the test(s) and services shall be: Functional Testing Services Price Approve (Initial) Comprehensive Post Offer Functional Employment Testing $200.00 Post-Employment/Fit-For-Duty/Return to Work Testing $200.00 Basic Carpal Tunnel Evaluation N/A Upper Quadrant / Carpal Tunnel / Post-Offer Evaluation N/A Job Analysis and Validation Process (*$200.00 per hour plus travel expenses related to transportation, lodging, meals, tec., to be billed at the rate incurred) $200.00* No Show Fee (24-hour cancellation required) $200.00 Centralized Billing (one time set up fee) Waived Test Development(per test protocol) $1,200/test COMPANY acknowledges that WorkSTEPS provides it testing services to Company through a licensed network of independent third-party providers and therefore Company acknowledges each licensed provider utilized to provide Company services will be treated as a party to this contract with regard to p ayment for services rendered. All WorkSTEPS Providers who have provided WorkSTEPS testing services to COMPANY will be compensated within thirty (30) days of receipt of invoices. 1. Job Analyses. Job Analyses is the foundation of the COMPANY’S functional employment testing program. A job analyses is a measurement of the physical demands and requirements of the essential functions of a specific job. Accurate and current job ana lyses are the COMPANY’S responsibility. Job Specific Authorization Forms that document essential function requirements must be executed by COMPANY’S representative and provided to WorkSTEPS before testing can begin. COMPANY managers should use professionals experienced in assisting with job analyses or other trained and certified ergonomic assessment specialists to assist in the preparation of job analyses and documentation of essential functions. The job analyses should be based on a close, careful examination of the specific job by an individual trained and competent in making the physical measurements of the essential functions of the specific job. The job analysis provides specific job content validity to COMPANY’s functional employment testing program, which seeks to simulate the specific physical demands necessary to perform essential job functions. Accurate DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 2 and up-to-date job analyses help ensure that employment decisions are based on objective, sound, individual, and job specific information. Likewise, accurate and up -to-date job analyses helps ensure that no individual or group of individuals is discriminated against. COMPANY agrees to enter into an agreement in the form attached hereto as Exhibit “1” with the Analyst that will perform the job analysis. 2. Terms. The term of this Agreement shall be from February 5th, 2024 through June 30th, 2025. 3. Termination. This Agreement may be terminated by either Party hereto. The termination shall be effective five (5) business days after receipt of notice thereof. Receipt shall be deemed effective upon actual delivery to the noticed Party. Upon termination, COMPANY shall be responsible to pay for any employment tests that have actually been performed prior to the termination. 4. Ownership. All data and information generated by the WorkSTEPS Functional Employment Testing Program for Company shall be the property of WorkSTEPS and Company. WorkSTEPS shall use best efforts to keep such data or information in a legally compliant manner pursuant to all state or federal laws affecting such data or information. COMPANY may keep copies of data or information for use in its normal course of business, but COMPANY hereby agrees that should it have possession of any WorkSTEPS materials, forms, procedures, protocols, or information, that such shall be deemed proprietary and confidential and kept strictly confidential. COMPANY shall use best efforts to see that such is not ut ilized for any purpose that would reasonably be deemed in competition with WorkSTEPS. 5. Confidentiality. WorkSTEPS shall keep all information or materials received by COMPANY strictly confidential and shall not divulge any such information or materia ls without the express written consent of COMPANY. 6. Third Party Claims. In the event of any third-party claims associated with the services provided under this Agreement, the party receiving notice of the claim shall immediately inform the other party of such claim. WorkSTEPS and COMPANY shall timely make available to each other such information and assistance as reasonably requested in connection with the defense of any potential claim or action. 7. Release of Data. Notwithstanding any prohibition contained within this Section, WorkSTEPS or COMPANY may release data or information as contemplated herein should a state or federal court of law require it. WorkSTEPS may also release data or information received from the testing of COMPANY’s employees for any legitimate business purpose, provided that (i) any personal information is kept confidential, and (ii) that all state and federal laws regarding such data or information are strictly followed. 8. Proprietary Marks. COMPANY acknowledges that it has been advised that WorkSTEPS believes the WorkSTEPS name, and its marks and proprietary software, protocols and testing process are federally trademarked and copyrighted. COMPANY agrees that WorkSTEPS proprietary software, protocols, processes, procedures, including modifications thereto, are, and shall be considered “proprietary” and “confidential information.” WorkSTEPS confidential and proprietary information will be provided to COMPANY for the sole purpose of having the WorkSTEPS Provider provide functional employment testing services to the COMPANY. COMPANY acknowledges, agrees and confirms that COMPANY’s disclosure or misappropriation of WorkSTEPS proprietary information could cause irreparable injury to WorkSTEPS, and COMPANY hereby expressly agrees that it will not use the confidential and proprietary information provided to COMPANY, except for the express purposes described in this Agreement. 9. Protected Health Information. WorkSTEPS may receive from Company health information that is protected under applicable state and/or federal law, including without limitation, protected health information (“PHI”) as defined in the regulations at 45 C.F.R. Parts 160 and 164 (the “Privacy Standards”) promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). WorkSTEPS agrees not to use or disclose (or permit the use or disclosure of) PHI in a manner that would violate the requirements of the Privacy Standards if the PHI were used or disclosed by Company in the same manner. WorkSTEPS shall use appropriate safeguards to prevent the use or disclosure of PHI other than as expressly permitted under this Agreement. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 3 Use of PHI. WorkSTEPS will use PHI solely for Company’s benefit and only (i) for the purpose of performing services for Company and (ii) as necessary for the proper management and administration of the Company or to carry out its legal responsibilities, provided that such uses are permitted under federal and state law. Company shall retain all rights in the PHI not granted herein. Disclosure of PHI. WorkSTEPS may disclose PHI as necessary to perform its obligations under this Agreement and as permitted by law, provided that WorkSTEPS shall in such case: (a) obtain reasonable assurances from any person to whom the information is disclosed that it will be held confidential and further used and disclosed only as required by law or for the purpose for which it was disclosed to the person or entity; (b) agree to immediately notify Company of any instances of which it is aware that PHI is being used or disclosed for a purpose that is not otherwise provided for in this Agreement or for a purpose not expressly permitted by the Privacy Standards; and (c) ensure that all disclosures of PHI are subject to the pr inciple of “minimum and necessary use and disclosure,” i.e., only the minimum PHI that is necessary to accomplish the intended purpose may be disclosed. If WorkSTEPS discloses PHI received from Company or created or received by WorkSTEPS on behalf of Company, to agents, including a subcontractor (collectively, “Recipients”), WorkSTEPS shall require Recipients to agree in writing to the same restrictions and conditions that apply to the WorkSTEPS under this Agreement. 10. Remedies. THE PARTIES agree that (i) the covenants and restrictions contained herein are of material consideration to this Agreement and are reasonable and necessary to protect and preserve the interest of both PARTIES; (ii) irreparable loss and damage will result from any breach hereof; (iii) monetary damages will not be sufficient to compensate a PARTY for any such default or breach by the other party; and (iv) in addition to all other remedies provided at law or in equity, a PARTY shall be entitled to seek and obtain temporary, preliminary and permanent injunctive relief in a court of law to prevent and restrain any breach or contemplated or threatened breach of and to specifically enforce the provisions of this Section, and neither PARTY will be obligated to post a bond or other security in seeking such relief or to provide proof of irreparable harm. Such remedies shall be in addition to and not in limitation of any injunctive relief or other rights or remedies to which a PARTY is or may be entitled at law or in equity or under this Agreement. 11. Exclusivity and Performance of the Test. For as long as this Agreement is in effect, COMPANY shall not acquire the same or similar functional testing services from anyone other than WorkSTEPS or its’ duly licensed providers. COMPANY acknowledges and understands that the tests are to be performed by medical providers that are independent contractors that have been licensed by WorkSTEPS to perform the tests identified. 12. Non-solicitation of Employees. COMPANY acknowledges that WorkSTEPS has invested considerable time and financial resource in the training, education, and certification of the professional staff necessary to deliver the services set forth on Attachment “A” to this Agreement. During the term of this Agreement, and for a period of one year after its termination, COMPANY agrees that it shall not actively or knowingly solicit or make an offer of employment to any of WorkSTEPS employees or WorkSTEPS licensed Providers associated with the delivery of these services to COMPANY nor shall COMPANY utilize the proprietary WorkSTEPS Network to perform any other competitive product to the WorkSTEPS Testing Program. 13. Use of Information after Termination. Without limiting the generality of this Section, THE PARTIES agree that after the termination or expiration of this Agreement, such PARTIES will not use the proprietary, confidential information of the other PARTY to provide the same or similar services to any person (unless and until such information ceases to be proprietary and confidential through no fault of the PARTY seeking to use the same), however, nothing in this Section shall prohibit Company or its affiliates, after termination of this Agreement, from providing a service to COMPANY similar to the services provided by Provider hereunder as long as neither COMPANY nor its affiliates uses the proprietary, confidential information of WorkSTEPS in so doing. 14. Employment Decision. COMPANY acknowledges and understands that this Agreement contemplates the functional employment testing of prospective employees and/or actual employees of C OMPANY. That COMPANY, as employer of the individuals tested have a significant role, both before and after the test, including, but not limited to, selection of the essential functions of the applicable job, the writing of job DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 4 descriptions, if any, in communicating with the individuals to be tested in a consistent manner, in making appropriate employment decisions based on test results and in properly processing and advising those individuals tested. 15. Adherence to Laws. COMPANY agrees to follow state and federal employment laws, regulations and practices including, but not limited to, appropriate procedures related to employment testing as set forth in the Americans’ With Disabilities Act and any and all applicable laws. COMPANY further acknowledges that Company, not the Provider, nor WorkSTEPS is responsible for making employment decisions concerning any post employment candidates’ or current employees’ suitability for employment or continued employment and for making decisions concerning reasonable accommodations. 16. GENERAL INDEMNITY 16.A. WorkSTEPS shall indemnify and hold COMPANY, its directors, officers and employees harmless from all claims, damages, losses, fines, penalties, costs and expenses, including reasonable attorneys’ fees (hereafter, “Liabilities”), arising out of or resulting from this Contract, and either (1) caused, in whole or in part, by the negligent act or omission of WorkSTEPS, anyone directly or indirectly employed by it (including without limitation, WorkSTEPS’s subcontractors of any tier), or anyone for whose acts it may be liable, or (2) related to any payments due or owing between the WorkSTEPS and its subcontractors. 16.B. COMPANY agrees to indemnify and hold WorkSTEPS, its directors, officers, employees and PROVIDER harmless from and against any and Liabilities arising out of or resulting from this contract and caused in whole or in part by the negligent act or omission or willful misconduct of the COMPANY. 16.C. If the Parties are concurrently negligent, each Party’s liability shall be limited t o that portion of negligence attributable to it as determined under the applicable proportionate responsibility rules of the State of Texas. 16.D. Notwithstanding anything to the contrary herein, neither Party shall be liable to indemnify the other for the negligence, gross negligence or willful misconduct of the other. 16.E. All indemnity provisions of this Contract shall be deemed independent covenants and shall survive completion or termination of the Contract or any claimed breach thereof. REMAINDER OF THIS PAGE INTENTIONALLY BLANK DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 5 This Agreement shall be governed by the laws of the State of North Carolina. Jurisdiction for any claim or action arising out of this Agreement shall be in an appropriate state or federal court of law in the State of North Carolina. EFFECTIVE THIS _____ DAY OF ________________, 20____. WorkSTEPS, Inc. COMPANY Signature Company Title Title Printed Signature Printed Signature PROVIDER _________________________________________ Signature _________________________________________ Title _________________________________________ Printed Signature DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Vice President of WorkStrategies Anthony J Viggiano MARCH27.00 24.00 County Manager Bonnie B Hammersley 6 Exhibit “1” Contract for Services For Job Analysis Bid Proposal While the ADA does not require that a formal job analysis be conducted to determine the essential functions of a specific job position, the ADA does require an employer to prove that any exclusionary cri teria obtained from a medical examination used to withdraw an offer of employment or terminate employment are “job related and consistent with business necessity.” Thus, the PROVIDER should conduct a job analysis of the positions for which employment tests are performed to ensure that the employment test is measuring the candidate’s or employee’s ability to perform essential job functions. It is imperative that the Company provides accurate information to the PROVIDER regarding the essential job functions for specific job positions. The Company acknowledges that the Company is responsible for familiarizing itself with the ADA’s definition of what is job related and consistent with business necessity and providing the PROVIDER accurate information concerning essential job functions. A separate job analysis should be performed for each position for which the Company desires to utilize employment testing. The job analysis may include filming, weighing, and measuring tasks for the selected job positions for the Company. The Company understands that the evaluation is dependent upon the complexity of the job and is billed based on the services requested to meet the Company’s specific needs. The Company understands that the job analysis usually takes between one (1) and (6) hours to complete per each job position/title. Additional expenses billed include, but are not limited to travel and lodging expenses, meals, and shipping expenses of necessary equipment. The Company hereby authorizes PROVIDER to provide said job analysis at the rate of $200.00 per hour. The Company hereby authorizes Provider to provider said job analysis for each job position for which the Company will be requesting employment testing at the rate referenced above. Reference Information Department of Labor (article): https://www.dol.gov/odep/pubs/fact/opening.htm Medical Inquiries (ADA): https://www.eeoc.gov/policy/docs/qanda-inquiries.html Company Signature/Title Date Printed Signature Provider Signature/Title Date Printed Signature DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 3/27/2024 Anthony J Viggiano Vice President of WorkStrategies HR Director Brenda Bartholomew 3/27/2024 7 “Attachment A” Description of Services Post Offer Testing to Include: Medical History – The candidate is taken through a comprehensive medical history interview to obtain information on previous injuries, surgeries, treatments, as well as current medical conditions. Candidate’s also sign a “falsification of the information” clause which states that falsifying information on the medical history, could result in the withdrawal of the conditional job offer of employment. Musculoskeletal Examination – A WorkSTEPS certified licensed clinician completes a comprehensive musculoskeletal evaluation with over 100 baseline measures. Static Grip - This portion of the tests measures grip strength and gathers baseline strength readings on the employee. Dynamic Lifting - This portion of the test utilizes NIOSH’s 4-standard lifting postures to gather baseline material handling data, as well as to qualify individuals to attempt job simulation tasks. Candidate’s are instructed on proper lifting techniques for each lifting posture. Job Specific Tasks - This portion tests the candidate’s ability to perform the essential functions for the position being offered in a controlled clinical setting. The essential functions are created from a job analysis which captures accrual weights and measures for that position begin tested. Fit for Duty Testing as Part of A Return To Work (“RTW”) Program To Include: WorkSTEPS will be conducting Fit-for-Duty (Post-Injury RTW) Tests on existing employees to include the following: Any reported injury, illness, or condition that gives the employer re asonable belief that the employee’s ability to perform essential job functions will be impaired or create a direct threat to health and safety. This category may also include testing at the request of the employer because, although there has been no formal injury or medical condition reported, the employer has observed current performance problems or has received reliable reports of performance problems indicating that the employee may not be able to perform essential job functions or may pose a direct threat to the health and safety of the employee or others. Even if the employee has fully “recovered” from injury or illness and no longer considers him or herself “injured”, for documentation purposes the test should be identified as a “post -injury” fit for duty, or an injured worker, because that was the trigger for the test. When testing an employee post-injury or illness the provider will: o Use the WorkSTEPS Fit for Duty Physical Capacity Consent Form o Use the WorkSTEPS Post Injury Fit for Duty Medical History Interview o Not perform “routine” medical measures, including heart rate and blood pressure, that are not related to the injury or condition for which the employee is being seen, or that are not contributing to a job-related functional deficit. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 8 o Not perform the standard “baseline” tests such as step test, Sorenson’s or grip if they are not related to the injured area. o Perform only the dynamic lift postures that are considered qualifying criteria. o Perform any and all standard job specific tasks for the position and expand to include any additional essential function tasks that could be impacted by their injury or condition. Company / Title Date WorkSTEPS Representative /Title Date DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE 3/27/2024Vice President of WorkStrategies HR Director 3/27/2024 INSURANCE AND COVERAGE AMOUNTS Select Physical Therapy / WorkStrategies Insurance Coverage Amounts Commercial General Liability $1,000,000 per accident/$2,000,000 aggregate Workers Compensation $100,000 - Each accident $100,000 - Bodily Injury by disease each employee $500,000 - Bodily injury by disease (policy limit) Professional Liability/Errors & Omissions $1,000,000 Per occurrence Auto coverage If they will be driving from location to location $500,000 Combined Single Limit DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE September 28, 2023 Donna Davenport Orange County Human Resource Manager 131 West Margaret Lane Hillsborough NC 27278 Dear Donna: Thank you for the opportunity to meet with you and to discuss Orange County’s needs and Select Medical’s WorkStrategies services. Select Medical’s proactive approach to the prevention and treatment of work-related injuries is consistent with your team’s desire to identify and properly place employees into appropriate job positions. Enclosed is a proposal for Select Medical to provide WorkStrategies Services. Please feel free to contact me if you have any questions regarding this proposal or and of Select Medical’s WorkStrategies services. Thank you for your consideration of Select Medical. Sincerely, Amy McCartney, PTA WorkStrategies Coordinator 336.765.5664 amccartney@selectmedical.com DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE PROPOSAL TO: Post Offer Employment Testing Submitted: September 28, 2023 Prepared by: Amy McCartney, PTA WorkStrategies Coordinator 336.765.5664 amccartney@selectmedical.com DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 2 Introduction to Select Medical Co-founded by Rocco A. Ortenzio and Robert A. Ortenzio in 1996, Select Medical began as a regional provider of outpatient physical rehabilitation. Contract therapy was added to the company's specialized health care offerings in 1997, and was quickly followed by the introduction of long-term acute care in 1998. In 1999, Select Medical made one of its largest acquisitions by purchasing NovaCare Physical Rehabilitation and Occupational Health. In three years, Select Medical had gone from a small start-up into a diversified health care company with a national presence. This strategically progressive yet responsible growth was one attribute that led to the company's recognition as one of the “Best Managed Companies in America” by Forbes. In April 2001, the company completed an initial public offering and was listed on NASDAQ. Fourteen months later, Select Medical was listed on the New York Stock Exchange, where it is currently traded under the NYSE ticker symbol SEM. In 2004, the company experienced clinical and operational growth when it acquired the world-renowned Kessler Institute for Rehabilitation, thus formally adding inpatient medical rehabilitation to its patient care offerings. This care line continues to grow through joint ventures and partnerships with some of the most well-respected names in medicine. More than 20 years later, the Select Medical of today encompasses four areas of expertise: critical illness recovery, inpatient medical rehabilitation, outpatient physical therapy and occupational medicine, all of which are delivered and supported by more than 46,000 talented health care professionals across the U.S. Despite its record growth, Select Medical remains true to its founding principles of clinical quality and operational excellence, which have been a top priority since day one. Regardless of the hospital, center or clinic size or scope, Select Medical is devoted to helping others and achieving outcomes that improve quality of life. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 3 Overview of WorkStrategies The Select Medical WorkStrategies Program provides solutions for workers’ compensation through the delivery of services from injury prevention to injury management and case closure. The main objectives are to: reduce the frequency and severity of injuries, achieve higher levels of employee productivity, and reduce the employer’s total cost for workers’ compensation and lost work time. The Select Medical team partners with employers, case managers, claims managers, TPAs, brokers and insurance companies to ensure timely and effective solutions. WorkStrategies is exclusively provided by Select Medical’s outpatient division family of brands, including Select Physical Therapy, NovaCare Rehabilitation, Physio, KORT, Saco Bay Physical Therapy, Kessler Rehabilitation, SSM Health Physical Therapy, Emory Rehabilitation Outpatient Center, CSM Champion Sports Medicine, Rehab Associates, Banner Physical Therapy, and Baylor Scott & White Institute for Rehabilitation – Outpatient Therapy. We are proud to provide the following benefits to our customers: Excellence in Clinical Care Exceptional Customer Service Proven Clinical Outcomes National Presence/Local Market Focus Convenient Locations & Hours Prompt Appointment Availability Timely and Effective Communication Most Insurance Plans Accepted Managed Care/Contracting Expertise Proven Network-Building/Management Employers pay more than 15 to 20 billion dollars in workers’ compensation costs each year. Eighty (80) percent of workplace injuries are due to worker habits and more than half are musculoskeletal (sp rains and strains) in nature. At Select Medical, our objective is to effectively partner with employers to reduce the costs of work-related injuries. Our services include: worksite/on -site physical therapy, athletic training/injury triage, first aid and prevention, job analyses, functional capacity evaluations, ergonomic assessments, pre-and post-offer screenings, return-to-work programs, and injury prevention education programs. A Reduction in: An Increase in: Medical & Indemnity Costs Productivity Lost Productivity Faster/Safer Return to Full Duty Related Overtime Costs Employee Morale Time Out of Office (Travel and Therapy) Communication Among all Parties Claims Management/Billing Review DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 4 Post Offer and Fit for Duty Testing Introduction Select Medical is pleased to present this overview regarding the development and administration of a Post- Offer Employment Testing program. This overview includes the steps to implementing the process an d pricing. Statement of Business Necessity Post-Offer Employment Test is a tool to help match the physical abilities of a worker to the specific physical demands of a job. Appropriate job placement helps eliminate the risk of injury due to over-exertion and lack of physical ability. In addition, this program is an effective tool for cost reduction and cost containment related to reducing the number of work-related injuries and associated costs such as time off, worker replacement, lost productivity, employee turnover, reserve allocations, administrative costs and legal expenses which all contribute to the negative financial impact of on -the-job injuries. Select Medical’s WorkStrategies Program has been administering Post-Offer Employment Tests for more than twenty years. The model has been refined, computerized and studied throughout this time. It is valid and reproducible. Employers using this model have experienced tremendous success in reducing musculoskeletal injuries and their related costs. Although it does not completely alleviate musculoskeletal injuries, they are reduced an average of 50% during the first year’s implementation. Employers who utilize the model in conjunction with other injury management programming and ergonomic technologies are achieving even higher reductions. Select Medical’s employment testing program meets the legal requirements of the EEOC, ADA and other Federal regulations and is provided by WorkStrategies Specialists. As an administrator of the Post Offer Employment Testing, our company has helped employers to increase productivity, reduce job turnover and reduce costs associated with turnover such as new hire orientation, training and workers’ compensation costs associated with injured workers. Testing Services A Post-Offer Employment Test is performed by a trained WorkStrategies Specialists after a conditional offer of employment is made to an applicant. The test is created from a defined process including an onsite job analysis that determines essential job functions including the strength, postural/agility and lifting requirements associated with a specific job. Based on the data collected at the worksite and in observation of employees functioning in the job, a test battery is developed. Emphasis is placed on two primary functional areas: 1) Dynamic lift testing at various levels in order to determine employee’s level of strength 2) Job simulation testing in order to determine employee’s ability to perform essential functions of target job DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 5 Initial Implementation There are five basic steps in the process of implementing the employment testing program: 1) Completion of agreement 2) Identification of job positions to be assessed and onsite job analysis for identified positions 3) Test criteria development 4) Test administration, analysis and reporting 5) Evaluation of program effectiveness Identification of Job Positions The employer designates the job positions for which the employment testing program will apply. It is not necessary to set up testing for every job within your company. Many companies will choose to target the job positions that are the most physically demanding, have the highest injury incidence or have the highest turn-over rates. The primary goal of the onsite job analysis is to identify physical or biomechanical d emands that are routinely encountered by workers in each job title. The WorkStrategies Specialist will quantify the repetitive, strength and agility requirements of these tasks. Sources of data may be actual measurement of product weights for materials routinely handled or review of historical activity reports and training schedules. The primary determinant of the amount of time that needs to be spent on site is how long it would take to assess the number of jobs identified by your company with typically two to four hours spent per job title. If a current job analysis is available, then this data will be reviewed and the job site visit will include the confirmation of data in the given JSA. Test Criteria Development We anticipate it will be possible to identify essential job functions that will comprise a job related physical ability test battery for your company. This test battery would be based on the data gathered during the onsite visit related to physically-demanding essential functions. Based on the onsite job analysis information, test criteria will be drafted for each job title (typically less than one hour development time per job) and submitted to the employer for validation/signature. Select Medical encourages the employer to arrange a testing demonstration of the employment test prior to full implementation so test criteria can be discussed and agreed upon. Components of the test can include (some tests on this list are optional dependent on employer needs): Medical History Interview: comprehensive interview conducted by clinic staff which collects information on test candidate’s orthopedic and medical history as well as allowing them to identify any limitations or restrictions they have and request any accommodation. Cardiovascular status: resting blood pressure and heart rate taken for safety screening Musculoskeletal Evaluation Screening: focused on collection of baseline information regarding with over 50 analytical measures including posture, range of motion, strength, reflexes, flexibi lity, joint mobility, joint integrity throughout the body Static Strength Testing: isometric testing including standard grip measures. The static testing can be expanded to include five (5) position grip measures and pinch strength measures if there is a high incidence of repetitive hand motion found in job site analysis or company has high incidence of carpal tunnel claims. Aerobic Capacity Baseline testing: three (3) minute step testing protocol to determine aerobic capacity classification of test candidate. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 6 Dynamic Strength Testing (Lifts): Maximal lift testing performed in up to four (4) different positions (floor to knuckle, 12” to knuckle, knuckle to shoulder and shoulder to overhead) to determine if client is able to safely qualify for the physical demand level of the job. Capable/non-capable safe lifting criteria set based on data collected during the job analysis regarding job lifting requirements. Job Specific Testing: testing designed to simulate the essential functions of the job which may include material handling (occasional or continuous lifting, carrying, pushing or pulling) or postural/agility evaluation which may include reaching, climbing, bending, squatting, crawling, entering enclosed space or other simulation of job-related positional requirement. Test Administration, Analysis and Reporting A WorkStrategies Specialist will administer the test battery. Each employee to be tested is required to complete a confidential medical interview prior to the test to verify it is safe to procee d with the test. Medical clearance may be required prior to testing if the information on the interview so indicates. It should be noted that for the employer to be compliant with Federal regulations, the Post-Offer Employment Test requirement must be a part of the employer’s personnel policies and all applicants/employees in the job classification must be required to have a Post-Offer Employment Text. In other words, the employer must not be selective with whom the test is administered. Once the test has been administered, Select Medical will send the report indicating a “Met Demands” or “Did Not Meet Demands” result to the employer’s designee. This information is communicated immediately by email, phone or Fax, as specified by employer. Evaluation of Program Effectiveness Information will be collected by Select Medical on a quarterly basis outlining employees tested, job titles and test results. These will be communicated to you so rates related to meeting or not meeting the demands can be monitored. In addition, a yearly review will be conducted to determine annual rates and to review injury rates and costs in order to identify programs benefits. This will utilize information from you, the employer, regarding injury rates, injury costs, turnover, and productivity to insure the program is beneficial. Modification to program or testing protocols that reflect job specific task and business necessity can be made with authorization by employer and Select Medical. Conclusion Post Offer Employment Tests are an effective way to reduce the number of injuries among newly hired employees. A validated POET provides the additional benefit of allowing the employer to make a hire/no hire decision with the comfort of knowing that the test is compliant with Federal regulations. Select Medical presents this proposal with confidence that a validated POET program offers a cost - effective injury prevention opportunity for your company and the Fit for Duty testing would assist you with safe and effective return to work / remain at work strategies. We appreciate the opportunity to present this information. Fee: $200.00 Job Site Analysis- Hourly Rate (Minimum of 2 hours, maximum of 4 hours) $1,200.00 Test Development (per test protocol) (Includes test criteria development and validation) $200.00 Post Offer Employment Test $200.00 No Show/Cancellation Fee DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 7 Post Offer and Fit for Duty Testing Utilizing the WorkSTEPS Protocol Introduction Select Medical is pleased to present this overview regarding the development and administration of a Post- Offer Employment Testing program. This overview includes the steps to implementing the process an d pricing. Statement of Business Necessity Post-Offer Employment Test is a tool to help match the physical ab ilities of a worker to the specific physical demands of a job. Appropriate job placement helps eliminate the risk of injury due to over-exertion and lack of physical ability. In addition, this program is an effective tool for cost reduction and cost conta inment related to reducing the number of work-related injuries and associated costs such as time off, worker replacement, lost productivity, employee turnover, reserve allocations, administrative costs and legal expenses which all contribute to the negative financial impact of on-the-job injuries. Select Medical’s WorkStrategies Program has been administering Post-Offer Employment Tests for more than twenty years. The model has been refined, computerized and studied throughout this time. It is valid and reproducible. Employers using this model have experienced tremendous success in reducing musculoskeletal injuries and their related costs. Although it does not completely alleviate musculoskeletal injuries, they are reduced an average of 50% during the first year’s implementation. Employers who utilize the model in conjunction with other injury management programming and ergonomic technologies are achieving even higher reductions. Select Medical’s employment testing program meets the legal requirements of the EEOC, ADA and other Federal regulations and is provided by WorkStrategies Specialists. As an administrator of the Post Offer Employment Testing, our company has helped employers to increase productivity, reduce job turnover and reduce costs associated with turnover such as new hire orientation, training and workers’ compensation costs associated with injured workers. Introduction to WorkSTEPS The WorkSTEPS Program was developed over a decade ago in response to industry's need for reliable, medically/legally defensible employment testing programs which could effectively reduce work place injury incidence and work place injury costs. The Program, which is based upon objective scientific data, conforms fully to EEOC Guidelines for application of the Americans with Disabilities Act (ADA). Implementation of testing programs using the WorkSTEPS Program has enabled hundreds of industries to realize significant work place injury incidence and injury cost reductions. The data generated by the WorkSTEPS Program has been used to successfully litigate fraudulent injury claims, and to establish a basis for legitimate settlements of bona fide work place injury claims. In the first court case involving WorkSTEPS data, an employee seeking $1.2 million in compensation, received a jury award of only $22,000, for medical services and legal fees, based primarily upon pre-existing condition data recorded during the WorkSTEPS testing of the employee. DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 8 The WorkSTEPS Program is dependent upon collection and interpretation of data pursuant to stringent medical and scientific protocols. Employers benefit by matching the physical demand levels of the specific job to the physical capabilities of the employee, which reduces injury incidence and decreases employee turnover. The WorkSTEPS® Test also assists in eliminating fraudulent claims and in establishing a basis for legitimately controlling claims. The WorkSTEPS Program starts with a thorough job analysis by Select Medical representatives. The job analysis information forms the basis for preparation of the essential function component of the WorkSTEPS Employment Test. In addition to the "essential function" component necessary to make hiring recommendations in accordance with the ADA, WorkSTEPS protocol includes a comprehensive battery of additional medical and functional performance tests on each employee. If significant, this medical and functional data can be used to withdraw an offer of employment, but otherwise can be used to establish baseline data of an e mployee. This facilitates detection of existing impairments and other medical and physical conditions of the employee. The information is retained for comparison to post-injury data and establishes a basis for eliminating fraudulent injuries, and quantifying the legitimate value of bona fide injuries. More information about WorkSTEPS including a frequently asked questions section can be found at: http://www.worksteps.com/ Testing Services A Post-Offer Employment Test is performed by a trained WorkStrategies Specialists after a conditional offer of employment is made to an applicant. The test is created from a defined process including an onsite job analysis that determines essential job functions including the strength, postural/agility and lifting requirements associated with a specific job. Based on the data collected at the worksite and in observation of employees functioning in the job, a test battery is developed. Emphasis is placed on two primary functional areas: 1) Dynamic lift testing at various levels in order to determine employee’s level of strength 2) Job simulation testing in order to determine employee’s ability to perform essential functions of target job Initial Implementation There are five basic steps in the process of implementing the employment testing program: 1) Completion of Tri-party Agreement (employer, WorkSTEPS, Select Medical) 2) Identification of job positions to be assessed and onsite job analysis for identified positions 3) Test criteria development 4) Test administration, analysis and reporting 5) Evaluation of program effectiveness DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 9 Identification of Job Positions The employer designates the job positions for which the employment testing program will apply. It is not necessary to set up testing for every job within your company. Many companies will choose to target the job positions that are the most physically demanding, have the highest injury incidence or have the highest turn-over rates. The primary goal of the onsite job analysis is to identify physical or biomechanical demands that are routinely encountered by workers in each job title. The WorkStrategies Specialist will quantify the repetitive, strength and agility requirements of these tasks. Sources of data may be actual measurement of product weights for materials routinely handled or review of historical activity reports and training schedules. The primary determinant of the amount of time that needs to be spent on site is how long it would take to assess the number of jobs identified by your company with typically two to four hours spent per job title. If a current job analysis is available, then this data will be reviewed and the job site visit will include the confirmation of data in the given JSA. Test Criteria Development We anticipate it will be possible to identify essential job functions that will comprise a job related physical ability test battery for your company. This test battery would be based on the data gathered during the onsite visit related to physically-demanding essential functions. Based on the onsite job analysis information, test criteria will be drafted for each job title (typically less than one hour development time per job) and submitted to the employer for validation/signature. Select Medical encourages the employer to arrange a testing demonstration of the employment test prior to full implementation so test criteria can be discussed and agreed upon. PAVE Validation: WorkSTEPS recently introduced the first automated, online physical abilities va lidation tool on the market. PAVE, an acronym for Physical Ability Validity Evaluator, automates the test creation process for physical ability tests for nearly all positions and offers unprecedented legal defensibility to employers. PAVE yields a validated report that specifically links the process used to validate the physical demands of the position to the requirements set forth by the federal Uniform Guidelines of Employee Selection Procedures, Equal Employment Opportunity Commission and the 1990 Americans with Disabilities Act as amended. The addition of PAVE has provided an unprecedented degree of legal defensibility to the WorkSTEPS testing program, already recognized as an industry gold - standard. The Select Medical consultant meets onsite with a representative sample of Job Experts from the positions that were targeted for job analysis and for which job analysis has been conducted. Job Experts are qualified job incumbents who perform and/or supervise the targeted jobs. The following criteria are presented as guidelines for selecting the members of the panel. The Job Experts chosen should: Collectively represent the demographics of the employee population (with respect to gender, age, race, years of experience, etc.). It is a good idea to slightly ove r-sample gender and ethnic groups to ensure adequate representation in the job analysis process. Be experienced and currently active in the position they represent (e.g., Job Experts should not be on probationary status/temporarily assigned to the position). While seasoned Job Experts will often have a good understanding of the position, it is also beneficial to include relatively inexperienced Job Experts to integrate the “newcomer’s perspective.” However, at least one DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 10 year’s experience on the job should be a baseline requirement for Job Experts selected for the panel. Represent the various “functional areas” and/or shifts of the position. Many positions have more than one location or “work area” or even different shifts, where job duties may differ. Include between 10% and 20% supervisors for a given position. For example, if a seven to ten person Job Expert panel is used; one to two supervisors should be included on the panel. During the workshop, Select Medical consultants work with the Job Experts to refine the list of job duties and physical requirements until a consensus is achieved. This results in a master, consolidated list that reflects the majority opinion of the group. The contents of the master list are then inputted into the PAVE software, whi ch yields a physical ability test event and a survey for Job Experts (incumbent workers, supervisors, plant managers, etc.) to complete in order to validate the test event. A representative sample of Job Experts completes the survey during an on - site, in-person demonstration. The Job Experts will indicate the importance of the job duties that have been identified in the test event, and the frequency that those job duties are performed. These same Job Experts would also provide similar ratings of the physical requirements that have also been identified. Once the job analysis process for the target positions has been completed, and if the findings support the validity of the testing process, PAVE will generate a full, validated physical ability test report d esigned to address the federal Uniform Guidelines, which can serve as the legal defense of the test. This report will include information about which important job duties are performed by those who hold the target job, as well as the physical abilities that are needed to perform those duties. Select Medical encourages the company to arrange a testing demonstration of the employment test prior to full implementation so that test criteria can be discussed and agreed upon. Components of the test can include (some tests on this list are optional dependent on employer needs): Medical History Interview: comprehensive interview conducted by clinic staff which collects information on test candidate’s orthopedic and medical history as well as allowing them to iden tify any limitations or restrictions they have and request any accommodation. Cardiovascular status: resting blood pressure and heart rate taken for safety screening Musculoskeletal Evaluation Screening: focused on collection of baseline information regarding with over 50 analytical measures including posture, range of motion, strength, reflexes, flexibility, joint mobility, joint integrity throughout the body Static Strength Testing: isometric testing including standard grip measures. The static testing can be expanded to include five (5) position grip measures and pinch strength measures if there is a high incidence of repetitive hand motion found in job site analysis or company has high incidence of carpal tunnel claims. Aerobic Capacity Baseline testing: three (3) minute step testing protocol to determine aerobic capacity classification of test candidate. Dynamic Strength Testing (Lifts): Maximal lift testing performed in up to four (4) different positions (floor to knuckle, 12” to knuckle, knuckle to shoulder and shoulder to overhead) to determine if client is able to safely qualify for the physical demand level of the job. Capable/non -capable safe lifting criteria set based on data collected during the job analysis regarding job lifting requirements . Job Specific Testing: testing designed to simulate the essential functions of the job which may include material handling (occasional or continuous lifting, carrying, pushing or pulling) or DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 11 postural/agility evaluation which may include reaching, climbing, bending, squatting, crawling, entering enclosed space or other simulation of job-related positional requirement. Test Administration, Analysis and Reporting A WorkStrategies Specialist will administer the test battery. Each employee to be tested is re quired to complete a confidential medical interview prior to the test to verify it is safe to proceed with the test. Medical clearance may be required prior to testing if the information on the interview so indicates. It should be noted that for the employer to be compliant with Federal regulations, the Post-Offer Employment Test requirement must be a part of the employer’s personnel policies and all applicants/employees in the job classification must be required to have a Post -Offer Employment Text. In other words, the employer must not be selective with whom the test is administered. Once the test has been administered, Select Medical will send the report indicating a “Met Demands” or “Did Not Meet Demands” result to the employer’s designee. This info rmation is communicated immediately by email, phone or Fax, as specified by employer. This test can include components to evaluate the Upper Extremity / Carpal Tunnel regions. The test would determine capability as it related to repetitive job function, rather than heavy material handling tasks. Results are based measures including strength tests, joint integrity, neurological tests, provocation tests, and other measures to perform screening to identify test candidates who are exhibiting symptoms of neurological or other conditions of the upper extremity. Evaluation of Program Effectiveness Information will be collected by Select Medical on a quarterly basis outlining employees tested, job titles and test results. These will be communicated to you so ra tes related to meeting or not meeting the demands can be monitored. In addition, a yearly review will be conducted to determine annual rates and to review injury rates and costs in order to identify programs benefits. This will utilize information from you, the employer, regarding injury rates, injury costs, turnover, and productivity to insure the program is beneficial. Modification to program or testing protocols that reflect job specific task and business necessity can be made with authorization by employer and Select Medical. Fit For Duty Testing The employer has the right to perform FFD to existing employees under 4 scenarios referenced in ADA: 1) Voluntary testing such as a company sponsored health fair (TAM VI-15) 2) As needed basis if an employee demonstrates difficulty performing ANY essential job function (TAM VI-13) 3) On a regularly scheduled interval as part of recognized company policy to determine whether individuals in physically demanding jobs continue to be fit for duty. (TAM VI-12) 4) When an employee becomes disabled or injured or when an employee wishes to RTW after an injury or illness to determine ability to perform essential function with or without accommodations (TAM VI-12) Post employment medical exams or inquiries must be “job related and consistent with business necessity”. Once the test has been administered, Select Medical will send the report indicating an Essential Functions Met or Not Met result to the employer’s designee which clearly identifies what tasks the employee can safely perform and listing any tasks that were not tolerated. This information is communicated immediately to you by email, phone or Fax, as specified by employer. For those cases in which the DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 12 employee does not meet the strength demands or essential functions of the job, the employer should exercise all other options prior to considering termination: Returning to original position (void if original position is being eliminated) Allowing the employee the opportunity to condition to the demands of target job Exploring reasonable accommodations for the employee within the target job Conclusion Post Offer Employment Tests are an effective way to reduce the number of injuries among newly hired employees. A validated POET provides the additional benefit of allowing the employer to make a hire/no hire decision with the comfort of knowing that the test is compliant with Federal regulations. SELECT MEDICAL presents this proposal with confidence that a validated POET program offers a cost - effective injury prevention opportunity for your company and the Fit for Duty testing would assist you with safe and effective return to work / remain at work strategies. We appreciate the opportunity to present this information. Fee: $200.00 Job Site Analysis- Hourly Rate (Minimum of 2 hours, maximum of 4 hours) $1,200.00 Test Development (per test protocol) (Includes JST development and validation) $200.00 Post Offer Employment Test $200.00 Fit for Duty $200.00 No Show/Cancellation Fee DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 2 DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE Select Medical WorkStrategies P a g e | 3 DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 4/5/2024 Graham Company, a Marsh &McLennan Agency,LLC company One Penn Square West Philadelphia PA 19102 SelectMed Unit 215-567-6300 215-405-2711 SELECTMED_UNIT@grahamco.com Liberty Mutual Fire Ins.Co.23035 SELEMED-01 Allied World Assurance Company,AGSelectSubsidiaries,Inc. c/o Select Medical Corporation 4716 Old Gettysburg Road Mechanicsburg PA 17055 National Fire and Marine Insurance Company 20079 American Guarantee &Liability Ins.Co.26247 LM Insurance Corporation 33600 647816589 C X 10,000,000 X INCLUDED IN SIR X Excess of$2M SIR INCLUDED 10,000,000 X Y EN065306 12/31/2023 12/31/2024 INCLUDED A 2,000,000 X AS2-631-509047-034 4/1/2024 4/1/2025 B X 15,000,000 X X C01445/022 12/31/2023 12/31/2024 15,000,000 E E XWA7-63D-509047-013 WC5-631-509047-023 4/1/2024 4/1/2024 4/1/2025 4/1/2025 1,000,000 1,000,000 1,000,000 C D Professional Liability Property EN065306 ZMD5917837-18 12/31/2023 12/31/2023 12/31/2024 12/31/2024 $7M Per Claim/$7M Agg SEE BELOW Excess of $5M SIR PROPERTY COVERAGE:$5,000,000 Limit for Unnamed/Unscheduled Locations;Specified Limits for Scheduled Locations.Coverage is provided on a replacement cost basis. Coverage is provided for all medical professionals currently or previously employed or contracted by the above Named Insured,but only for professional services performed for or on behalf of the above Named Insured. Orange County,its officers,agents and employees are additional insureds on the above General Liability Policy if required by written contract. Orange County 300 West Tryon Street P.O.Box 8181 Hillsborough NC 27278 DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE