R-24-12VILLAGE OF DEERFIELD
RESOLUTION NO.2024 — R-24-12
A RESOLUTION APPROVING AN AGREEMENT FOR PROFESSIONAL THERAPY
SERVICES WITH FIRST RESPONDERS WELLNESS CENTER. LLC
WHEREAS, the Village desires to provide support services to Village police
officers to help cope with the stress of being a police officer ("Services"); and
WHEREAS, the Village has budgeted sufficient funds in the 2024 fiscal year for
the Services; and
WHEREAS, the Village has identified and negotiated a agreement with the First
Responders Wellness Center, LLC ("Consultant") to provide the Services at a cost of
$185.00 per employee with a cost not to exceed $11,000.00 ("Agreement"); and
WHEREAS, the Village Board has determined that it will serve and be in the best
interests of the Village and its residents to approve and enter into the Agreement with
consultant;
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE BOARD OF
DEERFIELD, LAKE AND COOK COUNTIES, ILLINOIS, as follows:
SECTION 1: RECITALS. The Village Board hereby adopts the foregoing
recitals as its findings, as if fully set forth herein.
SECTION 2: APPROVAL OF AGREEMENT. The Village Board hereby
approves the Agreement by and among the Village and Consultant in substantially the
form attached to this Resolution as Exhibit A and in a final form approved by the Village
Manager.
SECTION 3: AUTHORIZATION TO EXECUTE AGREEMENT. The
Village Board hereby authorizes and directs the Village President and the Village Clerk
to execute and seal, on behalf of the Village, the final Agreement.
SECTION 4: EFFECTIVE DATE. This Resolution shall be in full force and
effect from and after its passage and approval according to law.
[SIGNATURE PAGE FOLLOWS]
AYES: Benton, Berg, Jacoby, Metts-Childers, Oppenheim
NAYS: None
ABSTAIN: None
ABSENT: Seiden, Shapiro
PASSED: February 5, 2024
APPROVED: February 14, 2024
RESOLUTION NO: R-24-12
ATTEST:
Kent S. Street, Village Clerk
Daniel C. Shapiro, Mayor
EXHIBIT A
Agreement
FIRST RESPONDERS WELLNESS CENTER
477 E Butterfield Rd. Suite 408 Lombard, Illinois 60148
100 Tri State International Suite 260 Lincolnshire, Illinois 60069
1412 W. Washington Blvd. 2°d floor Chicago, Illinois 60607
Agreement for Professional Theral)v Services for
Mental Health Screeninrs/Wellness Visits
This Agreement was made on 12/06/2023 between the First Responders Wellness Center
(Hereafter "Contractor") and Deerfield Police Department (Hereinafter "Agency').
Whereas "Contractor" is an independent therapy provider formed to render therapeutic Officer
Mental Health Screenings/Wellness Visits as part of the SAFE-T Act and overall police, dispatch,
and/or fire wellness program which incorporates therapeutic services, psychoeducation, and
building coping strategies for individual law enforcement officers, firefighters, and personnel who
work for the Agency.
Whereas Agency is desirous of securing the services of Contractor and the Contractor will provide
services to individuals of the Agency. The Agency will not be privy to the content or
conversations during the sessions or any therapeutic notes. The Agency will only be given a brief
written or verbal notification that an individual member of the Agency has attended and completed
their wellness visit on a specific date. The Agency will not have access to any other documents
or information about a specific individual member of the Agency.
In consideration of the mutual covenants and conditions hereinafter expressed, and other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and parties
hereto covenant and agree as follows:
1. DUTIES OF CONTRACTOR: ( FIRST RESPONDERS WELLNESS
CENTER) hereby appoints contractor to serve and perform therapeutic officer
wellness visits to each member of the Agency in a confidential meeting space
(477 E. Butterfield Road Suite 408 Lombard, IL 60148, 100 Tri State
International Suite 260 Lincolnshire, Illinois 60069, 1412 W. Washington Blvd.
2" d floor Chicago, Illinois 60607, telehealth, or agreed upon location). During this
time, the contractor will spend one, 50 to 55 minute session per member in a
therapeutic, private office to assess the individual of the Agency's psychological
strengths and weaknesses to increase the member's coping skills, give the
member psychoeducation about any specific needs and/or trauma, and/or give
suggestions for overall mental wellness during the term of this Agreement. The
Contractor will not diagnose a member of the Agency with a mental illness or
determine their psychological suitability nor fitness for police work during the
wellness visit. The contractor will not provide any information or notes to the
Agency other than attendance of the member. The agency will not be responsible
to pay for more than one 50-55 minute sessions per calendar year.
2. CERTIFICATION/LICENSE: Contractor shall at all times be duly
certified/licensed to practice in the state of Illinois.
3. RELATIONSHIP BETWEEN PARTIES:
A) In the performance of the work, duties, responsibilities, and obligations
involving Contractor under this agreement, it is expressly understood and
agreed between the parties that Contractor shall at all times act and perform as
an independent contractor, specializing in the provision of wellness visit
therapeutic services. Nothing in this agreement shall be deemed to constitute
the parties as joint ventures or partners or anything other than independent
contractors.
B) As an independent contractor, Contractor will not be eligible to participate in
any employee benefit program of agency and will not be eligible for vacation
or holiday compensation.
C) Agency shall neither have nor exercise any control or direction of the methods
by which Contractor's work is performed, except that Contractor agrees to
perform at all times in strict accordance with the currently approved practice
of police psychology and ethics. Furthermore, Contractor shall follow all
guidelines, policies, and procedures of Agency.
D) Contractor assumes all liabilities and responsibilities concerning the
withholding of federal, state, and local taxes and social security taxes,
worker's compensation, disability, and unemployment insurance obligations if
applicable. Contractor agrees to indemnify agency for any liability (including
legal fees and costs) incurred as a result of Contractor not withholding income
tax and social security or any other taxes, worker's compensation, disability
and unemployment compensation obligations or contractor's failure to pay
required income tax and social security or any other taxes, worker's
compensation, disability, and unemployment obligations.
4. WRITTEN ALLOCATION AGREEMENT AND ACCESS TO RECORDS:
Contractor agrees to not maintain any records for Wellness Visits to the Agency
other than the name and date of attendance of service. The Contractor will not
maintain any records or notes for individuals of the Agency other than exceptions
that are in accordance with Illinois law, these exceptions are if they are immediate
harm to themselves or others, or report that they are abusing a child, elderly, or
disabled person. Exception see below.
Exception:
tion:
If a member of the Agency discloses to the Contractor that the member is an
immediate harm to themselves or another, is abusing a child, elderly or disabled
person, the Contractor may have to contact 911 or the nearest police department
and/or hospital to ascertain their safety. The clinician will not call the
department but 911. Additionally, if a member of the Agency discloses that they
are abusing a child, disabled or an elderly person. The Contactor will notify the
appropriate agency and limit the disclosure to the minimum necessary to achieve
the purpose and to be in compliance with Illinois law. If this exception would
occur the Contractor will keep a report of the actions taken to be in compliance
with the law and within the limits of confidentiality and HIPPA.
5. INSURANCE:
A) Contractor shall, at its own expense, carry and maintain occurrence type
professional liability insurance in amounts not less than one million dollars
($1,000,000.00) per occurrence and two million dollars ($2,000,000.00) in the
aggregate. If occurrence type liability insurance is not available, Contractor
shall purchase claims -made type professional liability insurance amounts not
less than one million dollars ($1,000,000.00) per occurrence and two million
dollars ($2,000,000.00) in the aggregate. Upon request, contractor shall
provide to Agency certificates of insurance evidence of the above coverage
and renewals thereof.
B) Upon termination of this agreement for any reason if Contractor
shall have purchased and carries claims -made professional liability insurance
during the term of this Agreement pursuant to subparagraph (a) above,
Contractor shall purchase all professional liability coverage in amounts no less
than one million dollars ($1,000,000.00) per occurrence and two million
dollars ($2,000,000.00) in the aggregate covering the acts and omissions of
Contractor in the event that it terminates its Claims Made Policy or ceases to
be insured in the State of Illinois.
6. DISAGREEMENTS: All matters of policy, rules, regulations, services, fees,
and other items of induct, wherein Contractor may be involved in carrying out
responsibilities, shall be jointly determined by Contractor and Agency.
7. TERM: The term of this Agreement shall be for a period of twelve (12) months
once the first wellness visit has been scheduled and renew yearly. Starting 2024,
the rate for a wellness visit will be $185.00. Either party may terminate this
Agreement at any time after 12 months without cause, upon no less than (30)
day's written notice given to the other party. In the event of termination, the final
visit shall be released 90 days after all required documentation is submitted to the
agency.
8. LOCATION OF SERVICES: if the location of services will be at a location
other than the FRWC offices, it is required that there will be a minimum of six
members during the daytime hours or four members in the evening or weekend
hours to be seen consecutively on the date the therapist is scheduled to meet at the
department with a usual goal of 7-8 members. Generally, wellness visit meeting
times can be scheduled between 0800-2000 hours, but they will need to be
consecutive meeting times. For example, 0800-1630 or 1100-1930 hours if
seeing eight members. FRWC may be able to meet outside of these hours based
on clinicians' availability
9. AMENDMENTS: This agreement may be amended at any time by written
instructions executed by the authorized official of Agency and Contractor.
10. BILLING: The Agency will pay bills within the requirements of the Local
Government prompt Payment Act (501LCS 505n. A wellness visit is $185.00 per
member for 2024.
11. CANCELLATIONS/NO-SHOW: We require a 24 hour notice for cancelations
of wellness visit. We do understand that your department works in emergency
services, so if there is an emergency, we suggest you have a backup for each
wellness visit. We will grant up to two (2) emergency absences per calendar year,
but all others will be a charge of $75.00. If there is a no show with no emergency,
there is a $75.00 fee for the therapists time.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year
first above written.
AGENCY: Deerfield Police De artin
Authorized Official for Agency: 01iMex' ilrli► .5410Z S' Date: oC'dZ T,102Y
Signature:
CONTRACTOR: First Responders Wellness Center/Dr. Carrie Steiner
Authorized Official for Contractor: Dr. Carrie Steiner Date: 12/06//233 7
Signature: c2 —/ 0 44 (/
477 E. Butterfield Rd. Suite 408 Lombard Il 60148
100 Tri State International Suite 260 Lincolnshire, IL 60069
1412 W. Washington Blvd. 2na floor Chicago, IL 60607
Main: 630-909-9094 Fax: 630-597-2583
Fee for Services 2024
Individual Debrief sessions: $190.00 for a 55 minute session.
Group Debrief sessions: $330.00 for a 90 minute session. Clinician will go to the
department for group debriefs or in one of our offices.
Wellness Visits: $185 for 55 minutes for 1 individual wellness visit for
departments less than 100 members. Over 100 members is $175.00 for 55
minutes.
Sessions 45 minutes $175 for departments with less than 100 and $165 for
departments with over 100 members.
Pre -Employment Testing: $610.00 This includes testing, clinical interview and
report.
Fitness for Duty Evaluations: $2475.00 This includes testing, clinical
interview, reviewing background information, report with recommendations.
Re-evaluations for fitness for duty: $1825.
FOID certification Testin : $720.00. This includes clinical interview, review of
documents, report, and report sent to Ill State police.
Presentations:
$225 per hour
4 hours is $800
8-hour day is $1650
Travel more than two hours away from Lombard office: All travel costs paid by
agency including all airfare and travel expenses (or if driving it is .54 cents per mile
of travel outside of Chicagoland/suburban areas) and all hotel expenses.
eerfieldt
olice
Department
Date: January 22, 2024
To: Kent Street, Village Manager
From: John J. Sliozis, Chief of Police
Subject: Request for Board Action — Resolution Approving an Agreement for
Professional Therapy Services with First Responder Wellness Center LLC.
On February 5, 2024 at the regularly scheduled meeting of the Mayor and Board of Trustees,
the Police Department will seek authorization to enter into an "Agreement for Professional
Therapy Services for Wellness Checks" with First Responders Wellness Center, of Lombard,
IL. 60148.
BACKGROUND
As part of Officer and Staff Wellness the Police Department desires to begin scheduling all
employees for a "Wellness Check" with star from the First Responders Wellness Center of
Lombard, Illinois. The "check" is a 55 minute one -on one session with a licensed mental health
professional to evaluate an employee's current abilities to cope with job stressors and to offer
additional healthy ways to deal with current and future stress. The clinicians are primarily former
first responders which helps build a professional rapport during the wellness check which is not a
fitness for duty evaluation, is not a form of punishment, and is not intended to screen for a
mental health diagnosis or disorder. The department is not given any information that is shared
in session unless of an emergency nature or required by law. Department and union
representatives have met with Center personnel to discuss session benefits and methodology and
are in agreement concerning the checks.
This will be the third time scheduling these "Wellness Checks" with the First Responders
Wellness Center and meets the requirements of the Illinois SAFE-T Act.
The cost is not expected to exceed $11,000 and is included in the FY 2024 Budget. The
agreement has been reviewed by Village Counsel.
RECOMMENDATION
The Department recommends the Mayor and Board of Trustees approve the Resolution
authorizing the Police Department to enter into the agreement to provide a Wellness Check for
each employee of the Police Department. This service will be provided by First Responders
Wellness Center, Lombard, IL 60148.
0,4 '
John J. Sliozis
Chief of Police