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9
ORDINANCE NO. 16,266
AN ORDINANCE TO AUTHORIZE THE CITY
MANAGER TO EXECUTE AN AGREEMENT WITH
BLUE CROSS AND BLUE SHIELD OF
ARKANSAS TO PROVIDE INSURANCE
COVERAGE TO QUALIFIED LITTLE ROCK
STUDENTS FOR DRUG AND ALCOHOL ABUSE
TREATMENT; WAIVING COMPETITIVE
BIDDING; AND FOR OTHER PURPOSES.
523
WHEREAS, the City of Little Rock declared in Little Rock,
Ark., Ord. 16,086 (August 20, 1991), its intent to combat the
proliferation of drug and alcohol abuse by teenagers and at -risk
youth; and
WHEREAS, one aspect of this program is assuring that
students that suffer from the effects of alcohol or substance
abuse receive appropriate medical treatment; and
WHEREAS, in this first year of the program has treated over
200 students for the primary and secondary effects of drug and
alcohol abuse; and
WHEREAS, the Fighting Back program has determined that
these initial results are indications of a successful effort to
combat drug and alcohol abuse affecting Little Rock citizens of
school age; and
WHEREAS, Arkansas Blue Cross and Blue Shield, a Mutual
Insurance Company, ('Blue Cross") has agreed to provide such
insurance and is the only company that has taken the steps to
get an insurance program approved by the Arkansas Insurance
Commission; and
WHEREAS, it is impractical and unfeasible to subject this
insurance contract to competitive bidding under the present
circumstances.
NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF DIRECTORS OF
THE CITY OF LITTLE ROCK, ARKANSAS:
SECTION 1. After consideration of the information provided
it, the Board of Directors find that the further implementation
of a program to counter the effects of drug and alcohol abuse,
particularly of school age children, fulfills a valid and vital
public purpose.
SECTION 2. The City Manager is authorized to enter into a
contract with the Little Rock School District and Blue Cross, in
0 -59
C— ('o
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524
a form substantia ly the same as that attached as Exhibit A to
this ordinance, for the purpose of providing qualified City
students with appropriate health care for drug and alcohol
treatment.
SECTION 3. Because Blue Cross is the only company that has
to date developed a policy of this type that has been approved
by the Arkansas Insurance Commission, and because Blue Cross has
worked so closely with the Little Rock School District and the
Little Rock, Arkansas, Fighting Back program, the Board finds
that it is impractical and unfeasible to subject this contract
to competitive bidding; therefore, the requirement of
competitive bidding is waived.
SECTION 4. EMERGENCY CLAUSE. Drug and alcohol abuse is a
severe problem directly affecting the health, safety, and
welfare of all citizens but particularly school -age children in
the City of Little Rock. This insurance programs needs to be in
place for the beginning of the 1992 -1993 school year which
begins on August 31, 1992, as one means of helping to eradicate
the devastating effects that alcohol and drug abuse have on the
classroom. Therefore, this ordinance shall be in full force and
effect from and after the date of its passage.
PASSED: August 18, 1992
(a e -�
APPROVED 0
CITY CLERK
AS TO FORM:
e-
is .rte
�- THOMAS -•1'i 01 5T
CITY ATTORNEY
...� .�
••
•
FIGHTING BACK! E
ARKANSAS BLUE
A MUTUAL
v
IBIT "A" 525
LANKET INSURANCE CONTRACT
WITH
CROSS AND BLUE SHIELD,
INSURANCE COMPANY
This is an agreement among Arkansas Blue Cross and Blue
Shield, A Mutual Insurance Company, hereinafter referred to as
"Insurer ", "we" or "us ", whose home office is located at 601 Gaines
Street, Little Rock, Arkansas and the Little Rock School District,
hereinafter referred to as "District," "you" or "your," whose
Administrative Office is located at 800 West Markham, Little Rock,
Arkansas, and the City of Little Rock, hereinafter referred to as
"City ", whose offices are located at 500 West Markham, Little Rock,
Arkansas.
ARTICLE I. WE AGREE:
- In consideration of the District's and City's execution of the
Application for Insurance and of the premium set forth in Schedule
A, attached hereto, Insurer agrees to provide Qualified Students
insurance coverage for drug and alcohol treatments subject to the
following terms and conditions:
SECTION I. Definitions
A. Plan: The Plan is the School Drug Insurance Program,
described in this Agreement, designed by Insurer for Qualified
Students of the District.
B. Student: A Student is an enrolled, full -time student of
the District in grades K -12, during the time this Agreement is in
force, certified as such by the District.
BIC
526
C. Gatekeeper: A designated person or persons who has the
Cnecessary training, certification and experience to evaluate the
drug or alcohol abuse patterns of Students to determine if eligible
Students qualify for the benefits available under the Plan. This
person or persons will be employed by the District.
D. Oualified Student: A Student that has been determined by
the Gatekeeper to qualify for services available under the Plan.
E. Designated Provider: A health care institution, located
in the same county as District, which is licensed and qualified to
render treatment for alcohol and drug abuse and which has entered
into an agreement with Insurer to participate in the Plan.
SECTION II. Benefits
A. Up to $360.00 per Qualified Student for Level 1
Treatment by a Designated Provider, Education and Counseling:
Treatment consists of (a) two one -hour group sessions per week for
up to four weeks, if necessary, and (b) one one -hour private
session and three two -hour group sessions with the Qualified
Student's family.
B. Up to $1,500.00 per Qualified Student for Level 2
Treatment by a Designated Provider, Intervention Group Therapy:
Treatment consists of (a) an initial assessment, (b) three one -hour
group sessions, per week for up to eight weeks; (c) follow -up with
two -hour group or one -hour individual sessions each week for six
months; (d) one one -hour private session and up to six two -hour
group sessions for the Qualified Students's family.
BIC 2
527
C. Up to $4,000.00 per Qualified Student for Level 3
Treatment by a Designated Provider, Limited Residential Care:
Treatment consists of (a) social, physical and psychological
assessment of the Qualified Student; (b) twenty -four hour
residential care for no more than seven days; (c) after residential
care, three -hour group sessions three times a week for six months;
(d) three one -hour private sessions and six two -hour group sessions
for members of the Qualified Student's family; (e) periodic drug
screening and (f) for Qualified Students with severe chemical
dependency, inpatient detoxification for up to three days.
D. Up to $13,500.00 per Qualified Students for Level 4
Treatment by a Designated Provider, Intensive Residential Care:
Treatment consist of (a) twenty -four hour supervised residential
living up to ninety days; (b) after care one one -hour individual
session per week or one two -hour group session per week for six
months; (c) Level 3 treatment components (a), (d), (e) and (f).
SECTION III. Limitations
A. No benefits are provided under this Contract to any
student other than a Qualified Student.
B. No benefits will be provided for admission of a Qualified
Student in Level 3 Treatment more than once during a twelve month
period.
C. No benefits will be provided for admission of a Qualified
Student in Level 4 Treatment more than once during a twelve month
period.
BIC 3
528
D. No benefs will be provided for •Qualified Student's
Level of Treatment which is not started while this contract is in
force.
E. No benefits will be provided for a Qualified Student's
Level of Treatment which is not provided by a Designated provider.
SECTION IV. Other Insurance
A. Designated Providers have agreed to accept payment under
the Plan as payment in full.
B. If any of the benefits under the Plan are available to a
Qualified Student under any other individual, group or blanket
disability insurance policy, health maintenance organization plan,
union welfare plan, employer or employee benefit organization,
self- insurance or any other non - regulated group disability benefit
plan, benefits of.the Plan will be reduced when the sum of:
1. Benefits that would be payable under the Plan in the
absence of coverage of the Qualified Student's other
insurance; and
2. The benefits that would be payable under the Qualified
Student's other insurance, in the absence of the Plan, exceed
the maximum Benefit, set forth in Section II. of this
Contract, for the Qualified Student's Level of Treatment.
In that case, the benefits of the Plan will be reduced so that they
and the benefits payable under the other insurance do not total
more than the maximum Benefits set forth in Section II. of this
Article for the Qualified Student's Level of Treatment.
SECTION V. Other Provisions
BIC 4
r
0 529
A. As a condition of coverage, District authorizes
Designated Providers to furnish Insurer, its agents, or any of its
subsidiaries, upon request, all records, or copies thereof,
relating to services provided under the Plan.
B. Notice and Proof of Claim
1. You must submit written proof of any treatment received
by a Qualified Student under the Plan not later than December
31 of the calendar year following the one in which such
treatment was received.
2. We shall furnish you such forms as are usually furnished
by us for filing proof of claim. If such forms are not so
furnished within fifteen (15) days after you give us written
notice of treatment of a Qualified Student, you shall be
deemed to have complied with the requirements as to proof of
claim upon submitting within the time fixed for filing proof
of claim (subparagraph 1. above), written proof covering the
occurrence, character and extent of loss for which claim is
made.
3. Benefits payable under the Plan will be payable
immediately upon receipt of written proof of claim.
C. Legal Actions. No court suits shall be brought to
recover from the Plan before sixty (60) days after written proof of
claim has been furnished in accordance with the requirements of
this contract. No legal action shall be brought after the
expiration of three (3) years from the time written proof of claim
is required to be furnished.
BIC 5
530
ARTICLE II. UNLESS OTHERWISE AGREED IN WRITING, THE CITY AGREES:
SECTION I. To pay us the premium charges set forth in
Schedule A of this Contract.
SECTION II. That the District is the member of Arkansas
Blue Cross and Blue Shield with authority to act in accordance with
Article V. of this Contract.
ARTICLE III. UNLESS OTHERWISE AGREED IN WRITING, THE DISTRICT
AGREES TO:
SECTION I. Act as the agent for your Students (not of us)
in all dealings between us and such Students including:
A. Notifying us of changes in Students' status;
B. Provide notice to us of a Student's acceptance into the
program, which Designated Provider and Level of Treatment.
C. Providing Students all communications and notices from
US.
SECTION II. Employ and train the Gatekeeper.
SECTION III. Hold Insurer harmless against any claims or
liability which may arise as a result of Gatekeeper's determination
of Designated Provider or Level of Treatment.
ARTICLE IV. ALL PARTIES AGREE:
SECTION I. This Blanket Insurance Contract and the
accompanying application constitute the entire contract among the
parties. All statements by you shall be deemed representations and
not warranties, unless there is fraud. No statement will be used
to void coverage or reduce benefits unless it is contained in a
written application.
BIC 6
531
SECTION II. We may amend the terms of is Contract. If we
do so, we will give 30 days written notice to you. Such change
shall be effective on the date fixed in the notice. Unless all of
the parties agree to another date, any change in benefits and
premiums shall occur on the anniversary date.
SECTION III. Any of the parties can cancel this Contract by
thirty days written notice to the others. We cannot cancel before
the last day of any period for which we have received premiums.
ARTICLE V. POLICY PROVISIONS RELATIVE TO MEMBERSHIP, MEETING
AND VOTING.
SECTION I. Annual Meeting. An annual meeting of the
members shall be held each and every calendar year in the State of
Arkansas for the purpose of electing directors, receiving and
considering reports as to -the. business and affairs of the
Corporation, and transacting such other business as may properly
come before the meeting. The meeting shall be held between January
1 and April 1 of each year at such place, date and time as shall be
fixed by the Board of Directors or the Chief Executive Officer.
The Board of Directors may, from time to time, provide that the
place, date and time of the annual meeting shall be set forth in
the policy of members as provided in Article III, Section 3 of
these ByLaws.
(THE ANNUAL MEETING OF THE MEMBERS SHALL BE HELD EACH YEAR AT
THE HOME OFFICE OF THE COMPANY ON THE THIRD THURSDAY IN MARCH
AT 1:00 P.M. (PROVIDED, IF SUCH DAY SHALL BE A LEGAL HOLIDAY,
BIC 7
532
THEN AT THE SAME TIME AND PLACE ON THE NEXT SUCCEEDING DAY
WHICH IS NOT A LEGAL HOLIDAY)].
SECTION II. Special Meetings. A special meeting of members
for any purpose may be called by the Board of Directors or Chief
Executive Officer, and shall be called by the Chief Executive
Officer or the Secretary at the request of members holding one -
third (1/3) of the voting power entitled to vote at such meeting.
Such request shall state the purpose or purposes of the meeting and
no other business outside the scope of the stated purpose or
purposes shall be transacted. Unless ordered by the Board of
Directors, the time and place of each special meeting of members
shall be determined by the Chief Executive Officer.
SECTION III. Notice of Meetings. So long as each insurance
policy issued by the Corporation sets forth the place, date and
hour of the annual meeting of members, no notice of any annual
meeting shall be required to be given to any member, regardless of
the number or nature of proposals to be considered and voted upon
at the annual meeting. If notice of the annual meeting is not set
forth in each insurance policy, written or printed notice of the
annual meeting and every special meeting of the members, stating
the place, date, time and the purpose or purposes of such meeting
shall be given to the members entitled to vote at such meeting not
less than ten (10) , nor more than sixty (60) , days before the date
of the meeting. All such notices shall be given, either personally
or by mail, by or at the direction of the Chief Executive Officer
or Secretary unless ordered by the Board of Directors. Notices
BIC 8
533
which shall be mailed shall be deemed to be "given" when deposited
L.
in the United States Mail addressed to the member at the member's
address as it appears on the records of the Corporation, with
postage prepaid [first class mail, if the notice is mailed thirty
(30) days or less before the date of the meeting), and any notice
transmitted other than by mail shall be deemed to have been "given"
when delivered to the member.
SECTION IV. Ouoru m. Except as otherwise proviaea by
applicable law, a majority of the members of the Corporation
(present in person or by proxy) shall be necessary to constitute a
quorum for the transaction of business at any annual or special
meeting of the members of the Corporation.
SECTION V. Voting Riahts. Each member shall be entitled to
one vote for each policy held by him -upon each matter coming to a
vote at meetings of members. Provided, a group policyholder shall
be entitled to a number of votes equal to the number of certificate
holders insured under the group policy. Such vote may be exercised
in person or by written proxy.
SECTION VI. Vote Required. A majority of the voting power
represented at any meeting of members shall be necessary and
sufficient to approve any given matter. There shall be no
cumulative voting.
SECTION VII. Proxy. At all meetings of members a member may
vote by proxy executed in writing by the member or by the member's
duly authorized attorney in fact. Such proxy shall be filed with
the Secretary before commencement of the meeting or at such later
BIC 9
• • 534
time as shall be expressly permitted by the Corporate officer
presiding at such meeting. Each application for an insurance
policy issued by the corporation shall contain a provision pursuant
to which the policyholder thereof grants a revocable proxy to the
Board of Directors with respect to all matters to be considered and
voted upon by members at any meeting for the term of such insurance
policy.
BIC 10
ARKANSAS BLUE CROSS AND BLUE SHIELD,
A MUTUAL INSURANCE COMPANY
601 Gaines Street
Little Rock, Arkansas 72201
(herein called the Company)
BLANKET INSURANCE APPLICATION AND PROXY
COMPANY, IN CONSIDERATION
of the application made by
LITTLE ROCK SCHOOL DISTRICT
(herein called the District)
M
Blanket Insurance Contract Number 1 and in consideration of payment
by the City of the charges as herein provided in Schedule A, agrees
to provide the benefits described in the Blanket Insurance
Contract. This agreement shall be for a period of Twelve (12)
months beginning at 12:01 a.m. on August 24, 1992, (the Effective
Date) to August 24, 1993, (the Anniversary Date) and from year to
year thereafter, unless the Contract is canceled as provided
therein. The premiums shall be paid in advance of the Effective
Date and thereafter as provided herein. This Application is made
and delivered in the State of Arkansas. It is governed by the laws
of such and is subject to the terms and conditions of the Group
Contract, which is a part of this Application by reference.
Signed at Little Rock, Arkansas, this �/ tf day of
1992. 7-
ARKANSAS BLUE CROSS AND BLUE SHIELD,
A MUTUAL INSURANCE COMPANY
Authorized Signature
BIC 11
LITTLE ROCK SCHOOL DISTRICT
Authorized Signature
535
10� own
PROXY
536
I hereby appoint the Board of Directors ( "Board ") of Arkansas Blue
Cross and Blue Shield, A Mutual Insurance Company ( "Company ") as my
proxy to act on my behalf at all meetings of members of the
Company. This appointment shall include such persons as the Board
may designate by resolution to act on its behalf. This proxy gives
the Board, or its designee, full power to vote for me on all
matters that may be voted upon at any meeting. The annual meeting
of Members is held each year at the home office of the Company on
the third Thursday of March, at 1:00 o'clock p.m. beginning March
17, 1988. If the third Thursday of March is a legal holiday, then
the meeting will be at the same time and place on the next day
after, which is not a legal holiday. Special meetings may be
called upon notice mailed not less than ten (10) nor more than
sixty (60) days prior to such meeting. This proxy, unless revoked,
shall remain in effect during my membership in the Company. I may
revoke this proxy in writing by advising the Company of such at
least five (5) days prior to any meeting. I may also revoke my
proxy by attending and voting in person at any Member's meeting.
800 West Markham, Little Rock, Ar.
Address
LITTLE ROCK SCHOOL DISTRICT
By:
ignature and Title
Dated this 7 1 "j - day of C( (a_/� t!¢ 1992.
BIC 12