Employee Benefit Trust Minutes - 08/04/2005 ti
CITY OF WICHITYA FALLS
EMPLOYEE BENEFITS TRUST MEETING
August 4,2005
Present: Bill Sullivan, Chair
Darron Leiker, Interim City Manager
Gail Garmon, Employee Benefits Coordinator
Joe Bryan, PA (On-Site Clinic)
The meeting was called to order by Bill Sullivan at 10:00 AM
Agenda Items:
Approval of Minutes
Darron Leiker made a motion to accept the minutes of the last meeting with no
corrections. Bill Sullivan seconded the motion. Motion carried.
Discussion of On-Site Clinic
Bill Sullivan explained that over the last couple of months,the Employee Benefits Trust
Board had been reviewing each aspect of the benefits offered to City employees. As a
part of that review Joe Bryan was asked to review the inner workings of the City's On-
Site Clinic.
Joe presented a folder of documents outlining the services offered through the clinic and
the contractual agreement between the City and Joe Bryan&Associates. He explained
that of the 42 hours (at $225.00 per hour)the Clinic is open each week, about 60% is
spent seeing employees for personal illness,and the other 40% is for Risk Management
(Work/Comp) and pre-employment. He further explained how the laboratory procedures
performed in the On-Site Clinic are done at a much reduced rate through agreements with
United Regional Reference Lab. This represents a big savings for the patients,the City's
Health Plan and the Risk Management fund.
Jim Dockery asked Joe for clarification as to how the patient referral system works and
how many patients seen in the On-Site Clinic are then referred out to other doctors. Joe
explained that when possible,patients are treated in the On-Site without being referred
out. Patients with illnesses out of the expertise of himself and Ken Phillis, PA, are then
referred out to specialists or family practice doctors.
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Darron Leiker inquired as to when the fee paid to Joe Bryan(his hourly rated paid by the
City)was negotiated and if there was any automatic cost of living built into the contract.
Joe explained that his contracted fees have not been renegotiated in several years and that
there is no cost of living provision in his contract.
Joe suggested to the Board that the $10.00 the employee pays to visit the On-Site Clinic
generates little money and if that were decreased and the services (office visits) were
offered free of charge,that the use of the On-Site Clinic would probably increase
considerably.
Darron Leiker reported that the County has inquired as to the possibility of an agreement
between the County and City to allow County employees and their dependents to use the
City's On-Site Clinic. Joe Bryan stated that the clinic could handle the County patients if
such an agreement were interred into.
Jim Dockery inquired as to what the City paid outside of the $225 hourly rate. Joe
explained that the City pays for any vaccines, topical medications and medical supplies
used by the Clinic. The City also pays $250.00 per week to Tom Talbert, MD to oversee
the Clinic. In addition, the City pays the United Regional Reference Lab for their
services. Out of the $225 per hour rate paid to Joe Bryan & Associates, Joe pays the
second PA, Ken Phillis and the two assistants working in the Clinic. This includes the
24/7 on-call services.
Bill Sullivan asked about mal practice insurance which Joe explained was carried by Dr.
Talbert, himself, and Ken Phillis.
Darron Leiker wanted to know what other suggestions Joe had for getting more of the
City employees to use the On-Site Clinic. Joe explained that the Clinic is limited on
space and there is no restroom facility within the Clinic. Jim Dockery asked about the
availability of the Clinic and the hours of operation. Joe explained that in the past they
had tried having the Clinic open on Saturday mornings but that it was not utilized.
Jim Dockery asked about how the On-Site Clinic had come into being. Joe Bryan
explained that the former Administrator had wanted to enter into an agreement with the
Clinics of North Texas (where he worked at the time) and that an agreement could not be
reached. He was approached by the Administrator and they formed the On-Site Clinic
here in the auditorium. That was fourteen years ago.
Joe then explained how use of the On-Site Clinic for pre employment allows the pre
employment physicals and drug screens to be done and back to the City in a very short
amount of time allowing for better and quicker hiring, etc.
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Bill Sullivan asked whether or not Joe felt it was a good idea to have the Clinic here in
the building. Joe said that he would prefer to see it in a more central location and with
more space. One suggestion was at the current Health Department once that facility is
added onto which is scheduled for the near future.
Jim Dockery expressed concern that there are not enough patients being seen in the On-
Site Clinic for the $225 per hour that is being paid. It was discussed that the referral
situation (Plan D) might not be a good idea and might need to be discontinued. These
patients would need to be seen in the Clinic first and hopefully have no need to go
elsewhere. Jim Dockery also expressed concern that those enrolled on Plan D of the
City's health insurance are getting services for less than is charged to those on other
plans. This is particularly true with regard to lab procedures. The possibility of requiring
all lab work to be done at the On-Site Clinic (regardless of the plan) to allow for the
reduction in lab fees for all plans, was discussed. Jim Dockery suggested the possibility
of requiring employees on Plan D to use the On-Site Clinic for "primary care". Darron
Leiker expressed his concern over how this type situation would be perceived by the
employees.
Darron Leiker inquired as to whether or not Joe Bryan had any opinions about the City's
overall health insurance. Joe explained that he felt that the City was getting so much
more for the money than would be available through a private carrier. Using a third party
administrator or private carrier would cost considerably more than is currently being
spent for the employee and dependent coverage. Primarily because the City is self-
insured, self-administered.
Bill Sullivan explained that, although the Board is, overall, satisfied with the On-Site
Clinic procedures and services, they felt it their duty to seek proposals from other sources
prior to the January 2006 renewal of the contract. After discussion of other clinics in the
City and services they could provide, it was decided that the Board would draft an RFP to
get proposals for the clinic services.
Meeting was adjourned at 12 Noon.
Re pectfully su mitted,
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Gail Garmon
Employee Benefits Coordinator