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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. 0 I' . t 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. ' a t 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, &1U Gail Garmon Employee Benefits Coordinator