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Employee Benefit Trust Minutes - 02/14/2011 City of Wichita Falls Employee Benefits Trust Board Minutes February 14, 2011 The meeting was held in the City Council Conference Room, 1300 Seventh Street, Wichita Falls, TX 76301. Present: Darron Leiker, City Manager Jim Dockery, Asst. City Manager/CFO Miles Risley, City Attorney Tammy Guerra, Human Resources Manager Becky Chapman, Employee Benefits Coordinator Agenda Items: i. Call to Order: Meeting was called to order at 2:00 pm. ii. Approval of Minutes: Motion was made by Jim Dockery to approve the January 11, 2011 minutes, second by Tammy Guerra. The motion carried unanimously. iii. Consideration and possible approval of IPS recommendations and strategic plan for the employee clinic —Tammy reviewed the recommendations that IPS provided in a letter to the City. a. IPS recommended that the City obtain appropriate reporting from the onsite clinic personnel to evaluate the cost of occupational injury and sickness visits against outsourcing these services through an off-site third party. The board agreed to gather the appropriate reporting and consider further research on this recommendation. b. IPS recommended that the City consider frosting the glass in the waiting room of the onsite clinic to partially eliminate privacy concerns. Tammy will speak with Delbert Gales about getting this installed. IPS also recommended that the City evaluate the feasibility of installing the necessary plumbing to support a private bathroom within the clinic. Presently, the clinic escorts patients to the public restrooms. IPS wanted to see if there was a possibility to build a restroom inside the clinic. Tammy stated that the numbers were not readily available; however, there might be other options. Option #1- Research the cost of sending the patient directly to the lab for collection of the urine sample instead of collecting it on-site and see which would be more cost effective. Option #2- Create a separate stall in the women's restroom by bringing down the wall that separates the restrooms from the onsite clinic. So the onsite clinic would have direct access to the restroom. However, the board agreed that it is more a concern of the clinic than the employees. Employees, as far as it is known, have not complained about it. c. IPS recommended that the onsite clinic consider rearranging the office layout because the waiting rooms are very close to the exam rooms. IPS was concerned that this might be a HIPPA violation. Possible remedies would be to relocate an exam room or look into sound proofing them. The board agreed to gather the i appropriate research and consider further action on this recommendation at a later date. d. IPS recommended the City consider co-pay collection by clinic personnel rather than Human Resources to mitigate privacy concerns. IPS further recommended the current $5 co-pay lever be maintained for clinic visits. Presently employees go to the Human Resources office to pay for a clinic visit. An alternative option would be to have employees pay for their visit at the clinic instead of in the HR office. The board agreed to gather the appropriate research and consider further action on this recommendation at a later date. e. IPS recommended the City consider implementing a short employee survey that would be filled out after a clinic visit to gauge satisfaction with services provided and PA Performance. They also recommended that Mr. Phyllis develop employee communication pieces educating the employee population about the services performed through the clinic and the qualifications of a Physician's Assistant. Tammy stated that implementing patient satisfaction surveys would be an easy, efficient and cost effective method of collecting patients' feedback. Mr. Phillis agreed to provide educational materials to help the employee population understand the qualifications of a Physician's Assistant. Mr. Phillis also stated that he would not mind giving presentations to different departments about the services that the clinic provides. f. IPS recommended the City require the onsite clinic staff to undergo HIPAA privacy and security training and to consider a designated person within the clinic to obtain a professional HIPAA certification. Tammy shared with the board that this particular recommendation, along with a few others, would require the direct cooperation and willingness of the clinic management. A letter will be drafted outlining the recommendations and soliciting feedback from Mr. Phyllis. g. IPS recommended a number of reports be generated from the clinic for the EBT board's consideration. They further recommended that the City should evaluate Electronic Medical Record (EMR) software, which could potentially supplement the reporting, provided through the clinic. Without an EMR in place, it is difficult to discern if the onsite clinic is cost effective. The board agreed to gather the appropriate research and consider further action on this recommendation at a later date. A letter will be drafted outlining the recommendations and soliciting feedback from Mr. Phyllis. Open Session- a. Darron questioned who is eligible for the free Wellness Program benefits. Tammy and Becky explained that all employees and their dependants that are on the City's health insurance should not pay for the lab work/wellness visit if it is considered routine. However, if the doctor states it is not a routine procedure/visit that the employee will be charged. b. Darron brought up news that a Florida judge mentioned that the Health Care Reform Act is unconstitutional and should not be enforced. Miles explained that it has been declared unconstitutional; however, there has been a declaratory judgment which means the government can still enforce it and not declare an injunction to prohibit the act. c. The provisions in the healthcare reform act that will be most costly for the City is the loss of annual and life time benefits limits. Some entities have asked for exemptions on these provisions and to the surprise of many, the federal government has issued them quite liberally. The exemption is renewed annually, and it will only be good for four years (until 2014). The exemptions will not be available after 2014. Darron asked if government entities qualify for the exemptions. Miles stated there have been municipalities that have been exempt. Tammy questioned if City grandfathered status would have any impact on the exemption. Miles responded that more than likely it does not matter. Tammy also asked if the City needs to show economic hardship to be eligible. Miles affirmed that the City would need to explain that they would be in economic jeopardy with out the exemption. h. Adjourn at 2:50 pm.