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Mingus on-site medical clinic may be feasible
Board learns details of Lake Havasu School District clinic
8/7/2012 6:32:00 PM
By Philip Wright
COTTONWOOD - The Mingus Union High School Governing Board met in a special work session Monday afternoon to hear how the on-site medical clinic for the Lake Havasu Unified School District came about and how it is working. Lake Havasu District opened such a clinic for its employees and dependents May 1.
The Mingus board is considering opening an on-site medical clinic in an effort to reduce health-care insurance costs for the district.
The board recently took action to eliminate coverage for employee dependents. One month later, the board voted to hold off on taking away dependent coverage until Dec. 31. That move was intended to give the board time to investigate whether an on-site medical clinic would work for the district.
David Stewart, vice president of the Employee Benefits Department of Webb & Greer Insurance Agency (WGI) in Tempe, spoke to the Mingus board and answered questions. He has worked with the Lake Havasu District and its trust for years.
Stewart explained that the Lake Havasu District's clinic has two nurse practitioners, one full time and one part time. The clinic also has a part-time medical doctor and two medical technicians. He said the clinic has early morning and late afternoon hours and is open for a few hours on Saturday.
He also explained that the district's board was not involved in the decision to open the clinic, and no maintenance and operation budget money was used. Instead the district's trust made the decision and provided the start-up costs for the clinic.
The Lake Havasu District clinic was located in a vacant office building that had to be renovated and brought up to code. At this time, the Mingus administration and board is looking at placing the clinic and its nurse practitioner in the same space currently used by the school's nurse to provide care to students. The school nurse is provided by the Verde Valley Medical Center.
"It's been very well received," Stewart said. Although he added that the clinic is not without opponents. "Some doctors are not happy with us."
He said that the employees and dependents that have used the clinic so far have given positive feedback.
"From 99 percent of reports, they absolutely love it," Steward said. He pointed out that one of the positive things for employees and dependents is that the medical staff is able to spend more than five minutes with each patient.
"We don't do specialty care," Stewart said. "We have a referral program."
Board member John Tavasci Jr. asked Stewart if there were many employees who decided not to participate.
"We don't know yet," Stewart said. He added that the clinic hasn't been open long enough to get good numbers on the percentage of employees who are willing to use it.
Stewart said the Trust of the Lake Havasu School District anticipated that between three and five years after opening the clinic cost savings will be at least $1 million.
He said that Lake Havasu District employees still have their regular health-care coverage, which allows them to go to their regular providers. Their co-pays have not changed, at least for the first year. When those employees and dependents go to the clinic, there is no co-pay. Basically, there has been no change to the employee's primary care.
He said the co-pay system and the deductibles could change next year for the Havasu District employees and dependents.
Tavasci asked Stewart if, in theory, the district could save enough money to pay for the clinic by hiring a nurse practitioner.
Stewart explained that in Lake Havasu the doctor and nurse practitioners are not district employees. He said the board did not want employees seeing employees for confidentiality reasons.
"It's not cheap," Stewart told the Mingus board. He said that some school districts would love to open such a clinic, but they do not have the money.
But, according to Stewart, the concept of on-site medical clinics is growing in education, industry and government. "We're on the cusp of this growing throughout the country," he said.
Stewart told the board that the district could encourage its employees and dependents to take advantage of a clinic by raising their deductibles and eliminating their co-pays. It all comes down to saving enough money in reduced insurance costs to pay for the clinic.
Mingus currently pays $6,300 for each employee's individual health-care insurance. The district also is paying each employee who has dependents covered an additional $4,002 for them to put toward the coverage. The employees with covered dependents are currently paying $5,100 out of pocket for the dependent coverage. Once their dependent coverage is eliminated, they will be paying $9,102 to insure their families.
Stewart said he would not be comfortable seeing a district with no more than 100 employees going to the on-site clinic program. Mingus has about 120 employees, but with dependents that number goes up to around 180 to 200.
At this time, the Mingus board is looking into opening the clinic idea up to other school districts, including Cottonwood-Oak Creek, and even to the City of Cottonwood and other entities, such as fire districts. David Snyder, director of business services for C-OC, attended the work session.
Mingus School Board President Jim Ledbetter said that one idea he considers viable is to work out an agreement with the Verde Valley Medical Center to operate the clinic. In that situation, the district would contract with the hospital for services.
He also suggested that maybe the district would want to look at taking away its employee and dependent co-pays and raise their deductible to $2,500. Once the deductible is met, employees would be covered 100 percent thereafter.
"Your cost at the center is a fixed cost," Ledbetter said. "You negotiate that up front."
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