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HomeMy WebLinkAbout02/18/2021Indian River County Florida Indian River County Administration Complex 1801 27th Street, Building A Vero Beach, Florida, 32960-3388 www.ircgov.com Meeting Minutes - Final Thursday, February 18, 2021 9:00 AM Employee Health Clinic Workshop This meeting can be attended virtually via Zoom. Instructions can be found at the end of this agenda and also online at www.ircgov.com. Commission Chambers Board of County Commissioners Chairman, Joseph E. Flescher, District 2 Bice Chairman, Peter D. O'Bryan, District 4 Commissioner Susan Adams, District 1 Commissioner Joseph H. Earman, District 3 Commissioner Laura Moss, District 5 Jason E. Brown, County Administrator Dylan Reingold, County Attorney Jeffrey R. Smith, Clerk of the Circuit Court and Comptroller Terri Collins -Lister, Deputy Clerk Board of County Commissioners Meeting Minutes - Final February 18, 2021 1. CALL TO ORDER 2. ROLL CALL Present: 5 - Chairman Joseph Flescher Vice Chairman Peter O'Bryan Commissioner Susan Adams Commissioner Joe Earman Commissioner Laura Moss 2.A. A MOMENT OF SILENT REFLECTION FOR FIRST RESPONDERS AND MEMBERS OF THE ARMED FORCES 2.B. INVOCATION Mr. Stan Boling, Gracespring Covenant Church 3. PLEDGE OF ALLEGIANCE Commissioner Laura Moss 4. ADDITIONS/DELETIONS TO THE AGENDA / EMERGENCY ITEMS A motion was made by Vice Chairman O'Bryan, seconded by Commissioner Moss, to approve the Agenda as presented. The motion carried by the following vote: Aye: 5 - Chairman Flescher, Vice Chairman O'Bryan, Commissioner Adams, Commissioner Earman, and Commissioner Moss 5. DEPARTMENTAL MATTERS S.A. Human Resources 5.A.1. 21-0258 Health Plan and Employee Clinic Workshop Recommended Action: Workshop to review and discuss an Employee Health Clinic. Future action to be determined at the workshop. Attachments: Staff Report Cocoa IRC Schools Martin County BoCC Martin County Sheriff Office Plantation Port St. Lucie St Lucie County Bocc City of Stuart Indian River County Florida Page 1 Board of County Commissioners Meeting Minutes - Final February 18, 2021 Human Resources Director Suzanne Boyll recalled the Board's request for staff to bring back information on an employee health clinic. In a PowerPoint Presentation, Director Boyll gave an overview of the County's current health plan design, the total members enrolled, and the payroll deductions for the Gold and Silver Health Plans. Chairman Flescher along with Commissioner Earman sought and received clarification from Director Boyll on the number of members and retirees including their dependents enrolled in the County's health plan. Director Boyll discussed the County's health plan costs pointing out that 70% of the medical claims and 20% of pharmacy claims less the rebates accounted for those costs. She reviewed the County's implementation of cost -savings measures for the health plan: an additional prescription savings program, an option for a lower premium health plan known as the Silver Plan, increased emergency room copays, and the Telemedicine benefit. Vice Chairman O'Bryan sought and received information from Director Boyll in regard to the high dollar prescription claims review process and his concern on how it could impact an employee's health if a different medication was prescribed than what had been recommended by the doctor due to cost. Mike Meredith, Executive Vice President with Lockton, the County's Insurance Broker, stated that Lockton employs pharmacologists to determine what drugs give the same health outcome or better to keep the costs down. Ms. Boyll responded to Commissioner Moss that the increase in the expenditures for the pharmaceuticals could be related to the higher cost medication or a chronic condition. County Administrator Jason Brown pointed out the rising cost of prescription drugs were a problem; however, the implementation of the prescription savings program over the years had resulted in a savings. Director Boyll reviewed other health savings options the County had explored and stated the County was currently undertaking an analysis of savings on a supplemental benefit for non -emergent surgeries called SurgeryPlus and Marketing of Pharmacy. Director Boyll and Mr. Meredith detailed the SurgeryPlus supplemental benefit and provided information to the Board on the access to the network of Surgeons of Excellence nationwide where they bundle the pricing for procedures. She indicated if it was something the County wanted to pursue, it would be voluntary participation for the member and under this service incentives could be built in such as member deductibles and copays waived. Director Boyll outlined the primary cost drivers of the health plan and pointed out the cost drivers would always be there regardless of whether there was an employee health clinic. She turned the Board's attention to the employee health clinic and Indian River County Florida Page 2 Board of County Commissioners Meeting Minutes - Final February 18, 2021 stated that out of the fourteen (14) employers that had responded to the clinic survey, only eight (8) employers had employee clinics. She reviewed the results of the survey and emphasized that the employee clinics were unique to its employer. The Board sought information on the reason the City of Palm Bay closed their employee clinic, two employee clinics in a location versus one employee health clinic, and the number of retirees that reside in the County. Director Boyll replied there was no reason given on why the City of Palm Bay had closed their employee clinic and emphasized the importance of utilizing consultants to guide the clinic evaluation and vendor selection process. She did not have a breakdown of the number of retirees, but pointed out that 54% of enrollees live within a ten mile radius of 32960. A discussion followed on the survey in regard to the retirees with Commissioner Earman stating some of the surveys indicated limiting the employee clinic to the age of 65 and under because of Medicare. Melissa Anchia, Lockton Health Risk Solutions Expert, via Zoom, used the PowerPoint Presentation to discuss the challenges and opportunities with the different types of clinic services and staffing options. Vice Chairman O'Bryan sought and received information from Ms. Anchia regarding when an employee would utilize the clinic and also received clarification from Commissioner Earman on a Nurse Practitioner and Physician Assistant's scope of work. Ms. Anchia spoke on the opportunities and challenges with on-site; near -site, virtual, retail/community based, direct primary care locations, and how the estimated value and return on investments on an employee health clinic were measured noting the employer may not see results for several years. She presented an example of a recently implemented clinic with their goal to provide a competitive benefit to members combined with a three year goal for risk reduction and medical plan savings. She pointed out some of the key performance indicators that clients were looking for was the number of clinic users, the estimated value in clinic services provided, the savings and the top visit types. She concluded that Lockton looked at several key metrics from the Indian River County Health plan data to demonstrate the plan savings through the diversion of community visits to the clinic, risk reduction, and how it could translate into a clinic strategy. Director Boyll stated that the survey respondents with a clinic indicated a savings and overall value; however, she was unable to get tangible numbers to support their savings. She proposed implementing a wellness strategy into the clinic that could result in a positive impact to individuals on the health plan and potentially impact future claims, but noted it would be an additional service to be administered and managed. Director Boyll concluded that staff was unable to provide any assurances that overall plan costs would be reduced by the implementation of a clinic; however, there would be perceived value from the members who utilized the clinic. She indicated that if the Board determined it was in the best interest of the plan and its covered members, staff would bring back an agenda item to recommend the Board engage the services of Lockton Companies Clinic Consulting Services in the amount of $75,000. Indian River County Florida Page 3 Board of County Commissioners Meeting Minutes - Final February 18, 2021 The Chairman called a recess at 11: 00 a. m., and reconvened the meeting at 11:10 a.m., with all members present. Commissioner Moss referred to the percentage of plan members that lived within the 10 -mile radius of the 32960 zip code and she inquired on the number of walk -in -clinics within that 10 miles radius. She questioned the origin of the employee health clinic and asked if it was something the employees had requested. Director Boyll did not have information on the number of walk -in -clinics within the 10 -mile radius and confirmed that some employees had come forward and made reference to other employers with health clinics. She indicated that the employee group had not been surveyed as a whole in regard to an employee health clinic. Commissioner Moss felt it was important to survey the employees and mentioned incorporating a wellness program apart from establishing a clinic. Vice Chairman O'Bryan sought and received clarification from Director Boyll and Mr. Meredith on the StopLoss Premiums and the analysis that Lockton used to predict the number of high cost claimants. He was open to further exploration of an employee health clinic, but expressed concern with under -utilization. County Administrator Brown further discussed that everyone under the plan had access to a once -a -year wellness visit at no cost. Chairman Flescher was very interested in an employee health clinic for patient care, and he emphasized that the County needed to consider the reduction of costs through other options or plans. He felt it was critical to survey the employees for their interest in an employee health clinic. Commissioner Earman was interested in looking at options to keep the Employee Health Plan costs down and agreed that the County needed to take a further look into an employee health clinic. He added that an employee health clinic could be more than a health advocate for the employees, such as the first step in the Worker's Compensation process, and could be utilized for drug testing or physicals if required by the County. He also wanted to look at partnering with other agencies within the County. Commissioner Adams had the same questions and observations as Commissioner Earman and felt there were opportunities to partner with other entities to help offset costs. She thought it was important that the respondents with clinics indicated that they received a perceived savings, and that their employees looked at it as a positive value. She also felt the County needed to address the unnecessary Emergency Room visits. She opined there was not enough information in the presentation to make a decision and was in favor in obtaining additional information in order to move forward. Indian River County Florida Page 4 Board of County Commissioners Meeting Minutes - Final February 18, 2021 The Chairman opened the discussion to public comment. John O'Connor, President of the Indian River County Firefighters Association Local 2201, referred to the presentation and felt the insurance was not affordable or competitive. He urged the Board to look at other venues or opportunities for health savings in order to be competitive in the marketplace and retain the best employees. County Administrator Jason Brown summarized the Board's desire to further look into an employee health clinic and recommended bringing back an agreement with Lockton at a future Board meeting. He suggested looking into partnering with other entities and preferred not to build a stand alone clinic, but contract with other clinics, and he addressed the need to drive down the number of emergency room visits. County Administrator Brown agreed with Commissioner Moss that it was important to survey the employees to determine their overall interest because that would drive the success or lack of success of an employee health clinic. In response, Commissioner Adams cautioned that there was not enough information on an employee health clinic for an employee survey and the importance of marketing the clinic to the employees. Chairman Flescher was for an employee survey and felt it was important to know the hours the clinic would be available to the employees. Commissioner Earman referred to Director Boyll and County Administrator Brown on whether the employee's health plan and the employee health clinic were considered as two separate items. County Administrator Brown replied that the employee health clinic would become part of the County's health plan. A discussion followed on the process once the County decided to move forward. Ms. Anchia and Mr. Meredith detailed the different phases of the process indicating the total process would take up to 12 months. The Chairman asked if there was anyone who wish to speak; there was none. He indicated that there was a consensus among the Board on the County Administrator's pathway to move forward with an employee health clinic and thanked everyone for their input. It was the consensus of the Board to: 1) determine through an employee survey, the overall interest of an employee clinic; 2) return to the Board at a future meeting with an agreement for a consultant to further look into Employee Clinics; 3) look into partnering with other groups such as the School Board, City of Vero Beach, etc.; 4) preferred not to build a stand alone clinic, but contract with other clinics; and 5) address the number of Emergency Room Visits. Indian River County Florida Page 5 Board of County Commissioners Meeting Minutes - Final February 18, 2021 6. ADJOURNMENT There being no further business, the meeting adjourned at 12:05 p.m. Indian River County Florida Page 6 Board of County Commissioners Meeting Minutes — Final , February 18, 2021 Jeffrey R. Smith, CPA, CGFO, CGMA Clerk of Circuit Court and Comptroller By: 0a" Deputy Clerk SPECIALCALL/TCL/2021 Minutes Approved: MAY 1 8 ; 2021 "'"'•R��ERCO Indian River County Florida Page 7