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HomeMy WebLinkAboutInformal Minutes 11-24-2009BOARD OF COUNTY COMMISSIONERS ST. LUCIE COUNTY, FLORIDA INFORMAL MEETING Date: November 24, 2010 Convened: 1:30 p.m. Commissioners Present: Chairman, Charles Grande, Doug Coward, Paula A. Lewis, Chris Dzadovsky, Chris Craft Others Present: Faye Outlaw, County Administrator, Lee Ann Lowery, Asst. County Administrator, Carl Holeva, Human Resources Director, Athena Adams, Deputy Clerk AUDUBON DONATION AND OXBOW CLASSROOM Opening remarks were made by the County Administrator. The County Administrator alluded to a discussion held at the last Strategic Planning Session and addressed the fact they had decided to cancel several projects due to lack of funding. They also recommended deferring certain projects. This project was one cancelled due to the construction anticipated at 1.5 million. They had partial funding. Some of the funds ($300,000) were anticipated to be from impact fees, however these funds came in question due to the county was in a labor dispute with the City of Port St. Lucie. $162,000+ were to be allocated from the general fund and $100,000 indicated in the memorandum, this left a gap. The Board gave direction to cancel the project due to the shortfall. The $162,000 was placed in the fund balance to help close the shortage moving forward. They have had interest from Ms. Murphy who bequeathed $100,000 and asked what was the county's intent with the funds. She believes there are opportunities to apply for grants and some funding opportunities to assist with the construction along with possible impact fees. She requested direction from the Board. The Assistant County Administrator requested being able to explore keeping this project alive and pursue the grants. They need to investigate the time line and see what they could pull together. Com. Craft questioned the cost of operating. She stated this is something they need to explore this and they would need to create a structure they could use as a classroom and also be used by the Audubon Society. The County Administrator stated they would investigate this and come back to the Board with the information regarding the funding and requested the green light to move forward. Com. Dzadovsky stated he would like to make sure they will all be able to work together and also work out the administrative issues. Com. Coward recommended investigating the possible funds and if it is not possible they should refund the money. Com. Grande questioned when they would be able to provide the information to the Board. The County Administrator stated she would work expeditiously and attempt to have it after the first of the year. The Board concurred. EMPLOYEE HEALTH CLINIC The Human Resources Director addressed the Board on this item. PHYSICIANS IMMEDIATE CARE Dr. Kenneth Palestrant, MD addressed the Board and presented his proposal for their consideration. (Presentation attached). Dr. Palestrant advised the Board that the employees would be seen at all of his locations and then the entity would be invoiced at the end of the month for those patients seen. He believes you have to balance both quality health care and the costs. The clinics provide a number of services at their locations, i.e. intervenus therapy, respiratory therapy, lab work done on premises and prescriptions provided on site also. Dr. Palestrant addressed the accessibility and availability of his locations. His clinics are open until 7:00 p.m. nightly and 9 a.m. to 5:00 p.m. on Saturday and Sunday. Com. Coward questioned why they did not submit to the original RFP. Dr. Palestrant stated they were in the process of opening a new location and also the fact the idea of having an onsite clinic proposed model he felt they could provide a better model of having employees come to their locations. The Human Resources Director stated their model was to have an employee health clinic on site. There were other responders however they presented alternatives to the onsite clinic model. Dr. Palestrant advised the Board they presently have 120 prescriptions in the location they can administer. Also there is no charge for the second visit within the 10 days of the first treatment for the same condition. CARE HERE PRESENTATION The Crown Consulting Group representatives addressed the Board and provided a presentation on the Employee Health Center. The representative gave an overview of the Care Here facilities indicating they had around 80 facilities nationwide. This would be an onsite facility and employees would be able to use the other facilities in the state. The representative addressed the City of Port St. Lucie operational overview with regard to their facility. Their fee is based on per employee per month fee and not on how many times an employee or their family members go to the clinic per month to address their condition. The more visits or utilization does not change the revenue they make from the county. CARE Here presently provides 140-180 medications at this time. After the financial analysis, they will review and see what medications they can provide at no cost. In Port St. Lucie after 24 months the actual claims trend was only up 0.4% per member. Unlike the traditional delivery system which has failed to contain costs, the City of Port St. Lucie has successfully mitigated trend, saving money for the City, employees, their families, and tax payers. Com. Coward asked if they could project the actual savings versus our current expenses. 2 They expect to save one million dollars the first year and 7 million after 3 years. A 4% to 6% savings from our current expenses. Average cost per visit in the City of Port St. Lucie for example is $78.00. Com. Coward stated he wanted to look at the big picture rather than per employee. Com. Craft recommended the Citizen's Budget Committee review and dissect these comparisons and come back to the Board. Com. Grande stated he believed they could not come to a conclusion without there being a thorough investigation of what is being presented. The County Administrator stated she felt the Committee would be on a huge learning curve unless they were able to sit down and speak with the two applicants and digest what is being presented and come back with a recommendation. She advised the Board she did not have the opportunity to have the information and break it down to show what the Board is requesting. Com. Coward stated although he respected the recommendations made he believed this issue should remain in hands of the professionals. He does not believe this is a project where they should utilize the Citizens Budget Committee. Com. Lewis stated she believes there is a specialized knowledge needed and felt this was not an issue to present to the Citizens Budget Committee. Dr. Palestrant asked what they would be providing for $78.00 per visit opposed to their charge of $160.00 per visit. The representative stated the services are similar and it would all depend on the provider they select, however it would all be included in the cost. Com. Coward questioned why did staff recommend to pursue the employee clinic concept her The Human Resources Director advised the Board the prior County Administrator directed staff to review the employee clinic model and he then requested to do a cost analysis on the employee health clinic concept. This is nothing new and it has been around for many years. Com. 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