Two down, one to go.
Thirteen days after the School District of Waukesha approved an intergovernmental agreement for a shared medical clinic with the city and county, the Waukesha County Board joined them in going ahead with the proposal.
After a healthy discussion with many stating pros and cons of the agreement, the board voted 19-4 in favor of the shared clinic during a board meeting Tuesday night.
Now, all that waits is the city to vote on the agreement.
The onsite health clinic, which would be available to employees of the three entities and their families, is estimated to save the county about $3 million, the school district $3.4 million and the city $1.2 million for a total of about $7.7 million over the five-year period, the length of the joint agreement.
The clinic would be located on the Waukesha County Courthouse campus in the offices of the county division of public health at 615 W. Moreland Blvd. The facility was vacated when the Public Health Division was relocated to the new Health and Human Services building that opened last fall.
"Under the proposal, individuals will always continue to have the option of receiving health services elsewhere," said Norm Cummings, the county's director of administration. "Therefore, all insured can use Pro-Health services and facilities or any other health providers they choose. Employees and their families have been provided multiple options and will continue to have those options under the proposed clinic model."
The process to have a shared medical clinic began in October 2012 when the three entities partnered together to conduct a feasibility study. Twelve health care providers submitted Requests for Proposals (RFPs) before the North Carolina-based Healthstat was selected by the three governmental entities on Jan. 27, 2014.
"I think this process has been excellent," said Supervisor and former City of Waukesha mayor Larry Nelson, adding this kind of intergovernmental agreement where the county, its largest city and the largest school district "can work together for the good of the taxpayer" will be a "role model" for others to follow.
Nelson also predicted that the city would join the county and school district in the "not-so-distant" future.
Many after the meeting believed the results of the mayoral election next week could be a deciding factor in how the city moves forward with the onsite clinic. Shawn Reilly, who is challenging Mayor Jeff Scrima, is in support of the onsite clinic.
A few county board members questioned how an out of state vendor was chosen as well as what would happen if the savings aren't met.
But other members said local providers were part of the bidding process, including ProHealth Care and they came up short. Cummings said after the meeting that five area providers were vetted during the RFP process.
"I don’t believe government should get involved in the health care business," said Supervisor Kathleen Cummings, who along with Supervisors Janel Brandtjen, Pauline Jaske and Jennifer Grant voted against the shared clinic.
Brandtjen called it a "slap in the face" to its community partners for not selecting a local provider.
However, Supervisor Patricia Haukohl said it would be a "slap in the face and an insult" to the vendor chosen if the county and the other entities begin looking at other proposals.
"We scrutinized these proposals to make sure they were done fairly and were done so carefully," Haukohl said.
An evaluation committee made up of representatives from the county (Employee Benefits Administrator Peter Hans, Waukesha County Purchasing Division Manager Laura Stauffer and Grant), city (HR Manager Donna Whalen) and the school district (Christine Hedstrom, assistant superintendent for Human Resources and Labor Relations) selected the vendor based on a scoring criteria.
Norm Cummings said the ProHealth Care proposal had a negative return on investment.
Supervisor Peter Wolff added that Healthstat could very well end up hiring local doctors, thus creating jobs.
"We shouldn’t oppose saving taxpayers $3 million," Wolff said. "Because it benefits our employees is a bonus. This is a very innovative way and a wonderful opportunity that we need to take advantage of.
"Unfortunately it didn’t go to a local contractor. Healthstat came up with the best bid. This is providing a wonderful service for our employees."
The city was originally scheduled to vote on the intergovernmental agreement last week but the process is being delayed after ProHealth Care's request for the city to look at an alternative proposal.
Scrima brought in representatives from ProHealth Care to a Common Council meeting earlier this month where they stated why a shared onsite health clinic, specifically with using Healthstat, isn't the best option and now wants to submit an alternative proposal that wasn't in the RFP.
"To whine and cry after the fact," Supervisor Walter Kolb said, "that’s not playing by the rules."
The mayor also said in an email that employees would be required to use the clinic and that ProHealth Care would match the savings of Healthstat.
However, City Administrator Ed Henschel, who was asked to get another proposal from ProHealth Care for just the city, followed up with an email to city employees saying that employees are not required to use it or could use both the clinic and your own doctor. A patient record at the clinic can also be sent to an employee's primary care physician.
"They can treat your common illnesses and can refer you to specialists within our network if needed," Henschel said. "You have the option to use the clinic for none, all, or some of your medical services."
He added that getting another proposal from ProHealth Care "violates his sense of ethics" and won't do it because the process has already been thoroughly vetted.
Henschel told city employees they will be asked to pay a co-pay of no more than $5 when using the clinic. He said the co-pays employees are charged with will accumulate and apply toward satisfying employees' deductible under the health insurance plan.
Henschel also noted that in the past the city had to participate in an annual biometric blood test and health risk assessment and the city's participation determined what was paid toward its health insurance premium.
"Our plan will continue the biometric and health risk assessment process and to tie employee contributions to health insurance as we have done in the past," Henschel said. "We would anticipate that the clinic provider will conduct the biometric testing and employees will fill out the health risk assessment and review the results with someone from the clinic in a process nearly identical to what has been done in the past."
If the city denies the intergovernmental agreement a new agreement would have to be brought forward for the school district and county board.
According to Healthstat's proposal, the clinic, if approved, could open in September.
The cost of operations would be shared in proportion to the eligible members of each entity with the school district paying 44 percent, county 40 and city 16.