By Marvin G. Cortner
Editor

Amid criticism from the local medical society, the Osceola County School Board July 13 on a 4-1 vote authorized negotiations with North Carolina-based Healthstat to administer a medical clinic to serve School District employees and their families.

Healthstat could be paid up to $795,000 over five years to administer the facility, which would be housed at School District headquarters on Bill Beck Boulevard in Kissimmee. The mid-level clinic is projected to open in January.

The School Board began considering opening the clinic as a way to deal with annual medical insurance cost increases that the board called unsustainable. The board earlier this year, for example, was grappling with a $4.2 million increase in the cost of providing medical coverage to district employees for the coming fiscal year budget.

Dr. John Littell, president of the Osceola County Medical Society, told School Board members at the July 13 meeting that he and other doctors in the community would be offended if the School District just to save money was to “encourage its employees to go to a mid-level medical provider rather than to their family physicians.”

Littell also chided the School Board for not having consulted doctors in the community first before deciding to establish a clinic.

In April, the School Board tentatively decided that the district should not pursue its own clinic, following a feasibility study and a review of requests for proposals from healthcare providers – including Healthstat, the top ranked firm at the time – that showed it would not save the district money, mainly because the cost of a visit to a clinic primary care physician would be considerably higher when compared to the private sector. Based on the analysis of the direct savings by consultant Aon Consulting, the clinic would lose money each year.

However, at a School Board workshop June 29, a new model for the clinic was   used based on staffing by a nurse practitioner rather than a doctor along with a 30 percent coinsurance payment for those using the clinic. That new model with more cost borne by employees – which may not be the final version – showed an on-site clinic would save between $654,489 and $1,716,225 over five years when compared to employees using the district’s currently-approved primary care physicians.

School Board member Cindy Hartig, the lone vote at the July 13 meeting against negotiating with Healthstat, said the district should get “local doctors to manage the clinic.” She also questioned whether it would be cost-effective to run a clinic and said that mid-level clinics do not reduce the number of visits to emergency rooms as some School Board members claimed.

“Why not negotiate with them (local doctors) for management,” Hartig said. “We need to look at other options; we need input from the medical society.”

Superintendent Michael Grego on Friday explained that Healthstat would not provide the staff for the clinic but that the district would negotiate with local medical professionals for that purpose.

“We are not negotiating (with Healthstat) for the service,” Grego said. “If we get a management contract, then we go into who provides this service and for how much. The only way to see if this is feasible is to sit down with a company to see what actual costs would be. It’s a work in progress.”

Grego said companies aren’t willing to commit the time and resources to detailed cost analyses of proposals until they see the School District is serious enough to negotiate a contract. He also said the district would stipulate that local medical professionals be hired to staff the clinic.

The superintendent also said district teachers and other unionized employees support the idea of a clinic as a way to reduce their out-of-pocket medical costs. He also said district staff and their counterparts from the cities of Kissimmee and St. Cloud and Osceola County government also are continuing to discuss the idea of a shared clinic but that the other entities “aren’t as far along” as the district.

At the July 13 meeting, School Board Member David Stone said he has been “looking forward to a clinic for a long time” and, in response to Littell’s concern, said the district is “not trying to preempt” the care now provided by primary care physicians in the community.

“This would be an alternative to emergency room care … this would give flexibility to our employees,” Stone said, adding that the clinic would probably treat less than 1 percent of the county’s population. “This won’t put any doctors out of business.”