Friday, June 17, 2011

COSA Wellness: Fat, Fit or Futile?

A San Angelo City retiree recently shared the following:

The City Clinic is now for “urgent care” only.  I just happened to find this out when I went in late last month.  The staff are a P.A., and medical assistant, and a receptionist.  It is walk-in only.  Appointments are not accepted, but at least it is open from 8-4 five days a week now with Dr.Gordy Day overseeing it.  For months prior to that it was staffed from 7:45 to 8:45 am only.  Now the clinic will not do ANY wellness stuff, blood tests, refill ongoing meds, do physicals, Pap smears, etc.  These are all things that we were URGED and ENCOURAGED to do when the Clinic first opened.  We were told we “should” go to the Clinic for all these things to save costs – so many, many of us did.  Now, after all of us have lost relationships (and records) with our former doctors, we are now forced to find new Primary Care Physicians and pay the huge deductibles AFTER we chose a plan (and deductible) in October.

Apparently a letter went out to employees but retirees received NOTHING. I just don’t know what to do! It is very difficult.
City leaders emphasized a wellness program as the key to getting health insurance expenses under control.  They committed to such a strategy in 2009 and reemphasized it in November 2010.

Considerable discussion was held on the wellness program, health risk assessment (HRA) services, etc.

It was a specification in a January 2011 request for proposal.

The City is interested in establishing a successful wellness program.  A baseline health risk assessment with annual evaluations is requested
The RFP provided clinic history:

The Clinic averages 5400 patients per year, 1100 of those are Tom Green County employees who are eligible through an agreement with the City of San Angelo. The Clinic serves approximately 1400 employees (900) or retirees (500) and their insured dependents.

The City opened the Clinic in 2004.  Over the years it transformed into a family practice  operation.

Does ceasing the clinic's family practice nature mean the contractor needs more time to ramp up services?  Or is it a retrenchment by the city in managing its health care costs?  The City of San Angelo's risk shift to employees and retirees continues, the question is the pace of the next phase of the responsibility dump. 

It's difficult to know the City's health insurance plans, despite direct questions.  However, COSA has a clear track record of shedding health programs, as well as insured dependents.  What does the ongoing wellness gap mean?  Fat, fit or futile leaders...

Update 8-28-11:  The City committed to a wellness program in 2004, when Harold Dominguez was Interim City Manager.   The minutes from September 2004 state "Mr. Barta applauded Council's vision in authorizing the establishment of the Health Clinic noting it had a significant impact on negotiations. He stated the Clinic was continuing to average 14 patients per day and that plans were being developed in the area of wellness and health education programs."  Alvin New became Mayor to implement things that had been talked about.  Wellness is clearly one of those things.

No comments: