At this time last year, Northampton County Council was considering a long-awaited pay study, Gracedale performance audit and a review of IT. Over the objections of the Executive, it set aside $450,000 for that purpose in December. Since that time, nearly a year has gone by without issuing a request for proposals (RFP). It was finally sent out on Thursday of last week. Council wasted a year with resolutions and ordinances, even a meeting in which it called a "Clerk" as an expert on pay studies, RFPs and Gracedale audits. In violation of its own ordinance, it last week watered down its much ballyhooed pay study so that it applies only to nonunion workers. It did so without even bothering to vote on it. At the rate it's going, the current workforce will be long retired before there's ever a pay study.
Council works very hard to move as slowly as possible, and is doing so now with a proposed health center for county workers. Executive Lamont McClure has yet to make a formal proposal, but Council has actually introduced an ordinance designed to make sure it never happens. It's sponsored by Council members John Goffredo and Tom Giovanni. I respect legislative resistance to being rushed. But there has never been any urgency. This ordinance is little more than an attempt by legislators to ensure nothing happens. We've all seen gridlock on a federal and state level, and now it is beginning to rear its ugly head in county government.
The proposed ordinance was introduced without discussion last week. On its face, it's dishonest.
It falsely states that "Northampton County Council has not been advised as to the start up costs for this Employee Health Center, liability
issues, operational costs, return on investment, and detailed
projected cost savings to Northampton County, if any ... ."
Integrity Health Center, a Princeton-based health center, has already presented twice to Northampton County Council, both here and here. Council has been provided at least one memorandum, responding to concerns raised. Doug Forrester, the founder and CEO at Integrity, has personally appeared at both presentations. He has also invited Council members to reach out to him with any questions.
In contrast to misrepresentations made in the proposed ordinance, County Council has been advised that the health center will cost $800,000 a year to operate. It has been told there will be start-up costs for a facility ($2.2 million estimate) and equipment ($300,000) estimate. It has been informed that it could expect to see between 1.8 and 2.2 times its annual investment in saved medical costs. ($1.44 million to $1.76 million). Council has been told how many people will staff this center and what they will be paid. John Goffredo knows this because he questioned Integrity about the nurse salaries during the second presentation. They've also been told that there's money in the budget for this project, which is located under medical costs.
In addition to its misrepresentations, Council also objects to a voluntary survey of the workforce because it was only completed by about 450 of 2000 workers. It wants another survey done. Frankly, I'm unsure whether a public employee can be forced to respond to a survey. The same folks who complain about mask mandates want to force county workers to participate in a survey. I doubt that can be compelled, especially among union workers. This objection is really little more than a red herring.
In this ordinance banning a health center before it is even formally proposed, Council demands a Request For Proposals in accordance with the Administrative Code, Section 13.07. There's no need for an ordinance telling the county to follow another ordinance. That's what the law already requires. It even specifically permits noncompetitive negotiations with a sole source, so long as the Exec explains why this is necessary and Council agrees.
Council has thus far failed to even seek proposals on the pay study promised a year ago. Now it wants to screw employees out of an exclusive and voluntary health center designed to give them same day medical service with no co-pay. It also wants to screw taxpayers out of $1.44-$1.77 million in savings a year.
This is not good government. This is gridlock.
Council President Lori Vargo Heffner has told WFMZ-TV69 that Council has the right to take all the time it needs and get all the information it wants. It also has obligations to the employees and taxpayers. Based on the way it has mishandled the pay study and Gracedale audit over the course of a full year, I'd say Council needs to get off its ass.
She complains that the Exec has failed to state where the center will be located. That's a bit disingenuous on her part. She knows very well that the County has a location in mind because she's been so advised during a public meeting. The County is unwilling to publicly identify the location only because it is unwilling to prejudice itself in lease negotiations. That's called looking out for the taxpayer.
Vargo Heffner also states that "[m]ost of Council feel this is an inappropriate way to approach this." Really? Has she been conducting meetings privately? Behind closed doors? How the hell does she know what most members of Council want? There's been no such expression at any public meeting. There have been concerns raised and answered.
If Council were really interested in helping the employees and taxpayers, it could invite one of the five governmental entities already using Integrity to explain how it has worked. I understand that Integrity has even offered to set it up. Shouldn't that be part of Council's due diligence instead of just rejecting an idea out of hand? Why has it failed to do this?
Let's review, shall we? A New Jersey company that specializes in public health centers and already has five locations has offered its services to NorCo. It would be a voluntary health center, one that an employee could use if he wants for all or just some medical services. It would be exclusive to NorCo employees. There would be no co-pay. It would be open every day, with hours that will be optimized for the workforce. It will offer same-day appointments to county workers for a wide variety of medical services, including mental health counseling. Start up costs are about $2.5 million, and operation costs are about $800,000. This will save the county between $1.44 and $1.77 per year in medical costs. It is popular with 450 employees who responded to a survey.
Council, for no real good reason, wants to either kill it or erect so many obstacles that it will never get off the ground.
UPDATED 11 am: In my original version of this story, I incorrectly reported that the RFPs for a pay study and Gracedale audit were still collecting dust. They went out on Thursday.
44 comments:
Where, oh where is Ron Angle when we need him? We need and want a man who can make Northampton County great again.
The plan stinks and it wouldn’t solve the health issues of the community. We need to see specialists and they wouldn’t be at the community health center. Let’s just cover our community at 100% medical benefits with the same salary and the workforce would be appreciative and happy employees.
1) Gridlock is perfectly acceptable, especially when spending taxpayers' hard earned money during a recession after a pandemic. The system is built to enter gridlock during controversial times and over controversial issues. It's as American as mom and Chevys and apple pie.
2) Where are the notes regarding the county's negotiations with our two largest employers, St. Luke's and LVHN? These are world class organizations that employ hundreds or thousands of NorCo and Lehigh Valley residents. Where are their presentations? Were they given a chance to compete for this? It doesn't seem so. If they weren't, that's outrageous and reason enough to kill this process and start over.
3) Let's have better, more transparent government that respects county taxpayers and the companies for whom they choose to work to support their families and community.
I find it discouraging that a project that will actually benefit working class county employees is being blocked and dismissed by a council that makes it its mission to be tone deaf. Families are struggling under this corporate manufactured inflation, and we need services like this more than ever, yet our council members want to play politics.
Ron is a no nonsense leader !
In government, there are always obstructors who cannot celebrate any thing good. Most often it is politically motivated. They strategize on ways to bring things down, peddle unreliable information and create a narrative that fits their regressive agenda. Their actions disgust volunteers to the point of discouragement at a time when a community volunteer is a golden commodity. They create an atmosphere that is a means to an end and cannot even lebrat community projects that are positive.
I would be concerned by the quality of care at a health center like this. I would ask lots of questions regarding what physician staffing levels are ect. It sounds like a very impersonal experience much like going to an urgent care center.
All of the information stating this will save the county millions is sourced from the company who stands to make nearly $1 million every year simply for administering it? Jeez, I wonder why council is hesitant to take them at their word. At least you are doing your due diligence as a blogger/journalist....right?
Doesn't Lori V-H work for a competing health care system
Should she not recuse herself from all discussions since she is trying to save her own job?
Can't wait until Meyers is President next year, he will know what to do
The shame of all this is that no member of County Council is willing to do their homework on this issue. Take the time to visit these other outlets that are presently in operation and discuss with the organizations that contract with them to see if they are indeed saving money and getting a bigger bang for their buck. The second part of this is, there aren't too many people who completely trust Dirtinger, Barron, and McClure when it comes to truthfully presenting this proposal. The feeling within the government is that they can't be trusted to tell the truth. If McClure is so pro employee, why hasn't he done something about having a genuine realistic pay study? You can't have it both ways. You can't tell the employees you are here to help them and then screw them on the flip side. Extend the olive branch by doing what is right and do the pay study, implement the study, and then let's talk about a health center. You want to promote a health center because the main reason is it will save money. You won't do a pay survey because you know your employees are way underpaid and it will probably cost you some money to correct it. Time for McClure to show his sincerity. You can't have it both ways.
Their are bigger problems in the county to tackle then the health center right now.
You may describe them as bumbling, but I welcome this attempt to derail this. County workers already have time to take off for appointments and the copay is not burdensome. Check with how the rest of the non-government workers get their health care needs met. Why duplicate and fragment health care for the employees? Something smells here. The focus of county's efforts on healthcare should be directed at improving the health care facility known as Gracedale. And the old Bethlehem Steel program not relevant in our current healthcare systems.
I'm not a Northampton Co. resident, so I'm just an observer. This plan seems plausible, but redundant. We live in an area where the two hospitals stumble all over each other to be the biggest, newest, best provider. They spend millions upon millions of their not-for-profit earnings on these remarkable, non-taxible, profit factories. Recently I've had to use one of these health care systems and I'm amazed at the charges. It's really impossible to figure out; the anesthesiologists' group charge, the surgeons' charge, the operating room nurses' charge, the operating room charge, and on and on. Yes, good insurance covers most of it, but these charges are just outrageous. This is why insurance costs so much. I can't believe these things need to cost this much even with a hefty markup. (And administrators' salaries and perks-- don't get me started. I personally know of a mid-level manager at a local hospital network, who is regularly entertained with island trips and Florida golf trips by a medical equipment supplier, and he thinks nothing of the conflict of interest involved. And sadly, neither does his employer. And the tax scam of giving LVHN execs NIZ addresses...) That being said, I welcome any competition for these "health networks." I suspect that St. Luke's and HVHN put the heat on McClure to table this idea, but do they even pay County taxes?
"All of the information stating this will save the county millions is sourced from the company who stands to make nearly $1 million every year simply for administering it?"
Based upon independently obtained actuarials that Integrity has offered to make available to Council, but that not one single member of Council has pursued. Of course, this should be questioned and verified, but Council has not bothered to do so since August. They've just repeatedly panned the idea.
"I would be concerned by the quality of care at a health center like this. I would ask lots of questions regarding what physician staffing levels are ect. It sounds like a very impersonal experience much like going to an urgent care center."
It would actually be the exact opposite. The staffing levels were all laid out for County Council. The advantage of an exclusive health center is that the employees there would get to know county workers and build relationships with them in a setting that is far more relaxed than is provided by our hospitals. This staff would even include a patient advocate who would help employees sort through the health coverage.
With respect to questions about our "world class" hospitals, Council could make clear that it wants an RFP to give them an opportunity to bid. I doubt they would because this is exclusive to county employees. They would want more profit. I also think they would rotate staff in and out of the center so that the impersonal experience mentioned would be present.
"Their are bigger problems in the county to tackle then the health center right now."
From an employee perspective, the biggest problem is a staff shortage. That's why I find it hard to believe that McClure is so opposed and that Council has failed to issue an RFP after a year of dithering. Having said that, an employee health center would make the county a more attractive place to work and would have the added bonus of saving the county taxpayer dollars.
"Doesn't Lori V-H work for a competing health care system
Should she not recuse herself from all discussions since she is trying to save her own job?"
She works for St. Luke's. According to the WFMZ-TV69 article written by Jeff Ward, St. Luke's is "interested in talking about the idea." It is clear to me that Vargo Heffner is conflicted. Is it a de minimis conflict? I think she needs to seek guidance from the state ethics commission. Until she gets an opinion, she should recuse herself from voting or even participating in any way on this matter. I note that she does recuse herself when it comes to St. Luke's bonds. Thus she should decline to participate in the enactment of this ordinance unless there is a 4-4 tie. That's when the doctrine of necessity kicks in.
All I see happening with this it if it goes through is pretty obvious. Now its voluntary but if doesn't go through health benefits are going up for employees. And in a couple years it will be if you use only the county health center your benefits will cost this and if don't they will cost this. And a couple years after that it will be the only choice for county employees.
Next I can guarantee if it opens every injured employee for the county will have to go there. Not lets think who will they have in mind. The injured employee or the county that's paying their pay checks. It's just a way to get almost socialize medicine. And doing it by death by a thousand small cuts other then just coming out and killing our benefits I one swipe.
Your opinion of our two health care systems is immaterial. They should be asked to submit proposals. Not investigating their offerings is dereliction of duty and gives the appearance of a needless rush. Any council members with potential conflicts of interest should recuse. This isn't difficult. Let's investigate this properly and transparently. Good government takes time, sometimes. And haste almost always makes waste.
Employee health center is a waste of energy and taxpayers money. We have the finest private health care facilities in our region. Why unnecessarily duplicate their services. Most employees have already established warm, trusting relationships with their PCPs and specialists. Why would they use the county's health center when they are already satisfied with current providers? And I would not trust a county paid vendor to protect my confidentiality. This dumb idea is a solution without a problem.
good for them, if they killed it, government should not be in the health care business. especially just for government workers. Government workers already are appearing to be a new elite groups.
A piece of the puzzle I don’t see mentioned is the lack of inter connectivity with the data from the proposed health center (which I think on its face is an OK idea) with the two big local care providers. St. Luke’s and LVHN use the Epic “MyChart” platform to share data between the two systems. This has obvious advantages for them, and arguably a huge amount of benefit for users.
At this point I see providers from both systems and my records are always available regardless of where I seek local help. This won’t happen easily with Integrity, since they haven’t bought an Epic license (at least they aren’t a licensed user when I looked for them in my MyChart app). So if an employee needs additional follow through, will they be referrred to another Integrity practitioner up the line? Sure won’t be easy to migrate the data over to a local specialist…meaning duplicated tests, etc. Or to let a primary care physician pick up from the place the workplace care stops.
There is no such thing as a free lunch. Integrity looks like it wants to capture and keep Norco employees as patients, not care and release to employees’ usual providers.å
John, Integrity will provide only primary care. If a referral is needed, they intend to establish relationships with local hospitals so that employees will be able to visit local specialists. This was mentioned by Integrity's Doug Forrester at the first presentation. It should be relatively easy to get an Epic certification, but I am shocked that many of the pharmacies do not appear to use it. That's where I get my boosters and immunizations, and it does not appear on my online chart.
You have good questions, and I think Integrity has good answers. Council members could insist on an Epic certification.
" I suspect that St. Luke's and HVHN put the heat on McClure to table this idea, but do they even pay County taxes?"
I'm unaware that McClure or Council has been pressured by local hospitals in any way, at least not yet. They do not pay taxes.
11:05, A few points. Integrity is voluntary, not mandatory, and has operated that way at five other locations for some time. So I think your fear about it become mandatory is unwarranted. I'd agree you might want to have that more firmly established.
You suggest that employees injured on the job will be forced to use Integrity. Untrue. This will not be a place for worker's comp issues. The health center will be there for the employee's benefit. The employer will benefit in reduced medical costs but Integrity's relationship with the employee is confidential. There is a barrier between the county and the health center.
As explained in a presentation, Integrity will deal with the acute phase of a worker comp issue, and then refer the patient out.
John, your points are well taken. People are aware these guys went to many places including Lehigh and were sent away. There is really no upside to this deal for the county. No guarantees of medical cost savings even written into the contract. Great start up and yearly costs no written guarantees of any taxpayer breaks. Just arrogant McClure press releases. The real problem is that O'Hare is so far up McClure and Barrons asses it is no wonder the boys are as rotund as ever.
The council should take all the time they need and have independent auditors review the plans promises. With all the millions they claim to have saved it should be no problem to have it confirmed independently.
If I live outside of the location of the health center, why would I want to drive my sick child all the way to (presumably) downtown Easton to see a doctor? If I like my current PCP, who is familiar with my family and medical history, why should I have to start over with a new PCP? How many employees live within a 15 minute radius of the new center, as it is more likely those folks who would benefit from this approach. Are the projected savings based on a % of the County's covered lives using this center, and how reasonable is that %? What if the projected savings do not materialize because of underutilization of the center - all those sunk costs are not recoverable.
For several years Lehigh County has run a health clinic in the government center staffed several days a week by a St. Luke's Nurse Practitioner. Employees downtown can use the clinic for flu shots, visits for non-emergency issues, blood draws, and other services, with no copay. This is not for their families, and does not replace their PCP, but it apparently saves the County some money though not millions of dollars. It also has a convenience factor for those employees working in the building, although the employee's (paid) time off from work to visit the clinic is not considered in the equation. Not sure anyone has really looked at the numbers to quantify the savings, as some visits to the clinic during the workday might not have warranted a visit to a PCP (splinter in finger, e.g.), so is that really a savings?
Maybe start smaller and then see if the market will bear the full-blown health center.
1) Although the county has a location for the health center, it has not been disclosed publicly. It will certainly be within the county, and probably will be centrally located. It should be convenient to county employees and their families.
2) You don't need to start over with a new PCP. You con continue to use whomever you have. This is voluntary. You might still find it advantageous in filling prescriptions, getting lab work done or getting physical therapy. It is for the entire family.
3) Medical savings are based on a reduction in what other providers charge for the services performed. Hospitals, urgent care centers and doctors tend to get every dime they can. The county will spend $800,000 per year for the health center and get back $1.44 to $1.77 in reduced medical costs to a self-insured county. It makes financial sense. It is based, I believe, on an estimate of 12,000 visits per year. If actual visits are lower, the savings will be lower. If higher, it will be more.
4) This will not be a clinic like you describe, but will be much more expansive and offer a wide array of medical services, including patient advocacy.
Another failed attempt to have government take over our health care.
From an employee perspective the biggest problem is not being paid a living wage and literally having to choose between groceries or gas in the car.
Living on your own is not an option. Working for norco means one must have either a spouse, partner, or roommate. I’d rather see the proposed start up money go towards livable wages.
Not wanting to be a nay Sayer, I just can't imagine giving up my family doctor for a clinic. Nor can I see my fellow employees going to a clinic over their family doctors. The comments I am hearing is "why do something to try and make Him (McClure) look good when he shaft's us every day by not doing a pay study. Now he wants our co-operation. When hell freezes over.
"Pretentious asshole" "Narcissist" "arrogant", Terms O'Hare uses to try and sully Mr. Myers and others who have stood up to the Mcclure authoritarian bully form of county government. The union bosses in McClure's pocket should tend to their own flock as many of their members want to ditch th union because instead of more money they are getting gimmicks like this one.
I agree that with the comment that if this is such a sure thing these failed politicians that run this company should offer a contract where they cover any losses, Afet all they and the McClure gang promise it will save millions, right?? What other gimmicks are you selling for your patron McClure?
If you believe that I have a bridge to sell you over 33 the Tatamy exit
It just seems like a dumb idea. Why not just take the money they would spend on start-up costs and annual overhead for the employee health center and put it towards the contributions to the employee health plan to lower the deductible and copays for employees and let them go where they want? Not to mention, Good luck staffing a new health center. LVHN and St Luke's are both in a staffing crisis and they pay way more than the County will ever pay. The County can barely keep enough staff employed to keep Gracedale going, how do they expect to operate another healthcare center paying below-market wages?
Annon 9:36, the best post on this topic. For all the euphemistic and pretentious comments on this plan, as well as the guilting and shaming of any questioners by McClure and O'Hare, at its heart it just doesn't make any sense. Truly an emperor without clothes moment.
They claim of spending millions of dollars (some of which has not been quantified), they will prevent future healthcare increases. Think about that. If the money was not spent on this duplication of services, how many years would any other increases be paid for? Also, the Bethlehem steel analogy is just silly. That was a time when thousands of immigrants with many languages worked in a dangerous place with few community healthcare facilities available. It made sense. This makes no sense. Thankyou county council for your common sense.
It was not requested or needed by staff, nor will it protect any taxpayers. Just another my way of the highway deal by Mclure being sold with the help of his loyal toady O'Hare. If it passes, follow the money. Who gets the lease, or any contributions.
I am not certain about the viability of McClure’s proposal in opening a “employee health center”. I want to give him the benefit of the doubt on the idea. I would like to see more in writing on the proposed savings. If a negotiated discount with St. Luke’s and LVHN is part of the deal by the vendor, savings may be possible. Northampton County ‘s health care costs are far above the average county’s costs and have been for years. Can’t hang that on McClure. He is the first County Executive to “try “ to reduce costs through innovation. By the way I did not vote for him and Bernie I do not have an admiration society thing for him. I believe there are “other ways” of reducing health costs for employees that have worked elsewhere. I do not hold Mr. Barron in high regard as to his “Talent Level” in creative County governance solutions. He at best is a minor league player. McClure could grab the bull by the horns and provide the leadership to solve the County’s and other local governments health care costs by truly innovating but alas this is a one party place and I won’t hold my breath.
You just contradicted yourself in two post. One they wont have anything to do with it. Now its just the acute phase . You know the part that says you dont need a follow up. Put some ice on it your fine. So which one is it. And I of course I believe that so called barrier is as strong as steel...ok
The health center just seems so…redundant? If the workers are paying for health insurance and can receive treatment anywhere, including St. Luke’s, LVHN, and Teledoc, why would they need to go to another place to seek additional treatment? For something quick, Teledoc is used. If I need a prescription refill, I’m sending my primary care doctor a message through the LVHN app and asking for a refill which then automatically goes to CVS. I don’t need to go to some health center and be seen by anyone. Why would I want someone other than my main doctor treating me and then referring me to specialists. If I need blood work done, there are labs at hospitals and pretty much any strip mall in the valley. How would building this health center, paying those doctors/nurses save any money? How do they even know how many workers would even use it? How many years would it take before is actually “saves” the taxpayers the millions and billions and trillions of dollars they spend on the county workers health care {and salaries for that matter}?
". You know the part that says you dont need a follow up. Put some ice on it your fine. So which one is it."
I reviewed the meeting video where this was discussed. They will stay out of worker comp matters, but will treat people in the acute phase. This is NOT contradictory.
" If the workers are paying for health insurance and can receive treatment anywhere, including St. Luke’s, LVHN, and Teledoc, why would they need to go to another place to seek additional treatment?"
It would be more convenient. Same day appointments. It would be cheaper. No co-pay.It would be more inclusive - primary care would include chiropractor, physical therapy, mental health therapy, patient advocacy. It'ssimply a better service, far from redundant.
"For all the euphemistic and pretentious comments on this plan, as well as the guilting and shaming of any questioners by McClure and O'Hare,"
The only person insulting anyone is you. Now I will shame you.
Your argument is that O'Hare and McClure are jerks, so therefore the proposed health center is a bad idea. That is illogical, an ad hominem worthy of Trump.
Its about time they put this Health Center to rest! Most County Employees would not use it. Yeah! volunter but then you go to a different Dr. as the one you have been going to for years! COUNCIL! Do not let McClure spend County money on this. Just another of his and his crazy Adminstration Screwy Ideas!County employees can't wait till him and Chucky Cheese are gone!
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