NorCo Council Rejects Voluntary Employee Health Center ... Again

At their Thursday night meeting, Northampton County Council voted 5-4 to reject a $3.8 million contract with Integrity Health to establish a voluntary health center for most primary care for county employees with no co-pays. This project has been described as a win for county staff, who could seek and obtain medical care with same-day appointments. It has also been described as a win for the county, which expects that this center will save money. 

The project was supported by Council members Ken Kraft, Jeff Warren, Kelly Keegan and Ron Heckman, all of whom are Democrats. It was opposed by Council President Lori Vargo Heffner and Council member Jeff Corpora, both of whom are Democrats. It was also opposed by Republican Council members John Goffredo, John Brown and Tom Giovanni. 

Kraft and Keegan suggested that Vargo-Heffner, who is employed by St. Luke's, is conflicted. She responded that she sought an opinion from the state ethics commission and has no conflict. This assertion was corroborated by Council Solicitor Chris Spadoni. 

Kraft also argued that employee health care "is going in the wrong direction," and that they are being forced to contribute more of their income for health care. "This will save money," Kraft argued, but acknowledged that support requires "a leap of faith." 

Council member Goffredo noted this measure was voted down before (in 2023) based on the same pro and con arguments. "When you tell me government is going to do something cheaper, and I have to take a leap of faith on it, every one of my instincts is telling me it's a bad idea." 

Kandsye McClure (no relation to the county exec) once stated, "Take a leap of faith. You will either land somewhere new or learn to fly."

NorCo Council Delays Consideration of Voluntary Employee Health Center

Northampton County Council was poised to consider a resolution approving the controversial employee health center at last night's meeting. But Council member Jeff Warren, who proposed the measure, moved to withdraw it last night after learning that Council member Tom Giovanni was visiting family in Italy. (I might see him there when I win the Giro d'Italia this year).  Warren would prefer to wait until all nine members of Council are physically present and can vote. The eight members were present, either in person or by phone, voted to allow Warren to withdraw the resolution. 

A County Employee Tells Me Why She Supports a Voluntary Health Center For Workforce

Northampton County's most controversial issue at this time is an exclusive and voluntary health center for its workforce, with no co-pays. Many of you reject this out of hand as yet another perk for public sector workers that are denied to the rest of you. It certainly is a great benefit, but the county is doing this because it will actual.ly save you money. The county is self-insured, and health costs are increasing exponentially. It is projected that this clinic will save taxpayers between $1.5-2 million per year over the next five years. If this fails, the county can bail out at that time. 

I bumped into a county worker (I won't name her) at the grocery store last week. She was loading up for what she expected was going to be another long night. She works at a 24/7 operation, and gets mandated a lot. I asked her what she thought about the health center. 

She told me that, because she is mandated frequently, she often has to cancel doctor's appointments. She's unable to schedule minor procedures. Council member Tom Giovanni,. who opposed the health center, stated that there should be more of a focus on preventative care. Well right now, she's unable to get preventative care. If she or her child needs medical attention, they are pretty much forced to use an urgent care facility. This costs her money in the form of co-pays and costs the county money ion the form of higher medical costs. 

So she would welcome a health center as a facility that would enable her to get the preventative care she needs. 

McClure Claims His Health Center Proposal Still Alive

Blogger's Note: Northampton County Executive Lamont McClure issued a news release today that continues to make the case for his proposed health center, even though it has already been rejected by County Council in a 5-4 vote. He may be trying to flip one of the No votes. Morelikely, he is making a pitch to the County Council that takes office in January.

FROM NORTHAMPTON COUNTY: Northampton County Council rejected the Administration’s proposed Employee Health Center at their meeting on Thursday, July 20th.

“I am utterly disappointed in our current County Council. The Employee Health Center would have saved taxpayers $1.5 million - $2 million per year. The services provided by the Health Center would have been an option for employees on top of their current health insurance. The services would have been strictly confidential, strictly voluntary, and provided on a no-copay basis,” says Lamont G. McClure. “Northampton County employees and residents have been seriously misled by certain members of Council regarding this project. Council had been given sufficient time to ask for more information.”

5/25/2022 – Northampton County Department of Human Resources sent a survey to all Northampton County employees to garner interest in a potential Employee Health Center. Survey results show that an Employee Health Center is overwhelmingly supported by employees:

Would you use an onsite or near-site Health Center that is run by a 3rd party and offered exclusively to County employees and their insured dependents?

78.2% Yes
21.8% No

Would you frequent a Health Center (check all that apply):

24.3% -During work hours
39.3% - After work hours
26.7% - During lunch time
9.8% - Other

Which of the following would you prefer?

46.2% - Onsite Center
40.8% - Near Site Center
9.2% - Virtual Clinic
3.8% - Mobile Clinic

Which medical providers would you use at an Employee Health Center (top 5 answers)

14.6% - Physician
11.4% - Physician Assistant
10.5% - Nurse Practitioner
8% - Nurse
5.5% - Medical Assistant

8/17/2022 – The first presentation in front of Northampton County Council Finance Committee about an Employee Health Center. Integrity Health presented to the Finance Committee for 1 hour and 15 minutes.

Attending from Integrity Health:

Douglas Forrester, Chairman & CEO
Mark Caliguire, Vice President of Government Relations and Client Development
Dr. Joseph Calabro, Chief Physician Executive

10/19/2022 – Integrity Health presented to the Northampton County Council Finance Committee for 50 minutes.

Attending from Integrity Health:

Douglas Forrester, Chairman & CEO
Mark Caliguire, Vice President of Government Relations and Client Development
Judy Lagana, Chief Clinical Officer & Senior Vice President

In this meeting, Administration advised that funding for the Employee Health Center is present in the 2023 Budget, including how the Self Insurance Trust Fund could potentially pay for the Health Center. Former Council President Lori Vargo Heffner said at the time: “The fact that he’s just proposing a single vendor and not being transparent with the rest of it is problematic. How can you say when it’s millions of dollars on the line that he wouldn’t have to go through competitive bidding? I don’t think that’s good government.”

2/24/2023 – Integrity Health operates several health centers in New Jersey and expanded to Lycoming County, Pennsylvania. In response to Former Council President Lori Vargo Heffner’s statement, Administration reviewed Lycoming County’s RFP Outline model and Northampton County then posted an RFP through the Public Purchase Platform and invited 665 entities to possibly bid on the project.

4/27/2023 – The proposals on the project were due to Northampton County. The County received five proposals and one letter from St. Luke’s Hospital that was a no bid. There were 55 entities that downloaded the bid package from the system. The purchasing department, fiscal department, and human resources collectively answered 57 questions about the RFP on the system over the two months it was posted. The purchasing department extended the deadline for submitting RFPs so that all bidders could review answers to the questions asked.

5/5/2023 – The Request for Proposal Committee met for the first time to review the five proposals the County received. This committee included Northampton County Commissioner Tom Giovanni, Director of Human Services Susan Wandalowski, Director of Human Resources Mary Lou Kaboly, Director of Fiscal Affairs Stephen Barron, and Procurement Manager Kathryn Anderson. At this meeting, the group felt strongly that Integrity Health and Everside should both be interviewed based on price and services. Care ACT was also extended an interview as they had the potential to be competitive with the other two. This was a unanimous decision, and interviews were scheduled in person or via Zoom as some bidders were more local than others.

5/31/2023 – The Request for Proposal Committee met to discuss the interviews and make a decision. The group considered the price, hours, service delivery model (i.e., doctor vs. nurse practitioner vs. physician assistant, etc.), ROI/performance guarantee, and virtual visit options. Also, each company discussed their focus on primary care health, wellness, and education. Integrity Health was unanimously selected by the Request for Proposal Committee. The Request for Proposal Committee specifically asked Mr. Giovanni if there were any other concerns that Council had that the group needed to address.

6/14/2023 - The Request for Proposal Committee presented their decision to County Council, along with the objective process undertaken by the group.

7/19/2023 – County Council was presented with a contract and a matrix related to a performance guarantee and was asked to vote at the next County Council Meeting. This information was promised to be delivered to Council for consideration at the 6/14/2023 meeting at the suggested timetable of Mr. Giovanni.

7/20/2023 – Council votes against awarding the contract 5-4.

“Providing county employees with the best health care available while controlling costs for both county employees and taxpayers will continue to be a top priority of mine. This project isn’t dead yet,” says Lamont G. McClure.

NorCo Council Nixes Employee Health Center in 5-4 Vote

Last night, by a 5-4 vote, Northampton County Council ended Executive Lamont McClure dream of a voluntary and exclusive health center for county employees. They voted down $3.7 million contract with Integrity Health over the next five years.  

The Council members opposed were Tom Giovanni, John Brown, John Goffredo, Kerry Myers and Lori Vargo Heffner. 

It was supported by Council members John Cusick, Ron Heckman, Kevin Lott and Tara Zrinski. 

Arguments in support. 

Ron Heckman: "I don't know if this is going to work ... I'm hoping this is an incentive and that it helps the employees."

John Cusick: "I'm willing to give this a shot ... ." To shut it down "is a little short sighted." He hopes it saves money. It is is not a new concept Beth Steel was doing it decades ago. 

Kevin Lott: The alternative to a health center is to cut benefits. "This is an option that has a track record," he noted, in obvious reference to successful health centers in New Jersey. Even if it does not save, "it will be a nice benefit for employees."

Tara Zrinski: This will incentivize employees to stay with the county. 

Arguments opposed: 

Tom Giovanni, the Quiet Man, said that he consulted an expert, his wife of 45 years. She's a nurse and told him that what people really need is preventative care.  "What we really have to do is educate people that you need to have a primary physician, you need to have preventative care, not white 'till you have something really critical. Hypertension, obesity, diabetes, smoking. That's all important things that could kill your health. ... I'm not going to support this. We need to teach people preventative care."

John Brown declined comment, but has spoken out against the proposed health center numerous times, stating the county should pursue other options, i.e. increasing co-pay and employee contributions. 

John Goffredo: has been doing everything he can to look at it positively. "Healthcare in America is systematically flawed. He believes this will actually lose money while creating more government. He said employees are looking for better wages, not a health center. 

Lori Vargo Heffner. Does not see enough detail or clarity. There are no real numbers. For one year, has received no comments from any employees seeking a health center,  She said it is "insulting to hear the way this company presents healthcare."

Kerry Meyers: Thinks the emplyee survey should have been updated. If they wanted this, they'd be here. 

NorCo Council to Consider Contract For Voluntary Employee Health Center

NorCo Council's Finance Committee will today consider a proposed contract between the County and Integrity Health for an exclusive and voluntary health center that caters to the county workforce. 

Why do this? 

It's a great convenience to employees, even those who already have a primary care physician. But it should help the county reduce the cost of medical care as well. Since 2014, Northampton County has imposed no increases in the co-pays of county employees. But medical costs continue to rise in a county that is self-insured. This year's budget projects a $6.5 million increase. The total cost of medical care to county employees is estimated at nearly $30 million.

According to its website, Integrity Health offers "customized, patient-centered, cost-effective health programs built on the wisdom of coordinated care." It operates at six locations in New Jersey, with a seventh in Lycoming County. Its Chair is Doug Forrester, a former Republican candidate for the US Senate (2002) and Governor in New Jersey (2005). He founded Integrity after his daughter suffered a traumatic brain injury.  From X-Rays to chronic disease management to routine lab tests, it offers extensive primary care. 

I do not have the salient contractual details, including cost. That information will be disclosed when Council's Finance Committee considers this matter