TAMPA CITY COUNCIL
Special called meeting
Thursday, October 28, 2010
10:30 a.m. session
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10:32:16 >>THOMAS SCOTT: We'll have roll call.
10:32:18 >>GWEN MILLER: Here.
10:32:20 >>CHARLIE MIRANDA: Here.
10:32:22 >>CURTIS STOKES: Here.
10:32:22 >>THOMAS SCOTT: Here.
10:32:26 The first order of business is the comp plan amendment.
10:32:30 Who is going to address that?
10:32:34 >>GWEN MILLER: Move to open the public hearing.
10:32:37 >>THOMAS SCOTT: All in favor?
10:32:46 Number one, this is the public hearing on adoption.
10:32:51 Does anyone from the public wish to address council on
10:32:53 item number 1?
10:32:55 Any comment by staff?
10:32:57 >>GWEN MILLER: Move to close.
10:32:58 >>THOMAS SCOTT: Moved and seconded.
10:33:00 All in favor?
10:33:04 >>CHARLIE MIRANDA: Move an ordinance presented for
10:33:06 second reading and adoption, Tampa comprehensive plan,
10:33:09 standards and economic development, economic
10:33:16 development overlay associated with the green tech
10:33:19 corridor that enables development of targeted
10:33:22 industries in selected areas of Tampa providing for
10:33:24 repeal of all ordinances in conflict providing an
10:33:26 effective date providing for severability, providing an
10:33:29 effective date.
10:33:29 >>THOMAS SCOTT: Seconded by councilman Stokes.
10:33:33 >>THE CLERK: Motion carried with Caetano absent at
10:33:47 >>THOMAS SCOTT: Item 2.
10:33:51 Anyone from the public wish to address council on item
10:33:55 >>CHARLIE MIRANDA: Move to close.
10:33:56 >> Second.
10:34:00 >>THOMAS SCOTT: All in favor?
10:34:01 Councilman Stokes.
10:34:03 >>CURTIS STOKES: Move an ordinance for second reading
10:34:07 and adoption, an ordinance amending the Tampa
10:34:08 comprehensive plan, public school facilities element,
10:34:11 to modify an objective related to student generation
10:34:14 rates, providing for repeal of all ordinances in
10:34:16 conflict, providing for severability, providing an
10:34:20 effective date.
10:34:20 >>THOMAS SCOTT: Seconded by councilman Miranda.
10:34:23 Record your vote, please.
10:34:35 >>THE CLERK: Motion carried with Caetano being absent.
10:34:38 >>THOMAS SCOTT: Does anyone wish to address council on
10:34:41 the third item from the agenda?
10:34:43 >>CHARLIE MIRANDA: Move to close.
10:34:43 >> Second.
10:34:47 >>THOMAS SCOTT: Moved and seconded.
10:34:48 All in favor?
10:34:49 Councilwoman Mulhern, number 3.
10:34:51 >>MARY MULHERN: I move an ordinance being presented
10:34:54 for second reading and adoption, an ordinance amending
10:34:56 the Tampa comprehensive plan, mobility and capital
10:35:00 improvements element to modify and add objectives and
10:35:02 policies related to transportation concurrency and
10:35:05 strategies for mobility, providing for repeal of all
10:35:08 ordinances in conflict, providing for severability,
10:35:11 providing an effective date.
10:35:11 >>THOMAS SCOTT: Seconded by councilman Miranda.
10:35:16 Record your vote.
10:35:22 >> Motion carried with Caetano being absent.
10:35:25 >>THOMAS SCOTT: Item 4.
10:35:26 Anyone from the public wish to address council?
10:35:30 >>CHARLIE MIRANDA: Move to close.
10:35:31 >> Second.
10:35:32 >>THOMAS SCOTT: All in favor?
10:35:33 Item 4.
10:35:35 >>CHARLIE MIRANDA: Move an ordinance for second reading
10:35:37 and adoption, an ordinance amending the Tampa
10:35:39 comprehensive plan, to add goals, objectives an
10:35:42 policies to establish a 40th Street corridor community
10:35:45 vision plan, providing for repeal of all ordinances in
10:35:47 conflict, providing for severability, providing an
10:35:50 effective date.
10:35:50 >>THOMAS SCOTT: Seconded by Councilwoman Mulhern.
10:35:53 All in favor -- record your vote.
10:35:58 >>THE CLERK: Motion carried with Caetano being absent.
10:36:03 >>THOMAS SCOTT: Item 5.
10:36:05 Anyone from the public wish to address council on item
10:36:09 >>CHARLIE MIRANDA: Move to close.
10:36:10 >> Second.
10:36:12 >>THOMAS SCOTT: All in favor?
10:36:13 Councilwoman Miller.
10:36:14 >>GWEN MILLER: Move to adopt the following ordinance
10:36:16 upon second reading, an ordinance amending the Tampa
10:36:19 comprehensive plan, capital improvement element by
10:36:21 updating the schedule for the of projects for fiscal
10:36:25 year 2011 through fiscal year 2016 providing for repeal
10:36:31 of all ordinances in conflict, providing for
10:36:33 severability, providing an effective date.
10:36:36 >>THOMAS SCOTT: Seconded by Councilwoman Capin.
10:36:38 Record your vote.
10:36:38 >>THE CLERK: Motion carried with Caetano being absent.
10:36:43 >>THOMAS SCOTT: Item 6.
10:36:45 Anyone from the public wish to address council on item
10:36:48 >> Randy Goers, land development.
10:36:54 Just for the record this is a map amendment on Adamo
10:36:57 Drive going from heavy industrial to RMU 100.
10:37:02 The Planning Commission recommended not to approve
10:37:09 The MPO, the board FDOT and region planning council all
10:37:15 had issues or objections as well as city staff.
10:37:17 Thank you.
10:37:17 >>THOMAS SCOTT: Councilman Miranda.
10:37:23 >>CHARLIE MIRANDA: Also for the record, if it had been
10:37:24 the other way around and this had been a residential
10:37:27 mix use that was going to go to industrial, I would
10:37:29 have voted against it because Adamo Drive is a main
10:37:32 corridor to the city, and all you see now is
10:37:36 dilapidated buildings, not that they are in great shape
10:37:40 but they are also in deplorable conditions.
10:37:43 When I see something like this, and I see land
10:37:46 developed all around the port, the port themselves have
10:37:48 not been here, if they weren't in the audience would
10:37:52 have never spoke, and when this council zoned all the
10:37:56 land north of Channelside and Kennedy for multifamily
10:38:00 use around Adamo Drive, and through 21st street,
10:38:05 the board had no objections there.
10:38:06 I wonder why they have objections to something this far
10:38:09 Thank you.
10:38:10 >>JULIA COLE: City of Tampa legal department.
10:38:15 I did also want to reiterate for the record the
10:38:18 discussion that we had at the previous hearing.
10:38:21 You were shown this provision of the comprehensive plan
10:38:25 in staff reports and it was also verbally discussed
10:38:28 which provides standards upon which you are making your
10:38:31 decision today.
10:38:32 Given that this particular comprehensive plan amendment
10:38:35 doesn't meet your locational criteria that is set up in
10:38:39 subsection 2, that you would be reviewing this pursuant
10:38:42 to subsection 3.
10:38:44 In subsection 3 it requires City Council -- allows City
10:38:48 Council to approve this comprehensive plan amendment
10:38:51 upon the finding that this comprehensive plan
10:38:54 amendment -- that this land use amendment is no longer
10:38:58 in the best interest of the public, and I would say
10:39:00 that part of your approval process that finding would
10:39:02 be made.
10:39:03 I did also want to reiterate for the record -- and we
10:39:06 talked about this at the previous hearing -- if this
10:39:10 comprehensive plan designation is approved, that the
10:39:13 property owner will have to come forward with a site
10:39:16 plan controlled district.
10:39:17 It is something that is obligated with, within your
10:39:20 code, and it is something that has to be processed,
10:39:23 meaning that it wouldn't be able to come to City
10:39:26 Council in the Euclidean zoning district.
10:39:28 City staff would not even be able to move forward with
10:39:30 the application unless it's a site plan controlled
10:39:32 Again I just wanted to make that clear for the record
10:39:35 so there's no questions later on.
10:39:38 >>CHARLIE MIRANDA: For the record, let me understand
10:39:40 what you said in laymen's terms.
10:39:42 They still have to come back for rezoning, and they
10:39:46 still have to meet all the regulations of that
10:39:50 >>JULIA COLE: That's correct.
10:39:52 But that rezoning must be a site plan controlled zoning
10:39:55 Thank you.
10:40:01 >>YVONNE CAPIN: Site plan controls, meaning the
10:40:07 conditions that is on the site plan.
10:40:08 >>JULIA COLE: Like a PD district.
10:40:12 In this instance it would be a PD.
10:40:14 There's other parts of the city where you have site
10:40:15 plan control districts that are not PD zoning district.
10:40:21 But in this instance it would for this particular
10:40:24 property, it would be a planned development zoning.
10:40:26 >>MARY MULHERN: Ms. Cole, can you leave that up there?
10:40:33 Because I just -- I just want to point out, I voted --
10:40:38 I was the only one that vote against this at the first
10:40:41 reading and I am going to vote against it again based
10:40:45 on that number 3 criteria, that our local planning
10:40:47 agency and our planning staff did propose alternative
10:40:52 amendments, which could have happened, and they are
10:40:57 >>THOMAS SCOTT: Motion to close?
10:41:05 >>CHARLIE MIRANDA: So moved.
10:41:06 >>JULIA COLE: I believe we should give the petitioner
10:41:09 an opportunity.
10:41:10 >>THOMAS SCOTT: Petitioner?
10:41:12 >> I first would like to thank council for being here
10:41:15 This is a specialest by the council, and I want to give
10:41:19 commendation, because you are working in an extra
10:41:23 capacity regarding potential issues that may arise in a
10:41:26 few days that are on the ballot.
10:41:27 And I think that's very pro business and very proactive
10:41:30 and I personally appreciate it and I think the viewers
10:41:34 need to know that.
10:41:35 Staff made their opinions on this issue and we
10:41:37 understand them, and they put that on the record and we
10:41:41 heard that.
10:41:41 Thank you.
10:41:44 >>CHARLIE MIRANDA: Motion to close.
10:41:47 >> Second.
10:41:48 >>THOMAS SCOTT: All in favor?
10:41:49 Councilwoman Capin.
10:41:50 Item 6.
10:41:52 >>YVONNE CAPIN: I move an ordinance being presented for
10:41:57 second reading and adoption, an ordinance amending the
10:41:59 Tampa comprehensive plan, future land use element,
10:42:03 future land use map for the property located in the
10:42:05 general vicinity of southeast corner of Adamo Drive and
10:42:08 50th street from heavy industrial to regional mixed
10:42:11 use 100 providing for repeal of all ordinances in
10:42:14 conflict, providing for severability, providing an
10:42:18 effective date.
10:42:23 Original motion -- oh, do I need to read -- oh, thank
10:42:26 >>THOMAS SCOTT: Seconded by councilman Caetano.
10:42:31 Record your vote.
10:42:41 >>THE CLERK: Motion carried with Mulhern voting no.
10:42:45 >>THOMAS SCOTT: Item 7.
10:42:46 Anyone from the public wish to address council on item
10:42:50 >>GWEN MILLER: Move to close.
10:42:51 >> Second.
10:42:52 >>THOMAS SCOTT: Moved and seconded.
10:42:53 All in favor?
10:42:55 Item 7.
10:42:56 Councilman Caetano.
10:43:00 While you are trying to find that, ask if
10:43:09 administration wants to come over.
10:43:11 >> An ordinance amending the Tampa comprehensive plan,
10:43:15 future land use element, future land use map to
10:43:18 designate the economic development overlay in the
10:43:21 general vicinity of University of South Florida, Fowler
10:43:24 Avenue, Bougainvillea Avenue, 30th street, 46th
10:43:28 street, 50th street, and McKinley drive, providing
10:43:31 for repeal of all ordinances in conflict, providing for
10:43:34 severability, providing an effective date.
10:43:34 >>THOMAS SCOTT: Seconded by councilman Miranda.
10:43:48 >>THE CLERK: Motion carried unanimously.
10:43:49 >>THOMAS SCOTT: Item 8.
10:43:54 Anyone from the public?
10:43:56 Item 8.
10:43:56 >>GWEN MILLER: Move to close.
10:43:57 >> Second.
10:43:59 >>THOMAS SCOTT: All in favor?
10:44:01 Councilman Miranda.
10:44:02 >>CHARLIE MIRANDA: Move an ordinance for second
10:44:05 reading, an ordinance amending the Tampa comprehensive
10:44:08 plan, future land use element, future land use map for
10:44:11 the property general generally bounded by Busch
10:44:12 Boulevard on the north, 22nd street on the west,
10:44:15 Hillsborough Avenue on the south, and Tampa city limits
10:44:18 on the east from residential 10, residential 20,
10:44:21 residential 35 to community mixed use 35 providing for
10:44:25 repeal of all ordinances in conflict, providing for
10:44:27 severability, providing an effective date.
10:44:28 >>THOMAS SCOTT: Seconded by Councilwoman Capin.
10:44:35 Record your vote.
10:44:35 >>THE CLERK: Motion carried unanimously.
10:44:42 >>THOMAS SCOTT: Julia, do we need to take any other
10:44:48 action with these comp plans?
10:44:50 >>JULIA COLE: No, we don't.
10:44:52 They have been approved and we will move forward.
10:44:57 >>THOMAS SCOTT: Thank you very much.
10:44:57 Then we'll move to our next item on the agenda which is
10:45:01 the health care issue that we voted on last week.
10:45:08 I sent a memo out, back to the agenda for today.
10:45:14 So in the process, so council will understand, I did
10:45:19 receive a call from the mayor stressing the urgency and
10:45:22 importance of this particular plan, and also advising
10:45:25 that we needed more information and council wanted to
10:45:30 be briefed on this issue so that we can try to bring
10:45:33 some resolve to the issue.
10:45:34 So at that point, that's where we are today.
10:45:37 Any question.
10:45:42 >>CHARLIE MIRANDA: For clarity of ourselves I would
10:45:44 like to ask our attorney do we need to waive the rules
10:45:47 to have the special called meeting?
10:45:48 I'm not saying that the chairman can't do it but I want
10:45:50 to make sure that we do it so that no one else in the
10:45:53 audience or someone watching or listening can come back
10:45:55 and say we did something that we shouldn't have done.
10:45:57 >>MARTIN SHELBY: Mr. Miranda, that would be
10:46:02 Rule 7-B does state an item may be placed on a future
10:46:06 agenda by majority vote of the City Council.
10:46:08 The chairman does have the ability to call an emergency
10:46:11 meeting, but in lieu of the fact he didn't, the
10:46:14 appropriate step would be to waive the rules.
10:46:17 >>CHARLIE MIRANDA: I move a motion to waive the rules,
10:46:18 Mr. Chairman.
10:46:18 >>JOSEPH P. CAETANO: Second.
10:46:21 >>THOMAS SCOTT: Moved and seconded.
10:46:23 All in favor?
10:46:25 Let me just be clear.
10:46:26 Under the rules that we could have called an emergency
10:46:28 meeting, but in that we were already having a special
10:46:31 called meeting.
10:46:32 I just want to be clear on that issue.
10:46:34 All right.
10:46:35 We'll have administration come forward and make a
10:46:37 presentation at this time.
10:46:43 You may have a number of questions.
10:46:49 Kimberly Crum, director of human resources.
10:46:51 I really appreciate the opportunity to come before you
10:46:53 today and revisit this important initiative which is
10:46:56 designed to improve the health of our employees and
10:47:01 their family.
10:47:03 I prepared just a very brief presentation today that
10:47:06 will address some of the questions that we received so
10:47:08 since our last presentation before you.
10:47:10 So if we could have the slides.
10:47:22 The City of Tampa covers over 10 that you people today
10:47:25 with a total for fiscal year 2010 of $35 million.
10:47:29 This the benefits provided for employees and retirees
10:47:33 under all bargaining agreements.
10:47:35 And we have the goal of providing high quality benefits
10:47:37 while effectively managing the costs to employees and
10:47:40 the city.
10:47:41 And just as a reminder we talked about last week how
10:47:44 the cost of the plan is based on claims so if we are
10:47:46 able to reduce claims in future years our costs will be
10:47:59 Voluntary centers are being use across the nation --
10:48:06 excuse me.
10:48:07 The wellness centers here at the city are planned to be
10:48:10 managed by an outside vendor, Care ATC, by physician
10:48:14 and staff at each location.
10:48:15 They will be providing hey quality medical care
10:48:18 designed specifically to be proactive so that wellness
10:48:21 screening can help uncover health issues early so that
10:48:24 they can be properly treated.
10:48:37 By cutting the cost of visits in half, by ensuring that
10:48:41 consumable medical supplies and prescriptions are
10:48:44 charged to the city at cost and impact on those five
10:48:50 primary risk factors that drive the costs in our plans.
10:48:53 We will see ease of employment scheduling so time away
10:48:58 from work is limited and have fewer barriers to getting
10:49:00 treatment when needed.
10:49:02 The benefits to employees include convenience.
10:49:06 Each visit they make to a voluntary wellness center
10:49:08 will be zero cost payments as well as zero co-payment
10:49:12 for generic prescriptions that heir stocked there.
10:49:15 They will have continuity of care, seeing the same
10:49:18 doctor at each location, and they'll receive support
10:49:21 for wellness initiatives like diabetes management,
10:49:24 weight loss and tobacco cessation, three of the primary
10:49:27 risk factors that drive a great portion of our costs.
10:49:30 And just a reminder that all participation within the
10:49:33 voluntary wellness centers is voluntary.
10:49:38 Moving onto the cost comparison.
10:49:40 Several questions were raised around this, just to
10:49:43 ensure that we are all working from the same sheet of
10:49:48 But Humana based renewal premiums as we shared with you
10:49:52 before was nearly 40,800,000, or an increase of over
10:50:00 Humana's final offer was 38.6 million or increase of
10:50:06 In contrast, United Health Care's best and final offer
10:50:10 was just over $36 million or increase of just over 6%.
10:50:15 And their best and final offer after considering
10:50:18 voluntary wellness clinics and the savings that they
10:50:21 would provide was just over $35 million.
10:50:24 You see the premium savings with the voluntary wellness
10:50:28 clinic listed at 951,773.
10:50:37 So the question has arisen, what happens to the
10:50:39 premiums if we don't go with the voluntary wellness
10:50:45 If they aren't approved premiums have to go up to cover
10:50:48 that increase in cost.
10:50:50 Now, we know that the city bears the majority of that
10:50:53 cost increase, but in order to cover the full cost of
10:50:55 the employee premiums would be reflected here on this
10:50:59 The first column you see is the premium rate with
10:51:02 voluntary wellness centers, and the second column is
10:51:05 the premium rate without voluntary wellness centers.
10:51:09 So in addition to having an increase in premiums,
10:51:11 employees would also not have the benefit of free
10:51:15 visits, free generic drugs where appropriate.
10:51:19 In the choice plan, which is the plan that requires two
10:51:22 activation steps, those employees instead of paying
10:51:27 less than $117.46 per pay period, they would be asked
10:51:30 to pay $126.19 or 7% increase.
10:51:35 You see the select plan goes from 133.10 to 144.59 for
10:51:40 an increase of 8.6%, and the foundation plan $150.63 to
10:51:48 168.45 for an increase of 11.8%.
10:51:55 With the approval of the voluntary wellness centers,
10:51:58 we'll see additional savings on worker's comp.
10:52:01 Because we'll be using the downtown location of primary
10:52:05 triage for nonthreatening or non-life threatening on
10:52:08 the job injuries, we'll save 550,000 in the first year.
10:52:14 So coupling the unit health care credits that we would
10:52:17 get, having implemented voluntary wellness centers
10:52:21 along with the workers' compensation saving, we are
10:52:24 looking at a savings of over $1.5 million.
10:52:29 We have been asked about the second year savings.
10:52:32 While it's difficult to predict until we are at renewal
10:52:36 time, the best and most conservative information shows
10:52:41 that we will likely have a one to one savings.
10:52:44 So for every dollar we invest into the wellness
10:52:46 centers, we'll receive a dollar back in our renewal
10:52:50 next year.
10:52:51 So with that we are estimating $2.6 million in savings
10:52:56 with United Health Care, and 1.4 million under worker's
10:53:01 comp savings for a full year for a total of about $4
10:53:08 And with that, I thank you for your attention and for
10:53:11 your continued interest in the wellness center concept
10:53:14 and we would be happy to take questions.
10:53:16 >>THOMAS SCOTT: One we can question and I will
10:53:18 recognize Councilwoman Mulhern.
10:53:20 Under the 4.1, is that after expenses, the savings?
10:53:25 >> What we are showing here, councilman, is that the
10:53:27 2.6 would be the cost of the clinic.
10:53:31 We expect that next year when we go to renewal with
10:53:35 United Health Care they will see that the clinics have
10:53:37 saved at least that much money, and will weave that
10:53:42 into their premiums for next year.
10:53:44 >>THOMAS SCOTT: Councilwoman Mulhern, then councilman
10:53:46 >>MARY MULHERN: Yeah, I mean, it kind of boils down to
10:53:50 I if we felt comfortable with your numbers it would be
10:53:58 I mean, I wasn't comfortable, and I just found out
10:54:02 yesterday, and I just got this memo which was very
10:54:06 I appreciate it, and basically boils down to what you
10:54:09 have up there.
10:54:10 But I have a couple of questions.
10:54:11 One is in looking through this, you have the time --
10:54:17 implementation time line checklist.
10:54:20 And it occurs to me, you have already signed the letter
10:54:23 of intent, right?
10:54:24 >> I believe the letter of intent happens as soon as
10:54:28 the committee moves forward, but we have signed no
10:54:33 contract with them.
10:54:34 >> But the letter of intent, I mean, you are doing all
10:54:37 these things -- I guess at the employee meeting, that's
10:54:48 what got ahead of us, I think, right?
10:54:52 Because you got these employee meetings already
10:54:57 And then, you know, arranging space, recruiting
10:55:01 physicians, space buildout.
10:55:03 You haven't done any of that.
10:55:04 >> Care ATC has been reviewing available space but we
10:55:08 have not listed any space because we don't have a
10:55:11 >>MARY MULHERN: So maybe Mr. Fletcher could tell me,
10:55:14 is there a letter of intent that was already signed?
10:55:17 >>CHARLES FLETCHER: No.
10:55:21 If I understand the concept -- Chip Fletcher, city
10:55:25 Sometimes vendors call them different things.
10:55:27 But when we do a bid, when that bid is awarded, we
10:55:30 issue a notice of award.
10:55:32 And that might be what you are referring to as the
10:55:35 letter of intent.
10:55:35 >>MARY MULHERN: Well, attachment C, implementation,
10:55:41 time line responsibility checklist.
10:55:43 So this is part of what you are asking us to approve.
10:55:45 >>CHARLES FLETCHER: That would be part of -- no,
10:55:48 that's their proposal.
10:55:50 >>MARY MULHERN: I'm just trying to understand how
10:55:56 we -- it looks like -- much of this is already being
10:55:59 implemented, so --
10:56:02 >>CHARLES FLETCHER: What you are looking at -- I'm
10:56:04 What you are looking at is what the vendor gave us, in
10:56:07 an interview, in a presentation.
10:56:11 We don't have anything -- they are using the term
10:56:14 letter of intent.
10:56:15 We are not issuing anything called a letter of intent.
10:56:18 It's just a semantic --
10:56:22 >>MARY MULHERN: Well, it's not just semantics because
10:56:24 you are already meeting with employees and offering
10:56:30 It's not semantics.
10:56:31 That's real happening.
10:56:34 >> These time lines you see in this interview material
10:56:37 is not in the contract.
10:56:38 It is not in any document I use as part of the
10:56:45 It is a marketing piece that was provided to us by the
10:56:47 >>MARY MULHERN: Well, I just wanted to point out that
10:56:51 we are being asked -- I'm not even sure what we are
10:56:54 being asked to approve.
10:56:55 But this is the question I have.
10:56:58 Because based on your numbers -- and I think Chairman
10:57:01 Scott asked the question already, and I don't feel like
10:57:04 we really -- I didn't understand the answer.
10:57:09 Your telling us that in the first year you are
10:57:15 projecting to save between the credit, what is the
10:57:25 credit based on?
10:57:26 How much we are going to be paying them?
10:57:27 Is that basically how much they are estimating they are
10:57:30 going to get a year?
10:57:32 >> The $951,000 is the credit that United Health Care
10:57:36 is giving to the city in its premium.
10:57:41 If we implement voluntary wellness centers -- you may
10:57:45 recall in the first presentation --
10:57:46 >>MARY MULHERN: Okay.
10:57:48 No, I understand.
10:57:48 But the numbers sort of come close, because when I
10:57:52 added up your figures about the total cost to implement
10:57:57 three clinics, the overhead, the rent, and what you are
10:58:02 estimating for overhead and estimating for
10:58:07 compensation, the total comes to $2.8 million a year,
10:58:13 for the rent and the personnel.
10:58:17 And I guess the overhead, although I don't know how
10:58:20 you -- you know, I'm not sure how you figured that out.
10:58:23 So to me, in the first year, and that's a recurring
10:58:28 cost every year, $2.8 million.
10:58:31 >>> Yes.
10:58:33 >>MARY MULHERN: So your cost, that's the cost running
10:58:37 these clinics.
10:58:40 Based on your numbers which, you know, I certainly
10:58:44 haven't had time to really look into, but my question
10:58:48 is, so if we accept this estimate of 4 million, you are
10:58:55 actually saving -- you have to subtract the cost, those
10:59:01 administrative costs, right?
10:59:02 >> The cost and the savings in the health plan should
10:59:05 be a one-to-one trade-off.
10:59:07 That is the conservative estimate that we are using.
10:59:10 >> Right.
10:59:11 >> So, yes, we will still pay each year, based on the
10:59:14 numbers that we provided, $2.68 million for a full year
10:59:18 to operate all three --
10:59:21 >>MARY MULHERN: Okay, well, my numbers that I did with
10:59:24 a pencil in my own math skills, so maybe I was off, but
10:59:29 I was 2.8 million, not 2.6.
10:59:35 The next question -- so those costs -- that's not
10:59:40 really a credit.
10:59:41 They are giving us a credit, but we are paying for it.
10:59:44 >>> You're paying to operate the wellness centers, but
10:59:49 you are getting the benefit of what the wellness
10:59:51 centers provide in the health plan.
10:59:55 They are a handshake.
10:59:56 There's no question about it.
10:59:58 That's why United Health Care was willing to give us a
11:00:01 credit this year for implementing the voluntary
11:00:02 wellness centers, because they know the more people use
11:00:05 the wellness centers, the fewer visits we'll have in
11:00:08 the health plan.
11:00:10 And so they are charging us less out of the gate.
11:00:12 >>MARY MULHERN: So we are paying --
11:00:15 >>> You are going to pay for it.
11:00:17 >>MARY MULHERN: They are charging us less than we are
11:00:20 paying somebody else if we have another contract.
11:00:22 >>> That's right.
11:00:23 We tried to be very transparent by that up front and
11:00:26 say that is how we are opening the wellness centers
11:00:29 under budget.
11:00:30 >>MARY MULHERN: But you are including that credit as a
11:00:32 savings without debiting it, the cost of the
11:00:36 So I think at the very least we have to subtract --
11:00:42 just take that 2.68 million out, and your actual
11:00:50 savings is only the worker's comp portion.
11:00:53 That is because it balances out, United Health Care
11:00:56 gives you that credit, but you are paying it in rent
11:00:59 and you're paying those administrative costs to the --
11:01:04 whatever, Care ATC.
11:01:06 So, really, I think your estimate of savings is 1.45
11:01:11 million, not 4.13 million for the first full year.
11:01:16 So my next question is, what is your -- what is this
11:01:22 based on, these estimates?
11:01:28 It's based on 40% of employees using this within that
11:01:31 first year?
11:01:32 >> In the first partial year, it's estimated that 40%
11:01:35 of our employees will go to the doctor at the voluntary
11:01:41 wellness center.
11:01:42 So that's a 40% estimate for the first partial year in
11:01:46 the way that we had rolled out the concept of three
11:01:50 wellness clinics.
11:01:51 >> So what happens if we don't get to that?
11:01:55 >>> What would happen if we don't get to that, that
11:01:57 would involve the service level agreement that we have
11:01:59 with Care ATC.
11:02:01 They are very motivated to ensure that 40% of our
11:02:07 people go.
11:02:07 I can tell you that in Clearwater, who is in the very
11:02:10 early stages of their implementation, they are on track
11:02:12 to not only meet that but surpass it because of the
11:02:15 activities that Care ATC has put in place in
11:02:19 conjunction with the administration there.
11:02:21 After 90 days they are at 32% participation already,
11:02:24 and their office visits are full, because employees are
11:02:28 interested in utilizing the voluntary wellness centers.
11:02:32 And our employees have given up great -- given us great
11:02:36 feedback following implementation of their rollouts.
11:02:41 >>MARY MULHERN: Okay.
11:02:45 I guess that's -- those are my questions.
11:02:48 But I also just want to ask you, what you showed us, is
11:02:52 there anything new from last week?
11:02:55 >>> The only thing that you see that's new in the slide
11:03:00 from today was the memo that was provided earlier.
11:03:03 So there's nothing beyond that.
11:03:04 >>MARY MULHERN: So that's what I was asking you about.
11:03:12 And I'm still not completely convinced that the savings
11:03:14 are really guaranteed.
11:03:20 It is all based on the assumption that this is all
11:03:25 going to happen.
11:03:28 But it would be nice if all the questions that we had
11:03:31 last week about this, if we could get some answers
11:03:34 about the idea of having -- starting out with one
11:03:41 clinic, starting out with one year contract, to see if
11:03:46 this is worth it.
11:03:47 So it goes along with the -- the health care proposal.
11:03:54 We need to hear about that, hear from you on that,
11:03:57 because basically we are déjà vu, back here again with
11:04:02 nothing new and no compromise or really new
11:04:07 >> With regard to starting out with one clinic, you
11:04:15 must understand that the pro forma that's been put
11:04:18 together by Care ATC uses basic assumptions in its
11:04:24 business plan, and respectfully, it's very important in
11:04:30 that business model, in order to meet the number of
11:04:32 visits, that Care ATC has given us credit for, even in
11:04:36 the first partial year, the first year of their
11:04:39 contract, the first partial year of the Care ATC
11:04:43 wellness clinic.
11:04:46 We really need to make the investment into the clinic
11:04:48 so that we can get started on the savings, and to try
11:04:51 to do a clinic scenario within one year is just not
11:04:57 And to try to cut back on the number of visits or the
11:05:00 implementation schedule means that Care ATC's proposal
11:05:05 to us is not valid, and we would have to start all over
11:05:09 and promise fewer visits under a different scenario as
11:05:12 in just one clinic to begin with.
11:05:16 So I have deep concerns in the way that the agreement
11:05:20 is structured that we would be able to make that work,
11:05:24 because I wouldn't want United Health Care to enter
11:05:28 into an agreement with us where we promise a certain
11:05:30 number of visits and we can't possibly meet that.
11:05:33 >>THOMAS SCOTT: Councilman Miranda.
11:05:37 >>CHARLIE MIRANDA: I really don't know where to start
11:05:39 because there's so many things to discuss here.
11:05:41 First of all, we are not discussing anything that
11:05:44 wasn't discussed last week, in my opinion.
11:05:47 It was already on the table.
11:05:49 I offered a 30-day grace period and I was turned down
11:05:52 by the administration.
11:05:53 So instead of having a 30 day grace period we only had
11:05:56 a one-week to come back on the same thing.
11:05:59 Let me say what I think happened.
11:06:02 And you may not like it but I'm going to say it.
11:06:08 You met with Humana, you did your due diligence and saw
11:06:11 it was better to go with United.
11:06:13 In that contract with United even though last week or
11:06:15 so the administration said health care is one thing,
11:06:18 wellness is another, they are not combined.
11:06:20 And today by your own admission you stated that they
11:06:25 are combined because that was a promise that was made
11:06:28 to United.
11:06:29 We were not privy to that.
11:06:30 You said that this morning.
11:06:32 If you want me to replay the tape I will.
11:06:34 Let me go back and say this.
11:06:36 When you go back and you make a decision to go with
11:06:41 United, that's a decision between yourself and the
11:06:43 mayor and the administration.
11:06:47 I don't believe this council has any quarrel with you.
11:06:49 When you start making promises without getting approval
11:06:51 from the council, there's where the line is drawn in
11:06:55 the sand, because you don't have the right to do that.
11:06:58 You didn't have the right to do that under that
11:07:01 assumption you were going to get rubber stamped by this
11:07:04 So what you have done now is put the burden on us like
11:07:07 we are the bad guys or bad ladies, as the case may be,
11:07:11 and handle it in that fashion.
11:07:14 When I look at some things, and I look at number,
11:07:19 facilities, number and location, how many do we have?
11:07:23 >>> We have in a facilities.
11:07:24 >> How many are you going to have if this passes?
11:07:27 >>> The plan is to have three.
11:07:29 >> All right.
11:07:29 The plan is to have three.
11:07:30 Did that change from last week?
11:07:32 >>> No, sir.
11:07:33 >> Where are the locations?
11:07:34 >>> We have not determined locations.
11:07:37 >> So you don't have --
11:07:38 >>> The recommendation is that one would be located
11:07:40 near downtown, one would be on the north side, and one
11:07:43 would be near Brandon.
11:07:45 >> All right.
11:07:46 So two of them, I assume, are outside the city limits.
11:07:49 >>> That was the recommendation.
11:07:50 >> I'm making an assumption.
11:07:52 I don't know if.
11:07:55 Let me go to math, something I know very little about.
11:07:59 When I look at the second bullet down approximately 20
11:08:02 to $22 a square foot is the asking rate.
11:08:06 I guess that whatever this company name made that sums,
11:08:10 the wellness people.
11:08:12 Care ATC made that assumption.
11:08:15 And that the clinics were going to be approximately
11:08:17 three clinics at 2500 to 3,000 square foot, and that
11:08:21 the budget of 220,000 for 10,000 square foot before
11:08:28 I'm making another assumption because that's all we
11:08:30 have to go on is assumptions here.
11:08:32 Here is where the problem lies.
11:08:34 That's why I wanted 30 days.
11:08:35 When you look at the assumptions that I am making
11:08:37 myself, okay, the clinics are approximately 3,000 to
11:08:41 3300 square foot, at $22 a square foot, that will give
11:08:45 you $6,600 a month rent.
11:08:49 Am I correct in that number?
11:08:52 >> Without a calculator I am going to take your word
11:08:54 for it.
11:08:54 >> Don't take my word for it.
11:08:56 I'm just going by what you gave us.
11:08:58 So that being the case, if I multiply $6,000, forget
11:09:05 the other part, times 6,000 times 12, the rent for one
11:09:10 clinic is $72,000 a month.
11:09:15 I mean a year.
11:09:15 >> Per year.
11:09:17 >> I knew I would make a mistake somewhere.
11:09:20 So now you are looking at $72,000 a month times --
11:09:24 >>> Per year.
11:09:25 >> I want to see if you caught me the second time
11:09:27 A.year times three locations of 72,000.
11:09:31 That's why the budget down here is 220.
11:09:34 Now, what is 72,000 times three?
11:09:43 So you are asking us to approve rents of $216,000 plus
11:09:51 all the complete pass throughs, where the city had its
11:09:55 own building for a clinic.
11:09:57 And still may have other properties for a clinic.
11:10:00 Now, we talked about differences in time and location
11:10:06 that people won't go.
11:10:08 Let me tell you what I have done.
11:10:10 If there was an airline leaving Tampa to New York round
11:10:13 trip for $300 and there was an airline leaving Orlando
11:10:16 to New York for free, people would drive to Orlando
11:10:22 because it's free.
11:10:24 When McDonald hamburgers it started with one location.
11:10:32 But the people from Outback restaurant, good people,
11:10:34 had a model where they are at today.
11:10:39 You know how many places they started? Uno, one,
11:10:43 Henderson and Kennedy.
11:10:44 So the doctor costs, 260,000, not by my numbers but the
11:10:51 numbers we received here.
11:10:52 A family practitioner or general practitioner in this
11:10:56 area takes home between 120 and 150,000, not 260,000.
11:11:04 And we have to pay the rent, we have to pay the pass
11:11:10 Who knows what the relocation costs are?
11:11:12 I don't know that.
11:11:14 This council doesn't know that.
11:11:16 What I am trying to say is give us something to pass.
11:11:20 Why don't we start with one clinic, like business
11:11:23 people have start, and promote yourselves? Let me tell
11:11:26 you this and very sincere.
11:11:28 I went and talked to the former administrator of the
11:11:31 county commission.
11:11:32 I didn't pursue it any further because they had their
11:11:35 own problems.
11:11:36 We talked in detail about the size of just the
11:11:40 governments in this area between ourselves, the county,
11:11:44 state attorney, public defender's office.
11:11:47 The sheriff has a different type of insurance.
11:11:50 It would have been the largest most cost savings, and I
11:11:54 stopped because I saw what was happening.
11:11:58 Maybe in the country.
11:12:00 And the taxpayers are the ones that are funding this.
11:12:02 So before I think as an elected official, my heart
11:12:09 tells me about being a taxpayer first.
11:12:12 And I tell myself, is this the best we can do?
11:12:16 If we market ourselves, if we go and ask the doctors
11:12:18 and family practice and general practitioners if they
11:12:22 needed some more business?
11:12:24 I don't know if you did or not.
11:12:26 I don't know that.
11:12:28 Have we looked at any model where we just call
11:12:30 different cities and put out an RFP in the Penny Saver,
11:12:35 which is a great newspaper, and I don't know how many
11:12:37 health clinics and professional doctors read that
11:12:39 section of the paper.
11:12:41 Did we do that?
11:12:42 I don't know.
11:12:43 So it's difficult for me.
11:12:49 And how do we get to the number?
11:12:53 I believe that's called capitalization where you think
11:12:56 you have so much that you think are going to go so
11:12:58 therefore you base it on that number and the revenue is
11:13:00 based on that number, whether they go or not, we pay.
11:13:04 Because that's how it's capped out.
11:13:06 It's not based on the 10,000.
11:13:08 It's based on the 4,200, whatever the number was.
11:13:12 You cap that number.
11:13:13 You multiply it by a certain fact.
11:13:15 You take percent.
11:13:16 That's what they get, whether we use it or not.
11:13:20 I'm not an insurance agent, but I did take all the
11:13:26 insurance tests there are in America.
11:13:28 So it is -- we talk about things that are wonderful.
11:13:33 Same doctor.
11:13:35 Well, could be and maybe not.
11:13:37 But let me show you another thing,
11:13:43 Number 3.
11:13:45 Low upfront costs or installation fee.
11:13:47 That sounds wonderful.
11:13:48 And it is.
11:13:51 Until the dot is there and you follow it and it says,
11:13:54 these charges will be amortized over a three-year
11:13:59 So the front part is not true.
11:14:03 There is front upcost.
11:14:06 It's just spread out.
11:14:08 So why don't we say it the way it is?
11:14:10 Your costs will be amortized over 36 months.
11:14:13 The first sentence makes the brain think, oh, there's
11:14:16 no cost because that's what you read.
11:14:18 But then you have to go in detail and understand.
11:14:19 It's the same thing with the human part about the cost
11:14:23 of rent.
11:14:24 The way it's worded -- I had to look at it and say,
11:14:30 what are they say saying?
11:14:32 Instead of putting the cost per clinic would be $6600 a
11:14:36 month, they don't say that.
11:14:38 They say in the verbiage.
11:14:41 You it's like you want to have a romance with
11:14:43 yourselves but it's not.
11:14:44 It's the fact that there are too many -- I see this
11:14:57 that I don't understand.
11:14:58 I'm all for saving money.
11:14:59 I guess you can call me cheap.
11:15:00 You can call me frugal.
11:15:02 What is that word that was used?
11:15:07 You can call me anything you want.
11:15:08 But at the end of the day, I read everything that comes
11:15:11 through here.
11:15:13 And I want to make sure that not only the employees get
11:15:17 a good deal, but that the taxpayers that are paying for
11:15:21 the employees get a good deal also get a good deal.
11:15:26 This thing they have done in such a way that you set a
11:15:28 model not only for Hillsborough County, not only for
11:15:30 the State of Florida, but for the country, where this
11:15:33 thing were successful, something in health care would
11:15:37 be change including the taxpayers having an opportunity
11:15:40 to go to the clinics.
11:15:41 But we don't do that.
11:15:42 We take the easy way out.
11:15:44 We put an RFP out, which you don't have to do in
11:15:48 You don't have to do it in legal.
11:15:50 Am I correct?
11:15:51 >>CHARLES FLETCHER: This would probably be considered
11:15:59 an operating agreement over the charter which we have
11:16:01 would RFP.
11:16:04 >>CHARLIE MIRANDA: So then go out for a bid to a legal
11:16:06 firm to do that.
11:16:07 It's also the same thing, isn't it?
11:16:09 >>CHARLES FLETCHER: No, that is not correct.
11:16:11 Professional services agreement can be contract out
11:16:13 So if we were going to hire directly a doctor, then we
11:16:17 would not have to bid that.
11:16:19 If we were going to open a clinic that would be
11:16:21 operated, and we would have an operating agreement,
11:16:24 that would have to be bid.
11:16:27 >>CHARLIE MIRANDA: All right.
11:16:29 So you just said it.
11:16:30 You would hire a doctor that would open a clinic, you
11:16:31 don't have to do it.
11:16:33 That doctor has his own clinic.
11:16:34 >> The distinction is whether or not you are getting
11:16:37 professional services of a professional, somebody to
11:16:42 come in and do something or provide services.
11:16:45 If you are actually requiring someone have a facility
11:16:48 that is managed in a certain way, then you would have
11:16:51 to have an RFP operating agreement.
11:16:53 >>CHARLIE MIRANDA: So what you just said is if you are
11:16:55 an existing doctor, with an existing office of your
11:16:59 own, sir, and the city never -- they just say I am
11:17:03 going to call 15 doctors, in the county, in the city,
11:17:07 where they, quote-unquote, the population is of
11:17:10 retirees, then by your own admission you don't have to
11:17:13 have an RFP.
11:17:14 >> So long as we didn't have any standard on how they
11:17:16 operated the clinic.
11:17:17 But in this instance the choice was to have standards
11:17:19 for how the clinic was operated.
11:17:21 >> I understand that.
11:17:22 So you are telling me that a doctor from eight to five
11:17:26 doesn't keep it clean -- the first paragraph on the
11:17:29 first page is you must have clean wonderful beautiful
11:17:32 All doctors have that.
11:17:33 I mean, that's another lighting on the Christmas tree.
11:17:40 And it's just too quick, too fast.
11:17:43 I didn't make these agreements.
11:17:45 This council didn't make agreements with United.
11:17:48 We weren't even told -- if we talked about this council
11:17:52 getting briefed by the administration from last weak to
11:17:55 this week, I can swear to you on a stack of Bibles I
11:17:58 have never been called.
11:17:59 I don't know about how many council members were called
11:18:01 but I wasn't called.
11:18:02 I don't know about other council members.
11:18:05 My number hasn't changed.
11:18:09 So I'm just saying what's there.
11:18:15 The cost, St. Josephs has an operation.
11:18:21 Tampa general doesn't have it.
11:18:22 Because the way it was formatted was formatted for only
11:18:26 specialty items that these good folks are bringing us.
11:18:29 It's a miniature HMO in another form.
11:18:32 You can change it wellness, you can call it best
11:18:37 standards practice, you can call it anything you want.
11:18:40 We can do better than what we have done.
11:18:43 We can meet our obligation with United.
11:18:47 Notice we, not the council members, that made those
11:18:49 promises to United.
11:18:50 I didn't make them.
11:18:51 This council members didn't make them.
11:18:53 >>CHARLES FLETCHER: I need to be clear on this.
11:18:58 We structured the RFP and the negotiations with United
11:19:01 so that we knew exactly what the financial choice was,
11:19:05 whether we have the clinic or not.
11:19:07 So one of the reasons we have not finalized or even
11:19:11 gotten that far in negotiation was United was because
11:19:14 we didn't know where council was going to be on this
11:19:17 So we had the number with the clinic and without the
11:19:21 So clearly we have respected council's roles in that
11:19:26 >>CHARLIE MIRANDA: Well, that's fine, but it was never
11:19:29 brought to us in that format.
11:19:30 However, the enrollment time, when you change, and you
11:19:32 have enrollment -- and I'm not in the enrollment
11:19:36 because I don't have any insurance with the city other
11:19:38 than death, and if I die I get somebody else collects
11:19:42 Maybe they want to give it to me in the casket, I don't
11:19:46 So what I am saying in the enrollment time, these
11:19:50 employees have to make a choice between this plan, that
11:19:54 plan and that plan, and at the same time, I guess,
11:19:58 whether we like it or not, whether they have been told
11:20:00 or not, they are smart people.
11:20:05 They understand about the health clinic.
11:20:07 This is all getting to them in a way that it should not
11:20:12 happen this way.
11:20:13 But it has happened this way, for whatever reason.
11:20:17 There is nothing wrong but I guarantee you the cost of
11:20:24 rent would be eliminated.
11:20:26 They are already paying their own insurance for
11:20:30 whatever malpractice they may do.
11:20:34 That would be eliminated, or charged very minimal for
11:20:38 So what I am saying is that we haven't looked outside
11:20:40 our little sandbox at all.
11:20:42 We just took the standard, get it done, and forget
11:20:49 about it.
11:20:49 There was only one mistake.
11:20:53 On this side of the dais, no one really knew all the
11:20:59 So it's not about me voting it down.
11:21:02 I have had three letters, three, in a week.
11:21:05 I answered all three of them.
11:21:07 And let me tell you about this.
11:21:09 I use my agent, I asked yesterday.
11:21:17 She told me.
11:21:18 I hate to say where you had your hair done, and she
11:21:23 told me. It was a much greater distance than anyone
11:21:28 would drive to go to the health clinic for free.
11:21:32 Because there's a common bond with somebody you like,
11:21:35 common bond with somebody you appreciate to talk to,
11:21:38 whether you are a doctor or a nurse.
11:21:42 There is no doubt in my mind, none whatsoever, that
11:21:45 anyone that lives in those zone zip codes, whatever
11:21:49 they are in Brandon or Lutz, can drive to an empty
11:21:53 location, that may be or maybe not have a lot of
11:21:56 build-out or more than likely doctor's vacancy, because
11:22:02 now doctors are going to work for hospitals for the
11:22:04 same reason, for costs.
11:22:07 And there is plenty available that we could do this,
11:22:11 save costs, that we have taken a route just because
11:22:16 other cities have taken the same route.
11:22:19 This is not taking a chance, this is not gambling, this
11:22:21 is facing it so that the employees get a better deal,
11:22:25 the taxpayers get a better deal, and maybe the county,
11:22:30 state attorney's office, the public defender's office,
11:22:33 and other analysis will come on board.
11:22:35 We made it so political that even union leaders are
11:22:39 I got one today, God bless 'em.
11:22:46 And, you know, that's how I am.
11:22:49 I like to lay it all on the table.
11:22:51 We gave away a building that we had that would have
11:22:53 been the most perfect health center in the city.
11:22:57 And I'm going to pay $6600 rent for an office.
11:23:03 I told you I was a taxpayer before I became an elected
11:23:06 And I'll always be a taxpayer first.
11:23:10 So what I'm saying to myself is, you drive to Orlando
11:23:16 for something for free.
11:23:18 If you had gas in Wesley chapel for 1.50 a gallon and
11:23:23 today it's 2.75 you would drive to Wesley chap toll get
11:23:27 And we are saying the employees are not smart enough to
11:23:29 go get something for free?
11:23:31 I'm not a doctor and I'm not a chemist, but let me also
11:23:35 tell you those good folks that are, that there is a
11:23:37 difference between generic and the real McCoy.
11:23:43 And that's in the metabolism of the pills and the
11:23:47 contents of the pills.
11:23:50 The real McCoy is guaranteed to be 100 percent of
11:23:53 whatever the compound is.
11:23:56 The generic is not.
11:23:59 It may be 80% of it, whatever.
11:24:02 See, they have got to give it to you.
11:24:04 The law says brand X must give brand Y up to so many
11:24:09 years all of the ingredients, but they don't have to
11:24:14 tell you how to formulate those ingredients to make to
11:24:17 the that compound, and there's where we are at today.
11:24:22 So do I take generic?
11:24:24 Only when the doctor forgets to put medically
11:24:28 Those are two very important words.
11:24:30 "medically necessary."
11:24:33 And this is what happens to me when I don't take the
11:24:36 real McCoy as a diabetic.
11:24:40 My sugar level goes way high when I start taking
11:24:42 Metformin versus Glucophage, or Glipizide versus
11:24:51 Glucotrol XL.
11:24:57 I don't like to look at mannequins in windows.
11:25:02 Get to the meatballs and let's get going.
11:25:05 I mean, it just doesn't make sense to open three at
11:25:08 I understand you made a commitment.
11:25:10 But I didn't make that commitment.
11:25:12 Neither did this board.
11:25:13 >>THOMAS SCOTT: Councilwoman Capin has a question.
11:25:18 >>YVONNE CAPIN: Thank you.
11:25:21 On the credit, the 2,680, did you refer to that as a
11:25:28 Or is that a guarantee?
11:25:31 >>> No, ma'am.
11:25:33 Our contract with United Health Care, as Mr. Fletcher
11:25:35 said, was bid two ways.
11:25:38 One way -- and it's just for this year.
11:25:41 So I was very clear, or tried to be very clear in my
11:25:44 comments regarding the second year, or the first full
11:25:47 year savings, and that is that we are estimating for
11:25:50 the first full year what united health care's credit to
11:25:56 us might be, and the best estimate that we can give is
11:25:59 based on Care ATC and other wellness clinic operators
11:26:03 to use a similar model, physically offer for every
11:26:07 dollar that's spent in the maintenance of the clinic,
11:26:10 there is a 1.5 to sometimes a $2 payback.
11:26:16 What we have done on this slide is given you only a
11:26:19 one-for-one payback because we certainly don't want to
11:26:22 overestimate or overpromise what might be the trade-off
11:26:26 in the first year.
11:26:29 >>YVONNE CAPIN: Okay.
11:26:31 I understand that part.
11:26:32 Let's say that it is the credit that is 1,680,000.
11:26:43 It's a number.
11:26:47 What I am asking is United Health Care, that is a
11:26:51 guaranteed credit, whatever that number may be.
11:26:54 >> It is not a guaranteed credit.
11:26:58 We will have to renegotiate next year with United
11:27:00 Health Care, or whatever vendor we use for health care
11:27:04 next year.
11:27:05 It will be a new negotiation.
11:27:07 And it will be based on the expenses that we incur
11:27:10 during this year, just like it has been forever.
11:27:15 Because we are a fully insured plan, they look at the
11:27:19 costs we have incurred, the claims expenses that we
11:27:21 had, for the current most recent year as well as
11:27:26 several other itself, and they predict what's going to
11:27:28 happen next year with the city, the health of the city
11:27:31 employees and retirees, and that's when we'll know for
11:27:35 sure what the rates will be for next year.
11:27:36 But our goal was to give you an idea, a very
11:27:39 conservative idea of what you might expect the clinic,
11:27:44 the wellness centers to pay back.
11:27:51 >>YVONNE CAPIN: Thank you.
11:27:56 >> It's fixed under the upcome contract that you have,
11:27:58 but with any health care plan you have to renegotiate
11:28:01 rates every year based upon the experience for the
11:28:03 insured pool.
11:28:04 So that's the part that she said handshake, there's a
11:28:09 belief and expectation it will continue over multiple
11:28:11 years but we have to negotiate that each year.
11:28:13 This year, it will be fixed.
11:28:15 It is fixed in the draft that we have now.
11:28:17 It will be fixed when we bring --
11:28:20 >>YVONNE CAPIN: I understood that.
11:28:21 But thank you for clarifying that.
11:28:23 So again, it will be renegotiated depending on our
11:28:26 claims, depending on which is every year.
11:28:29 It's done -- that's the way it's done every year.
11:28:32 >>> Yes, ma'am.
11:28:35 >> The other thing I want to talk about is that the
11:28:38 employees being briefed on this, is this something --
11:28:44 is this done every year, the employees are told?
11:28:48 >> Both in of the enrollment meetings are held every
11:28:52 year, regarding the health plan for the coming year.
11:28:55 >>YVONNE CAPIN: Okay.
11:28:55 Thank you.
11:28:56 >>THOMAS SCOTT: Councilman Stokes and Councilwoman
11:29:01 >>CURTIS STOKES: Ms. Crum, I have a couple of
11:29:03 The contract, looking at the thing about the business
11:29:09 plan and the business model, I'm trying to think this
11:29:11 out long-term.
11:29:12 You all mentioned projections in the business model.
11:29:15 If Care ATC's business model based on a three-year plan
11:29:19 with three years or three options, and the health care
11:29:21 plan is based on the one-year option, what happens next
11:29:29 year when we renegotiate the contract?
11:29:33 With Humana or United, and the wellness clinics are
11:29:47 part of that?
11:29:48 Assuming United rebid for the same contract.
11:29:50 They are going to put in their increased costs, if it's
11:29:57 6.3%, $35 million this year.
11:30:01 Assuming they increase 6% this year, and project a
11:30:07 savings won't add up, because we are making this based
11:30:14 on six year projections or three year projections, one
11:30:17 year project savings for Humana, and the numbers aren't
11:30:22 syncing up.
11:30:23 The savings aren't real.
11:30:25 >> Let me see if I can help with that.
11:30:27 Of course we are going to renegotiate our health care
11:30:30 expense every year just as we always have.
11:30:32 And each year it will be based on the claims experience
11:30:35 that the city employees and retirees and covered
11:30:39 dependents had for that year so we never know what our
11:30:44 expense will be for the next year until that evaluation
11:30:46 has taken place.
11:30:48 That's done in conjunction with our consultant
11:30:50 Gallagher, and with the renewal company, the company we
11:30:53 are working with, for the RFP process.
11:30:56 So it's really important that as we look towards
11:30:58 renewal next year, we need to have had the wellness
11:31:02 centers in place, so that employees could begin using
11:31:05 them, and begin uncovering health conditions and
11:31:09 getting treatment for those early before they turn into
11:31:14 health issues, like strokes, cancer, et cetera.
11:31:17 And so that's why it's so important for to us get
11:31:20 started on the clinics, the wellness center program, so
11:31:24 that we have those savings next year when it's time to
11:31:32 >>CHARLES FLETCHER: We are expecting to bring you a
11:31:34 multiyear contract with United Health Care but the
11:31:36 rates will be negotiated this year.
11:31:39 >>CURTIS STOKES: Right. If their rate increases every
11:31:42 year the cost savings presented here aren't really --
11:31:46 >>CHARLES FLETCHER: The way the cost savings would be
11:31:48 analyzed is we would get a cost with the clinics and
11:31:51 then you would determine the cost savings based on that
11:31:54 relative value of the rate premium with the clinic, and
11:31:57 the premium without the clinic.
11:31:59 That's how that would have to be determined as we all
11:32:02 know, health care insurance rates go up every year,
11:32:07 unless we have some miraculous change in the economy.
11:32:10 So I think we will have an increase in the premium.
11:32:13 The question is, how does that compare to the premium
11:32:16 without the clinic?
11:32:20 >>CURTIS STOKES: Are the savings still savings?
11:32:22 >> That is something we have to evaluate he have year
11:32:23 based upon what the estimates are negotiated each year,
11:32:28 but the track roared is there would be the credits that
11:32:30 are described by the administration.
11:32:36 >>CURTIS STOKES: Another question.
11:32:37 Two more questions for Ms. Crum.
11:32:40 The devil is always in the details.
11:32:42 I have two sample monthly invoices for two different
11:32:47 >>> Yes, sir.
11:32:48 >> One is for 223,397 and the other for 225,080.
11:32:56 >> In the memo, we transmitted to you the first sample
11:33:02 monthly center invoice wellness center invoice that had
11:33:05 the 223,000 number.
11:33:07 That is the most up-to-date sample invoice.
11:33:11 The second one was provided as part of the final
11:33:13 presentation that was dated July 26th.
11:33:16 That was their initial proposal, but that is not the
11:33:20 proposal -- that's just a test of time, and our back
11:33:23 and forth during negotiations.
11:33:25 They were able to make several updates to some of the
11:33:30 projections they made.
11:33:31 While the numbers aren't that different, the lower
11:33:33 number is the most recent updated version.
11:33:37 >>CURTIS STOKES: Thank you.
11:33:37 The last question.
11:33:38 My main concern, Ms. Crum, has always been the for the
11:33:44 employees and the upkeep of these clinics.
11:33:52 I not Pinellas on numbers, but in case three emergency
11:33:57 patients should use them currently in place, assume
11:34:00 that it's after hours, emergency, someone will go to
11:34:05 the emergency room, assume it's not an emergency, we
11:34:12 will also propose a one team consisting of nurse
11:34:15 practitioners and medical assistant to rotate between
11:34:19 three clinics and provide evening and weekend hours.
11:34:27 If Ms. Mulhern is at the clinic in Brandon, if we put
11:34:32 it in Brandon, after hours, the nurse practitioner is
11:34:36 currently seeing a patient in Lutz, does she have to
11:34:43 wait until that nurse practitioner completes the exam
11:34:46 in Lutz, then drives to Brandon?
11:34:48 >>> No.
11:34:49 We don't anticipate having people moving between
11:34:51 locations on a given day.
11:34:52 >> Or they would drive from Brandon to Lutz?
11:34:57 >> There would be posted hours for each of the centers
11:35:00 and those hours would be fixed.
11:35:02 And either a physician or the nurse practitioner may be
11:35:05 available for night or weekend hours.
11:35:07 But there would be no "in an emergency call a number."
11:35:14 There would be fixed hours.
11:35:15 >> So three different hours.
11:35:19 So if you want to go to the clinic, if you are living
11:35:22 in Brandon, and you want to go to the clinic after
11:35:25 hours, you have to drive to Lutz or drive to the center
11:35:29 of Dale Mabry?
11:35:31 >>> The hours would be posted, councilman Stokes.
11:35:35 So everyone would know what hours the clinics are open.
11:35:38 If that clinic is not open, then they should go to
11:35:41 their nearest health care provider within the network.
11:35:45 So we wouldn't have people traveling during a given day
11:35:48 or a given evening or weekend hours.
11:36:00 >>CURTIS STOKES: Thanks.
11:36:01 >>THOMAS SCOTT: Councilwoman Mulhern.
11:36:02 >>MARY MULHERN: The more questions we ask the more
11:36:07 questions we have.
11:36:08 One thing that I don't think you gave me when I asked
11:36:12 earlier about the your projections.
11:36:18 And you said your projection for the first half year
11:36:22 was 40%.
11:36:26 What is it in that projection you gave us for the first
11:36:30 full year?
11:36:30 >>> The first full year's projection is that 80% of our
11:36:34 employees and their families will make visits to the
11:36:36 clinic within the first full year, and that is Care ATC
11:36:42 standards, and that is what they are meeting in their
11:36:44 other locations.
11:36:44 >> 80%.
11:36:47 >>> Doesn't mean that 80% of all the people go.
11:36:50 It means that 80% of the families go.
11:36:52 >>MARY MULHERN: Okay.
11:36:56 That sound like a pretty high percentage.
11:36:57 But then the other question is, well, I'm confused
11:37:04 about this after hours stuff, because I thought this
11:37:06 were in a after hours.
11:37:10 Are there after hours or not.
11:37:12 >> When we opened the centers and it was proposed by
11:37:15 Care ATC that the hours at opening would be 8 to 5,
11:37:18 basic standard hours.
11:37:19 And as employees begin to come and visit the clinics,
11:37:22 we are going to be watching at the end of their visit,
11:37:25 they do a customer service type survey, no names, no
11:37:31 indication, but simply say how they felt about their
11:37:33 visit that day, and there will be questions about
11:37:38 So we have not established --
11:37:40 >>MARY MULHERN: So that's not then part of any of your
11:37:43 projections for the cost?
11:37:44 >>> The costs are projected, yes.
11:37:46 Because we do have been the costs of the nurse
11:37:48 practitioner and the cost of the additional staff
11:37:51 person that would help cover those hours.
11:37:54 But it's very difficult to answer questions about what
11:37:57 the hours will be at each location because we haven't
11:37:59 established them yet.
11:38:00 >>MARY MULHERN: These total?
11:38:08 >>> Yes, ma'am.
11:38:09 >>MARY MULHERN: For the staffing?
11:38:11 You are including having after hours?
11:38:13 >>> Yes, ma'am.
11:38:15 If you look at the sample monthly wellness center
11:38:17 invoice, the very first line item says facility health
11:38:23 care and staff costs, that cost is based on three
11:38:27 doctors, one for each of the wellness centers, one
11:38:30 nurse practitioner, which is the floating nurse
11:38:33 practitioner, and seven medical assistants, two for
11:38:36 each of the locations, and one which can float.
11:38:39 Between the three.
11:38:40 >> Okay.
11:38:43 So I guess those are the questions that councilman
11:38:47 Stokes asked.
11:38:48 And I'm not sure that it really makes sense.
11:38:56 But I guess you are saying your projections include 24
11:38:59 hour care in one location?
11:39:02 >>> We do not anticipate 24 hour care at any of the
11:39:05 three locations.
11:39:06 After hours or weekends segment does not mean 24-hour
11:39:11 open wellness centers.
11:39:14 So just to be clear, we do anticipate 8 to 5 being the
11:39:19 normal work day type schedule, but then having people
11:39:22 who will float and do the earlier hours, later hours,
11:39:27 or weekends.
11:39:28 >>MARY MULHERN: But they don't know what those are.
11:39:30 So what did you base your estimates on?
11:39:34 >>> We based the estimates on the personnel costs so we
11:39:36 know we will have people --
11:39:38 >>MARY MULHERN: For what hours?
11:39:40 >>> For their full time salary.
11:39:42 So they will have a 40-hour week.
11:39:44 We just haven't plugged in which location they will be
11:39:46 in for each of those 40 hours.
11:39:48 >>MARY MULHERN: Oh, okay.
11:39:50 >>> Is that helpful?
11:39:52 >>MARY MULHERN: Yeah, yeah, but it doesn't -- it
11:39:55 doesn't -- still doesn't really make sense.
11:39:57 But the other question is, back to these questions that
11:40:02 we have and the new questions that keep coming up,
11:40:08 people have been briefed on this as an option for them
11:40:14 to sign up for, right?
11:40:16 >>> They don't have to sign up for them.
11:40:18 But, yes, employees have been briefed about our plan to
11:40:21 implement these.
11:40:25 >>MARY MULHERN: I guess I don't remember -- I guess
11:40:27 because it's a new option, but normally, the other
11:40:31 years, is this the practice of this administration that
11:40:37 you offer options for health care before council has
11:40:42 even been briefed on it, much less passed it?
11:40:46 >>> First of all let me say that each of the plans that
11:40:48 are before our employees this year remain the same.
11:40:52 The benefits are the same, whether with the clinic or
11:40:56 without the clinic.
11:40:57 Now, obviously if we don't implement wellness centers,
11:41:00 then they will have the option of zero co-payment or
11:41:03 zero generic prescriptions at a wellness center.
11:41:06 But the network that's provided and the level of
11:41:10 benefits that are provided remain the same.
11:41:13 So there's no difference there.
11:41:15 Unfortunately, each year, when we do the insurance
11:41:17 renewal, because the contract doesn't come to council
11:41:21 until later in the year, we are often in front of
11:41:24 employees talking about open enrollment before the
11:41:29 insurance plan.
11:41:31 >>MARY MULHERN: Right, but you had this proposal in
11:41:34 July, you said.
11:41:34 >>> They made their proposal in July.
11:41:37 >>MARY MULHERN: So we could have heard about it in
11:41:41 >>> You could have heard about it earlier, certainly,
11:41:44 than you have.
11:41:45 >>MARY MULHERN: I just want to point out, too, that
11:41:49 Mr. Miranda asked for 30 days, and then he said you
11:41:53 gave us a week but I only found out this was on the
11:41:55 agenda yesterday.
11:41:57 So really we have only had maybe 24 hours to look at
11:42:02 So -- yeah.
11:42:14 I -- I don't know.
11:42:16 But I do feel that, you know, what you are claiming as
11:42:22 savings is not actually -- really, the only thing I can
11:42:26 see in the projection for your first year based on your
11:42:30 numbers is 1,450,000 because the cost -- the cost --
11:42:39 credit you are getting -- claiming you are going to
11:42:43 get, but we are not sure, that we are not actually
11:42:46 going to have it in writing of, you know, this
11:42:50 2,687,060, you know, the same as -- or less than your
11:42:59 estimate, what I add in your figures up to be the
11:43:02 estimate for the cost, as well as the administrative
11:43:06 So the numbers just aren't adding up.
11:43:11 You know, I would just like to also point out the fact
11:43:15 that not only are we not using historic buildings, but
11:43:22 we are hiring some company out of Oklahoma to run a
11:43:25 local -- three local health care clinics.
11:43:29 And it's not just that, as Mr. Miranda pointed out,
11:43:32 that we have people here, and we have buildings here.
11:43:36 I mean, we probably have after-hours clinics that are
11:43:41 open during the day that we can use.
11:43:44 There's all kind of possibilities for getting a better
11:43:47 And, you know, if we hadn't seen a lot of deals -- I
11:43:52 shouldn't speak for anybody else.
11:43:54 But I have seen a lot of deals where we didn't get the
11:43:57 best deals, the taxpayers didn't get the best deal, and
11:44:01 when something gets rushed through, it just seems
11:44:05 very -- it's worrisome, because it feels like -- it's
11:44:13 not necessarily going to stand up to the, you know, the
11:44:17 scrutiny that we are giving it, just at the council
11:44:22 So I think the -- you have put us in this position
11:44:27 where we didn't have the information we kneed, which we
11:44:33 could have had months ago, and the employees are asking
11:44:39 us to pass this because of promises that have been made
11:44:42 to them and offerings that have been made to them, but
11:44:46 it puts us in this really bad position where we are not
11:44:49 necessarily convinced that we are going to be saving
11:44:54 money, and basically are talking about another
11:45:00 insurance contract, another privatized plan where they
11:45:06 are going to have to be -- the other thing that is very
11:45:09 strange is how do they make money?
11:45:12 When you look at the numbers, it doesn't seem to add
11:45:14 up, because they have got to make some money.
11:45:17 They have got to be able to make money on this.
11:45:21 And certainly doctors and the pharmaceutical industry
11:45:30 know how to make money and they'll figure it out.
11:45:33 >>> If I may, one of the reasons that I think we are so
11:45:38 excited about this opportunity is that while there are
11:45:42 other doctors' offices and clinics and certainly
11:45:45 24-hour offices with availability here in town, this
11:45:51 group is dedicated to make sure that we are getting
11:45:58 each visit half the costs that our folks pay within the
11:46:02 network plan.
11:46:03 They are looking at giving us significant cost breaks,
11:46:06 as you can see from their presentation.
11:46:09 They have only listed a small portion of the generic
11:46:12 drugs that they will likely stock.
11:46:14 And there is a significant savings there.
11:46:16 And so in bringing this to you, our goal is to have
11:46:21 done an RFP that was a widely cast net, where there
11:46:25 were many companies that came to view it, but two
11:46:29 companies that bid, that each of them came back with
11:46:34 similar proposals.
11:46:37 This is what they do.
11:46:38 And so I bring this before you asking for your support
11:46:43 of it.
11:46:45 >>THOMAS SCOTT: Well, let me just say that it is now 15
11:46:47 minutes of 12.
11:46:48 I have to be gone by 12.
11:46:49 I have a series of questions.
11:46:51 Councilman Caetano has some.
11:46:58 Councilman Caetano and Mr. Miranda.
11:47:00 And Mr. Miranda, I do have a series of questions.
11:47:03 >>CHARLIE MIRANDA: I understand.
11:47:03 >>JOSEPH P. CAETANO: As Ms. Mulhern said, we have to
11:47:09 get the best deal.
11:47:10 A couple months ago there was an article in the "The
11:47:13 Tampa Tribune" yesterday about the parking meters.
11:47:15 I hate to bring it back.
11:47:16 But the city of St. Petersburg put 1,400 parking meters
11:47:22 at a zero cost.
11:47:23 We spent $2.1 million, okay.
11:47:27 So we did not get the best deal, in my opinion.
11:47:30 And I'm very concerned.
11:47:35 Our job here is to be a watchdog.
11:47:37 I talked to a doctor this morning who has done nothing
11:47:39 but emergency room.
11:47:41 And I am not going to say everything that he said, but
11:47:43 he said you take this plan to a bank, they won't give
11:47:47 you a loan because it's not a good business plan.
11:47:49 This is what this gentleman does for a living.
11:47:52 I faxed him the 30-something pages that I got
11:47:55 yesterday, and he read it overnight and called me this
11:47:58 And I'm not going to go into all the detail because we
11:48:01 don't have enough time.
11:48:01 But I'm very uncomfortable with this.
11:48:05 I'm burnt over the parking meters and I don't want to
11:48:09 be burned again.
11:48:11 Thank you.
11:48:11 >>CHARLIE MIRANDA: Thank you.
11:48:15 This will be my second bite at the apple.
11:48:16 I won't make this as long as the first one.
11:48:19 Two things that come up to me.
11:48:21 $72,000 rent for location, the administration has not
11:48:26 changed, has not budged, does not want to compromise,
11:48:29 to come back with real figures.
11:48:30 That's number one.
11:48:33 Two of them are outside the city limits.
11:48:37 Number three, in my mind, forget the other two.
11:48:39 One clinic.
11:48:40 What is $72,000 a year debt service?
11:48:45 Over a million dollars.
11:48:50 And 4.5 percent, much more than a million dollars.
11:48:55 Am I correct?
11:48:56 >> Yes.
11:48:56 >> So the city can build its own clinic.
11:48:59 It chooses not to do that.
11:49:01 I'll tell you what I am going to offer you.
11:49:03 And I'll put it in writing. My whole net worth that
11:49:05 you can do better.
11:49:06 Not I.
11:49:08 You go out and shop it to the right people.
11:49:13 This is two times what the normal family or general
11:49:15 practitioner makes, 260,000.
11:49:20 That's absurd.
11:49:23 The costs are absurd. The pass throughs, I don't even
11:49:27 know what they equal.
11:49:29 You don't either.
11:49:30 You don't know where the doctors are coming from.
11:49:32 You don't know what their relocation cost is.
11:49:35 We are doing all of this when we have people in this
11:49:37 city that have vacant buildings, that we can rent, at a
11:49:43 much lower rate, and maybe even give it to us at half
11:49:46 price for a year.
11:49:47 Why do I say a year?
11:49:49 Because the health insurance plan basically, even
11:49:51 though it's multiple years, is on a yearly basis, based
11:49:55 on the conditions of the contract and the amount of
11:49:59 volume that was created when they had a profit or loss.
11:50:04 So you have a one-year contract with United, and a
11:50:07 three-year contract with a clinic.
11:50:13 At one clinic for one year to meet the United needs.
11:50:16 See how it goes.
11:50:17 Test it.
11:50:17 See if it works.
11:50:19 I hope that I'm right and wrong at the same time.
11:50:22 Because I want to see this happen.
11:50:24 I want to see this happen throughout this county,
11:50:28 throughout the state, throughout this nation.
11:50:30 That's the only way you are going to solve health care.
11:50:33 But by just giving it to another company to run, they
11:50:37 are not doing this for free.
11:50:39 You think they don't have administration costs,
11:50:41 transportation costs, travel costs, legal costs, party
11:50:44 costs, vice-president, president, secretary, treasurer?
11:50:47 Of course they do.
11:50:49 But that's what's wrong with America.
11:50:51 We take the easy way out.
11:50:53 I don't.
11:50:55 I still offer you my total net worth.
11:50:58 You want to offer me yours?
11:51:01 >> I think we have ten minutes left.
11:51:03 Let me just raise a couple of questions so that we can
11:51:05 move forward.
11:51:06 I guess the bottom line becomes this, and I'll make
11:51:09 some closing comment.
11:51:11 You have a proposal before us, and you have a proposal
11:51:15 that says, as I understand it, Humana this, United is
11:51:24 this with or without the clinics.
11:51:30 Basically when you look at this last memorandum you
11:51:32 sent us, I'm assuming that Humana original cost was
11:51:37 2011 was at 40.7 or 20.3% increase.
11:51:42 The best and final offer was 38.6%.
11:51:47 30.6 million.
11:51:51 United is 36.
11:51:54 And then with the clinic it drops to 35.
11:51:57 So in essence, if the clinics are not approved today,
11:52:03 you are still looking at United for a very minimal
11:52:08 Is that right?
11:52:09 >>> We would be looking at the United price, which was
11:52:11 the $36 million price.
11:52:15 Their best and final without the clinic.
11:52:17 >> So that still would be -- well, it would still be an
11:52:20 increase of 6.3.
11:52:24 >> Correct.
11:52:24 >> With the health care clinic, with the wellness
11:52:29 clinic, their final offer is 35.1.
11:52:39 I guess my question, what would be then the -- I guess
11:52:43 it would still be the same.
11:52:44 If you didn't have the clinic, it would -- the increase
11:52:47 would still be 6.3 over what we are currently maying
11:52:51 >> That's correct, sir.
11:52:52 >>THOMAS SCOTT: So then what will be the increase with
11:52:57 the 35.1?
11:52:59 What is the increase with the clinics?
11:53:03 Follow what I'm saying?
11:53:05 >>> What percentage increase is it?
11:53:08 >> Yes.
11:53:08 Over what we are paying now.
11:53:09 >>> That's reflected in the memo as well.
11:53:14 That's -- I'm sorry.
11:53:16 I can have the Elmo.
11:53:17 It's one of the slides that we had just a moment ago.
11:53:22 That's the 3.5% increase.
11:53:31 >> 3.5.
11:53:32 So then let's say the clinic goes away, if council
11:53:37 decides not to move this today, the plan would go up by
11:53:42 6.3%, assuming you are still going with United Health
11:53:46 Care, is that right?
11:53:49 >>> Yes, sir.
11:53:49 Secondly, you hired a consultant.
11:53:58 Is that right?
11:53:59 >> We have a consultant.
11:53:59 >> Well, you have a consultant.
11:54:03 Your consultant helped you through this process?
11:54:05 >> Yes, sir.
11:54:05 >> Based on that consultant, I'm assuming he looked at
11:54:08 all of these plans, based on his experience, based on
11:54:13 his research, he has recommended, or she has
11:54:18 recommended, or the company has recommended that you go
11:54:20 with the wellness clinics?
11:54:22 >> That is correct.
11:54:23 >> Based on that recommendation, could you tell us
11:54:30 where did he get his information or what did he look at
11:54:32 in terms of other municipalities?
11:54:35 For instance, you talk about Clearwater.
11:54:38 >>> Yes, sir.
11:54:39 >>THOMAS SCOTT: What has been the success or the story
11:54:42 of Clearwater?
11:54:43 What has been the success of the store at Lakeland
11:54:45 since he recommended this?
11:54:46 I haven't seen any of that other than you say all of
11:54:49 the clinics are full.
11:54:50 Well, right now a lot of the original ones are full for
11:54:55 that matter.
11:54:55 But we need to know based on the recommendation, why
11:54:58 this recommendation?
11:54:59 Follow what I'm saying?
11:55:00 >>> I absolutely follow.
11:55:01 With your permission, Chuck Tobin from Gallagher
11:55:05 benefits has been our consultant now for three years,
11:55:08 and chuck is with us and I think he should answer the
11:55:11 question directly.
11:55:13 >>THOMAS SCOTT: Okay.
11:55:14 Yes, ma'am.
11:55:14 >> Good morning.
11:55:15 I'll speak fast.
11:55:16 >> State your name for the record.
11:55:17 >> Chuck Tobin with Gallagher benefits services.
11:55:22 The clinic concept is really an old concept, when
11:55:26 companies used to have doctors in-house, and come as a
11:55:31 new concept in the last couple of years.
11:55:33 We put this in with the city of Lakeland several years
11:55:35 ago, and savings of about $1 million a year off the
11:55:38 health plan which is significantly smaller than what
11:55:42 the City of Tampa is, and that includes the price of
11:55:45 running the wellness center.
11:55:47 It's a smaller center.
11:55:49 It only deals with employees, dependents -- all these
11:55:54 items are what we are trying to get to with what you
11:55:56 guys are achieving.
11:55:58 That's the one that I have direct contact with.
11:56:00 We are seeing this across the board with a lot of our
11:56:04 clients are asking for us to start reviewing the idea
11:56:07 of clinics.
11:56:08 You guys are a little bit ahead of the game.
11:56:11 Like I said, step out of the box or kind of on the edge
11:56:14 of the box, but it is -- really has saved, what we have
11:56:17 seen, saved employers money by concentrating the care.
11:56:21 It really has to do with the patient-doctor
11:56:26 When you are going to the doctor, through any health
11:56:29 plan, it's a turning mentality, how fast can they get
11:56:33 people in and out of the doctors' office?
11:56:35 A patient usually spends about three to five minutes
11:56:37 with the actual doctor.
11:56:38 Under the clinic scenario, we are looking that they
11:56:42 spend 15, 20 minutes with the doctor.
11:56:45 This is where disease management program and how you
11:56:49 can identify that there are health care costs, health
11:56:52 care issues that are come about.
11:56:53 >>THOMAS SCOTT: Okay.
11:56:58 I have the floor right now.
11:57:00 Let me finish.
11:57:05 You had your turn.
11:57:06 You had your time.
11:57:09 So, then, based on your recommendation, your
11:57:12 experience, that is a real cost savings of dollars, is
11:57:17 what you are saying?
11:57:17 >> Yes.
11:57:18 Lakeland is smaller than Tampa.
11:57:19 >> They realized over a million dollars in savings?
11:57:23 >> That's correct.
11:57:24 >> In terms of clinic, how many clinics do they have?
11:57:26 >> They have one very, very small clinic.
11:57:29 And it's really the problem with -- one of the problems
11:57:31 that they have is it's so small they can't get people
11:57:38 It's that's why when we looked at the City of Tampa
11:57:41 model, we understood the number and volume that we had
11:57:46 to experience.
11:57:47 That is why we came up with the number of three.
11:57:51 Didn't come up with some magic number.
11:57:52 The number three came out with how many people we
11:57:56 expected to see, how many office visits can we see
11:57:59 within a given day?
11:57:59 They all come down to number of people that we can get
11:58:02 in the clinic.
11:58:04 >>THOMAS SCOTT: Now based on that, you looked at the
11:58:07 data on the geographical location or zip codes of
11:58:10 whereof we get, so you came up with the three
11:58:13 recommended sites.
11:58:14 Is that pretty much it?
11:58:15 >> That's exactly how we did it, yes.
11:58:17 >> Based on what time?
11:58:22 >> We tried to get them within the general area,
11:58:26 usually about 10 to 15 miles is about the most that
11:58:30 someone is going to travel.
11:58:31 >> Would there be an issue with moving, let's say, two
11:58:37 of the clinics within the city, which I talk to the
11:58:40 mayor, and that was going to be a convert -- concerted
11:58:43 effort to move another one of those into the city, in
11:58:46 my discussion, anyway with, administration.
11:58:48 So pretty much that should not have any major
11:58:51 ramifications if another clinic is inside the city.
11:58:53 Is that right?
11:58:56 Driving time?
11:58:57 >> It comes close.
11:58:58 We really have an issue and can separate the two areas,
11:59:03 the north Tampa area, we have traffic concerns, that
11:59:09 the timing to get to the doctor's office would take too
11:59:12 much time.
11:59:13 And in the Brandon area, it's the distance from the
11:59:19 bedroom communities to into the city limits area.
11:59:26 >> All of that, though, is based on assumptions.
11:59:28 Is that right?
11:59:29 >> That's correct.
11:59:29 >> And so based on sums, it's a possibility you still
11:59:34 could move one of the clinics within a certain driving
11:59:36 distance and still be successful given the fact that
11:59:39 you already, given your experience with Lakeland, they
11:59:43 already saved a million dollars with one clinic.
11:59:45 >> Yes, that's right.
11:59:46 Certainly the intent here was to draw more dependence
11:59:48 into the program -- dependents into the program, and
11:59:52 that's by bringing them out to the residential
11:59:56 City of Lakeland is really concentrating on the
12:00:00 employees only and really factored in the employees'
12:00:04 The design of the plan is a little different.
12:00:05 It's really factoring in the employee's wellness by
12:00:10 getting the wellness centers he out to the community
12:00:12 the intent was to get the dependent's more engaged.
12:00:16 >> I do have more questions, but Mr. Miranda wants to
12:00:19 raise a question.
12:00:21 >>CHARLIE MIRANDA: I want to raise a question quickly.
12:00:23 >>THOMAS SCOTT: Okay, because --
12:00:26 >>CHARLIE MIRANDA: You made a statement that I don't
12:00:27 believe, and I'll tell you.
12:00:29 You say the doctor in the different wellness center
12:00:34 gives you 15 minutes?
12:00:35 The only way to give you 15 minutes is if the body is
12:00:39 cold, and in a movement in the vascular, and you're
12:00:43 No doctor can be in business just giving patients three
12:00:46 to five minutes.
12:00:48 I take great offense to that because that's not a true
12:00:51 The doctors in this community, I don't know about
12:00:54 Lakeland, but I can tell you that they give you the
12:00:57 right and they at least check your heart, your lungs,
12:01:00 tip of your toes to make sure you are not getting --
12:01:03 that you are getting enough blood circulation.
12:01:05 Let me tell but the Clearwater experience.
12:01:07 They do have 700 employees going to the clinics out of
12:01:13 1600 and had to give them $25 Publix cards to go there.
12:01:17 >> I respectfully disagree.
12:01:18 The idea of the gift card was an incentive for the
12:01:21 employees with the health assessment.
12:01:24 It had no bearing --
12:01:25 >> Then I spoke to the wrong gentleman, the gentleman
12:01:28 that negotiated the deal so I respectfully disagree
12:01:31 with you.
12:01:31 >>THOMAS SCOTT: Mr. Stokes.
12:01:38 >>CURTIS STOKES: What's the start-up amount?
12:01:41 What's the start-up fee?
12:01:43 >> The start-up fee?
12:01:46 What do you mean a start-up fee?
12:01:48 >> The contract, compensation.
12:01:50 The start-up fee.
12:01:51 >>I don't have the contract in front of me.
12:02:26 >> Michael Laberge, Risk manager.
12:02:29 Respectfully, the answer to the question is that we are
12:02:30 asking Care ATC as part of this contract to front all
12:02:34 of the costs of any renovations of facilities.
12:02:38 The start-up fee would be the costs associated with
12:02:41 The cost would accrue to the city.
12:02:44 However, they would be amortized over the full 36
12:02:49 It is subject to the budget that we have provided to
12:02:52 you in the contract.
12:02:58 >>CURTIS STOKES: I didn't see in the here.
12:02:59 >> It's actual costs.
12:03:03 >> So when the clinic is finished we'll know what the
12:03:06 actual costs are.
12:03:06 We'll have the right to audit.
12:03:09 Mike has estimates, but it will be actual costs.
12:03:11 It's actual costs will be amortized over the life of
12:03:15 the contract.
12:03:16 >> So we won't no exactly what the dollars are until
12:03:19 it's completed but we have oversight.
12:03:27 But to get projections in the business plan you had to
12:03:30 plug in a number and the spreadsheet.
12:03:32 >> The initial discussions that Care ATC had with one
12:03:36 location where they are considering or leasing, all of
12:03:40 the costs with the exception of the x-ray equipment
12:03:42 would be part of the actual lease cost.
12:03:46 >>CURTIS STOKES: The reason I ask that question is when
12:03:49 I read this contract, it sound as if the city is
12:03:51 putting Care ATC into business.
12:03:58 The city shall be responsible in section 1.05 and 1.06
12:04:02 for all rent, security, property taxes, utility,
12:04:08 staffing, medical supplies, equipment, other items that
12:04:13 may be required by Care ATC or physicians to provide
12:04:17 adequate medical services under this agreement.
12:04:19 I think the reason I bring that up, as Mr. Miranda
12:04:23 alluded to, we have doctors in this community, and
12:04:27 would jump at the opportunity to open a clinic with the
12:04:31 city providing security, rent, because all the doctor
12:04:36 has to do is show up.
12:04:41 $260,000 a year.
12:04:43 >> Respectfully, councilman, is there a question that I
12:04:47 can answer?
12:04:50 >> The question I had was how much the start-up fee and
12:04:53 the shut-down fee.
12:04:56 Seems ware going to pay them to start up and to shut
12:04:59 down we have to pay them another fee.
12:05:01 And I was questioning what those fees were.
12:05:04 Page 11, 2.5.
12:05:07 >>CHARLES FLETCHER: The only purpose of those fees is
12:05:10 if we terminate prior to the end of the contract.
12:05:13 They bear those costs.
12:05:14 We do not terminate.
12:05:17 It is their capital that is covering those costs.
12:05:20 If we terminate, then we have to cover a portion of
12:05:25 those fees.
12:05:29 I'm sorry, I'll repeat that.
12:05:31 Those costs are calculated only for the purpose if we
12:05:35 terminate not for cause during the three years of the
12:05:41 >>CURTIS STOKES: What is that dollar amount?
12:05:43 >>CHARLES FLETCHER: We will know that.
12:05:44 There's an estimate in here.
12:05:46 >>CURTIS STOKES: A business plan and model it.
12:05:49 In my experience when you do a business plan and model
12:05:52 it, generally numbers connected to that.
12:05:57 We are.
12:06:00 >>CHARLES FLETCHER: We are not paying that cost unless
12:06:02 we terminate. If we are in a position where we are
12:06:04 terminating we will know what those costs are at that
12:06:06 >> But if we give projections and came up with the
12:06:15 sample monthly cost, then there has to be a number we
12:06:20 plug into the projections.
12:06:21 It would not be part of the invoice.
12:06:25 It is not part of the invoice because they are
12:06:28 capitalizing the project.
12:06:31 They are taking care of all these costs up front.
12:06:33 >> They are capitalizing the project but at what cost?
12:06:44 >>> The basis for the contract is we are seeking
12:06:46 authority for the full $7.6 million -- let me answer
12:06:51 the question completely -- over a three-year period for
12:06:53 the entire service.
12:06:55 That's what we are seeking council authority to do.
12:06:58 The actual expenses that would be accrued is subject to
12:07:02 a service level agreement on an annual basis that the
12:07:05 city attorney, the purchasing director and the HR
12:07:08 director would agree with Care ATC.
12:07:11 And what you are doing is you are setting the maximum
12:07:13 threshold, and we are going to be required to work
12:07:16 below that level.
12:07:18 We are going to provide those services within the
12:07:21 budget constraints that City Council provides.
12:07:25 >>CURTIS STOKES: So that 7.6 over three years or six
12:07:28 years --
12:07:31 >>> 7.6 million respectfully is the total amount of the
12:07:34 contract over three years.
12:07:35 That's what we are requesting authority for.
12:07:37 The question you are asking is with respect to the
12:07:40 initial start-up fee.
12:07:41 The initial start-up fee will be negotiated with Care
12:07:44 ATC once we have identified the locations that will be
12:07:47 set up.
12:07:47 We don't know what those are yet.
12:07:49 But we are asking and seeking the authority up to that
12:07:52 7.6 million total over three years.
12:07:55 And staff is going to be working with Care ATC to
12:07:58 maintain within that budget over the three-year period.
12:08:01 The cancellation fees and the set-up fees would be a
12:08:04 function of the locations that are selected.
12:08:09 We are looking to find locations that are currently
12:08:11 suitable and ready to go so that we don't have a lot of
12:08:13 initial set-up expense.
12:08:15 We may have to do some painting, we placement flooring.
12:08:18 We do know that we have to purchase an x-ray equipment
12:08:20 for the main location since we'll be doing some
12:08:23 worker's comp related activities there.
12:08:25 >> So the only part that Care ATC is providing is the
12:08:31 doctor, the nurse practitioner and the assistants?
12:08:36 >> They are providing all of the expertise, all of the
12:08:37 computer technology, they are providing all of the --
12:08:40 >>CURTIS STOKES: The city is taking care of the
12:08:41 capitalization costs?
12:08:43 >>> It would be accrued over a 36-month period.
12:08:45 >>CHARLES FLETCHER: Let me address -- we are not
12:08:50 communicating well the business plan, apparently.
12:08:53 They are covering those capital costs.
12:08:56 We will be required to repay those if we terminate
12:09:02 If we do not terminate, they will never show up on an
12:09:05 invoice, they will never show up on an annualized
12:09:09 payment, they will only be paid if the city terminates
12:09:14 They are covering those costs.
12:09:17 Does that help?
12:09:18 >> Councilwoman Capin.
12:09:23 >>YVONNE CAPIN: Mr. Fletcher, please.
12:09:26 You just opened something.
12:09:28 We will repay if we terminate.
12:09:31 Is it prorated if we terminate the second year?
12:09:35 >>CHARLES FLETCHER: Yes.
12:09:36 Let me say one thing, and that is also if we terminate
12:09:39 for convenience.
12:09:40 If we have a problem with the doctor, have a problem
12:09:42 with the service, if we have a problem with the
12:09:44 management, and terminate for cause, then they eat
12:09:47 those costs.
12:09:47 We are not responsible for those costs under that
12:09:51 >>YVONNE CAPIN: Thank you.
12:09:53 I'm going to say, I really appreciate all the questions
12:09:58 that my colleagues asked, and what it has done is
12:10:01 confirmed my vote for this plan that I approved last
12:10:11 So I really appreciate all the questions.
12:10:14 I understood many of it before we came on, and just
12:10:18 made it more clear to me today.
12:10:20 Thank you.
12:10:21 >>THOMAS SCOTT: Okay, councilman Caetano.
12:10:23 >>JOSEPH P. CAETANO: Mr. Tobin, you said Lakeland has
12:10:27 a clinic do. They run their own clinic there or do
12:10:30 they have an outside company running it?
12:10:32 >>> They have an outside company.
12:10:33 >> Who is that company?
12:10:34 >>> The name of the company is health stat.
12:10:37 >> How come we.
12:10:38 Heard from you other than at the meeting and we hired
12:10:40 you as a consultant for three years, and you are up
12:10:42 here today for two minutes?
12:10:46 >> I don't know.
12:10:48 I'm always welcome to come here.
12:10:50 >> I spoke to my consultant last night, and as Mr.
12:10:53 Stokes said you need a business plan.
12:10:54 And if you go to the bank with this, they are not going
12:10:56 to give you a loan.
12:10:59 >>THOMAS SCOTT: Let me just ask a follow-up question
12:11:01 and then we need to make a motion or whatever we are
12:11:04 going to do here.
12:11:09 Three years for the clinic.
12:11:10 Why three years?
12:11:12 >> Three years for the clinic, there's an idea we
12:11:15 wanted to spread the cost, those buildout costs over
12:11:18 those three years.
12:11:19 But the three years of the clinic is really designed as
12:11:21 a more clinical basis for really engaging people over
12:11:25 time and getting them engaged in management.
12:11:29 Three years is the typical time when we start seeing
12:11:32 the significant return in investment.
12:11:33 That's why the three years is kind of three years and
12:11:36 not four or something different.
12:11:39 That's when we really start seeing really engaging
12:11:41 people, chaining their behaviors and getting the cost
12:11:46 >> In your experience, how long have you been doing
12:11:49 >>> Consulting or the wellness center?
12:11:52 >> The wellness sent jeer we brought the first one into
12:11:55 the city of Lakeland three years ago.
12:11:57 >>THOMAS SCOTT: So anyone outside of that?
12:12:00 >>> not that I'm directly involved in.
12:12:02 >> What about your company?
12:12:04 >>> We have several throughout the state that were
12:12:09 City of Dell way beach is one that was mentioned last
12:12:12 week and some others.
12:12:14 City of Palm Bay.
12:12:19 >>THOMAS SCOTT: Mr. Fletcher -- thank you, I appreciate
12:12:21 your help.
12:12:22 So we can try to wrap this up, what's before us today
12:12:26 actually is moving forward on a contract for the
12:12:29 wellness center, not the actual United Health Care
12:12:33 >>> That's correct.
12:12:34 >> So the administration wants no, no council's
12:12:38 position based on these so they can go back and
12:12:40 complete, I guess, the other negotiated part of the
12:12:43 contract with United.
12:12:44 Is that correct?
12:12:45 >>> That's correct.
12:12:45 >> One last question.
12:12:48 Do we enter into a three-year contract with the clinic.
12:12:51 However, they can be terminated in the at any point.
12:12:55 >>CHARLES FLETCHER: That's correct.
12:12:56 >> And thoughts costs will be prorated?
12:13:00 >>CHARLES FLETCHER: If we terminate for convenience.
12:13:02 If we terminate for cause the contractor has to eat
12:13:06 those costs.
12:13:08 >>THOMAS SCOTT: Now, council, with all that being said,
12:13:09 no matter what, and I hear about it, what the clinics,
12:13:15 you are going to realize at least a million-plus
12:13:19 savings no matter what.
12:13:20 That's what I heard.
12:13:21 The idea is to save taxpayers dollars.
12:13:24 Now, perhaps if we had more time we maybe could have
12:13:30 done these other things but right now we are at a time
12:13:34 sensitive I shall you have.
12:13:37 But the issue for me at this point is, do we save
12:13:39 taxpayer dollars?
12:13:39 The answer is what?
12:13:41 You save taxpayer -- how much is that savings?
12:13:44 We know based on testimony today and looking at what is
12:13:47 provided that we are looking at at least a million
12:13:50 Is that safe to say?
12:13:54 >> Kimberley Crum: Yes, sir.
12:13:56 >> So we are looking at at least a million dollars
12:13:59 annually in terms of savings.
12:14:00 It could be more.
12:14:01 >> That's correct.
12:14:02 >> And secondly, in my discussion with the
12:14:08 administration, with the mayor, there is the
12:14:11 opportunity or at least there's going to be an
12:14:13 aggressive opportunity or at least to try to put
12:14:16 another clinic within side the city.
12:14:19 We have one but we are going to look at, as I
12:14:21 understand, talking to the mayor and also the
12:14:23 administration, making sure we are going to look at
12:14:26 trying to move one closer inside the city boundaries.
12:14:30 >> We are going to evaluate all sites very carefully.
12:14:32 >> Okay.
12:14:34 Now, I am going to support this today based on that and
12:14:38 plus the fact the savings of at least a million
12:14:43 I will close with this, and then we'll want to make a
12:14:48 I will say this.
12:14:49 Actually, what we have today is a tension, and the
12:14:57 tension is that the administration brought us this
12:15:00 document really at the last minute when we should have
12:15:04 had this much sooner so we could have done a workshop
12:15:07 and had opportunity to answer all of the questions, and
12:15:11 afford you the opportunity to go back out and do
12:15:13 additional research.
12:15:16 We got this document, we got this information at the
12:15:19 last minute.
12:15:20 In fact, we first found out about it when we read about
12:15:23 it in the paper.
12:15:24 I think we all were kind of concerned about really the
12:15:29 That's the issue.
12:15:31 That's the issue for this council.
12:15:33 Because what you have said to this council is this.
12:15:39 We pretty much look to you to rubber stamp because we
12:15:41 have already done it.
12:15:43 Now, you may not say that, but the action of bringing
12:15:49 it to us at the last minute caused us to be where we
12:15:53 So that has created some tension here with us.
12:16:00 I will say, my position is when you are bringing these
12:16:05 kind of things that need to be approved, council needs
12:16:08 to have these things far enough in advance so we can
12:16:12 have an opportunity to digest them, research them, and
12:16:15 look so that we know we are making -- or approving --
12:16:21 understand, we are elected officials, too, and we have
12:16:25 an obligation to do our due diligence and work hard to
12:16:27 make sure we are getting the best bang for our buck as
12:16:30 I recognize the fact the charter, we have a strong
12:16:35 mayor form of government, but within that strong mayor
12:16:38 form of government this council has a responsibility to
12:16:39 review and to look at and to sign off on certain
12:16:44 Either vote it up or down.
12:16:45 I recognize that.
12:16:46 So I will say, I am going to support this today with
12:16:51 the understanding that in the future that you all bring
12:16:54 these kind of things to us in enough time, not at the
12:16:57 last minute, and put us in this kind of position that
12:17:01 does not afford us the opportunity to get certain
12:17:04 answers and to maybe send out a clear signal and
12:17:09 So with that the floor is open.
12:17:20 >>CURTIS STOKES: Mr. Chairman, I am in strong support
12:17:21 of what you do.
12:17:22 I believe the wellness clinic will work.
12:17:25 But I still have grave concerns about the costs.
12:17:29 I don't believe the numbers.
12:17:32 But I do believe we may save about a million dollars a
12:17:36 Anytime the city can save taxpayers money, I
12:17:39 wholeheartedly agree with that.
12:17:41 Next year, this council, whatever council, maybe the
12:17:46 mayor, will face a daunting task of balancing the
12:17:55 With that, the million dollar saved next year, it's
12:17:59 almost certain that United Health Care, they will raise
12:18:03 rates, and it will be in excess of a million dollars.
12:18:07 Because it seems to me as a maximum savings that we
12:18:11 realize from these wellness centers, there's a cap of
12:18:14 about a million dollars.
12:18:15 Next year when United raises rates, say they raise them
12:18:19 6%, that's an additional $2.6 million.
12:18:24 We will be in the red on this contract on this
12:18:30 I just have real serious concerns about this going
12:18:35 I support the wellness clinics.
12:18:36 But looking in the crystal ball five years out, three
12:18:39 years out, the city is going to end up paying money for
12:18:44 this going forward.
12:18:45 >> That raises a question, though, because that's not
12:18:51 what the consultant said.
12:18:52 They are saying it will save money every year with the
12:18:56 Anyway --
12:18:57 >>CHARLIE MIRANDA: No, I don't want to speak to --
12:18:59 >>THOMAS SCOTT: If you want to speak to that.
12:19:00 >> Chuck Tobin again with Gallagher.
12:19:05 The important part of these clinics is in taking the
12:19:07 dollars and cents out of it is the clinical interaction
12:19:10 with the patient-physician.
12:19:12 What we see with these is typical health care trend,
12:19:16 what the health care carriers are trending out is 12% a
12:19:20 We could look at it without clinics, a 12% increase
12:19:24 with the clinic, a 6% increase.
12:19:27 That's kind of what we are seeing here.
12:19:28 That's different so that 6% difference is then
12:19:31 compounded the next year.
12:19:32 And then compounded the year after that.
12:19:34 So with the clinic mentality and really engaging these
12:19:39 people in the disease management programs, eventually
12:19:41 we are going to see what we anticipate is a three to
12:19:45 one return on investment for each year.
12:19:47 So when we are spending $2.6 million for the clinic
12:19:51 services, we are going to probably see a 7 to $8
12:19:54 million savings on the health insurance premium over --
12:19:58 at that third year, that third year.
12:19:59 >>THOMAS SCOTT: Okay, let's get a motion.
12:20:04 >>GWEN MILLER: I am going to make --
12:20:06 >>MARY MULHERN: I just want to be really clear about
12:20:09 this, unless I have been somewhere else.
12:20:14 We are paying the administrative costs of these
12:20:17 clinics, right?
12:20:20 We are paying the rent, the overhead, the City of
12:20:23 Tampa, right?
12:20:26 >>> That's correct.
12:20:29 >>MARY MULHERN: That's estimated by you at, based on
12:20:32 the second -- so going with your figure of 2.68 million
12:20:40 credit, that's about the same amount that we are paying
12:20:43 to open three clinics.
12:20:45 >>> That's correct.
12:20:46 >> So you have to subtract?
12:20:50 I mean, if you add that, basically, cost, United Health
12:20:57 Care is basically, you know, one or the other, either
12:21:01 we pay to open the clinics, we build out these clinics,
12:21:04 or we pay more of a premium.
12:21:09 I don't, you know -- I guess the projection is based on
12:21:12 the worker's comp.
12:21:15 I guess that's what we come down to.
12:21:22 I guess I'm talking to myself.
12:21:23 >>THOMAS SCOTT: Is there a motion?
12:21:24 >>CHAIRMAN: Before I make the motion I would like to
12:21:26 say that I was briefed about this, so I don't know why
12:21:31 other councilmen weren't briefed, but was briefed and I
12:21:34 understood it clearly when they came to my office and
12:21:36 talked to me about it.
12:21:37 So I am going to make a motion that we give the
12:21:41 administration or whoever it is the permission to
12:21:43 proceed with the wellness clinic.
12:21:46 >>YVONNE CAPIN: I let me speak to the motion
12:21:52 >>YVONNE CAPIN: I second it.
12:21:52 >>CHARLIE MIRANDA: Let me speak to the motion.
12:21:54 That's what I was waiting for.
12:21:55 The administration said it wasn't for 18 months, is
12:21:59 that correct?
12:21:59 I can run back or whatever the tape.
12:22:01 Yes, I was briefed.
12:22:02 I was briefed about four weeks ago when I told them I
12:22:04 would not vote for any clinic outside the city.
12:22:09 That is before I knew what the costs were.
12:22:11 When I start looking at costs, and I start running
12:22:13 numbers, it is catastrophic that you don't change, and
12:22:18 you don't budge, that you don't say it's either this
12:22:20 way or the highway.
12:22:23 Let me tell you that between last week to this week, I
12:22:28 don't know about the other council members, but my
12:22:31 number has not changed.
12:22:33 My office has not moved.
12:22:34 And I have had the same aide.
12:22:37 And no one has called.
12:22:39 I don't know about the other council members.
12:22:42 Because I'm sure they have been briefed.
12:22:47 So I guess maybe I never got elected.
12:22:50 So what I'm saying is that knowing what I know about
12:22:55 costs, knowing what I see here, knowing that United
12:23:00 health is for one year, the clinic contract is for
12:23:04 three, knowing what they said that if we get out
12:23:08 without cause, meaning if United Health Care wanted to
12:23:12 change, something happened, whatever, and you can't
12:23:15 forecast the future because everything we talked about
12:23:16 today is based on one word -- assumption.
12:23:21 I can't go on a business plan on assumption.
12:23:25 I didn't buy my house on assumption.
12:23:28 I didn't buy my car on assumption.
12:23:30 I bought it because I assumed I could pay for it.
12:23:38 This plan could be reduced if the city build their own
12:23:42 And let me tell you, Clearwater, you can check, the
12:23:46 gentleman I spoke to, looking into the future of
12:23:48 building their own building or having their own
12:23:52 That's a savings in itself.
12:23:56 The scare tactic is that you either do it now, it costs
12:23:59 the employees more money, I am going to pressure you
12:24:06 doing it my way or the highway.
12:24:09 That's not the attitude to take.
12:24:11 That's the attitude that was given.
12:24:13 And I will not be supporting the motion because when
12:24:17 you start to build out in the county, when you have
12:24:19 vacant spaces in the city, people that pay taxes in the
12:24:22 city, doctors that are here in the city that can do the
12:24:26 same thing for much less than $260,000 a person, a
12:24:29 doctor, is a waste of money.
12:24:33 You are wasting talent.
12:24:34 These are not just board certified.
12:24:37 These are specialists.
12:24:40 But, in a, we are going to take the easy way.
12:24:43 Ware going to hire a consultant.
12:24:44 Something went wrong with that guy with the yellow tie
12:24:47 that went wrong.
12:24:48 I don't do it that way.
12:24:50 Something goes wrong, I did it.
12:24:52 So it went wrong, I take responsibility for it.
12:24:55 We are afraid to take responsibility of going outside
12:24:57 the box.
12:24:59 By creating something different, something that works.
12:25:03 And therefore I will not be supporting that motion on
12:25:05 the floor.
12:25:06 Thank you, Mr. Chairman.
12:25:07 >>THOMAS SCOTT: Yes.
12:25:09 >>MARTIN SHELBY: I want to clarify the motion.
12:25:12 The motion is to move the substitute resolution?
12:25:14 >>GWEN MILLER: Yes.
12:25:15 Move the substitute resolution.
12:25:17 >>THOMAS SCOTT: Motion made by councilman Miller,
12:25:20 seconded by Councilwoman Capin.
12:25:22 All in favor of the motion say Aye.
12:25:24 >> CLERK: Caetano, Scott, Miranda --
12:25:30 >>THOMAS SCOTT: I voted yes.
12:25:30 >> CLERK: Caetano, Miranda, Mulhern and Stokes voting
12:25:35 You voted yes?
12:25:37 So the final vote would be Caetano, Miranda and Mulhern
12:25:40 voting no.
12:25:40 >>THOMAS SCOTT: So the motion passed by a vote of 4-3.
12:25:44 Is that right?
12:25:45 >>GWEN MILLER: Yes.
12:25:47 >>CHARLIE MIRANDA: Administration did a good job of
12:25:50 >> I will say this to us before we leave again.
12:25:53 I think it's always wise --
12:26:00 >> I take offense.
12:26:01 >> I think it's always wise that the administration
12:26:02 always talk to all council people and that's what I
12:26:05 recommended when I called the meeting that they brief
12:26:08 all of the council persons, even if you don't agree,
12:26:10 it's always wise to talk to everybody.
12:26:16 Motion to receive and file?
12:26:19 >> So moved.
12:26:20 >> Second.
12:26:22 >>THOMAS SCOTT: All in favor?
12:26:22 Council, I have one thing here from Greg Hart.
12:26:28 They want to schedule a workshop for the MBE update for
12:26:34 I would like to move that.
12:26:36 That's the workshop on --
12:26:40 >>MARTIN SHELBY: The 22nd, Mr. Chairman, your workshop
12:26:44 You have the bicycle safety action plan at 9:00.
12:26:48 >>THOMAS SCOTT: Okay.
12:26:49 >> Do you want to set this for 9:30?
12:26:52 >> Whatever time after that we'll move.
12:26:56 I move that.
12:26:59 >>GWEN MILLER: We have a motion and second.
12:27:01 All in favor of the motion say Aye.
12:27:03 Opposed, nay?
12:27:06 >>CHARLIE MIRANDA: We need accommodation for the award
12:27:09 I can move for the water wise award winners for the
12:27:15 >>THOMAS SCOTT: Moved and seconded.
12:27:16 All in favor?
12:27:18 Anything else?
12:27:19 Motion to receive and file, did we that already.
12:27:21 All right.
12:27:22 We stand adjourned.
12:27:23 Thank you.
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