Wellness Center Cost Containment via Community Collaboration

1. Wellness Center Cost Containment via Community Collaboration Dianne Ortega, RN Health and Wellness Manager Albuquerque Job Corps Center

2. Objectives • To fully understand the need for collaborative community projects. • To decrease the cost per student ratio from limiting any health and wellness program. • To learn various methods for establishing great community linkages. • To provide a more comprehensive wellness program within the Job Corps community. • To teach students how to access services in the community and prepare the student for employment.

3. Reasons for Cost Containment • Rising cost for health care • Increased center responsibility for payment • Regional Office mandates (99-01) • Accountability for student welfare due to licensure • Accountability for standards of care • Responsible for ensuring healthy young adults • Reasonable accommodations

4. What is available in the community to enhance center programs • Separate major program components and evaluate (medical, oral health, mental health, pregnancy, and drug/alcohol) • Types of programs available in the community. Look at services on a city, State, and national level.

5. Develop Library with Program Listings • U.S.-DOH-Mental Health and Substance Abuse Directory • U.S.-DOH-General Hospital Listings Directory • U.S. DOH-Family Planning Grantees, Delegates, and Clinic Programs Available through Department of Health; sent automatically if you are a provider, delegate, DOH-clinic • National Directory of Youth and Children’s Services 14 Inverness Drive East Suite D-144, Englewood, CO 80112 Cost: $139.00 • United Way Councils in each state • Regional Indian Contract Health Listings • Job Accommodation Network (JAN) Directory

6. Pap: $12.00 RPR: $8.00 GC: $7.00 Hct/Hgb: $5.00 Sickle cell: $4.00 Td: $2.00 each MMR: $21.97 each IPV: $7.82 Hepatitis b: $25.00/student Gloves: $7.00/box Gowns: $43.00 Table paper: $15.00/box UA dip (chem 9): $36.37 hcg tests: $4.00/each Looking at Cost Containment

7. Average # of new students = 20/wk (10 male, 10 female) x cost = expenses x 4 = average total expenses

8. 10 x 12 = $120.00 x 4 = $480.00 20 x 8 = $160.00 x 4 = $640.00 10 x 7 = $70.00 x 4 = $280.00 20 x 5 = $100.00 x 4 = $400.00 20 x 4 = $80.00 x 4 = $320.00 12 x 2 = $24.00 x 4 = $96.00 12 x 21.97 = 263.64 x 4 =$1,054.56 5 x 7.82 = $39.10 x 4 = $156.40 17 x 25 = $425.00 x 4 = $1,700.00 3 x 7 = $21.00 10 x .86 = $8.60 x 4 = $34.40 1.25 x 4 = $5.00 2 x 36.37 = $72.74/month 50 x 4 = $200.00 Cost Break Out

9. Monthly Expense Total monthly expense = $5,460.10/month (This total reflects only services required and listed above.) What would you do with an extra $5,460.10 a month in your budget?

10. Medications Commonly Ordered Penicillin PVK $3.94 each Diflucan $18.91 each Amoxicillin $4.10 each Mycelex $3.50 each Proventil $8.48 each Allegra $30.71 each Zithromax $10.56 each Keflex $6.51 each Pepcid $20.60 each Paxil $37.86 each Cipro $21.20 each Rocephin $21.01 each Doxycycline $2.10 each Vancenase $29.00 each Depo-Provera $22.53 each Flu vaccine $14.09 each Cost for a prescription as normally ordered using Perry Point, Maryland. Depot Cost.

11. Procedures Commonly Ordered MRI:__________ X-ray: chest__ wrist:__ ankle:__ CBC:______________ UA C&S:____________ What would you guess the cost for the above procedures would be?

12. **Refer to Title X Formulary **

13. Examples of Programs to be Contacted and Implemented County-Based Organizations • Indigent programs • Hospital affiliation • Sliding • Health care for the homeless • Fraternal organizations/service organizations • Membership • Affiliated: community service • Sliding-scale programs • Obtain copies of sliding-scale fees • Set up agreement for fee charging

14. Examples of Programs to be Contacted and Implemented (continued) County-Based Organizations (continued) • University programs • Counseling/rotation sites–LPN, RN, internships • Public health programs • STD/FP/TB/prenatal • Women’s health • Indian Health Services • Medical/surgical/women’s health • Contract services away from contract site • Pharmacy section • Counseling services • In- or outpatient services

15. Examples of Programs to be Contacted and Implemented (continued) County-Based Organizations (continued) • Educational youth programs • County-sponsored peer education • MADD, DADD, TADD programs • Police and corrections outreach programs • Public schools outreach programs • Ecumenical councils (church referrals) • Division of Vocational Rehabilitation (DVR)

16. Examples of Programs to be Contacted and Implemented (continued) State-Based Programs • Vaccines for children’s programs • Children’s medical services • Social security disability (medicare) • Granting foundations • Application to granting organizations • DOH – Title X – STD/FP • Grant, memo of agreement (MOA), provider agreement (PA) • DOH – TB Clinics • Agreement

17. Examples of Programs to be Contacted and Implemented (continued) State-Based Programs (continued) • State Children’s Health Insurance Program (SCHIP)–national program, state run • Become a MOSSA determiner • Agreement with Medial Assistance Division (MAD) • United Way program community services • Department of Education • DVR listings in the state

18. Examples of Programs to be Contacted and Implemented (continued) State-Based Programs (continued) • Support groups (AA, NA, CAA) • Diabetes Foundation, HIV Association, Lung Association • MOA/PA • SSA programs–medicaid/medicare • Private insurance/Third-party payor • Research programs

19. Examples of Programs to be Contacted and Implemented (continued) National Programs • SCHIPs = medicaid program • Delancy Street program • Community support group listings • National Alliance for the Mentally Ill • National Manic Depressive Association • Federally funded substance abuse programs • Pharmaceutical patient representative programs • Substance Abuse and Mental Health Administration

20. By setting up collaborative programs, the center is able to: • Stay is an underrun situation; use assigned monies on other needed items. • Save money for internal program enhancement. • Purchase items on your wish list. • Expose students to programs available in the community. • Teach students how and when to access services. • Minimize terminations thus decreasing the burden on worker’s compensation and center expenditures. • Build community relationships and support (center programs are then supported by the community). • Oversee program for compliance with MOAs (standards of care).

21. Collaborative partner programs are enhanced by: • Reaching a greater number of clients • Providing necessary services to the people most in need of services • Qualifying for additional monies through the state/grants/federal government • Volunteering center support for programs • Identifying potential work-based learning providers

22. Clearly implementation of these concepts will impact a program on a center, regional, and national level. Our center has enjoyed major cost savings through the use of partner programs. We as professional administrators should consider it our primary goal to provide optimal services for our students, while instilling pride in what we do as well as enhancing the image of the Job Corps community.