Wellness Center Cost Wellness Center Cost Containment via Containment via

Community Community CollaborationCollaboration

Dianne Ortega, RNHealth and Wellness

ManagerAlbuquerque Job Corps

Center

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ObjectivesObjectives

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.

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Reasons for Cost Reasons for Cost ContainmentContainment

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

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What is available in the What is available in the community to enhance community to enhance

center programscenter programs

a) Separate major program components and evaluate (medical, oral health, mental health, pregnancy, and drug/alcohol)

b) Types of programs available in the community. Look at services on a city, State, and national level.

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Develop Library with Develop Library with Program ListingsProgram Listings

a) U.S.-DOH-Mental Health and Substance Abuse Directoryb) U.S.-DOH-General Hospital Listings Directoryc) 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

d) National Directory of Youth and Children’s Services 14 Inverness Drive East Suite D-144,

Englewood, CO 80112 Cost: $139.00e) United Way Councils in each statef) Regional Indian Contract Health Listingsg) Job Accommodation Network (JAN) Directory

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Looking at Cost Looking at Cost ContainmentContainment

a. Pap: $12.00b. RPR: $8.00c. GC: $7.00d. Hct/Hgb: $5.00e. Sickle cell: $4.00f. Td: $2.00 eachg. MMR: $21.97 each

h. IPV: $7.82i. Hepatitis b:

$25.00/studentj. Gloves: $7.00/boxk. Gowns: $43.00l. Table paper: $15.00/boxm. UA dip (chem 9): $36.37n. hcg tests: $4.00/each

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

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Cost Break OutCost Break Out

10 x 12 = $120.00 x 4 = $480.0020 x 8 = $160.00 x 4 = $640.0010 x 7 = $70.00 x 4 = $280.0020 x 5 = $100.00 x 4 = $400.0020 x 4 = $80.00 x 4 = $320.0012 x 2 = $24.00 x 4 = $96.0012 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 = $21.0010 x .86 = $8.60 x 4 = $34.401.25 x 4 = $5.002 x 36.37 = $72.74/month50 x 4 = $200.00

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Monthly ExpenseMonthly 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?

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Medications Commonly Medications Commonly OrderedOrdered

Penicillin PVK $3.94 each Diflucan $18.91 eachAmoxicillin $4.10 each Mycelex $3.50 eachProventil $8.48 each Allegra $30.71 eachZithromax $10.56 each Keflex $6.51 eachPepcid $20.60 each Paxil $37.86 eachCipro $21.20 each Rocephin $21.01 eachDoxycycline $2.10 each Vancenase $29.00 eachDepo-Provera $22.53 each Flu vaccine $14.09 each

Cost for a prescription as normally ordered using Perry Point, Maryland. Depot Cost.

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Procedures Commonly Procedures Commonly OrderedOrdered

MRI:__________X-ray: chest__ wrist:__ ankle:__CBC:______________UA C&S:____________

What would you guess the cost for the above procedures would be?

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**Refer to Title X Formulary **

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Examples of Programs to Examples of Programs to be Contacted and be Contacted and

ImplementedImplementedCounty-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

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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)

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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

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Examples of Programs to be Examples of Programs to be Contacted and Implemented Contacted and Implemented

(continued)(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

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By setting up collaborative By setting up collaborative programs, the center is able programs, the center is able

to: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).

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Collaborative partner Collaborative partner programs are enhanced programs are enhanced

by: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

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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.