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Agenda 10/10/2017 Item #16E210/10/2017 EXECUTIVE SUMMARY Recommendation to approve First Amendment to Agreement #14-6293 with Millennium Physician Group, LLC to add limited pharmacy services through the MedCenter. OBJECTIVE: To provide limited pharmacy services through the MedCenter for promoting health, wellness, and productivity. CONSIDERATIONS: The employee health clinic (a/k/a the MedCenter) was established in December 2006. The MedCenter is currently managed under an agreement with Millennium Physicians Group, LLC (Board approved on September 9, 2014, Agenda Item 16.E.7). At its inception, the focus of services was limited to acute and primary care services to members covered under the Collier County Group Health Plan. However, with the implementation of the Invest in Your Health Program in 2009 as well as the Board’s approval of Resolution #2017-67 to become certified as a Blue Zones employer, services have expanded to include chronic disease management, medically monitored weight loss programs, a diabetes management program, a tobacco cessation program and a cardiac health program. To complement these services, the Risk Management Division is seeking approval from the Board to permit limited pharmacy services through The MedCenter. These limited pharmacy services will include commonly prescribed medications such as antibiotics and flu vaccines; however, narcotics will not be included in the program. These medications will be maintained and tracked by The MedCenter staff and the cost of these medications will be passed through to the Collier County Group Health Plan with no mark up. It is the opinion of staff that this program will add value and enhance employee health and productivity by allowing treatment to begin immediately (in the office); by eliminating an additional stop at the pharmacy; by reducing sick leave usage; and by enabling the employee to return to work sooner. By amending the agreement so that the current clinic services offered includes limited pharmacy services, if the County elects to exercise any of the three existing enhanced clinic options under the agreement in the future, those options would also include these services. FISCAL IMPACT: The estimated annual cost of the program is $11,774. However, this amendment does not add additional cost to the overall Group Health Plan. This amendment simply redirects payment for these limited medications (at cost) to Millennium Physicians Group rather than to a local pharmacy. There are sufficient funds in Fund 517, Group Health and Life Insurance to cover the cost of the program. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval. -SRT GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with this action. RECOMMENDATION: To approve the attached amendment to Agreement 14-6293, Onsite Medical Clinic with Millennium Physicians Group, LLC as outlined above to provide limited pharmacy services and authorize the Chair to sign the First Amendment. Prepared by: Sonja Sweet, Group Benefits Manager, Risk Management Division ATTACHMENT(S) 1. Collier County On-Site Medical Clinic Amendment to Agreement 14-6293 - signed (PDF) 10/10/2017 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.2 Doc ID: 3659 Item Summary: Recommendation to approve First Amendment to Agreement #14-6293 with Millennium Physician Group, LLC to add limited pharmacy services through the MedCenter. Meeting Date: 10/10/2017 Prepared by: Title: Benefits Analyst – Risk Management Name: Sonja Sweet 08/31/2017 11:28 AM Submitted by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 08/31/2017 11:28 AM Approved By: Review: Procurement Services Opal Vann Level 1 Purchasing Gatekeeper Completed 08/31/2017 4:40 PM Procurement Services Sandra Herrera Additional Reviewer Completed 09/05/2017 4:09 PM Procurement Services Ted Coyman Additional Reviewer Completed 09/06/2017 3:21 PM Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 09/25/2017 1:48 PM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 09/26/2017 11:59 AM County Attorney's Office Scott Teach Level 2 Attorney Review Completed 09/28/2017 8:48 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/28/2017 10:24 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 09/28/2017 1:52 PM Office of Management and Budget Laura Wells Additional Reviewer Completed 09/28/2017 2:59 PM County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 10/02/2017 4:47 PM Board of County Commissioners MaryJo Brock Meeting Pending 10/10/2017 9:00 AM FIRST AMENDMENT TO AGREEMENT #14-6293 "COLLIER COUNTY ON-SITE MEDICAL CLINIC" BETWEEN COLLIER COUNTY AND MILLENNIUM PHYSICIAN GROUP. LLC THIS AGREEMENT, made and entered into on this day of 2017, by and between Millennium Physician Group, LLC, authorized to do business in the State of Florida, whose business address is 6321 Daniels Parkway, Suite 201, Fort Myers, Florida 33921 (the "Provider" and "Millennium") and Collier County, a political subdivision of the State of Florida, (the "County" or "Owner"). WHEREAS, on September 9, 2014, Item 16.E.7, the County entered into an Agreement with Provider to provide on-site primary care health services; and WHEREAS, the parties desire to amend the Agreement to expand services under all four (4) clinic model options to provide onsite limited pharmacy services for the disbursement of commonly prescribed medications and flu shot vaccinations through the Med Center; and WHEREAS, by amending the current clinic Model Option 1 to include limited pharmacy services, the future exercise of any of the other three (3) expanded clinic options will automatically include those services; and WHEREAS, the Provider will request reimbursement from the County for the actual cost paid by Provider with no additional markup to the County. NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the parties as follows : Words Smtek Through are deleted; Words Underlined are added ••Remainder of this page left blank intentionally•• Page 1 of3 Agreement #14-6293 Collier County On-Site Medical Clinic Exhibit A Scope of Services * * * * * 3. CLINIC OPTIONS-BRIEF DESCRIPTIONS This Agreement provides for four ( 4) clinic options. Option 4 is not anticipated at this time, but may be considered for implementation in the future. These options are: Option 1: Current Clinic -The current clinic services. along with the nrovision of onsite limited pharmacy services as further set forth in Section 4. Clinic Options -Detailed Descriotions. * * * * * 4. CLINIC OPTIONS-DETAILED DESCRIPTIONS Option 1 -Current Clinic Model-Duplicate the current clinic model. including the proyision of on-site limited pharmacy seryices to be provided under all clinic model ootions under this Agreement. which will stock and dispense medications to treat acute episodic illness and chronic disease to include but not limited to: Flu Vaccine. antibiotics. and Steroid packs. Millennium will purchase medications directlv from suPPlier and the Countv will reimburse Provider at actual cost paid with no additional markup to Countv. Staffing to match what is in the pricing sheet in Exhibit B. * * * * * (SIGNATURE PAGE TO FOLLOW) Page 2 of3 IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Amendment on the date and year ftrst written above. ATTEST: Dwight E. Brock, Clerk of Courts By: ___________ _ Dated:------------------- (SEAL) BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: _______________________ _ Penny Taylor, Chairman Approved as to Form and Legality: Deputy County Attorney Print Name Page 3 of3