Employee Clinic Promotes Healthy Workforce, Healthy Bottom Line
What started as a one-room clinic in the basement of the Jefferson County Courthouse in 1999 has grown into a multiservice employee health clinic that has outgrown its location two times.
“In 2022, we cared for 4,643 patients,” shared Leslie Riggs, the registered nurse/certified nurse family practitioner who oversees the clinic.
The Jefferson County Employee Health Clinic was the first county employee clinic in the State of Texas. The brainchild of former Jefferson County Judge Carl Griffith, the clinic turned out to be just the right answer for a multipronged question. How can a county:
- maintain a healthy workforce;
- reduce the cost of the county health plan; and
- provide a quality, convenient, cost-effective health care alternative for employees and their eligible dependents?
Griffith worked with his friend and local doctor Mark Wilson drafting ideas and implementing plans until the doors first opened in 1999. The clinic eventually moved from the courthouse basement to the third floor. In January 2011, the clinic moved to its permanent home in the neighboring Annex 1 building, where it remains today.
As the clinic evolved, news of its success began to spread, said Riggs, who has two master’s degrees in nursing. In fact, the Texas Comptroller of Public Accounts caught wind of the Jefferson County clinic, conducted a study and savings analysis, and presented findings on the positives of a county health clinic at seminars around the state. In addition, representatives from several other counties and cities visited the Jefferson County clinic and later implemented their own programs.
The clinic is available to all full-time employees and their eligible dependents covered under the county benefits plan, Riggs explained. Retirees may also utilize the clinic until age 65. The office visits are free of charge to the employees and their covered dependents over 2 years of age, and patients are seen by scheduled appointments.
“I am so very pleased with our employee health clinic,” Jefferson County Judge Jeff Branick commented. “It provides our employees with on-site services with little or no wait time. These services dramatically improve health outcomes and result in time savings and fewer lost-time events.
“Our nurse practitioner and staff provide timely, caring, and thorough interventions as well as run-of-the-mill physicals and other services that would ordinarily result in health insurance claims,” Branick observed.
The clinic is funded by the county and is staffed by a certified family nurse practitioner (Riggs), a licensed vocational nurse, and an administrative assistant. A local physician maintains a collaborative practice agreement with the nurse practitioner as required by the Texas Board of Nursing.
“The clinic is set up to operate just like other health care facilities with two exam rooms, a lab station, a medical supply and pharmaceutical area, a waiting room, and a restroom,” Riggs described.
The clinic promotes health and wellness throughout the year. Yearly physical exams and wellness labs are performed to catch emerging health issues. Preventive education is provided to reduce cholesterol, blood pressure, and weight. Diet and exercise are encouraged to fit the capabilities of each patient. Goals are set, and the patient is monitored frequently to increase the chance of a successful outcome.
The nurse practitioner directs or refers patients requiring more intensive medical treatment to their primary care physician or specialist as indicated.
“The employees who are typically in good health never meet their deductible,” Riggs noted, “so when they get the flu or have minor care concerns, they can come to the clinic and be treated without costing them any money other than their written prescriptions.”
With the initial goals still in mind – a healthy workforce, affordable health plan, and cost-effectiveness – the county has continued to revamp services as needed. For instance, years ago a lack of a local dermatologist in the area prompted a need for expanded dermatologic care in the clinic rather than have patients wait for referrals.
“The clinic purchased a high frequency desiccator to remove benign or precancerous skin lesions, which provides a huge savings to the county health care plan,” Riggs elaborated. “This service proved to be a convenient and cost-effective solution. Having the equipment available on-site decreases the amount of time the employee is away from work, decreases plan costs for specialist visits, and allows education to be provided to prevent further skin damage.”
In January of this year, the clinic launched a new program called Healthy Changes.
“We meet monthly to talk about things that create better eating habits, exchange healthy recipes, share ways to be more active on a daily basis, and speak to the importance of being mentally healthy,” Riggs detailed. “We have 22 enrolled in the program, and we’ve gotten off to a great start.”
While a cost-savings dollar amount is difficult to quantify, the clinic has undoubtedly saved the county money, Riggs and Branick stated.
“The Jefferson County Employee Health Clinic has been instrumental in lowering overtime pay due to medical issues,” Riggs confirmed. “If employees call the clinic for an appointment, they are almost always seen the same day. This cuts down on lost time due to them waiting a day or more to be seen by their primary care provider.
“The quicker they are treated, the quicker they can return to work and minimize other workers staying over with overtime pay,” Riggs noted. “This has been hard to measure in monetary savings for the county, but overtime pay has decreased noticeably.”
COVID
During the pandemic, the clinic offered a drive-thru testing site initiated by Jefferson County Emergency Management (JCEM).
“I was sent to the frontline by Judge Jeff Branick to manage this test site,” Riggs said.
Nine temporary nurses joined Riggs in swabbing some 4,000 people over a two-month period from Jefferson County and five surrounding counties with the help of the Port Arthur Public Health Department and the Jefferson County Health Department. JCEM created a call center for the public; patients were triaged and given appointments for drive-thru testing.
“It was a huge undertaking, and several outside agencies came and observed our process so that they could replicate it in other areas of the state,” Riggs recounted.
Once this operation ended, the clinic resumed normal hours even though many entities in the state remained closed. To keep the other departments in the building from being exposed to COVID-positive patients, another drive-thru test site for employees and their dependents was created in the summer of 2020. In the last two-plus years, Riggs has tested almost 3,000 people from this drive-thru site. The clinic also gave almost 500 county workers the initial COVID-19 vaccination series early in 2021.
Jefferson County Commissioner Everette “Bo” Alfred has heard positive responses from many of the employees who have used clinic services, saying they have been seen promptly and received follow-up contact, all from friendly staff.
“The employee clinic has been a godsend for the employees because it enables them to get to see a nurse practitioner on short notice,” Alfred shared. “It also reduces their visits to the emergency room for themselves, their spouses, and their children.”