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.
The Jefferson County Employee Health Department 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, shared Leslie Little, a registered nurse and certified nurse family practitioner who oversees the clinic. 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.
As the clinic evolved, news of its success began to spread, recalled Little, who has a master of science 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.
In 18 years, there has been a steady increase in the number of yearly visits, Little reported. The employee clinic treated approximately 1,400 patients during the first few years of existence. In 2017, the clinic provided medical services to 4,252 county employees and/or their dependents.
“The employee clinic has been a success for Jefferson County,” Little declared.
The clinic is available to all full-time employees and their eligible dependents covered under the county benefits plan, Little 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.
The clinic is county funded and is staffed by a certified family nurse practitioner (Little), a licensed vocational nurse, and a medical 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 restroom,” Little 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,” Little 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, 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 four years ago to remove benign or precancerous skin lesions, which provides a huge savings to the county health care plan,” Little reported. “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.”
While a cost-savings dollar amount is difficult to quantify, the clinic has undoubtedly saved the county money with regard to overtime pay.
“The Jefferson County Employee Health Department Clinic has been instrumental in lowering overtime pay due to medical issues,” Little stated. “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,” Little declared. “This has been hard to measure in monetary savings for the county, but overtime pay has decreased noticeably since the clinic opened.”
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.