MINUTES
COUNCIL OF COLUMBUS, GEORGIA
WORK SESSION
OCTOBER 29, 2013
The meeting of the Council of Columbus, Georgia was called to order at
9:00A.M., Tuesday, October 29, 2013, on the 2nd Floor of the Citizens Service
Center, located at 3111 Citizens Way, Columbus, Georgia. Honorable Teresa Pike
Tomlinson, Mayor, presiding.
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PRESENT: Present other than Mayor Tomlinson were Mayor Pro Tem Evelyn Turner
Pugh and Councilors R. Gary Allen, Mike Baker, Glenn Davis, Bruce Huff, Judy W.
Thomas, and Evelyn Woodson. City Manager Isaiah Hugley, City Attorney Clifton
Fay, Clerk of Council Tiny B. Washington, Deputy Clerk of Council Sandra Davis
and Administrative Secretary Lindsey Glisson were also present.
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ABSENT: Councilor Charles E. McDaniel, Jr., was absent.
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INVOCATION: Led by Reverend Patricia Merchant, St. Thomas Episcopal Church.
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PLEDGE: Led by students from Brewer Elementary School.
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CONSENT AGENDA:
THE FOLLOWING RESOLUTION WAS SUBMITTED AND
APRPOVED BY THE COUNCIL: ____________________________________
A Resolution (350-13) ? Excusing Councilor Glenn Davis from the October
22, 2013 Council Meeting.
Councilor Allen moved the adoption of the resolution. Seconded by
Councilor Woodson and carried unanimously by those nine members of Council
present, with Councilor McDaniel being absent for the meeting
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WORK SESSION:
EMPLOYEES HEALTHCARE INSURANCE COST:
Director of Finance Pam Hodge came forward and went into many details and
gave the financial impact review of the Health Insurance for the Columbus
Consolidated Government, which included the following information as outlined
below.
Health Insurance Fund Expenditures from FY-2002 through 2018.
HEALTH INSURANCE FUND:
Current City Contribution = Increased by $250/employee to $5,650/employee in
FY13
Annual Costs of healthcare $25+ million, expected $2 million shortfall in FY14
Projected to increase 5-10% annually
Adjusted plan benefits in FY13
Increased office visit co-pays
Increased deductibles
Restructured prescription co-pays
Health and Wellness Center opened spring of 2013
Last change in employee premiums was Jan 2009
HEALTH INSURANCE COMPONENTS:
Plan Benefits (includes deductibles, co-pays, covered services)
Employee premiums
Employer contributions
Amount budgeted per full time position as part of each department?s budget
COST OF INDIVIDUAL (Employee Only) PLANS with proposed plan changes
PLAN TOTAL MONTHLY PREMIUM EQUIVALENT EMPLOYEE MONTHLY RATE
HWC
$409.54 $91.00
HMO
$411.34 $92.80
PPO/POS
$429.86 $98.87
CONTRIBUTION STRATEGY:
YEAR EMPLOYEES PAYS CCG PAYS
2013
24% 76%
2014
28% 72%
(Proposed)
After the conclusion of her presentation, Director of Finance Hodge then
responded to several questions of Mayor Tomlinson and members of the Council.
Director of Human Resources, Reather Hollowell then came forward and
stated that at the October 8th Council meeting, we talked about some specifics
issues and said there ere a lot of questions of how we could allocate the plan.
She then went into more details regarding the plan, after which she then
called forward Ms. Cathy Showers with Northwestern Benefits, the Columbus
Consolidated Government?s consultant for health care, who then gave of
executive summary of the plan.
After more than two hours of discussion on this subject, after Ms. Showers
had concluded her presentation, Mayor Tomlinson and members of the Council made
several comments and expressed their views regarding the proposal for
employees? healthcare costs.
Ms. Showers also responded to questions of the Mayor and members of
Council.
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NOTE: Councilor Allen left at 10:55 a.m. (See below for his return back to the
meeting)
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After the Mayor and Council concluded their discussion on the employees?
healthcare plan, City Manager Hugley pointed out that at the Council
directions, he sent out a memorandum to all employees and advised them that the
Council has invited them to attend the Council meeting for the discussion of
the employees? healthcare plan. He said he has asked three department heads to
come forward and speak to the issue.
Council members indicated that they wanted to hear everyone who wanted to
be heard on this issue.
The following individuals then called forward and expressed their comments
and concerns regarding the proposed increased for the employees? healthcare
plan.
Ms. Esther Radcliff, of the City Attorney?s Office, Ms. Laura Murphy, of
the Inspections & Code Enforcement Division, Mr. Randy Robertson, representing
the Fraternal Order of Police, Mr. Billy Watson, President of the Retired City
Employees Association, Mr. Kelvin Wells of the Sanitation Department, Ms.
Connie Fuller of the Public Services Department and Mr. Joseph (inaudible) of
the Engineering Department.
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WORKER?S COMPENSATION CLAIMS MANAGEMENT:
Ms. Ann Marie Emeril, Risk Manager came forward and gave a presentation on
Worker?s Compensation Claims Management, which is outlined below.
THE REASONS FOR STAFF?S RECOMMENDATION:
Claims handling
Size
Administrative expenses
Provision of care
RFP
CLAIMS HANDLING ? PANEL COMPARED TO MANAGED CARE
ORGANIZATION________________________________________________
Claims Handling
The Panel
Employee develops back pain after lifting something heavy at work
Managed Care
Employee develops back pain after lifting something heavy at work
The Panel
Employee tells his supervisor, is shown the posted panel and asked to make a
selection.
Managed Care
Employee tells his supervisor who can help him call the 800 number 24/7.
Employee also has a wallet card with that number for his own use. Employee
will speak to a medical professional, and still has a choice of medical
provider.
Claims Handling ? Panel Compared to Managed Care Organization
The Panel
An adjuster is assigned to the case by the TPA, usually after the employee has
sought treatment at an Urgent Care facility due to the fact that specialists
require appointments. The adjuster has no medical training and may have little
experience in handling personal injuries.
Managed Care
The medical professional called by the employee will find out what happened,
what is hurting, and any other pertinent information. If circumstances
warrant, that person can contact a specialist directly to request that the
employee be worked into the schedule.
CLAIMS HANDLING- PANEL COMPARED TO MANAGE CARE ORGANIZATAION:
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The Panel
In many cases the Urgent Care facility will order tests and see if an initial
treatment plan works prior to referral to a specialist. This can result in
expenditures in excess of $6,000 before the employee sees a specialist.
Managed Care
CLAIMS HANDLING ? PANEL COMPARED TO MANAGED CARE
ORGANIZATION:__________________________________________________
The Panel
Providers contact the adjuster assigned to the case for authorizations for any
treatment or referrals. Depending on the knowledge level and experience of the
adjuster response times are variable.
Managed Care
A medically-trained case manager, assigned only to CCG cases, will be the
contact person for all providers and will be able to interact with the provider
regarding the treatment plan and provide prompt authorizations.
The Panel
The Authorized Treating Physician (ATP) has total control of the treatment and
return to work of the employee, and is not required to enter into any
discussion about treatment options or address any concerns of the employer or
the adjuster.
Managed Care
Treating physicians are still in charge, but are subject to review by
medically-trained personnel. Thus, a more collegial approach to treatment is
taken, and this can benefit all those involved.
The Panel
If an ATP refuses to discuss a case where a patient has been out of work for
years with little more than an annual exam, all we can do is go to the State
Board for a ruling. The Board, not surprisingly, almost always accepts the
opinion of the physician over that of the non-medically trained Administrator.
Managed Care
Due to more involvement with medical specialists, fewer cases are likely to
result in employees being out of work long term. Where it is felt necessary to
take a case to the State Board, the Board will see a more complete picture,
resulting in more objectively fair rulings.
CLAIMS HANDLING:
Examples ? The good, the bad and the ugly
Claims cost breakdown
SIZE:
Member County size
Management models
ADMINISTRATIAVE COSTS:
Projected 2014 administrative costs per bids
National trends for excess coverage
PROVISION OF CARE:
Necessity for 24/7 triage coverage
Best care for employees as quickly as possible
Saving taxpayer dollars
Peer review as a benefit to physicians and patients
RFP:
No RFP since 2002
Standard procurement procedure followed
Evaluation committee drawn from Public Safety and General Government departments
Unanimous recommendation
SUMMARY:
CCG has word to do to reduce rate of injury
Injuries will still occur
Once an injury occurs we owe it to our employees and citizens to manage it well
The recommendation of the RFP Evaluation Committee provides the best
opportunity for quality provision of care and cost effective management of
injury claims.
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NOTE: Councilor Woodson left at this point in the proceedings, with the
time being 1:45 p.m.
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After Ms. Emeril concluded her presentation, several members of the
Council expressed some comments and concerns regarding the presentation. Ms.
Emeril then responded to those questions and concerns of the Mayor and members
of the Council.
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GAP TIME:
Director of Finance Pam Hodge came forward and went into some details in
explaining to Council what gap time is, as well as how it is calculated and to
whom gap time is paid.
Ms. Hodge, City Manager Hugley and Mayor Tomlinson responded to questions
of members of the Council with regards to gap time.
Attorney Kristen Stevenson also came forward and pointed out what the Fair
Labor Standards Acts says about gap time. Ms. Stevenson also responded to
questions of members of the Council as it relates to this subject matter as
well.
Muscogee County Prison Warden Dwight Hamrick came forward as well and
outlined the schedule he has instituted for his employees. He also responded to
questions of Mayor Tomlinson and members of the Council.
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PENSION BENEFITS CALCULATIONS:
Mayor Tomlinson pointed out that they have received a legal memo regarding
this subject matter and said that her and the City Attorney will be taking a
look at that and will bring this matter back at a later time. She said they
will also share it with the Pension Board.
With there being no other business to come before the Council, Mayor
Tomlinson then entertained for motion for adjournment. Mayor Pro Tem Turner
Pugh so moved. Seconded by Councilor Allen and carried unanimously by those six
members of Council present at the time, with Councilors Davis, Henderson and
Woodson being absent for this vote, and Councilor McDaniel being absent for the
meeting, with the time of adjournment being 3:57 p.m.
Tiny B. Washington, MMC
Clerk of Council
The Council of Columbus, Georgia
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