JOHN PEMBERTON/The Times-Union

Nurse practitioner Caroline Gertz talks to Steven Leonard during his visit to the clinic, which provides free basic care to school employees and their families.

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JOHN PEMBERTON/The Times-Union

Teresa Cook cleans up a new X-ray machine in a clinic set to open at Nease High School. Another clinic is planned to open at Pedro Menendez High School, giving St. Johns County school system workers three options for care. The first clinic is at Mill Creek elementary.

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BOB SELF/The Times-Union

Stephanie Latchaw performs the triage screening on Deirdre Hunt, a music teacher at PVPV/Rawlings Elementary School, during a visit to the clinic at Mills Creek Elementary. The clinic is open to employees of St. Johns County Public Schools.

Fast facts

- Money saved: $1 million yearly to the district

- Cost: No co-pay and free in-stock medication

- Appointments: Patients go online to make their own

The waiting room rarely has anyone in it.

There's usually not a reason to wait.

No receptionist sits at the front desk, and don't bother bringing a wallet - there's no bill to pay.

The health center outside Mill Creek Elementary near World Golf Village is unlike anything many of the 150 or so people who visit it each week usually see when they visit a doctor's office.

Last year, St. Johns County Public Schools opened the health center for employees and their family members age 12 and older who participate in the district's health insurance plan.

The district saved about $1 million in the first year on traditional health care costs, which are about $29 million annually, said Jim Springfield, associate superintendent.

He said that covered the initial set up of the center.

It's been so successful, the district is getting ready to open two more centers, at Pedro Menendez and Nease high schools, in a few weeks.

Numerous school districts and government agencies, as well as some private businesses, throughout the country are offering similar services. Putnam and Nassau school districts are among those considering options.

In St. Johns, patients make their own appointments online for a 20-minute visit with a doctor. If they need more time, they can reserve additional 20-minute blocks. If the medication they need is offered and in stock, the health center gives it out at no cost to the patient. And then they head out the door, never paying a co-pay for the visit.

The district contracted with CareHere to open the health center in May 2009 in an effort to keep control of rising health-care costs. It also hoped to encourage employees to visit the doctor when they needed and get necessary medication before minor health issues become major ones.

For Steven Leonard, whose wife works for the district, the center saves his family about $100 a month. He said the savings come mostly from prescription costs since he can pick up his blood pressure medicine for free every three months at the center, after he visits with a doctor.

"This is one of the best plans," he said.

Springfield expects each center to save the district about $1 million each year. That doesn't mean traditional health care costs won't rise, Springfield said, but it shouldn't rise as much with this new service.

Putnam Superintendent Tom Townsend said he doesn't think offering health center services will necessarily save the district money, though it may stop costs from growing as fast. But he said he does think it will encourage employees to get to a doctor faster and fill necessary prescriptions without having to worry as much about money.

Nassau school district already has a well-developed wellness center, and officials feel health centers would be a good next step, said Sharyl Wood, Nassau's executive director of administrative services.

The district is considering putting the first health center in Yulee, but officials are still answering questions from the public about the need for the centers.

Wood said employees could use the services for primary care, and the district hopes they'll take advantage of health management services before they have such issues as diabetes or heart disease.

"We want people to manage their health so they don't need medical services for those kinds of medical conditions," she said.

She believes it will help cut time when employees are absent from work because of health problems.

Wood said she is not sure what kind of cost savings the Nassau district might see. But she said there is a potential for savings, especially in the long-term when employees don't have as many health problems.

How it saves money

Springfield said his district is able to save money mostly because of fewer overhead costs associated with the health centers. The district hired CareHere to manage the centers and employ doctors and other staffers. The district pays a flat fee of $23 per person in the plan per month. There are about 6,500 people in the plan.

CareHere then tries to keep costs lower in part by working out deals with prescription companies and labs to get discounted prices.

At the center, patients can get help with the flu, manage their diabetes, talk to a nutritionist about diet and get annual physicals and other exams.

Springfield said members of the districts plan used to make 1.9 visits per month to a traditional doctor. That's down to 1.2 visits per month. That means the district doesn't have to pay as much in overhead costs, he said.

Each center has at least one doctor, plus a nurse and medical technician. There are exam rooms, consultation rooms, a pharmacy - with no narcotics - and a lab for drawing blood. The new centers will have digital X-ray machines.

The centers are open five days a week, plus half days on Saturdays. They open early some days and stay open later others.

CareHere brings in nutritionists, school psychologists and other specialists, as needed. They also offer online and some in-person classes.

Patients can take a blood test before they see a doctor, and then access all of their medical information online later.

When Mill Creek Elementary school nurse Kathleen Morales caught what her students had - something she describes as worse than the flu - she knew where to go.

"I walked over there last week sick as a dog," Morales said. "It's right here, very convenient."

The center didn't have the antibiotic she needed, but she did get a prescription and didn't have to dole out the $20 co-pay for the visit. Best, it helped her get back to school. She's also used the center for annual checkups and other health issues, she said.

She said she's even gone during the summer and it's taken little time out of her day.

"I'm in within five minutes," she said.

mary.palka@jacksonville.com, (904) 359-4104

link: http://jacksonville.com/news/metro/2010-10-20/story/st-johns-school...