The Franklin Public School District board on April 9 reviewed a suite of proposals to address the district's projected health-insurance deficit and heard a separate recommendation to create an on-site employee health clinic.

The fiscal picture and proposals
District staff told the board the most recent preliminary projection shows a roughly $1,082,000 shortfall in the district's health-benefit budget for the coming year. "Currently, we're sitting at $1,082,000 in the red," said Mister Chromie, a district staff member who led the presentation.

To close that gap staff and consultants presented 10 numbered options that ranged from maintaining the current plan (with higher employee premiums) to more sweeping changes such as switching to a single, higher-deductible plan, implementing narrow-provider networks, or changing the district's premium contributions. A short summary:
- Options 14: Keep current plan design but shift cost through larger employee premium increases or by capping district contributions.
- Option 5/6: Raise Plan 1 deductibles and add coinsurance while increasing Garner reimbursement levels; these reduce district exposure but increase employee out-of-pocket risk.
- Option 7: Move to a single high-deductible plan (the district's analysis shows this would save roughly $570,000 to the district but would raise costs for many employees).
- Options 9 and 10: Narrow-network alternatives (Nexus, Scentivo). Staff noted those could reduce provider prices but the specific proposals on the table would raise district costs in the near term and were not favored by several board members.

Public comments and staff concern
Public comment included two Franklin teachers who urged caution because higher employee premiums or large deductible increases could harm retention. Jonathan Schaeffer, a social-studies teacher at Franklin High School, told the board he had been told the Better Place to Work task force's numbers implied a roughly $1,000 salary increase next year but that premium and deductible changes could leave him "up to $5,000 less in my bank account at the end of next year." Schaeffer said such a swing would be a real concern for staff and for retention.

Garner and savings tools
Consultants from Brown and Brown presented results from the Garner provider-recommendation and reimbursement program the district currently offers. Brown and Brown reported:
- About 69% of eligible employees have engaged with the Garner tool,
- Garner estimates an approximate $385,000 claims-avoidance figure for the district to date, and
- Garner engagement yields a recommended provider for 98% of engaged members.
The board asked for more district-specific outcome data from Garner, including measures of health outcomes and verified per-member savings, as a follow-up.

On-site clinic recommendation
As part of the budget conversation district staff presented two vendor proposals to operate an on-site clinic for employees and dependents. Staff recommended ProactiveMD over QuadMed based on projected utilization and the vendor's k-12 experience. Key points:
- ProactiveMD's model includes an on-site nurse practitioner, an LPN/medical assistant and a patient advocate or care coordinator; ProactiveMD's early-year management and startup costs are higher than QuadMed's but the company projected stronger utilization and faster cumulative savings.
- ProactiveMD estimated a multi-year cumulative health-cost diversion (their term for avoided claims and lower-cost care pathways) of roughly $3.0 million by year 3 and about $6.5 million by year 5 for the district scenario presented. QuadMed's vendor proposal projected savings that reach a smaller cumulative amount by year 5.
- Staff emphasized the patient-advocate role: that person would identify at-risk employees from initial health-risk assessments, help book specialist visits, and actively guide members through lower-cost care pathways.

Board direction and follow-ups
Board members asked staff to produce additional analyses and alternatives. The board asked for:
- Modeling of a single-plan option with a $9,000 net deductible and Garner reimbursements to show the budget and employee-premium impact (staff noted they would run a 9k-deductible single-plan model),
- Additional district-specific Garner outcome data on health outcomes and verified per-member savings, and
- More granular estimates of the cash-in-lieu program at alternative subsidy levels (the board asked staff to model a phased cash-in-lieu reduction similar to last year's approach).

Mister Chromie and the consultants said the clinic savings were not yet built into the district's base projection because the board had not yet approved a clinic; staff said they would return with clearer estimates and final contract terms if the board wants to proceed.

Ending: Board members said they wanted a multiyear strategy rather than year-to-year changes and emphasized balancing affordability for employees with the district's budget responsibilities. Staff will return with the modeled scenarios and follow-up data requested by the board.