Penn Medicine representatives presented a proposal to Northern Lebanon School District trustees on Nov. 3 for a shared, employer-sponsored clinic that would provide no–co-pay primary care, counseling and basic on-site medications to school employees and dependents.

"In its simplest form, it's convenience free access to primary care, and wellness services for your employees and dependents," said Keith Fox of Penn Medicine, describing HealthWorks as an employer-sponsored program running since 2017 with 12 locations, roughly 60 employer groups and nearly 13,000 members. Fox said services include sick and wellness visits, rapid point-of-care testing, phlebotomy and a HIPAA-compliant texting app called Spruce to message providers directly.

Fox said the network model can be open to any employer or built as a near- or on-site primary-care practice for participating groups. He said Penn Medicine would take on the full capital fit-out cost for a proposed location and that the participating districts would enter a five-year services agreement; the districts would carry operational costs and initial allocations would be held constant for two years, then adjusted by actual membership.

On cost and participation, Fox said Assured Partners provided enrollment counts across interested districts and that his analysis showed about 1,400 people across the group. His heat map estimated a centralized retail location near Lebanon City would be convenient for about 1,000 people; in Northern Lebanon specifically, about 80 of roughly 200 people on the district plan live in the proposed catchment area, and he estimated roughly 60 of those would use the clinic in the first year. Fox offered a preliminary estimate of approximately $640,000 in annual operating cost across the participating districts, which he said would equate to about $50,000 a year for Northern Lebanon under the initial allocation model.

Board members asked for details on how participation and employee costs were calculated. Fox said participation estimates used the five most populous ZIP codes of current plan enrollees and that districts are not required to all join the program. Regarding employee costs, Leanne (district staff) said the model would be added to the district's existing self-funded health plan costs and "would not be any additional cost for our employees other than what they're already paying for their health care." Fox noted that for employees on a high-deductible plan, small charges related to HSA rules can apply; he referenced a current $49 in-person sick-visit charge for HSA accounts but said regulatory changes expected Jan. 1 may affect that treatment.

Leanne and Fox said contract language under legal review will clarify exclusivity clauses and triggers for opening the clinic to other employers if participation drops below specified thresholds.

The board thanked the presenters and moved on to other agenda items; no vote or formal commitment to join the clinic was recorded during the meeting.

Next steps: Penn Medicine and district staff will continue legal review and follow-up as districts consider the five-year services agreement and membership options.