Palm Coast council hears five‑year projections for on‑site employee clinic, no contract awarded

The Palm Coast City Council received a presentation June 2 on a proposed city employee on‑site clinic run by My Health OnSite that, according to the vendor’s model, would produce multi‑year savings for the city.

Brian Brham, vice president of My Health OnSite, told council the firm’s review of Flagler County data from 2021–2025 shows net savings ranging from about $307,000 to $675,000 in individual years and a roughly $2.7 million total marketplace savings over five years. The model blends professional office‑visit cost differentials, lab and prescription savings and a program management fee; it excludes emergency‑room diversion and does not add employee co‑pay savings or presenteeism into the ROI figure, the presenters said.

Reina Fuller, Palm Coast director of human resources, and Lisa Lynch, HR manager, said the city requested the five‑year projection and a historical county review at a May 12 workshop. Brham said the county’s clinic showed “sticky” utilization — about 71% of employees used the clinic three or more times in the most recent year — and that his team used a baseline 32 provider hours per week for the city projection with conservative growth and cost assumptions (5% cola, 3% utilization growth) to derive the five‑year estimate.

Council members focused on key assumptions. They asked whether employee out‑of‑pocket co‑pay savings and presenteeism reductions were included (Brham said they were shown on slides for context but not included in the ROI). Council members also questioned whether 32 weekly provider hours is sufficient for a city workforce of 600–650 employees and whether telehealth offerings (TeleDoc) would reduce clinic utilization; staff said hours could be scaled and that the vendor offers telehealth during core hours.

Operational details raised included staffing mix (physician vs. nurse practitioner hours), lab pricing, prescription management and how lease or facility startup costs would affect early years. Brham said the operational contract estimate for a 32‑hour clinic would be about $850,000 annually (operations-only) and that prior start‑up estimates ran roughly $380,000–$388,000; he emphasized that those figures exclude any facility buildout or lease cost, which staff must provide for budget planning.

Council members generally described the proposal as promising if the projected savings materialize, but they emphasized the need for an implementation plan to drive employee usage and annual contract review to verify savings. No contract action was taken; staff were directed to gather detailed facility standup estimates and return with those figures in time for the budget cycle.

The council opened the issue to public comment during its general public participation period but took no formal vote on a clinic contract at the June 2 meeting.

What’s next: staff will produce facility startup cost estimates and a staffing/hours plan for future council review; any contract award would return to council for formal approval.