Denton ISD approves a health clinic. But will it attract and keep teachers?

The Denton ISD school board spent some sweat over a proposed wellness clinic before approving it this week.

Six of the seven school board members ultimately cast a vote for the proposed agreement to have a Concentra clinic in the district provide primary care, screenings and care for employees on workers' compensation. The proposed clinic would be located inside the former Denton High School athletic complex and would cost $1 million.

That amount, which proved to be an eye-popping price tag for some school board members, would come from existing district funds: employee health insurance, the district's transportation budget, federal program funds, workers' compensation funds, high-deductible accounts and refunds from flexible savings accounts.

The agreement with Concentra, an Amarillo-based health care company, is for one year of trial operation with the potential to renew for another four years.

"We're not talking about going and finding another million from someplace else," said Chris Bomberger, the district's director of risk management and child nutrition. "We're talking about a clinic that is self-funding."

Bomberger is leading the proposed clinic project. The district left TRS-ActiveCare in 2022 to pursue cheaper health care benefits for employees. TRS-ActiveCare provides health insurance to most Texas public school workers and is funded by public school employers, TRS-ActiveCare participants and the state.

Bomberger said school districts across the region have opened clinics, which are run by corporate health care partners, in the last few years. He found that onsite clinics come with two chief benefits: less lost time in the classroom for teachers who have had to wait longer to see their providers than in years past, and a new perk for teacher recruitment and retention.

Place 3 school board member Amy Bundgus cast the sole opposing vote in the proposal. Bundgus has been outspoken in her support of teachers but had misgivings about a single clinic adequately serving employees working on campuses spread across 18 different municipalities. She reiterated her concerns about how hard it could be for district employees to get to a centrally located clinic — especially employees working on campuses on the congested U.S. Highway 380 corridor. On weekdays, employees at those campuses can have a 30- to 45-minute commute into Denton.

"I think about the distance, or as we talked about last time, the size of the district," Bundgus said. "How far are we seeking for someone to get to this clinic? And then I think about the cost. I keep coming back to the cost. I know that teacher retention and providing benefits that our teachers need is critical. I just ... when I think of that kind of money, could we lower their premiums? Could we get them a lower deductible?"

"Three years ago, we presented to the board an opportunity for us to leave TRS-ActiveCare with the anticipation that we can control our own destiny," Bomberger said. "Prior to 2013-2014 plan here, we were self-funded. There was reasons we jumped into TRS. At the time, that was the right choice."

Leaving TRS recently allowed administrators to explore new insurance partnerships.

"We are nine months into this first plan year away from TRS," he said. "Our plan is to be able to have data historically to then go into the marketplace to leverage our health to get the best possible points out there in the marketplace. Could we be with the best possible plans? Maybe. Are there better out there? We'll know in the future. It's too early for us to jump out there with nine months of historical data."

School board members posed a lot of questions about the clinic. They went over a sample questionnaire that could help health care providers to screen patients with possible mental health challenges — a screening that school district administrators wouldn't have access to. They surveyed metrics for the proposed clinic's success. Place 2 board member Sheryl English asked if the clinic could be open on one day each weekend to give employees more access to the clinic.

Bundgus also pointed out that in the district's "thought exchange" to invite employee comment on the clinic, 70% of employees who participated had a primary health care provider, with just 30% of respondents reporting they don't have a primary provider. She also pointed out that, for many employees, telehealth is free.

"I use Teladoc. It's a great tool," Bomberger said. "There's nothing like a personal relationship, like standing in front of a doctor and receiving care and knowing that they've got my interest at heart."

Place 7 board member Patricia Sosa-Sánchez asked Bomberger to consider the worst.

"I have to ask just what our losses would be should this not be successful," she said.

Bomberger said if employees don't adopt the clinic, the clinic will lose numbers.

School board President Mia Price said she has misgivings about a district clinic operating with a corporate partner.

"I guess my concern is, if you look around at most of our primary care providers, it's all corporate," Price said. "It's all corporate practice of medicine. I can tell you, having served on Texas Medical Association committees and councils, so many of our primary care doctors went under. They would come to the table saying, 'I spent half a million dollars or my personal savings trying to keep my practice running.' And that's a huge concern."

Bomberger said the district's health insurance provider is willing to work with the clinic, which makes it likely that district employees — most of whom enrolled in the district's health benefits — would get the care they need at an onsite center.

Ultimately, most of the board members were satisfied that a clinic is a risk the district can take.

"I think this is an excellent starting point," said Place 5 board member Charles Stafford. "It has a very high probability, and you have a good track record for everything."