Topeka School Care, LLC

Product Definition

• School based health clinic serving the students of USD 501 Topeka

• Staff: 1 full time APRN, 2 part time APRNs• Main location: Quinton Heights Building

– Monday-Friday 7am-noon, 1-5pm

• Satellite Clinics at district nursing offices– 20 hours a week per part-time APRN at rotating schools

Services Offered

• Routine physical exams, including sports physicals• Early detection, diagnosis, and treatment of illness/injury• Vision, dental, and BP screenings• Mental Health services• Limited onsite lab (glucose, urine dipsticks, strep screens)• Medication prescription• Health education, counseling, and wellness promotion• Fitness and nutrition counseling• Referrals for services not provided by clinic• Immunizations

Vision and Mission

Vision:To provide affordable, accessible, high quality healthcare to the students of Topeka 501 Unified School District.

Mission:The mission of Topeka School Care, LLC is to provide essential health services to the students of Topeka 501. We believe that helping children improve and maintain their health will result in improved academic performance and greater success in life.

Values

• Service: We serve the students and families of the Topeka 501 to improve our community.

• Respect: We respect the right of all children to have access to primary and urgent care services.

• Collaboration: We will work with community resources to improve healthcare for the district’s children.

• Quality: We commit to evidence based health care practices. • Education: We will strive to keep students healthy enough to

learn. We will offer health promotion programs.

The Benefits

• Allow students with acute/chronic illness to attend school• Improved overall health and wellness of all students• Increased access to healthcare (primary care and prevention)• Decreased trips to the ED• Decreased urgent care visits• Convenient • Decreased absenteeism• Increased academic performance

Market Analysis…About 501

• Largest School District in Shawnee County• 14,084 students (2011-2012)• 67% economically disadvantaged• Over 50% receive free-reduced lunches• Shawnee County Children

– 22,900 CHIP– 114,700 Medicaid– 7.4% uninsured

Market Analysis…501 Nursing Services

• 1800 accidents• 35,500 communicable diseases reported• 32,300 conferences with parents/staff/Health care provider• 7,500 health concerns (asthma, vision)• 2,800 psychological disorders (ADD/ADHD and anxiety)• 47, 500 medications administered (stimulants, BP meds)• 612 cases pediculosis• 60 pregnancies

Market Analysis…Competition

• Very Limited– Population is underserved – Limited financial resources– Long wait times for providers

• Shawnee County Health Agency• Stormont-Vail and St. Francis Hospital• Primary Care Networks• Urgent Care Centers

Market Analysis

Strengths• Direct access to care at

school• Improve attendance• Access for all students• Easy for parents• Increased preventative

services• Easy Referrals• Decreased ED and urgent

care trips

Weaknesses• $ for start-up• Lack of school funds to

provide service• Lack of parents knowledge

about services• Seasonal • Kids out of school for the

summer

Market Analysis

Opportunities• ACA mandates for health

insurance and expansion of Medicaid

• PCP shortage• Size of USD 501• Growth of student body• Potential to incorporate

teachers and staff

Threats• PCPs• 11 urgent care clinics• Established relationships

with providers

Marketing Strategy….GET the Word Out!

• Brochures and consent forms at enrollment• Educate current NU staff so they can educate parents• Information booths at school events• Fliers given to coaches prior to athletic seasons• District emails and alerts• Information home with students about special events

– Flu shot clinics– Sports physical days– Health promotion events

Distribution and Sales

• KanCare largest payer (67%)due to district socioeconomics• 7% uninsured• 26% private insurance

Pricing

• Accept KanCare reimbursement rates• Private insurance: pay fee for service charges• Uninsured: charged KanCare rates

Strategic Alliances

• Topeka 501: Major Collaborator– No direct funding for services– Use of facilities: Quinton Heights Clinic, Nurse Rooms at schools – Staff resources

• Nursing services• Teachers• Couselors• OT/PT/ST• Administrators

Strategic Alliances

• St. Francis Family Medicine– Provides protocol physician– Available for referrals

• St. Francis Hospital: at a reduced rate– Inpatient services– Lab– Radiology– Other diagnostics

Human Resources

• Partnership of 3 APRNS• 1 Full time APRN, 2 Part time APRNs

– Anticipate expansion of part time positions

Financial Plan: Assumptions

• Cooperation with 501: office space, equipment, and support

• 1 FT, 2 PT (reduced summer schedules) NPs– Patients seen:

• 70hr/week total – school year• 50hr/week total – summer

• Fluctuations r/t school year (e.g. summer and enrollment)

• Average of 10 office visits per day with additional physicals, immunizations, labs, and procedures

• Initial office visits primarily new patients with increasing number of established patients with time

Financial Plan: Assumptions

• Payroll, coding, and billing outsourced• EMR• Professional liability and 1/2 of certification fees for

FT, otherwise no benefits• 2nd year – individual health insurance will be

provided for FT

Pro Forma

• Start-Up Expenses• 3 co-owners• Start-up cash: $5000x3 + $50,000 = $65,000– 10% down– 5% interest– 5 years

Start-Up Expenses

Pro Forma

• Cash Flow– Profitable in Year 1 and 2– Revenue positive – no break even number– February

• Least net increase• Expected delays in reimbursement

– Monthly loan payment: $850 includes 5% interest– Total interest in Year 1: $2,065

Cash Flow

Pro Forma

• Projections– Revenue increase in Year 2• Increased awareness• Increased efficiency

– Year 2• Revenue: $397,410• Operating income: $136,542

Income Statement

THE END!

• Questions?