Trying to balance the budget for Niles school officials got tricky this year. Like other Trumbull County districts, Niles City Schools are trying a little wellness to improve both fiscal and physical health.
Shrinking revenues in a city hit hard by loss of business and home foreclosures mean less money to operate the school district. Added to that are rising energy bills and other expenses that left the district looking at a $2 million deficit.
After cutting transportation and teaching positions, the school balanced its budget. But the teachers contract still was being negotiated, and that meant dealing with requests for raises while making sure health care costs didn't increase.
"By making several changes, we were able to reduce the cost of health benefits," Superintendent Rocco Adduci said.
The union agreed to several changes in the benefits plan. Niles, a self-insured system, managed to save $250,000 on its premiums.
Part of the savings came from trying to improve employee health instead of paying for illnesses.
''While increasing deductible and co-pay amounts is a good start, over time, the value of the increase wears off due to utilization, technology, inflation and an aging population,'' said Ed Byers, spokesman for the Medical Mutual of Ohio company. Medical Mutual administers the health benefit for most of the school districts in Trumbull County.
''A few years later, a school district finds it is again looking for ways to control costs. Wellness is definitely an answer and a good start,'' Byers said.
In the wellness plan, routine and preventive exams and tests are covered fully. That encourages employees to stay in touch with their personal health situation, he said.
There also are free smoking cessation programs, and Medical Mutual offers a reimbursement for joining Weight Watchers and offers discounts for certain health club memberships.
In addition to implementing Anthem Blue Cross/Blue Shield's health and wellness program, Adduci said the district no longer will provide coverage for surgery treatments for morbid obesity. Because Niles is self-insured, the district covers the cost of employee medical claims, and pays a fee to the company to administer the program.
''These surgeries, and we have had several, are very, very expensive,'' Adduci said.
Employees still may have the surgery, but they must pay the cost themselves.
The Trumbull County schools insurance consortium also is placing new emphasis on wellness, along with changing coverage costs.
There are 14 school districts in the consortium. The plan, administered by the Educational Service Center, has seen costs increase for the schools by $5 million, or 33 percent, in since 2005.
Vicki Giovangnoli, superintendent of TCESC, said starting July 1, consortium members saw significant changes to their insurance plans. All employees on those plans now pay 5 percent of the monthly premium. Any new employees will be responsible for 10 percent of the payment. How that is handled is negotiated in each district, she said.
They also implemented Medical Mutual's wellness plan, she said.
''For routine exams, things like colonoscopies, X-rays, these are covered at 100 percent,'' she said. "We're really emphasizing preventive plans. There are no costs or co-pay to the employees.''
By having no costs to employees for routine things, she said, the districts hope to catch problems before they advance and become more expensive. Employees also are encouraged to use a confidential online health assessment.
The county schools still cover morbid obesity surgeries, but they're strictly monitored and have benefit caps and higher co-pays than other procedures, she said.
In Howland, a district like Niles that is outside the county consortium, school officials took another approach toward lowering costs. Their contracts have a working-spouse clause: If an employee's spouse is offered insurance benefits through their jobs, they have to take that plan or pay the school district $100 each month.
''We have yearly audits to make sure we are covering only those people we should be covering,'' Howland Superintendent John Sheets said.
Also, the school is forming a committee to explore ways to reduce costs further, using state-developed guidelines as a blueprint.
This year, teachers in Howland will pay 5 percent of their health premium for the first time in school history, Sheets said. The contract with support staff is still in negotiation.