September 10, 2018

Board of County Commissioners of Moffat County

Ray Beck, Chairperson
221 West Victory Way #130
Craig, CO 81625
Via E-mail: rbeck@mofftatcounty.net

Cc: Via E-mail: dcook@moffatcounty.net; fmoe@moffatcounty.net

Re: Employee Health and Wellness Center Agreement

Dear Commissioner Beck and Board of County Commissioners of Moffat County:

On behalf of the Board of Trustees of the Memorial Hospital/DBA Memorial Regional Health (MRH), this communication is (1) to
provide the required notice of termination pursuant to section twenty-five of the contact dated 12-21-17, and (2) to advocate for an
alternative arrangement for continued services based upon our mutual and beneficial community partnership.

We want to thank you for allowing us to provide the services on behalf of the Moffat County BOCC for an on-site wellness clinic to
service its qualified employees and their qualified dependents during 2018. It is our hope that you found that the quality of these
services exceeded the previous provider’s level of care and diligence, while doing so at an overall lower cost. Please accept this notice
of contract termination effective 12-31-2018.

Because we are aware of the on-going financial challenges of Moffat County as an entity, we would like to continue to collaborate with
you on an alternative solution. We believe that our proposed alternative solution will increase access for your employees and their
dependents while lowering the overall cost to the County’s self-funded employee insurance plan, and allow the BOCC to free up assets
that could be sold to help offset budget deficiencies in the County. As you know, we have provided to you reports showing that clinic
overall cost per visit to the BOCC’s stand-alone clinic is running between a low of $156.81 (February of 2018), to a high of $256.05
(June of 2018), for an average of $206.43 per visit. In the interest of mutual community benefit, partnership, and transparency, you pay
less than this today to MRH, on average, for visits to our existing clinics from those employees and dependents that choose not to use
the County off-site clinic.

Our proposal in to you is below in a side-by-side comparison of your current service offering.

Current BOCC Stand-alone Clinic MRH Proposal

Location 551 Tucker Street 2020 West Victory Way
Hours M-W-Thurs (varies) (24 hours a week) M-Sat: 7:30 AM – 7:30 PM (72 hours a week)
Appointment Required Not Required – Walk-in Only
Scope of Services As defined in contract: Exhibit B Same as defined in existing contract: Exhibit B
Drug Formulary/Service As defined in contract: Exhibit F Same as defined in existing contract: Exhibit F
Labs Cardiac Risk, Complete Blood Count, Cardiac Risk, Complete Blood Count,
Comprehensive Metabolic Panel, Thyroid Comprehensive Metabolic Panel, Thyroid
Stimulating Hormone, Hemoglobin A1c, PSA Stimulating Hormone, Hemoglobin A1c, PSA
Set-up Cost Year 2 of existing contract: $2,000.00 $0.00
Supply Cost Billed at actual cost Billed at actual cost
Operational Costs Year 2 of existing contract: $120,164.00 $ 100.00 /visit billed direct to Moffat County
Operational Cost Comparison 2018 Data (01/2018 – 06/2018)
Current BOCC Stand-alone Clinic MRH Proposal
Labs $3,966.27 (budget of $16,000/year) $3,966.27 (budget of $16,000/year)
Drug Formulary/Service $28,448.00 Generic Pricing on established formulary. Will
save costs on packaging, expired meds. Will no
longer have to be purchased in bulk. Est:
$25,603.20
Supply Cost $2,017.05 $0.00
Miscellaneous $289.99 $0.00
Operational Costs $60,082.00 (1/2 year) $32,600.00 ($100.00/visit x 326 visits as of
06/30/18)
Total $94,803.31 $62,199.47

Projected ½ Year Savings: $32,603.81 or 34.4%

In summary, MRH supports the existing and hopeful continued future partnership with the Moffat County BOCC for healthcare services
for its qualified employees and their qualified dependents in the most fiscally responsible manner possible. We believe that our
proposal reflects a much better option that allows MRH to continue its mission of serving the healthcare needs of the community and
the Moffat County BOCC to make an informed decision for potential future services exercising due fiduciary responsibility.

Thank you for your continued support and if you would like us to draft a proposed contract or contract amendment to formally structure
our proposal, we welcome the opportunity.

Yours truly,

Andy Daniels
Chief Executive Officer