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Felix Adamo / The Californian

Danny Garcia, director of human resources at Paramount Citrus, talks about the company's health center at the Paramount Citrus Cuties plant in Delano. At right is the office for the health educator coach.

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Felix Adamo / The Californian

Maria Manriquez, left, and her daughter Judy Amezcua have both used the health care services offered by Paramount Citrus at the company's Cuties plant in Delano.

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Felix Adamo / The Californian

One of the exam rooms at the Paramount Health Center is at right. This health center is located at the Paramount Citrus Cuties plant in Delano.

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Felix Adamo / The Californian

The Paramount Health Center is located at the Paramount Citrus plant in Delano.

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Felix Adamo / The Californian

Uju Makinde is a nurse practitioner at the Paramount Health Center at the Paramount Citrus Cuties plant Delano.

DELANO -- Like many people who visit the health clinic at Paramount Citrus' massive new plant, Maria Manriquez copes with high cholesterol and diabetes.

She visits the clinic about every two weeks to discuss her medications and the results of her daily diabetes monitoring. She consults with a health educator about diet and exercise.

Before starting the visits, Manriquez, 45, didn't realize that potatoes, rice and pastas could be bad for her health. Now she tries to eat more fruits and vegetables and limit how much red meat she eats.

The clinic's care has been "very good," she said. It is also free -- paid for by the company.

Manriquez, whose husband, Juan Amezcua, works for Paramount Citrus, is making the kinds of health improvements the company wants to see.

The Paramount health care program began offering a low-level of care to workers and their dependants several years ago. This year, the clinic moved from a trailer to a permanent building, and will celebrate the opening Friday.

"We want to take care of those (health) issues before you're ill and we needed a facility and we need a partnership that we could do that with," said Danny Garcia, Paramount Citrus' director of human resources.

Last year, Paramount teamed up with Kaiser Permanente to provide the care in Delano and at its pistachio and almond plant in Lost Hills. The agriculture giant pays for the two health centers, branded Paramount Health Centers by Kaiser Permanente, to the tune of $2 million annually.

The Delano clinic, a brightly painted space that looks like any doctor's office, offers primary care visits, lab work and baseline health screenings. The staff includes a nurse practitioner, licensed vocational nurse, health and wellness coach and registered nurse, along with a doctor that is not present every day.

All the services are free, save co-pays on prescriptions. Employees and their families don't have to be insured to visit the clinic, though Garcia said about 75 percent of Paramount Citrus' employees elect for some level of health care coverage through the company.

Since the program started in 2009, the Delano clinic has had about 4,000 visits a year, Garcia said. The two health centers are open to 8,000 Central Valley employees and their families, including workers from Paramount Farming Company and POM Wonderful, which are also part of the parent company Roll Global.

Individual patient information is confidential but Kaiser can tell the company about what kind of conditions it sees. Sharon Peters, chief administrative officer for Kaiser Permanente Kern County, said diabetes, high blood pressure and high cholesterol are common problems and that knowledge can help the company design programs to address those health risks.

Paramount isn't the first to offer on-site health care to employees. Mike La Penna, principal for health care consulting group The La Penna Group Inc., said his business has noticed an uptick in the number of clients providing on-site care in the past six or seven years.

But its setup sounds unique, he said, because the services are free and because of Kaiser's involvement.

La Penna wrote a book on workplace clinics and his company has helped businesses, including Toyota, establish them. They do it to increase worker productivity, decrease absenteeism and address health care costs, the consultant said.

"For large employer groups, the cost benefit is really in their favor,"Peters said.

He said setting up a clinic as Paramount has done in an agricultural setting could present challenges given that workers may have a variety of previous health care experiences and speak different languages.

"I admire what they're doing," he said. "They're taking on a challenge which I think is very important. I don't think they picked the easiest type of on-site clinic to implement."

Paramount administrators said they do hope access to on-site medical care reduces the time people need to take off work for illness and cuts health care costs. But Garcia said that wasn't the primary motivation.

"Rural care is difficult at times for our employee base," he said. "It's hard to find good primary care physicians that they can see on a normal basis."

Administrators said the company's take on wellness ranges from the products it produces to the environment for its employees. It's an attitude that trickles down from owners Stewart and Lynda Resnick, said David Krause, Paramount Citrus president.

"It's really about taking a proactive stance to health and wellness," Krause said.

Manriquez said she's been feeling better since she started to visit the clinic and her cholesterol has dropped. She's also brought her daughters, Anna and Judy Amezcua.

"The people here are respectful and they treat you better than how other like doctors would treat you," said Judy, 15.

Everyone in the family except for Juan has visited the clinic. Anna, 17, joked that they will be making an appointment for him, too.