AUTHORIZING THE CREATION OF ONE FULL TIME PUBLIC HEALTH NURSE (PHN) FOR THE SAUK COUNTY HEALTH DEPARTMENT (SCHD) WITHIN THE 2019 BUDGET PROCESS

AUTHORIZING THE CREATION OF ONE FULL TIME PUBLIC HEALTH NURSE (PHN) FOR THE SAUK COUNTY HEALTH DEPARTMENT (SCHD) WITHIN THE 2019 BUDGET PROCESS

Background:

Median FTEs in selected occupational categories Employed by Local Health Departments (LHDs) by size of population served (according to 2008 NACCHO Profile of LHDs – most recent study) lists eight (8) Registered Nurses for a population between 50,000 and 99,999. In the state of Wisconsin, the average PHN is approximately 1 to 10,000 population. In Sauk County, we currently have four (4) tax levy Public Health Nurses (PHNs) doing all Public Health programming with the exception of the Nurse Family Partnership program. Sauk County’s population in 2015 was 63,642.

The increase in demand and workload requires an increase in the number of PHNs that Sauk County employs. Sauk County requires more Public Health Nurse capacity.

Additionally, the State has recently added diseases requiring active surveillance and follow-up, which are mandated programs for all LHDs. These new requirements have made it necessary to put additional nursing time into the communicable disease program due to the requirements exceeding the capacity of one nurse.

Also, Wisconsin Dells welcomes annually, approximately 4+ million visitors and 10,000 J1 Visa students to assist with the tourism industry. This adds another layer of scope and complexity to address health and communicable disease issues in this transitory population.

With changes upcoming to the Affordable Care Act (ACA), intake hours may have to again be expanded, and more immunization clinics offered at satellite locations to address access to care issues.

                Since the Health Department has taken back the Foot Clinics in January 2017, they have consistently been difficult to staff. The job requires part time 8-12 hours per week, and provides no benefit package because of the FTE/LTE status. Ongoing recruitments are costly and time-consuming giving no stable, trained staff to clients. Over the last year, there has been constant replacement with foot clinic staff. Once individuals are hired and trained, they quickly move away to a position with more hours and benefits. The impact of this turnover on an organization’s bottom line is significant and measurable. In fact, it can be upwards of 30% of an employee’s annual salary. In real terms, if an employee’s compensation is set at $23,000 per year, the cost of replacing that position is almost $7,000.  A major focus has been to keep the foot clinic costs down ($30/visit), and yet have fees pay for the program. This position would allow the Foot Clinics to be staffed with a consistent nurse, allowing other nursing and management staff to focus on their primary programming instead of being foot clinic fill-ins.

This full time Public Health Nurse position would provide 25% support for the foot clinic program and the remaining 75% of the time would be allocated to work on the mandated, recently added diseases requiring active surveillance and follow-up.

Fiscal Impact: [  ] None   [ X] Budgeted Expenditure    [  ] Not Budgeted

NOW, THEREFORE, BE IT RESOLVED, by the Sauk County Health Department be authorized to create one full time (1.0 FTE) Public Health Nurse effective January 1, 2019.

For consideration by the Sauk County Board of Supervisors on October 16, 2018.

Respectfully submitted,

Sauk County                                                   Sauk County
FINANCE COMMITTEE                                PERSONNEL COMMITTEE

______________________________                ______________________________

JOHN DIETZ, Chair                                      TOMMY LEE BYCHINSKI, Chair

______________________________                ______________________________

THOMAS KRIEGL                                       SHANE GIBSON

______________________________                ______________________________

WILLIAM WENZEL                                     PATRICIA REGO

______________________________                ______________________________

KEVIN LINS                                                  CARL GRUBER

______________________________                ______________________________

KRISTIN WHITE EAGLE                            TIMOTHY MCCUMBER

Fiscal Note: 

The full time Public Health Nurse position estimated salary of $67,904 and benefits of $27,324.

Information System Note: $3,000 for computer and licensing software.

Office Space/Furniture: Existing office space will be utilized.