Oakland County approves reassignment of Children’s Village medical services to health department amid union and staffing concerns

Oakland County commissioners voted to reassign Children’s Village medical clinic operations from the Department of Public Services to the Health and Human Services Department, approving a staffing plan that would delete 18 positions and create 21 new positions under the health department.

The reassignment, approved by a committee vote on the item presented March 11, will move medical oversight of the county’s Children’s Village residential program into the county health department, with internal posting of the new health-department positions and an expected internal hiring period targeted for May 1 and a sunset date of July 1 for the old positions.

County officials and health department leaders said the change responds to clinical concerns raised about Children’s Village over the past year, the nonrenewal of an outside contractor contract, and a desire to create a continuous clinical structure under health-department leadership. Barb Henke, director of public services, said a clinical supervisor was dismissed and that several standard operating procedures were rewritten after a health-department clinical review. “We learned that Honor Community Health was going to not renew their contract with us,” Henke said, and county staff saw the reassignment as a way to secure clinical continuity.

Why it matters

Supporters told commissioners the move would place children served by Children’s Village within a continuous public-health clinical infrastructure, increase access to training, and reduce county liability tied to out-of-date procedures. Opponents — including multiple current Children’s Village nurses, union representatives and several commissioners — said the county’s approach risks unnecessarily displacing experienced staff who already meet licensure requirements and provide continuity of care to a high-acuity population.

What the plan would do

Barb Henke said the proposal would create 21 health-department positions, including a nursing supervisor and a mix of full- and part-time public health nurse roles and one auxiliary health worker to handle documentation. Current staff would be given priority in internal postings; the county aims to interview internal candidates first and hire as many as qualify by May 1. Henke said an 18-month deadline to obtain a bachelor of science in nursing (BSN) is part of the requested qualifications for the health-department nursing roles, but that extensions would be allowed for employees who enroll in a program. Tuition reimbursement recently increased as a county policy update, and Henke estimated eligibility of about $5,200 per year under that program; employees would be responsible for any remainder, and the county said additional financial assistance beyond existing reimbursement was not specified.

County staff described alternative placements for employees who do not move into the new public-health roles: two public-health-nurse II positions elsewhere in the health division and other county vacancies, plus a standard union bumping process tied to county seniority if positions are eliminated. County officials said county-wide seniority (used for pay and leave accruals) would be retained even if employees changed unions; only union-specific seniority would not transfer.

Staffing, training and oversight

Health-department leaders said the nurses would gain access to more in-house training, supervisory resources and a clinical team experienced in public-health nursing. Kate Guzman, identified in the presentation as a supervisor of clinical services, was described as having done on-site observation and policy review at Children’s Village. County leaders emphasized a six-month probationary period for any employee who takes a newly posted health-department position; managers said they prefer interviews up front rather than a transfer followed only by a probationary review.

Public comment and concerns

More than a dozen current and former Children’s Village nurses, union representatives and community members spoke during the public-comment period. Speakers repeatedly asked why long-serving registered nurses who hold associate degrees (ADN) — and who said they have strong performance evaluations and years of hands-on experience with the Children’s Village population — would be forced to reapply or obtain a BSN to retain their roles.

Tracy Cheuning, a full-time registered nurse at Children’s Village, asked the county to identify the clinical concerns Henke referenced and said neither she nor other nurses recalled a public-health review that interviewed the front-line nursing staff. “Not one nurse, including our nursing supervisor, is aware of any team of public health nurses or clinical team coming to Children’s Village for any type of review or investigation,” Cheuning told the committee.

Several nurses provided concrete cost and time estimates about completing a BSN and said accelerated programs are impractical for full-time workers. Veil Rubick, a registered nurse at Children’s Village, said she had invested $18,846 and three years in a BSN program and that local hospitals do not uniformly require BSNs for registered nurses. Sean Miller of Springfield Township asked commissioners to “grandfather in the ADN nurses” and argued that experience, not a degree, is the critical qualification for the Children’s Village population.

Union representatives raised practical concerns about recruitment and vacancies if positions are deleted and reposted. Chris Belling of the Michigan Association of Public Employees warned that a vacancy that took two years to fill previously could be difficult to replace if positions were deleted and advertised publicly.

Commissioner reaction and the vote

Commissioners split on the approach. Commissioner Gershenson said she had reviewed the record and believes the educational background matters for the high-acuity population; Commissioner Hausman and others said the county should not eliminate jobs only to have current employees reapply. Several commissioners asked for clarification on seniority, tuition reimbursement and whether employees would be able to retain county benefits; county staff repeatedly said county seniority and pay/benefits would remain "status quo" if employees were hired into the new positions, though union seniority would change.

A motion to support the reassignment, made by Commissioner Powell and seconded by Commissioner Taylor, carried in committee. The committee announcement said only that the motion was carried; no roll-call vote tally was stated in the hearing record.

What remains unclear

County staff described clinical concerns that prompted the review but did not enumerate all specifics during the public meeting, saying some details were personnel matters. Several nurses and commenters said no licensing violations or litigation involving Children’s Village nurses were known to them. The county said it used an internal review and consultation with HR, labor and court counsel, and that some supervisor/oversight changes had already occurred; staff also said the county used ARPA funds for a separate assessment of Children’s Village and will return with requests if additional funding for improvements is needed.

Next steps

County leaders said the positions will be posted internally first, that interviews and placements are expected by May 1, and that the sunset/transition deadline for eliminated positions is July 1. Commissioners and staff said they will return with further details, including recommendations for training and any budget amendments if additional funds are requested.