Carolyn White, registered nurse and medical manager of the Hunt County Health Department, asked the commissioners’ court on Dec. 23 to change a currently vacant medical assistant (MA) position back to a registered nurse (RN), saying the clinic’s expanding responsibilities exceed the MA scope of practice.

"This year alone, just since January 1 until 12/02/2025, my department has had over 530 communicable diseases that were reported to us," White told the court. She said the department investigated 11 suspected measles cases in 2025 and followed 154 contacts for up to 21 days. White also reported that, from Jan. 1 through Dec. 2025, the clinic recorded 1,061 patient visits and administered 2,954 vaccines.

White said the county participates in the Texas Vaccines for Children program (TVFC) and an Adult Safety Net program that supply vaccines; she described the health department’s oversight role for TVFC inventory among 13 local providers. White said the vacant MA post had been converted from an RN in 2021 as a cost‑saving measure but that grant and regulatory responsibilities now require higher clinical authority. She asked that, if approved, the RN start at an annual salary of $65,000 and that existing grant savings be applied so the county would see no additional FY‑26 cost if projected revenues are met.

Commissioners asked about workload, delegation of MA duties, and whether the change would require additional MAs later. White said the department would remain staffed by one RN (herself), one LVN and two MAs after the change; she argued that an additional RN, not another MA, would more effectively meet growing clinical demands. She also noted that the department passed a DSHS fiscal and policy audit this summer.

Judge Stovall and several commissioners urged colleagues to visit the clinic before making longer‑term decisions about staffing and facilities. No formal reclassification vote was recorded at the Dec. 23 meeting; commissioners asked staff to return with further information and suggested follow‑up discussion at a future meeting.

The court’s packet included budget and grant details that staff said would be used to confirm the net fiscal impact of a reclassification, and White said federal/state grant rules also require TVFC program approval for any contract or position changes.