Clay County commissioners on Dec. 30 approved hiring two registered nurses for the county’s withdrawal management detox facility and authorized backfill to replace any LPNs promoted into the new RN posts.

Troy, who presented the request, said the two budgeted RN positions are intended to prevent situations in which only one nurse is on duty and the facility would lose the ability to bill for withdrawal management services. "These 2 RNs should make things run a lot smoother," Troy said as he described the staffing shortfall and the facility’s reliance on nurses to meet reimbursement rules.

The board discussed the tradeoff between hiring outside RNs and promoting current LPN staff who are working toward RN licensure. Andrew Loewy said internal staff are promising but some are still waiting on board results; the board noted that once an LPN becomes an RN they cannot perform LPN duties and recommended adding backfill authority. Loewy also described recent census swings: "In January, we started off a little slow at 14. In November, we averaged 23 and a half," and said the facility’s capacity is 32.

Commissioner Evers moved to approve the two RN hires with backfill; Commissioner Bair seconded. There was no further recorded opposition, and the motion carried.

The hires are budgeted positions for 2026, and staff said they would try to use internal candidates when possible, but would recruit externally where necessary. The board instructed staff to manage promotions and backfill so internal advancement opportunities are preserved while maintaining the facility’s staffing reliability.

Next steps: implementation of the hires and any backfill will follow normal human-resources procedures and budget monitoring; commissioners said staffing levels will be revisited as usage and census change.