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St. Clair County advisory board backs creating a deputy clinician role after nurse-practitioner resignation
Summary
The St. Clair County Health Advisory Board voted to recommend changes to the medical director's job description so a newly posted position (proposed as a deputy physician assistant) would report directly to the medical director; the board voted to forward the revised job description and staffing table to the Board of Commissioners for consideration.
The St. Clair County Health Advisory Board on March 1 voted to recommend that county administration revise the medical director's contract and job description to grant direct supervisory authority over a replacement clinical position after a nurse practitioner resigned effective in early April.
Medical Director Dr. Nevin told the board the department will face an "underlap" in clinical services when the full-time nurse practitioner leaves and proposed replacing the role with a deputy physician assistant who would be on site full time and report directly to him. He said the change would allow him to provide telephonic medical direction when he is off site and help maintain clinical continuity.
"I would welcome a motion from the advisory board of health to recommend the county administration and department leadership make appropriate adjustments to the medical director's job description and contract to specify direct supervisory responsibilities," Nevin said, asking the board to forward revised documents to the Board of Commissioners for consideration.
Board members asked how long recruitment might take and whether the change would affect union status or the budget. Staff and administration representatives said the intent is for the replacement to be budget-neutral (a zero net change in the short term because it replaces an existing funded NP position), but that wages, classification (union vs. nonunion) and recruitment competitiveness would be evaluated by human resources. Dr. Nevin estimated it could take about three months to fill the position if posted in late April.
Board members and staff discussed interim coverage. Officials said part-time nurse practitioners currently on staff and a nurse practitioner at the Teen Clinic could provide temporary coverage for contraceptive services and STI care; the board noted some contraceptive procedures might need referral to outside providers during any gap, given a regional shortage of OB/GYN clinicians.
After discussion about scope, timeline and whether the job should be open to both physician assistants and nurse practitioners if recruitment proved difficult, a member moved and another seconded a recommendation that administration revise the medical director's contract and the nurse practitioner job description and forward the changes and staffing table to the Board of Commissioners. The board then voted in roll call: Klink, Hayes, Falk, Standell and Urban recorded "yes" and the motion carried.
Next steps: staff said HR would review the proposed job description and pay range and the health committee of the Board of Commissioners could consider the matter in April; if approved, the department would post the position and report back to the advisory board at the May meeting with recruitment results and any recommended adjustments.
The advisory board emphasized it expects the department to plan for referrals where needed during the transition and to return to the board with updates on coverage and candidate pools.
