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Monroe County health board approves HFI budget, presses council for nursing positions amid hiring freeze
Summary
The Monroe County Board of Health voted to submit the Health First Indiana (HFI) 2027 proposed budget while urging county leaders to approve roughly six additional clinical and support positions and to consider higher pay rates to recruit nurses. Board members warned that hiring constraints risk losing state HFI funding and curtailing services.
The Monroe County Board of Health on May 21 approved the Health First Indiana (HFI) proposed budget for 2027 and used the meeting to press for additional clinical staffing to replace services lost when the IU Health contract ended.
The board voted to submit the roughly $826,000 HFI proposal to the state before the June 1 deadline while debating how to fund and classify six additional positions the health department says are needed to meet state service expectations. "If we do not continue to be able to provide the services for HFI and prove to the state that we can do that, then we will essentially just lose our funding," the Chair said, arguing the county must be proactive in requesting positions in the budget.
Lori, a department staff member giving the update, told the board that commissioners had approved approximately $48,000 in additional short-term grant funding and that some IU contract dollars had already been moved into the county health fund to sustain nursing and clinic services. "We have included FICA and PERF in this; the self insurance into the county health fund is probably going to be around $450,000 for 2027," Lori said.
Board members spent the bulk of discussion on workforce: the department said it needs nursing, communicable-disease nursing support, a clinical assistant/medical-assistant position, and additional maternal-and-child-health staff. Staff estimated six total positions would be required to operate at expected capacity and suggested a first-pass salary estimate of roughly $65,000 for senior clinical roles, with competitive nursing wages closer to $36 per hour in neighboring counties.
Several members urged that the board formally request the positions and advocated asking the County Council for higher pay bands or special-salary classifications to make recruitment feasible. "We're competing with hospitals and home-health agencies that are paying much more," one board member said; another said the board should "ask for what we need, not what we think we're going to get told yes." The board moved to add three specific positions to the county funding request (senior public health nurse, maternal & child health nurse, and health services assistant) and to ask for salary levels that would include full-time benefits. Those motions were seconded and approved by voice vote.
Staff also warned that some grants require that positions be filled to receive award funding. Board members asked staff to prepare job descriptions and precise salary calculations so the County Council could consider new or reclassified positions.
The board concluded by voting to approve the HFI 2027 submission as shown in the packet and to continue advocacy with County Council for personnel and pay adjustments. The board did not adopt final hiring decisions at the meeting; next steps identified were preparing job descriptions, finalizing salary requests and submitting the HFI packet to the state by the required deadline.
