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County health staff seek added nurse hours and a supervisor role for expanded home-visiting program
Summary
Health department staff asked the board to approve a 0.1 FTE increase for the Hermiston Student Health Center nurse and sought direction to create a nursing supervisor position in a rural health/NFPX expansion; commissioners raised concerns about multi-year funding commitments and general-fund exposure.
County public-health staff told commissioners they want to increase a school-based nurse practitioner's hours at the Hermiston Student Health Center from 1.8 FTE to 1.9 FTE to better align daily clinic flow.
"This item is in regards to specifically the Hermiston Student Health Center," Public health staff said, explaining that longer daily hours would allow the nurse practitioner time to prepare before and finish charting after appointments. Staff said the Hermiston School District has approved the change and that the county would not use general-fund money directly for the current FTE adjustment. The staff recommended the change be effective Aug. 1.
Separately, health staff discussed rural health transformation funding and a proposal to expand their Nurse Family Partnership program to NFPX, including creating a nursing supervisor position to oversee an enlarged caseload. The staffer described the funding mix: a portion comes from rural health transformation and other streams would require a county match; the proposal also contemplates applying for an incentive fund that would match one-third of the expanded FTE but require a three-year commitment.
Commissioners supported the program's goals but raised concerns about long-term general-fund obligations if incentive funding or Medicaid reimbursement rates do not materialize. "We tell the sheriff's office all the time, we can't apply for positions that take a three-year commitment and then turn into general fund," one commissioner said. Staff said some of the general-fund ask could be reduced if targeted case management (TCM) reimbursement rates increase and if the incentive funding is awarded.
What happens next: Commissioners asked staff to put a request on a future agenda seeking approval to create the supervisory position and to provide more detailed budget projections, recruitment timelines and options for limiting county general-fund exposure.
