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Dolores County board seeks to add nursing oversight, local vaccine billing to IGA with Montezuma County
Summary
At its Oct. 1 meeting the Dolores County Board of Health directed staff to draft IGA changes to add nursing responsibilities and to pursue billing for vaccine clinics, after officials outlined potential revenue and the credentialing and oversight needed to bill insurers and restart VFC services locally.
The Dolores County Board of Health on Oct. 1 directed staff to draft changes to an intergovernmental agreement with Montezuma County Public Health that would add explicit nursing responsibilities and give Dolores County the option to credential local providers and bill insurers for vaccine clinics.
The move grew out of a presentation showing how clinics could recoup costs: a committee member noted that, using Medicaid reimbursement as a baseline, an Oct. 9 clinic could have generated roughly $3,001.93 in potential revenue from administered vaccines. "A total of $3,001.93 could have been revenue on October 9," the committee member said, citing line‑item estimates for flu and shingles doses.
Board members said the revenue opportunity matters because state funding for core public‑health functions has tightened. "Public health has to have a way to try to recoup money for their costs," the committee member said, noting that charging for certain services would not replace grant funding but could cover overhead, staff and facility costs.
Agency officials warned that launching local billing requires credentialing a certified provider (a nurse or higher), setting up fee schedules and back‑office billing, and maintaining medical oversight. "The person who is administering a vaccine should be the same person who's putting things into this because that's their license," an agency official said, describing how liability and accurate entries in the immunization system must align with who administers shots.
Officials also discussed the Vaccines for Children (VFC) program, which has been paused locally. They recommended that restarting VFC would be a logical time to begin local credentialing and billing, but emphasized that administrative work—tracking changing insurance fee schedules, reconciling payments with the treasurer's office and maintaining coder checks—would be substantial.
Board members directed staff to revise the IGA to include clearer nursing and billing language, to identify who would provide medical oversight, and to return to the board with draft language. The board did not take a final action on the IGA at the meeting; members said they will work on drafts and reconvene for a formal vote.
The board also discussed cold‑chain and security protocols for vaccine storage and agreed to ensure refrigeration, alarm systems and backup procedures are documented in the IGA before any local billing or vaccine storage changes are implemented.
