Ersel Schuster, former McHenry County Board member and candidate this year in District 6, offers another installment of her analysis of county government.

Illustration IV offers example “2- Nursing Division” McHenry County Health Dept.” as presented in: “A Document Proposing Reductions for McHenry County government.”

This installment is the second of four examples where reductions and/or elimination in county services could be realized in this department.

Once again, the county board has ignored the possibilities for saving millions in tax dollars.

To obtain any of the Reference Documents, email: ersel@sbcglobal.net.  Indicate which of those documents you would like.

Installment IV – TWO (2) of FOUR (4)              HEALTH DEPARTMENT –

SAMPLE RECOMMENDATION

NURSING DIVISION:

PUBLIC HEALTH NURSING DIVISION – MANDATE (Attachment E):     “55 ILCS 5/5 25013”

“(Early Identification of health concerns of children up to 3 yrs. Of age)”

FUNCTION (Attachment D):           ”Public Health Nursing:                Provides medical and educational programs most of which are funded through state and federal grants that include but are not limited to: Family Case Management, Women, Infant, Children (WIC), Health Works, Early Identification, Clinic Programs, Communicable Disease, Health Promotion, Health Child Care Illinois, Emergency Response, Illinois Breast & Cervical Cancer Program and We Choose Health Grant. The In Person Counselor Grant provides funding to assist residents to enroll in health insurance under the Affordable Care Act. McHenry County Health Department offers a variety of clinics to the public:  Hearing and Vision Screening for Children, IV/AIDS Prevention and Testing, Immunizations, TB Control, Flu/Pneumonia Clinics, and Chronic and Communicable Disease Control.”

Performance Indicators (Attachment D):                 2013         2014         2015

                                                                                  Actual    Mid-Year  Projected

“Nursing-WIC Program Caseload                              4,533      4,632        4,632

Nursing-Family Case Management Clients Served    8,336       8,350        8,350

Nursing-Breast & Cervical Cancer Caseload                871       1,090        1,200

Nursing-Illness Outbreaks Investigated                        12           16            18”

 OVERVIEW:   

• The nursing division of the McHenry County Health Department consists of many components in need of review.  For purposes of this paper, examples of the necessary investigation will center on the nursing division and the duplication of services between other governmental agencies, social service agencies and the private sector.
• Times have changed.  New and innovative solutions must be addressed.  This is no time to hide behind… “it has always worked this way;” or “county government is the only entity that can provide the service.”  Such suggestion must be taken out of the equation while new eyes realistically address the issues.
• Cursory review of the county nursing programs indicate a duplication of services provided by the county, local schools, local hospitals, clinics, social service agencies and the private sector.  Specifically, focus on school nursing programs and the county nursing programs; each is funded by real estate taxes, fees, grants and other taxing sources.
• School districts have varying degrees of health service programs with on-staff nursing personnel.   District 200, as one example, has received a grant to establish a “student clinic.”  The general public learned about this information from an article (Attachment H).
• Beyond that, the private sector is currently providing the same services and is in the process of expanding those services (Attachment I; 1, 2, 3 etc).  This is an excellent time to address the true need for McHenry County to use tax dollars to continue providing these same services.

RECOMMENDED:

• Initiate a taskforce: made up of 1 county board member; 1 member of the board of health; 3 members from private sector health service providers (pharmacy/hospital/clinics); 2 members – financial credentials; and 4 members of the general public.
• At the outset, it would be advisable for the taskforce to require staff to provide a full-blown definition of each and every element of this division.  This should include budget costs for each service.
• Attention should be given to qualifying, in 2015 terms, the last half of the Department’s “Background Description” statement from the 2015 Budget documents:  “The department has grown from a handful of employees to over 131 full and part time employees providing a multitude of comprehensive public health services that have now made McHenry County a healthier and more desirable place to live.”
• The taskforce should determine the need for McHenry County to provide various clinical services; shots; medical services, etc.  It should determine the population served by the department and whether or not the service is, or will be, provided elsewhere.
• Other than keeping records, mandated services need to be clearly and carefully identified.  This information should fulfill the requirements necessary for the county government to address various mandates of state and federal legislation.
• A realistic and beginning goal should be to relinquish county “nursing” services to the schools and private sector. At a minimum, staff should be reduced dramatically; reducing personnel costs.  There would be an even greater savings as related capital costs, contractual and commodity expenses are eliminated.
• Reconsider all existing grants.  Restrict future grant applications to commodities, capital expenditure and related expenses that will not increase personnel.
• While these recommendations will be considered too painful for many to consider, it is an excellent time to make these hard decisions.  The nursing profession is experiencing shortages of qualified personnel.  Jobs for these employees will actually grow as the private sector continues to open new, in-store clinics and services.
• Avoid comparisons as in “Bellweather Benchmarking” as each county is dramatically different in the services provided, area demographics, available providers, client makeup.
• Under the “administrative” mandate, the nursing division should be scaled back to record keeping and dissemination of critical health issues.