6 ] The Lovell Chronicle ] September 5, 2013
BY KARLA POMEROY
Big Horn County and the Wyoming De-
partment of Health and the Public Health
Nursing Division have a few months to iron
out differences to keep public health opera-
tional in the county.
The commissioners have told the state
that they will not sign a new contract, which
ends with the fiscal year June 30, 2014, if
the situation with the administrative assis-
tants remains the same.
At Tuesday's commissioner meeting,
Commissioner Keith Grant said, "We're
not going to have any more county employ-
kin for the st "
ees wor " g ate. He said the coun-
ty no longer wishes to have county employ-
ees who are supervised by state employees
such as with public health, Women and In-
fant Children program and the Cooperative
Extension Service. (See related story on
Extension.) •
There are two administrative assistants
with the county public health program, one
in Lovell and one in Greybull. Both are coun-
ty employees supervised by state employee
and nurse manager Kimberly Cowan.
Cowan told the commissioners Tuesday
that the Lovell position is currently vacant
and they are looking to fill the vacancy but
wanted the county's feedback.
Chairman Jerry Ewen said, "We'll hon-
or the contract that's in place and the coun-
ty will support that administrative position.
We have no intention of rescinding that for
the remainder of the year."
As for filling the vacancy and hiring the
new employee, Ewen told Cowan, "You're
the one who works with the employee and is
responsible for their performance."
Commissioner John Hyde, said, "I think
you do it the way it's been done in the past.
The only caveat is that at end of fiscal year
that position is in jeopardy unless state de-
cides to make it a state employee, which ob-
viously we think it should be."
The statewould have an option of fund-
ing the position, when they legislatiVely
only have funding for nurse positions, run-
ning the public health nursing program in
the county without the administrative em-
ployees or if the county does not sign a con-
tract, not having a public health program in
the county.
Cowan, Linette Johnson, state supervi-
sor; and Karen Mahan, state nursing chief,
said filling the vacancy with the uncertainty
of the status of the position starting July 1,
2014, may be difficult.
Ewen said the general consensus of the
commissioners is that they would financial-
ly support the position through the state
but the employee would not be a county
employee.
Hyde added that they would support
something similar to what the county con-
tracts with for the nurses, 65 percent state
and 35 percent county.
Cowan said she spoke to Big Horn Coun-
ty Clerk Lori Smallwood regarding the is-
sue and Smallwood said one idea could be
to have the administrative assistants under
her prevue but assigned to public health.
At the meeting Smallwood said, "I told
Kimberly I was willing to do whatever I
could to help resolve the situation. Kimber-
ly comes to the office when she has questions
about county policy. It would be no differ,
ent for the employee to come to me. Truth-
fully, would I know about the daily opera-
tions? No. I'm just willing to help to alleviate
concerns."
Grant and Ewen said that wouldn't ad-
dress their concerns.
Ewen said another issue is that the
county and state have different paid holi-
days, but Johnson said the nurses and assis-
tants all follow the county's schedule.
Service plan makes things equal
BY KARLA POMEROY
Big Horn County Public Health Man-
ager Kimberly Cowan presented a service
plan to the commissioners that will begin
Monday. The commissioners had asked
Cowan to come up with a plan to make sure
services were equal throughout the county.
There is currently a vacancy at the
Lovell office.
if there is no one at the Lovell office.
Commissioner John Hyde said he ap-
preciated the work on the plan.
Cowan said with the change in staffing
the public health nursing program likely
would not be able to administer the com-
munity development block grant that pro-
v/des funding to help people with medical
bills, rent and utilities. Without the admin-
Under the plan, the Greybull office will istrative support they likely won't be ap-
have clinics on Mondays and Wednesdays t)lying for the grant again.
and clinics will be held in Lovell on Tues- Cowan said the rent and utility help is
days and Thursdays. This includes tuber- mainly at the north end, with the town of
culosis screening, walk-in clinic and other Basin/Salvation Army receiving a grant to
clinic appointments, offer help at the south end.
Cowan said on scheduled clinic days, She noted in July they had 485 client
the appropriate office will be open to the encounters, 275 at the Lovell office and 210
public 9 a.m. to 4 p.m. Appointments will out of the Greybull office. They included
be recommended to ensure clients are seen adult health visits and exams, long-term
in a timely manner. Alternate appointment care eligibility assessment, maternal and
times will be available if necessary, family visits, MCH health exams, class en-
Clients will be able to contact the pub- counters, child immunizations, adult vac-
lic health nurse office by phone, each week- c/nations, communicable disease exam/ed-
day, 8 a.m. to 5 p.m. The new phone system ucation, tuberculosis screening and grant
will automatically go to the Greybull office vouchers issued.
Horn County
Grant said he wondered why the coun-
ty entered into an agreement with the state,
noting, "the biggest thing public health does
for the county is immunizations."
Mahan said state statute does not
mandate that they handle immunizations.
It states, "To operate a public health nurs-
ing program, which may include, but is
not limited to, provision of immuniza-
tions, evaluation of the need of individu-
als for nursing home admission or servic-
es and the operation of an infant public
health nurse home visitation subprogram.
The public health nursing program may,
where and to the extent appropriate, be
administered through or in conjunction
with county, municipal or district health
departments."
Mahan said the key word is may. She
said state statute only requires them to con-
duct the home visits for MCH (Maternal and
Child Health) home visits. She said that
program can be run through other agencies
rather than public health.
Ewen said the Joint Labor, Health and
Social Services Interim Committee, which
met in Lovell last week, are looking at sev-
eral options for public health.
He did note that Sen. Charles Scott
(SD30, Casper) has said he wouldn't mind
not funding public health at all.
Mahan said Scott proposed legislation
last session to that effect but it did not get
introduced.
"I'd like to come up with models that are
acceptable to a variety of counties. Rather
than a legislative solution I'd like to come up
with a contractual solution."
Ewen said, "Our opinion here is that
we're not interested in dissolving our rela-
tionship with public health nursing. Public
health nursing provides services to a seg-
ment of our population who may not get ser-
vices any other way. We are just still not sat-
isfied with the way it's set up."
Mahan and Ewen both said, "I hope we
can work it out."
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