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DISCUSSION: <br /> <br />~lth a 33% increase in clinic visits between ~ 89-90 and only 2 public <br />health nurses added despite the number of new programs and activities <br />introduced, the only way we have been able to accomplish this is at the <br />expense of home visiting (do~ra 74Z) and school visiting (do~'n 331). This, <br />plus the lack of time to conquer the paperwork, has led to loss of job <br />satisfaction. Ro one voiuoteers to do anything any more; everyone feels she <br />is already doing too much. <br /> .. <br />AIchough there are 13 pubiie health nurse positions, 1 is split between 2 <br />part-time public health nurses who do Just School HeaI£h and another puhiie <br />health nurse spends more than 50Z of her time doing Hatereity Care <br />Coordf~ation. The leave ll~ public health nurses to staff the clinics - <br />only t a nurse more than in FY 79-80 with 33Z more visits and many more <br />requirements of tests, procedures, etc. at each clinic visit. <br /> <br />RECO~IENDATIONS~ <br /> <br />Short Term - <br /> <br />Hire 1 full-time public health nurse and 1 full-time secretary with £ueds <br />generated by the ~aternity Care Coordination Program. During FY 88-89, <br />~48~178 was collected in this program. 41~ of the patients that delivered <br />had Nedicaid but were not In the HCC Program. If 2/3 of those had been able <br />to be enrolled in Haternity Care Coordination~ ~e could have realized <br />}20,328 more' in income for a total of $68,506. If thac were duplicated this <br />~W, it would more than cover the }48,931 estimated for salary and fringes <br />for these 2 positions. <br /> <br />Long Term - <br /> <br />T~o more public health nurses in the next FY will permit more nurses to be <br />assigned to the heavier clinics to accommodate the anticipated increase in <br />Haterni£y and Family Planning patients. <br /> <br />If 2 full-time physicians operate our clinics, they ~ill be seeing many <br />more patients than are now being seen. This will mean we will need clinic <br />health assistants, lab techs, and secretaries in order to support them. The <br />exact number will depend on the increase in patient visits. <br /> <br />To rais~ support staff level to maintain ratio of 1:4 as other professional <br />staff increase. <br /> <br />Policy be formulated stating that no new programs will be started unless <br />adequat~ ~teff is hired to support the program. If these programs generate <br />fu~ds, these should be used for staff positions. <br /> <br />9~20~90 <br /> <br /> <br />