Nobles County gets tangled in termination of contracts

Talk about it

WORTHINGTON — In his final meeting as Nobles-Rock Community Health Services administrator, Brad Meyer provided several letters of termination during the NRCHS board meeting Wednesday afternoon in Worthington. Among them was a contract between NRCHS and Sanford Health Visiting Nurses Association, with which the county had an agreement for administrative services for the past four years Meyer served the agency.

Despite a clause in the agreement requiring a 90-day notification if either party wanted out, Sanford and NRCHS came to a mutual understanding to terminate the contract on Dec. 31. As such, Sanford will not seek a new director for the agency as Rock and Nobles counties move toward a split at the end of 2011. At that time, Rock County will join Lincoln, Lyon, Murray, Pipestone Public Health in a new Southwest Health and Human Services agency, while Nobles County continues its consideration of a combined health and human services department.

With Meyer’s last day with the agency set for Dec. 22, he suggested Barb Navara be named Rock County’s public health director, and Cindy Frederickson be named Nobles County public health director through the end of 2011. Contact persons were requested by the Minnesota Department of Health.

Three other termination agreements were approved by the NRCHS board on Wednesday, including a food, beverage and lodging delegation agreement.

This contract with the Minnesota Department of Health is for the agency’s sanitarian, who conducts food, beverage and lodging inspections as well as public health nuisance inspections for vector complaints, meth houses and nuisance properties.

Because Nobles and Rock counties share a full-time sanitarian through the agency, terminating the contract would require Nobles County to reapply for a delegation agreement. The problem with that, said Meyer, is the state will only approve a delegation agreement with a public health agency. In Nobles County’s transition process, public health would be under the human services umbrella.

“That is going to be a sticking point,” said Meyer. “At this point, MDH does not see a loophole in the statute to allow Nobles County to (apply for a delegation agreement).

“To Jason (sanitarian Kloss), it looks like he’s out of a job at the end of next year,” he added.

To change the agreement, Nobles County must request a statute change and, in so doing, would be required by MDH to hire a second full-time sanitarian thanks to a clause in any new delegation agreement. Prior to this, NRCHS was grandfathered in and allowed to have just one full-time sanitarian.

If Nobles County can’t find a loophole in the agreement, Meyer said it has the option of contracting with the state for food, beverage and license inspections. The drawback to that is the county won’t have anyone to respond to nuisance complaints.

“The county, if it loses Jason, would have to then figure out who would do the garbage house and nuisance stuff because Jason does those at this time,” Meyer said.

In other contract terminations, NRCHS approved a mandatory one-year notice for termination of an agreement for PH-DOC, the electronic medical records program used by the agency. Meyer said the agency contracted with PH-DOC for five years, at a cost of $2.2 million. The contract doesn’t expire until the end of 2013, and Meyer told the board NRCHS may have to pay up to $25,000 per year for the next three years to buy out the contract.

“It would probably be Nobles County that would have to pay for it, since they would be using the program,” Meyer said.

Termination of a drinking water delegation agreement was also approved.

Meyer was asked if there were any other contract terminations that could end up costing the county, but he wasn’t aware of any.

In other action, the board:

* Received an update from Nobles County Human Services director Nicole Names on the research being done to join with Nobles County Public Health.

Names said a steering committee is meeting twice a month to develop sample budgets and organizational charts.

“I think we all, as a team, there’s nerves, there’s stress about what’s going to happen,” Names said. “Both of the agencies are feeling somewhat anxious about the change.”

Names suggested it would be good for the NRCHS board and Nobles County commissioners to have conversations with employees about the future.

“The sooner people know, the better,” she said.

NRCHS board chair Karen Pfeifer said that until the county decides what it’s going to do — a merger with human services has not yet been agreed to — there is nothing NRCHS can say to alleviate employee concerns.

“There’s no way we can squelch any rumors,” Pfeifer said. “We haven’t been involved in the process, so there’s no way we can assure them.”

Nobles County Commissioner and NRCHS board member Marv Zylstra suggested the county board have a special meeting in early January to address public health’s future.

* Approved rewriting a contract with Nobles County Human Services for a public health nurse position. The Human Services agency failed to budget enough funds for the position in 2011 and, as such, asked if NRCHS could utilize the nurse for at least four hours per week to keep her at full-time status.

Meyer said having the nurse in public health for eight hours per week would be more efficient, as it would allow her to conduct maternal child health and child-teen checkup visits. The cost to the agency for those eight hours per week would be approximately $16,000 for the year.

“We’re going to shoot for four visits per week, but if she only saw three per week, we’d make about $11,000 to $12,000 back,” Meyer said.

Names said because human services will lose her for eight hours per week, they will need to reassign some of her work.

“She’s a full-time employee, and we want to keep her a full-time employee,” Names said.

* Received a report that NRCHS is working with 33 individuals with latent tuberculosis infections and 2 individuals who are receiving direct observational therapy. Four more children and one adult who tested positive for TB came in within the last two weeks for direct observational therapy.

* Approved an interpreter contract with Eh Plaw to provide translation for the Karen language.

* Approved a child-teen checkup grant in which NRCHS will be reimbursed $26.50 for each visit it makes during 2011.

Tags: nobles county, news, nobles, nrchs, sanford, health