Board of Health advocates for full-time nurse

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As the town’s Fiscal Year 2020 budget process continues, the Board of Selectmen continued with operating and capital budget hearings for town departments. On the agenda at the meeting on Feb. 26, Board of Health Director Shaun McAuliffe presented his department’s proposed budget which included an additional $63,000 to fund a new position for a full-time public health nurse.

“We are requesting the increase to bring on a full-time public health nurse who would also act as the director of the Medical Reserve Corps,” McAuliffe said.

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He further explained that adding another full-time employee to assist with the day to day activities in the department would allow him to work more on public health and program development in the town.

“At this point I am covering, with my contract nurse, all of the public health duties,” he said.

Services provided by a public health nurse would include vaccination services throughout the year, health clinics, support for the Senior Center and other town departments with health-related program activities, and the mandated public health duties required by the state’s Department of Health.

According to both McAuliffe and Town Manager Norman Khumalo, there is an increasing need in the community for expanded services. Khumalo spoke of having this conversation more than once over the 10 years he has worked in Hopkinton and of the steps taken to try to coordinate with surrounding towns to find a solution. In all cases, he said other options such as using college interns or finding a nurse willing to work for more than one town have not worked.

Asked about services that are not being provided and where more coverage would be beneficial to the town, McAuliffe cited the e-cigarette usage by students and said that his department currently is operating in reactive mode.

“Do we continue to react, or do we start to develop programs and plans to put these projects in place where we can better provide health service to the residents?” he asked.

Further discussion by the board focused on the specific duties of a full-time nurse and what level of health services the town is obligated to provide. Of concern to Chair Claire Wright was the cost of employee benefits, in addition to salary, for a full-time nurse. The town currently spends $13,000 for a contract nurse.

Speaking as a nurse himself, Brendan Tedstone said, “I’m having a hard time swallowing that we need to bring on a full-time nurse right now.” He suggested looking into a per diem solution instead and offered to help coordinate that effort. “Without budget constraints, a full-time nurse would be the way to go, but working in the field I know that the per diem pools are strong.”

After confirming that the elected Board of Health had voted unanimously to support adding a full-time nurse, Brian Herr said that his primary concern was not getting involved in the work of individual boards and town departments, but with the overall tax impact of the FY20 budget on residents. He said he had no problem with the shifting of funds within the various buckets, but wanted to know if the total budget is going up. With the current plan to use some of the excess levy to balance the budget, Herr encouraged the board to focus on the overall tax impact.

“Deference to the elected board is where I go,” said Irfan Nasrullah.

After initially presenting his recommended budget at the Jan. 29 meeting, Khumalo said the board would be presented with a revised budget, based on the feedback provided throughout the budget hearings, at the board’s next meeting on March 5.