OTTUMWA — A important first step for a proposed Test Iowa clinic is complete, but a staffing shortage continues to plague the effort to get the indoor site running and is the biggest hurdle to getting the venture off the ground.
Emergency Management Agency Coordinator Tim Richmond as well as Wapello County Public Health Director Lynelle Diers addressed the Wapello County Board of Supervisors Tuesday that there could be one nurse available to help coordinate the site, but a second has been elusive.
The board did approve an agreement with Iowa Department of Public Health regarding testing, staffing and location, but obstacles remain.
Richmond said it's possible the site could be run by one nurse, but that it "wouldn't be a good deal." That nurse would come from a staffing agency, but securing a second has been difficult because of overtaxed medical clinics, especially with rhinovirus and allergies already rampant, and flu season beginning soon.
"The governor's office can't provide staffing this time, but they will still provide us with PPE and the online registration platform, which is huge because scheduling can be cumbersome," Richmond said. "The hardship for us is the staffing."
Diers could contract for one nurse, but that agency could only provide one at a rate of $75 per hour, room and board included. Richmond has discussed a partnership with leaders at River Hills Community Health Center to see if it could staff the other spot.
"One reason you need two is because that's the governor's expectation," he said. "I think that would be sufficient to run the volume we'll see. If we were at peak efficiency, we could process a patient every 10 minutes. If we had two nurses, we could theoretically do 72 people if we did a six-hour time frame."
Supervisors Brian Morgan and Jerry Parker both addressed the staffing issue, with Parker wondering if it was possible for a nurse from public health to work the clinic. He was concerned about approving a nursing contract with the staff agency if only one nurse is guaranteed, but Diers said that was all that was available.
Diers said her department has been swamped because of illness, calls for contact tracing, immunizations, etc.
"I'm not doing much administration," she said. "I'm putting in so many hours because all I'm doing is contract tracing. That phone doesn't leave my ear. It's just nutty down there, all hands on deck."
Richmond and Diers warned that not approving a nurse from a staff agency could also have consequences.
"With a staffing agency, you have more consistency than in hiring somebody because sometimes if you hire somebody, they decide they don't want to do it anymore," Diers said. "Then you're stuck again. With a staffing agency, you have that agreement so you know you'll have them."
Richmond and Diers both said if they didn't get one nurse from the agency, they likely wouldn't get that person back "because a lot of places are fighting for nurses."
As of now, the city of Ottumwa has been reluctant to share in the cost of the clinic, Morgan said, and instead rerouted the discussion toward contact tracing over testing, since there is a shortage of contact tracers as well.
"Is testing the best use of our CARES Act money?" Morgan asked, referring to questions posed by city officials in an email. "I know less testing creates less visible issues, but doesn't solve the problem. None of us disagree that we need to do something, in some facet."
Richmond and Diers said testing is the most important part.
"One of the greatest reasons we feel it's important is so people can have that knowledge and get back to work if that makes sense and is safe to do," Richmond said. "That's the biggest benefit."
"There are people in our community that don't have the funding to drive to Burlington or Des Moines to get tested," Diers said. "And that's why it would be nice to have something locally, because we are a low socio-economic county."
Richmond said the county has unused money to do testing through the end of the year, and he wants to "harness" that. He said the clinic will likely be a Monday-Wednesday-Friday model, but could be a five-day model, running from 2-8 p.m. at the northwest corner of Pennsylvania Avenue and Jefferson Street to provide for families so other medical clinics and hospitals are not overrun in the emergency departments, especially on weekends.
The plan would be to run the clinic for 13 weeks, then re-evaluate after the new year.
Though the board approved the agreement with IDPH, it would continue to work on the staffing issue.
"To me, it's a first step," Parker said. "We need to keep trying to find people so we're guaranteed there will be two nurses there. We don't have that yet, but we have the potential."