Long before Paul Kuehnert became the executive director of the Kane County Health Department in 2007, he was a public health nurse in St. Louis, Mo., where his responsibilities included visiting young mothers and their babies. Kuehnert’s role was to teach basic care skills and help the mothers and babies develop a strong relationship.
During one visit, on Christmas Eve, Kuehnert encountered a second visitor in the house when he arrived—the baby’s estranged father. The father seemed both agitated and threatening. Kuehnert quietly led the mom and her baby into the kitchen and then out the back door to his car. He took them to an emergency room of a local hospital where he put them in the care of a nurse, with directions to call social services.
That mother and baby, and the many others he visited, were key to Kuehnert’s enthusiasm for Kane Kares, which was in place when he took the Kane County job two years ago.
While Kuehnert is justifiably proud of Kane Kares, he faces economic challenges to keep the program at its current client level of about 150 nurse-family matches. Funding for the health department and all of its health services has dropped because of a decrease in county revenues. Funding is not the only issue, as there are other needs for the nurses. For example, as an immunization program begins nationwide to protect citizens against H1N1 Kuehnert may have to temporarily reassign some nurses from Kane Kares.
Kuehnert says he is in conversation with the NFP national staff about strategies for maintaining services without reduced funding and he is exploring whether he can decrease individual nurse caseloads while assigning them other revenue-generating public health nursing work, such as giving immunizations. If successful, in the long run the number of Kane Kares nurses could be increased and more families would be served.
“We’re going to document what we’re doing and keep the NFP in the loop,” says Kuehnert. Not surprisingly, the possible change is cause for concern to the program’s nurses, who often maintain informal ties with clients even after the official relationship ends.
“If we can find a way to stretch our resources by diversifying revenue and nursing work assignments,” says Kuehnert, “we hope to be able to keep the number of families served or even increase it, while still maintaining, or even exceeding, the successes we’ve achieved this far.”