OSAGE COUNTY — Osage County Health Department Administrator Kim Sallin told commissioners that preparations continue for the department’s new Quick Care clinic, as its nurse practitioner begins work on July 27.

Commissioners encouraged the health department to promote the new service with a grand opening once an opening date is established. “I think it needs to be a big deal,” said Eastern District Commissioner Jeff Peters.

Sallin said she wants to announce an opening date only after necessary equipment has been ordered, in case of extended lead times. “I don’t want to over-promise and under-deliver,” she said.

That equipment will be selected by the nurse practitioner after she begins work and has had a chance to review what has already been prepared.

Sallin estimated the clinic could begin seeing patients within a couple of weeks after the nurse practitioner starts work, but said the exact timeline will depend on how quickly equipment arrives, electronic medical record templates are completed, and clinic policies are finalized.

Commissioners also discussed clinic hours. Sallin proposed operating the Quick Care clinic four days a week, Monday, Wednesday, Thursday, and Friday, from 7:30 a.m. to 5 p.m., but said staffing until 5 p.m. presents challenges because of employee childcare schedules.

“We’re trying to work things out,” Sallin said. “It’s very difficult to find people to work in my office, and the people that I have right now ... have been there for a long time, and they’re very loyal.”

Sallin said the department has recently experienced a noticeable increase in patients using laboratory services and plans to begin asking new patients how they learned about the department. She said many residents are choosing to have laboratory work completed locally before physician appointments because results are generally available within 24 hours.

Commissioners also discussed funding for the Quick Care clinic, including potentially transferring county use tax revenue to cover startup costs once final equipment and supply needs are known.

• Osage County Treasurer Valerie Prater presented information she obtained from the Missouri Department of Revenue regarding county sales tax statutes after commissioners raised questions during last week’s meeting.

“I’ve had a lot of people approach me about if we can get another half-cent, so we can do a lot more with county roads,” Peters said.

Prater said the county has reached the maximum tax authorized under the statute governing its current half-cent road sales tax. “If you want to pass another sales tax, you would want to seek legal counsel and find that correct statute number,” she said, explaining that any additional tax would require voter approval under a different statutory authority.

Commissioners reviewed the county’s existing sales taxes and discussed several statutes that could potentially allow additional taxes if approved by voters.

Peters said he believes many taxpayers do not fully understand how local use tax works and suggested additional revenue from online purchases could lessen the need for another sales tax. The discussion led to a lengthy conversation about the difference between sales tax and use tax, particularly for online purchases and grocery deliveries.

• Representatives from employee benefits firm Acrisure Insurance introduced themselves to commissioners following the semi-retirement of longtime representative Ronnie Staggs.

Brad Roark, Jason Pecaut, and account manager Abby Schulte told commissioners they will now assist the county with employee health insurance and benefits.

Roark said the firm intends to evaluate every available option before the county’s Jan. 1 insurance renewal, including fully self-funded, level-funded, and traditional insurance plans.

“We’re going to look at every viable option that’s on the market for you all,” Roark said.

He said health insurance costs continue to increase across the industry because of higher medical costs, increased utilization, and rising prices negotiated by hospitals, and health care providers.

“It’s just a never-ending process,” Roark said. “Every time we turn around, we’re seeing double-digit increases.”

Roark explained differences between fully self-funded and level-funded plans, cautioning commissioners that self-funded plans require careful review because employers assume more financial risk. He noted some stop-loss contracts contain “lasers,” which require employers to pay significantly higher claim amounts for certain individuals before insurance coverage begins.

The representatives said they will review every available carrier and benefit structure before presenting recommendations later this year.

Roark said the goal is to have renewal options available by November, allowing the county time to make decisions before the Jan. 1 renewal.

The firm also plans to increase communication with county employees by making quarterly visits and encouraging employees to contact them directly with insurance questions or billing issues.

“If you get a bill in the mail and you don’t think you owe it, don’t pay it. Call us and let us look into it,” Roark said.

Commissioners welcomed the additional communication.

“One thing we’re big on here is communications,” said Presiding Commissioner Darryl Griffin.

• Commissioners continued discussing a proposed paid time off policy that would replace the county’s current vacation and sick leave system.

Prater questioned whether combining vacation and sick leave into one PTO bank would ultimately increase the county’s financial obligations because all unused PTO would be paid when an employee leaves county employment.

“My biggest fear ... is why are we combining sick leave?” Prater said. “With this new system, we’re paying everything out.”

Prater suggested keeping vacation and sick leave separate while allowing employees to begin accruing leave earlier in their employment rather than waiting until their anniversary date.

She also questioned a proposal that would eventually limit employees to carrying over only 80 hours of leave into a new year.

“That’s nothing, that’s no hours at all. I mean, that’s just two weeks,” she said, adding that employees dealing with maternity leave or serious family illnesses could quickly exhaust their available time and be forced to take time off without pay.

“I agree with you 100%,” Peters said.

Western District Commissioner Dale Logan said he continues to support moving to a PTO system because employees would earn leave based on the number of regular hours they actually work.

“If you come in and only work 35 hours this pay period, then you earn what you earn instead of us giving you extra vacation,” Logan said.

Logan acknowledged, however, that commissioners still need to revise portions of the proposal. “We’ve got to fine tune it a little bit,” he said, noting the current sick leave provisions need additional work.

Peters said he wants any changes to recognize the dedication of longtime employees.

“If you’ve got a guy that’s worked here 30 years ... he’s earned that vacation time,” Peters said. “I can’t find a spot in my heart to say you’re just not getting paid for it.”

Peters added that he hopes commissioners can find “a happy medium” that benefits both employees and taxpayers.

Prater also raised concerns about budgeting for future leave payouts, particularly when employees retire after accumulating large amounts of leave.

The discussion also included questions about probationary periods for new employees, holiday pay eligibility, sick leave accruals, and how much leave employees should be allowed to carry from year to year.

Commissioners said they plan to continue working with legal counsel before adopting a final PTO policy.

• Commissioners also discussed a recent traffic accident involving an Osage County road grader and a passenger vehicle.

Peters said he did not witness the accident and declined to speculate about who was at fault. “I’m not going to say who’s in the wrong or who’s in the right, because it’s not my place to decide,” he added. “We will turn it into our insurance, and the insurance companies will figure it out from there.”

Peters said he had spoken with the other driver’s insurance representative over the weekend and expected additional information after speaking with law enforcement.

Logan, who visited the scene, described what he observed but emphasized, “I can only give you my opinion.”

According to Logan, the road grader had stopped while grading a gravel road and backed up, striking a vehicle that he estimated was about 10 to 12 feet behind the grader.

Logan said the responding officer told him determining fault would ultimately be the responsibility of the insurance companies rather than law enforcement.

Commissioners questioned whether the grader operator could see a vehicle positioned closely behind the machine, noting the limited rearward visibility from heavy equipment.

No action was taken during the discussion, and commissioners said the matter has been turned over to the county’s insurance carrier while the claim is reviewed.

• Peters said the county’s new whipper is likely in Illinois getting fitted out, and asked the other commissioners to consider bulletproof glass in lieu of wire mesh for increased visibility. Peters said the cost difference was minimal, but Griffin asked him to find out the exact cost difference before any decision is made.

• Linn Community Betterment Association representative Neil Loethen asked for permission to put planters in front of the courthouse, adding that he would take care of them.

• Peters said Patrick Kliethermes planned to check on the width of road easements Logan needed to know about.   

ROAD & BRIDGE

Road and Bridge Foreman Neil Mantle said a hydraulic line failure temporarily sidelined one of the county’s brush-cutters but repairs have been completed. It also received new front tires, which the county already had on hand.

• He reported that work on CR 303 should resume early next week and said future road projects will require more advance planning, particularly where utility relocations and culvert replacements are involved.

• Mantle said obtaining culverts has become increasingly difficult because suppliers have limited inventory and long delivery times.

• Commissioners also discussed the future of CR 736, where repeated flooding has caused extensive damage.

Mantle said repairs would likely cost approximately $500,000 and that the underlying drainage problem cannot be permanently corrected without work in a nearby creek.

Peters said one of the affected landowners has declined to allow work within the creek channel, and he (Peters) saw no point spending so much money to repair the road without correcting the underlying cause of the issue to keep it from happening again.

Commissioners discussed permanently closing the road if the affected property owners pursue the legal process required under Missouri law. Peters said most of the adjacent land was owned by the person who declined the work, and that property owner supported closing the road, as did the other landowners.

Presiding Commissioner Darryl Griffin said county roads cannot simply be closed by commission action.

“There’s a procedure to close the road down,” Griffin said, noting that state law requires petitions, public notice, and a hearing before a county road can be vacated.

Mantle said closing the road would add approximately five to 10 minutes to some motorists’ travel time but would avoid spending hundreds of thousands of dollars on a road that may continue to fail after major rain events.

Peters mentioned how appreciative he was that the county had saved money for emergencies because that allowed the county to fix the roads after recent storms. He also reiterated that commission meetings are open to the public, if anyone has any questions.

Commissioners indicated they will seek additional legal guidance before taking further action.

• Road Report, June 23 - June 30: Creek rock was hauled on CR 723 (64T); quarry rock on CR 433 (31.76T), 706 (521.91T), 709 (84.88T), 711 (88.73T), 713 (21.86T), 715 (19.54T),

722 (16.63T), 723 (182.18T), 725 (34.60T), 726 (148.80T), 736 (20.29T), & 801 (87.14T); a culvert was replaced on CR 304 (11.03T placed at culvert site), 711 (14.64T), & 804 (14.39T placed at culvert site); road work was done on CR 315, 317, 319, 324, 325, 326, 433, 624, 715, 725A, & 736; tree removal was done on CR 321 & 435; brush mowers were working on CR 275 & 512; and grader operators were active as follows: G01 (CR 608), G03 (CR 206, 301, 304, 306, 307), G04 (CR 611, 711, 715, 718), G05 (CR 706, 726, 734), & G06 (CR 318).

• Grader G01 (2012 140M2 CAT, whipper tractor W41 (2006 John Deere 6615 w/Alamo Machete Mower), and whipper W43 (2007 John Deere 6615 w/Alamo Machete Mower) were serviced in-house. Grader G02 (2014 772G John Deere), dump truck DT31 (white 2004 Peterbilt), and dump truck DT32 (blue 2004 Peterbilt) were serviced out-of-house.

HEALTH DEPARTMENT

Sallin reported the health department interacted with more than 200 people during the Osage County Fair and said the department’s lactation station was used more than 15 times by mothers needing a private, air-conditioned place to feed or change their babies.

She credited Classic Buildings for donating the temporary building each year. “The fair was wonderful,” Sallin said. “We’re so grateful that Classic Buildings does that completely free of charge.”

• The department’s annual Shop with a Hero fundraiser was to be held Friday, July 3, with a pork burger sale at Thriftway beginning at 10 a.m. and continuing until sold out. Sallin said homemade cookies would also be available.

• Other upcoming events include the department’s community pool party from 10 a.m. to noon July 18 at the Linn City Pool, along with back-to-school vaccination clinics and CPR certification classes for area schools.

FINANCIAL

• Time sheets were approved by commissioners.