To the editor:
For more than 16 years, I have had the pleasure of serving Dallas County residents as a nurse with the Dallas County Public Health Department. For the last 14 of those years, I have served as the Department’s Maternal Child Health Nurse, providing health assessments for moms and babies, education and support to more than 100 families each year.
The Maternal Child Health Program has filled a gap in the community – one that I am proud to have helped fill over the years.
As the County’s Maternal Child Health Nurse, I have been with moms when they heard their baby’s heartbeat for the first time and rejoiced with them when they found out they were having their first girl after three boys.
I have answered questions on the weekends and after hours, and I have replied to excited text messages in the middle of the night, when moms are finally in labor and being admitted to the hospital.
I have held the hand of the mom who lost her babies and helped plan their burial.
I have helped a husband pack for his wife and put her in the car to take her back to the hospital with severe postpartum depression.
I have had to tell the mom who is just weeks away from delivering that I cannot find her baby’s heartbeat, and I have been with the teenage mom for the birth of her baby on a Saturday night because she felt she had no one else in her life that she could depend on.
These babies, women and families have become a part of me, and I am grateful for each one of them.
So why am I stepping away from a job that I love and feel so passionate about? After 17 years of service to Dallas County, I was blindsided by notification from the Human Resources Department that I would be losing health insurance coverage – something that I and my family cannot make do without.
Here is the situation: While working as the Maternal Child Health Nurse, I was scheduled to work 32 hours per week, and for the past several years my annual average of hours worked has exceeded 32 hours. As a part-time employee, per county policy, I was not eligible for any holiday pay, vacation or sick leave, despite working four full days per week and sometimes more.
In 2017 I had a very high-risk pregnancy that impacted my ability to work a full schedule due to physician-ordered bed rest. I ended up delivering my son at 32 weeks and spent three weeks in NICU.
I reached out to the HR Department to see if my health insurance would be impacted due to my maternity leave, and I was told that as long as I paid my premiums, my coverage would not be affected. So I took 12 weeks off to care for my son.
Imagine my surprise when on May 10, 2018, I received an email from the Dallas County Human Resources Director stating that since I did not average 30 hours per week, due to the premature birth of my son and the time off I took, I would lose health insurance coverage because, under the Affordable Care Act (ACA), the county is only required to offer insurance if employees average 30 hours per week during a defined measurement period.
Now an employer could choose, under the ACA, to offer health insurance coverage to employees who worked less than 30 hours per week. And county policy even stated that health insurance is offered to employees who “typically work 30 hours per week” — and I typically worked 32 hours per week.
However, when I made a request to the Dallas County Board of Health to continue my coverage and ensure no gaps in services for the families I serve, they were unwilling to even add the topic to the agenda for discussion.
I also received zero support from the Human Resources Director in trying to find a solution that would allow me to continue my coverage while still serving the residents of Dallas County. I had absolutely no access to a system where I could have kept track of my average hours worked per week, nor was I given any warning that this would be an issue.
After trying and failing to bring the county’s policy to the Board of Health’s attention, I tried the Dallas County Board of Supervisors but instead of doing what most would consider to be the right thing in extending my health insurance coverage, the Human Resources Department and supervisors decided to change the wording of the policy to eliminate any chance of my continuing coverage.
Effective July 1, 2018, instead of health insurance being offered to employees who “typically work 30 hours per week” — the previous county policy — it is now only offered to those who are full-time at 40 hours per week or to those who meet the minimum ACA requirements.
Interestingly, the three members of the Board of Supervisors are themselves considered part-time, yet they make a higher annual salary than many full-time county employees and also have family health insurance. And I would be willing to bet they don’t average 30 hours of work per week.
So where does this leave us? I was forced to leave the job I love so I could obtain health insurance coverage for me and my family. The county is left without a functioning Maternal Child Health Program, and more than 100 families are left without Maternal Child Health Services.
My position was grant-funded, so my salary and benefits were not even an added burden on the taxpayers of Dallas County. Therefore, I’m not sure why this outcome is seen as optimal in the eyes of both boards and the Human Resources Department.
Letting go of a position and a program that served so many families and that I truly loved has definitely been a grieving process for me. I was not here in this position because of the money. I was here to serve because in the end, isn’t that what we are all called to do?
Everyone is replaceable, including myself. I understand that. But it will be hard to find someone with the experience needed to do this job at the salary the county is willing to pay and without pro-rated benefits for part-time employees. For instance, nurses can work for neighboring counties at just 21 hours per week and qualify for health insurance and benefits.
To my knowledge, Dallas County has no plans of replacing my position or continuing the Maternal Child Health Program.
At the rate that our county is growing, we should be growing our public health department to serve the needs of our community, and yet we are down to a handful of people still on staff.
This county and its public health department have so much potential but until there are some major changes in county leadership, it will have devastating consequences to the families and taxpayers of this community.
If we can’t even invest and value our employees, how can we show that we are willing to invest in the children who will be the future leaders of this county?
Public health is where I grew up. It has been and always will be the place I call home. It has been an honor to serve this community, and I will truly miss it.
Stephanie Birt
Woodward
Wow. Sounds like the county is losing a valuable employee and resource. Condolences. This letter is a sad example of how the government actually feels about the value of women and children, both the individual treatment of the working mother carrying a high risk pregnancy and then taking time off to care for her own premature baby, and in the fact that they underpay her and then withdraw her health insurance benefits when she isn’t “earning her keep” and leave other pregnant women in the area with one less healthcare provider looking out for them.
Remember, we have a maternal mortality crisis in this country right now. One in 8 babies is born preterm, and prenatal care is an important part of helping make sure all our precious little preborns are given the best start in life. In other developed nations, babies get to have their mothers home with them for 6-12 months, and their mothers need not fear losing their jobs or health insurance because they Chose Life.
As a midwife, I can tell you that access to health insurance and financial concerns drive women’s options and choices in childbearing. Universal healthcare would foster better outcomes for women and babies. And rural healthcare suffers disproportionately when there is a shortage of maternity care providers. Perhaps readers will take this knowledge to the polls in November and vote in representatives who will support healthcare policy that makes health care and insurance a right and not a privilege.
Three things came to mind as I read this: 1) The hours you worked per pay period should be printed on your check stubs to prove the hours you worked. You had insurance while working zero hours per pay period. 2) If you paid you insurance while on leave, it shows they still considered you an employee even when not working 32 hours/pay period. 3) I would notify the supplier of the grant. If the county does not keep you or fill your position, they need to return the unused funds. As a retired RN, I know how hard it can be to leave a position where you feel you are making a difference. Hope you can find a place that allows you to use your special skills.
As a retired RN with 42 years of medical experience, I find it difficult to believe the lack of sensitivity in dealing with this issue. How can we as a society teach each other to look out for one another when we cannot set a believable example? Years ago, I recall a television advertisement that stated, “If caring were enough, anyone could be a nurse.” Nurses are educated, not trained. Circus animals are trained. Nurses are a special breed of people unto their own. Years of preparation are necessary to become a licensed nurse. I have never seen a nursing textbook or any textbook for that matter that teaches true empathy. A person either has it or they don’t. In the chain of care-givers from the nursing assistant to the director or nurses and beyond, one requisite is mandatory: either you care or you don’t. It seems our officials could take a lesson here. If money is a problem in financing a program with positive results, maybe a halt in providing some of the tax abatements in this county is in order.