Two county health operations that now rely on outside nursing contracts could move to county employees by Dec. 31 under a proposal presented Tuesday. The change would cover immunization services at the South Region Public Health Center and round-the-clock care at the Polinsky Children's Center, pairing a claim of closer clinical oversight with an estimated $1.8 million in annual savings beginning in fiscal 2027-28.
The services are different in scale and setting. UC San Diego has supplied nurses for the South Region immunization clinic under an arrangement dating to 2005. The current contract costs $434,952 a year. In 2025, the clinic delivered 26,660 immunizations to 7,505 patients and performed 1,525 tuberculosis tests for 795 patients, according to the county's board letter. Five other regional public health centers already use county nurses for comparable work.
Polinsky is a temporary emergency shelter for children entering protective care. Rady Children's Hospital provides its nursing under a $4.3 million annual contract that expires at the end of 2026. The shelter's average daily population was 21 in fiscal 2025-26, the county reported, as child-welfare practice placed nearly half of children needing out-of-home care with relatives. A small daily census does not mean simple care: children may arrive with incomplete records, urgent medication needs or trauma that changes how an examination is conducted.
County officials say employing the nurses directly would align supervision, training and quality review with the departments responsible for the programs. They also say the transition would support trauma-informed practice and give the system more control over staffing. Those are proposed operational benefits, not measured outcomes. Direct employment can clarify authority, but continuity will depend on recruiting enough qualified nurses, transferring records and keeping shifts covered while contracts wind down.
The fiscal estimate has two phases. The county projects about $583,000 in prorated one-time savings during fiscal 2026-27, then $1.8 million in ongoing annual savings. The later figure includes roughly $1.45 million tied to Realignment funding and $393,000 in general-purpose revenue. Savings are based on planned spending, so the realized amount will depend on salaries, benefits, vacancies, overtime and other implementation costs once positions are filled.
Rady supports the transition, according to the board letter, and nurses working under the current contract would be able to apply for county jobs. An application opportunity is not the same as retaining the same team. The proposal therefore needs practical measures of continuity: vacancy rates, turnover, missed clinic capacity, medication errors, after-hours transfers and patient wait times before and after the change.
Supervisors considered the item at their Sept. 15 meeting. When checked Wednesday morning, Legistar had not yet posted action results and characterized the minutes as draft. The description calls for completion by the end of 2026, leaving a little more than three months for labor, hiring, credentialing and handoff work if the board authorizes the plan.
For families using the South Region clinic, the visible test will be whether appointments and vaccine access remain steady. At Polinsky, where a child may stay only briefly, a delayed examination or disrupted medication schedule can consume much of the shelter stay. The accounting case is clear enough to examine now. The clinical case will be established only if the transition preserves access and documents safer, more consistent care.