Staff RN · Map My Pay Co-Founder · September 30, 2026
Every nurse on a county scale learns the same lesson in year one. The raise comes on your anniversary, it is one step, and there is nothing to do but wait for it. Madison County's contract with the New York State Nurses Association works that way on the base scale. Base pay sits below the national RN median at every step, and the points table that sets your hire step decides where on that scale you start. This piece is about the rest of the contract.
Five clauses in the agreement pay a nurse extra without a promotion and without an anniversary. Three of them are worth thousands, two are worth a few hundred dollars, and each one has a trigger you control. I have put a 2026 dollar figure on every one of them below, at Step 1 so the numbers are conservative, with the Step 4 and Step 8 figures where they change.
| At a glance | What triggers it | A year at Step 1 |
|---|---|---|
| Public Health Nurse grade | Written proof of a four-year nursing degree | $3,869 |
| Scheduled weekends at 1.5x | A place on the annual weekend rotation | about $3,733 for two Saturdays a month |
| Certification pay | One certification from the approved list | $624 |
| Tuition refund | Approved job-related coursework, graded A to C | up to $5,000 back |
| Precepting, acting up, holidays, overtime | Hours in the role, the month you work them | $0.60 to $1.00 an hour, or 1.5x base |
The steps alone will not get you there
The RN scale runs from Step 1 at $37.03 an hour to Step 8 at $42.75, and you reach Step 8 on your seventh anniversary. Spread over those seven years, the climb from $77,022 to $88,920 works out to about $1,700 a year per step. After Step 8, the scale adds 40, 30, 25 and 25 cents an hour at 10, 15, 20 and 25 years of county service. The 25-year row is $91,416.
None of that is in your control. You cannot skip a step, you cannot speed one up, and the hire step you were placed at follows you the whole way. The five raises below are different. Each one has a clause, a trigger and a dollar figure, and the county agreed to pay it when it signed.
Move to the Public Health Nurse grade
This is the biggest lever in the contract, and it is a grade change rather than a bonus. Section 9.06 says an RN who gives Human Resources written proof of a bachelor's degree in nursing is moved to the Public Health Nurse title. That title runs on a separate scale that sits $1.86 to $2.14 an hour above the RN scale at every step. At Step 1 the upgrade is worth $3,869 a year. At Step 8 it is $4,451. Because it is a grade, it grows with every January raise instead of sitting flat.
Check whether your degree meets the PHN qualifications
The county's current Public Health Nurse announcement lists two minimums, a bachelor's degree in nursing from an accredited program and a New York RN license. A degree from outside the United States needs an equivalency evaluation, and the county makes you pay for that evaluation. If your bachelor's is in another field, the title is out of reach until you finish the nursing degree, and section 5 of this piece is for you.
Submit proof to Human Resources in writing
Section 9.06 turns on written proof, so send HR a transcript or a copy of the diploma. Telling your supervisor does not start anything. Send it the week you are hired if you already hold the degree, because every two weeks on the RN scale with a bachelor's in hand costs you about $149 at Step 1.
Confirm the new step matches your old one
Section 3 of the Administration schedule moves a promoted nurse straight across to the same step on the higher grade. A Step 4 RN becomes a Step 4 PHN, at $41.27 an hour instead of $39.30. Check the step on your first PHN pay stub, because the upgrade pays nothing if the step resets.
| Step | RN | Public Health Nurse | Upgrade, a year |
|---|---|---|---|
| Step 1 | $37.03, $77,022 | $38.89, $80,891 | +$3,869 |
| Step 4 | $39.30, $81,744 | $41.27, $85,842 | +$4,098 |
| Step 8 | $42.75, $88,920 | $44.89, $93,371 | +$4,451 |
Get on the weekend rotation
Health Department nurses work a Monday to Friday week, so weekend hours are the one differential that recurs every month, and they pay well. Section 9.05 sets weekend work at 1.5 times base for nurses the county schedules on a Saturday or Sunday on a regular basis. At Step 1 that is $55.55 an hour on the RN scale and $58.34 on the PHN scale. The premium is $18.52 to $19.45 for every weekend hour. The catch is in the word scheduled. Weekend assignments are posted once a year by seniority, so you cannot decide on a Tuesday to work Saturday. You ask to be on the rotation.
Ask the Director of Patient Services for the rotation list
The weekend roster is built from the nurses who want it, in seniority order, when the annual schedule is posted. A new nurse who never asks is never on it. Put the request in writing before the posting date. Ask how many weekend slots the department fills each year, because that number is the ceiling on what this section can pay you.
Take the slots that 20-year nurses give up
Nurses with 20 or more years of service can opt out of weekend work, and each one who does opens a slot below her. In a small county health department, that is often where the openings come from, so it is worth knowing who is near that mark.
Trade assignments when you need to
A scheduled weekend can be swapped with another nurse with the department's approval, so a place on the rotation does not lock you out of every family Saturday for a year. The premium is paid on the hours actually worked, so a traded weekend pays the nurse who covered it.
| Weekend premium, PHN scale | Per hour | Two Saturdays a month, 192 hrs | Every other weekend, 416 hrs |
|---|---|---|---|
| Step 1 | +$19.45 | about $3,733 | about $8,089 |
| Step 4 | +$20.64 | about $3,962 | about $8,584 |
| Step 8 | +$22.45 | about $4,309 | about $9,337 |
The figures assume 8-hour shifts inside a 40-hour week, so the premium is the extra half of base on each weekend hour. A nurse still on the RN scale earns about $178 less a year on the two-Saturday pattern at Step 1. Weekend work is the same lever Kaleida Health pays 1.3 times base for in Buffalo, and the county's 1.5 is the better multiplier.
Add a certification the county pays for
Section 4 of the Administration schedule pays $0.30 an hour, or $624 a year, for one certification from a fixed list. The dollar figure is small. It belongs in this piece because the county also pays for the course, including tuition, fees, books, lodging and meals. A wound care or lactation certification also goes with you to your next job. Thirty cents an hour for a credential someone else paid for is a good trade.
Sponsored · Map My Pay earns a commission if you use the SoFi link below.
Costs like these add up fast when you are also paying off school. Start with the free check: see if your hospital counts for Public Service Loan Forgiveness on studentaid.gov. Many nonprofit and public hospitals do, and refinancing federal loans into a private loan ends that option for good.
If PSLF is not your plan, or your loans are already private, Map My Pay partners with SoFi at Work. My wife and I have used SoFi ourselves. We cosigned our daughter's college loans with them and borrowed from them when we bought our house. Their rates were the best we found, and they are still some of the best I see. Our readers get member rate discounts on student loan refinancing, and checking your rate won't affect your credit score. Check your SoFi member rate →
Pick one from the approved list
The list is written into the contract, and a national certification that is not on it earns nothing unless the county and the union agree to add it. Choose the one that fits the work you already do, because the differential does not stack, and a second certification adds nothing.
| Approved certification | Pays |
|---|---|
| Madison County IV Infusion | $0.30 an hour, $624 a year |
| ANA Public or Community Health Clinical Nurse Specialist | $0.30 an hour, $624 a year |
| Wound, Ostomy and Continence Nurse (WOCN) | $0.30 an hour, $624 a year |
| Lactation Consultant | $0.30 an hour, $624 a year |
| Diabetic Educator | $0.30 an hour, $624 a year |
Get the training cost covered before you enroll
The county's payment for the course is written into the same section as the differential, so ask HR for approval in writing before you register. A course you paid for yourself and then asked about afterward is a much harder conversation.
Plan to stay two years after the course
A nurse who leaves within 24 months of the training repays the county on a sliding scale, from 100% of the cost in the first months down to 25% near the end. You keep the credential either way, so time the course against how long you expect to stay.
Use the tuition refund to reach the next grade
For a nurse without the four-year degree, section 9.02 is the road to section 9.06. The county refunds 100% of tuition for an A and 85% for a B or C on approved, job-related coursework, up to $5,000 a year. An RN-to-BSN program spread over two years can run largely on that refund. The degree at the end is worth $3,869 a year at Step 1 and more at every step above it.
Get the coursework approved ten working days ahead
Approval has to come before the course starts, with at least ten working days' notice. A semester that begins before the paperwork clears is a semester you pay for in full.
Aim for the A
The 15-point difference between an A and a B is $750 on $5,000 of tuition. Pick a course load you can hold at the top grade rather than the heaviest one the calendar allows.
Submit the degree the day you finish
Section 9.06 moves you on the day HR receives the proof, so send the transcript as soon as it shows the degree awarded. Once you are on the PHN scale, section 9.06 has one more rung. A master's degree in nursing that the job does not require pays $2,000 a year to a full-time nurse, and the same tuition refund covers the coursework.
Pick up the smaller Madison County nurse pay differentials
Four more clauses pay by the hour, and none of them can be counted on for a fixed yearly figure. They are worth knowing because each one appears on the paycheck for the month you do the work.
A jail nurse in the Sheriff's Office has one more. Section 9.08 adds a flat $2.00 an hour when most of her hours fall before 7 a.m. or after 4 p.m. Health and Mental Health department nurses have no evening or night differential because they have no evening or night shifts.
Madison County nurse pay differentials on one paycheck
A nurse who moves to the PHN grade, takes two scheduled Saturdays a month and holds one approved certification earns $85,248 at Step 1. That is $8,226 above the RN base. The same three moves are worth $8,684 at Step 4 and $9,384 at Step 8, because the grade upgrade and the weekend premium both grow with the base.
| One year of pay | Step 1 | Step 4 | Step 8 |
|---|---|---|---|
| RN base | $77,022 | $81,744 | $88,920 |
| Public Health Nurse grade | +$3,869 | +$4,098 | +$4,451 |
| Two Saturdays a month at 1.5x, 192 hrs | +$3,733 | +$3,962 | +$4,309 |
| One certification | +$624 | +$624 | +$624 |
| Stacked total | $85,248 | $90,428 | $98,304 |
| Added over RN base | $8,226 | $8,684 | $9,384 |
Set that against the anniversary ladder. Steps 2 through 5 add $6,760 to a Step 1 salary and take four years. The three add-ons add $8,226 and can all be in place before the first anniversary. A nurse who does both, which the contract allows, reaches Step 5 on the PHN scale with weekends and a certification at $92,669 in year four.
Base pay at Madison County still sits under the national RN median, and the stack does not change that at Step 1. What it changes is the monthly number. A Step 1 RN on base pay keeps about $4,114 a month after 2026 federal and New York taxes and the $840 median rent in Oneida, NY. With the three add-ons she keeps about $4,560, or $446 more every month, before the pension contribution and health premium share come out. Whether that works for you depends on the rent you pay and the schedule you want. The Livingston County comparison shows how much of a hospital's higher rate survives the same taxes and rent.
The raise nobody has to approve
A county nurse can spend seven years waiting on anniversaries and never open the part of the contract that pays for a degree she already holds. The same pages cover a weekend slot nobody else wanted and a course the county would have paid for. None of the five raises above needs a promotion, an interview or a manager's goodwill. Three of them need a transcript, a written request and a registration form. The contract already said yes.
Sources: Agreement between the County of Madison, New York and the New York State Nurses Association, January 1, 2025 to January 1, 2028: Schedule A (January 1, 2026 column), Administration of the Hourly Regular Compensation Rate Schedule sections 1, 3 and 4, and sections 4.02, 5.03, 5.05, 6.02, 9.02, 9.05, 9.06, 9.07, 9.08 and 25.I, with Article 18 for the term. Madison County Department of Human Resources, Civil Service announcement 500-2026, Public Health Nurse, updated August 11, 2026, for the PHN qualifications. Kaleida Health and CWA Local 1168 agreement, Article 14, for the Buffalo weekend multiplier. Map My Pay city data for Oneida, NY rent. Tax figures use the 2026 federal standard deduction and brackets, 2026 New York State single-filer brackets and 7.65% FICA, for a single filer with no other income. Weekend figures assume 8-hour scheduled shifts inside a 40-hour week and are labeled as estimates.
Disclaimer: This article is for information only and is not financial, legal or career advice. Weekend assignments, certification approvals and tuition refunds are decided by the county under the contract, and take-home figures are estimates for a single filer. Confirm your own eligibility and pay with Madison County Human Resources and NYSNA before making a decision.