DATE: December 11, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director of Behavioral Health
SUBJECT: Behavioral Health Salary Resolution Amendment
RECOMMENDED ACTION(S):
TITLE
Approve Amendment to the Salary Resolution deleting one Head Nurse position and adding one Behavioral Health Nurse Manager Position effective December 17, 2018, as reflected on Appendix E.
REPORT
Approval of the Recommended Action will allow the Department of Behavioral Health (DBH) to convert one Head Nurse position to one Behavioral Health Nurse Manager position. The position oversees the DBH Medical Team, which includes seven (7) Nurse Practitioner/Psychiatric Mental Health Nurse Practitioner positions, two (2) Mental Health Nurse positions, seventeen (17) Psychiatric Technician/Licensed Vocational Nurse positions and one (1) Administrative Assistant position.
ALTERNATIVE ACTION(S):
If your Board does not approve the recommended action, the Behavioral Health Nurse Manager position would not be added and the Head Nurse position would not be deleted. Administrative Supervision of the Nurse Practitioner/Psychiatric Mental Health Nurse Practitioner (NP/PMHNP) positions will remain with the Division Managers.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The total estimated cost of the recommended position conversion for the remainder of FY 2018-19 is $50,600, which will be funded with Short/Doyle Medi-Cal Federal Financial Participation and Mental Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Behavioral Health Org 5630 FY 2018-19 Adopted Budget.
DISCUSSION:
During the FY 2016-17 Budget Hearing, the Board approved the addition of one (1) Head Nurse position to provide supervisory oversight of certain medical staff, thereby, reducing supervisory responsibilities of the Department’s Medical Director. The Head Nurse position was not intended to supervise the NP/PMHNP classification and aligned with the Department’s organizational model. However, subsequent organizational restructure of the Department’s operational business practices created the need for a senior management level position with administrative supervisory duties of the NP/PMHNP classification. On May 1, 2018, your Board approved the deletion of all Department Psychiatrist positions, including the Medical Director position, effective July 2, 2018. The deletion of the Medical Director resulted in an operational challenge for the Department as the NP/PNP positions could not be supervised by the Head Nurse. As a temporary remedy, the Department delegated supervisory duties of medical staff to the Division Managers. The added responsibilities has been difficult to manage as the Division Managers have oversight of 265 clinical staff.
Converting the Head Nurse position to a Behavioral Health Nurse Manager position would accomplish two goals: 1) Provide leadership through this senior management position; and 2) Offer supervision to the DBH Medical Team. This new classification differs from the Head Nurse classification in that the Behavioral Health Nurse Manager is an exempt, senior management position that supports, with direction, the wellness of individuals, families, and communities in Fresno County who are affected by, or are at risk of, mental illness and/or substance use disorders.
If your Board were not to approve the recommended action, the Department would continue to delegate supervision of the Medical Team to the Division Managers, adding twenty-seven (27) positions to their current oversight of 265 clinical staff. In order to provide appropriate support to the DBH Total System of Care, DBH is requesting to convert one (1) Head Nurse position to one (1) Behavioral Health Nurse Manager position.
REFERENCE MATERIAL:
BAI #13, May 1, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
Salary Resolution Appendix E
CAO ANALYST:
Ronald Alexander