DATE: October 22, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Salary Resolution Amendment
RECOMMENDED ACTION(S):
TITLE
Approve Amendment to the Salary Resolution adding:
a. one Supervising Public Health Nurse position,
b. one Health Educator position,
c. one Medical Social Worker I/II/III position,
and deleting
d. one unfilled Health Education Assistant position,
e. two unfilled Health Education Specialist positions,
f. five unfilled Office Assistant I/II/III positions,
g. two unfilled Public Health Laboratory Assistant positions, and
h. one Supervising Office Assistant position
in the Public Health Org 5620, effective October 21, 2019, as reflected in Appendix C.
REPORT
Approval of the recommended action will result in a net decrease of eight positions (add three and delete eleven) allocated to the Department of Public Health and create a salary savings of $307,375 for FY 2019-20. The position additions and deletions will continue the reorganization of the Department. This item is countywide.
ALTERNATIVE ACTION(S):
Your Board may choose to not approve the recommended action, in which case the Department’s organizational structure would remain unchanged.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The added/deleted positions will result in a salary savings in FY 2019-20 of $307,375 in the Department’s Org 5620. The added positions are funded with existing grants and Health Realignment.
DISCUSSION:
The Department continues to evaluate and implement organizational changes to maximize program efficiencies and to mitigate reductions in available 1991 Health Realignment. It is expected that cost for mandate health services provided by the Department of Public Health, Sheriff, and Probation will fully deplete the Health and Welfare Trust Account requiring a review of all mandated programs and services and related funding sources. This action supports the ongoing evaluation of programs and services. The Department continues to collaborate with the Administrative Office and partner Departments to address increased mandated health service costs and reductions in available funding.
The addition of the Supervising Public Health Nurse will allow the Department to have better oversight of clinical operations in both the immunization and congenital syphilis programs. The addition of the Health Educator will allow for a project coordinator for the Perinatal Equity Initiative, which is tasked with reducing African American birth disparities. The addition of the Medical Social Worker I/II/III will allow more clients in the Children’s Medical Services program to receive services more timely.
Children's Medical Services
Addition of one Medical Social Worker
Medical Social Workers (MSW) are integral to the operations of the California Children's Services (CCS) program. Their role encompasses a unique psychosocial component and they serve as a linkage to resources and programs within the community. The existing MSWs split the CCS caseload of 6,391 clients, rotating through three Medical Therapy Units (MTUs) and making home visits. The addition of a third MSW will allow more clients to receive services timely and staff to expand services to workshops and group sessions. Although not every client will need to see an MSW, the addition will improve the service span. The MSW will be funded with State CCS revenue.
Deletion of two Office Assistants
Over the past two years, the CCS program has digitalized client files, which has eliminated the need for Office Assistant (OA) staff to maintain paperwork; the two positions are vacant.
Community Health
Addition of one Supervising Public Health Nurse
The Supervising Public Health Nurse (SPHN) will allow for supervision of the newly developed congenital syphilis case management program and provide a balance of responsibilities among the SPHN's within Department’s Community Health (CH) Division. Currently, the SPHN in the Immunization (IZ) and Chest Clinic has fourteen subordinates. The SPHN is responsible for the supervision of staff and the evaluating standardization of phlebotomy and all other clinical services in the Department. The newly created SPHN will assist the existing SPHN by managing the congenital syphilis case management program and evaluating standardization of phlebotomy and all other clinical services. The SPHN will be funded with Immunization grants and Health Realignment
Deletion of two Public Health Lab Assistants
After a comprehensive analysis of Department’s Public Health Laboratory (Lab) impacted with two significant floods in three years, the Department contracted with a certified laboratory for milk and dairy testing. Based on the contract and re-design of the Lab site with a fully integrated Laboratory Information Management System, a significant portion of Lab operations will be reorganized. Once the new Lab is occupied, which is anticipated in July 2020, operations will be reevaluated to ensure appropriate classifications and support is available to meet community needs. Both Lab Assistant positions are currently vacant.
Deletion of three Office Assistants and one Health Education Assistant
Through reorganization, which includes setting appointments instead of walk-ins for the IZ and Chest clinics, the CH Division determined the vacant positions are not necessary.
Deletion of one Supervising OA
The addition of the SPHN will allow the Department to have better oversight of clinical operations in IZ and the congenital syphilis programs. The new SPHN will provide supervision to the four existing clerical staff resulting in the deletion of the vacant Supervising OA position.
Public Health Nursing
Addition of one Health Educator
The Department received funds for a Project Coordinator as part of the Perinatal Equity Initiative. The initiative is tasked with reducing African American birth disparities. Based on the responsibilities of the position, the most suitable classification for the role is a Health Educator. The position will be funded with State General funds, leveraging Title XIX Federal funds.
Deletion of one Health Education Specialist
The Health Education Specialist position, which is vacant, is no longer needed due to the shift from the Child Health and Disability Prevention Program to the reduction of African American birth disparities as part of the Perinatal Equity Initiative.
Emergency Management
Deletion of one Health Education Specialist
The Department has determined that a more appropriate classification is needed to fulfill the responsibilities of the Public Health Emergency Preparedness Program making the existing vacant Health Education Specialist position obsolete. The needed qualifications include planning, development, and coordination of disaster and emergency response and recovery activities for incidents affecting the County. The Department has been working with the County’s Human Resources Department to create a more appropriate classification for the above-mentioned tasks. Once the classification is created, the Department will return to your Board to amend the salary resolution.
REFERENCE MATERIAL:
BAI #43, October 22, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
Appendix C
CAO ANALYST:
Sonia M. De La Rosa