To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Add, cancel and increase the hours of positions in various classifications in the Health Services Department . (100% Hospital Enterprise Fund I).
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ADOPT Resolution No. 26204 to make the following represented position adjustments in Contra Costa Health Department:
1. Add two (2) Licensed Vocational Nurse (VT7G) 24/40 positions at salary plan and grade TAX-1287 ($5,329 - $6,805) and cancel one (1) vacant Licensed Vocational Nurse (VT7G) 40/40 position #7411 at salary plan and grade TAX-1287 ($5,329 - $6,805) in department 0540 and org 6417;
2. Add four (4) Community Health Worker I (VKWC) 40/40 positions at salary plan and grade TC5-0933 ($3,763 - $4,149) and cancel three (3) vacant Medical Social Worker II (X4VH) 40/40 positions #7911, #15712, and #15713, at salary plan and grade 255-1590 ($7,458 - $9,066) in department 0540 and org 6518;
3. Increase the hours of one (1) Clerk - Experienced Level (JWXB) position #15782 and its incumbent EE#90420 from 32/40 to 40/40 at salary plan and grade 3RH-0750 ($4,013 - $4,979); and
4. Increase the hours of one (1) Registered Nurse (VWXG) position #15807 and its incumbent EE#91255 from 24/40 to 40/40 at salary plan and grade L32-1880 ($12,004 - $14,991).
FISCAL IMPACT:
Upon approval, this action will result in an annual cost savings of approximately $43,357.37, with pension costs of $6,334.06 already included. (100% Hospital Enterprise Fund I)
BACKGROUND:
The Health Services department is requesting the following actions to support operational needs in various units:
1. The Martinez Wellness Center has had immense difficulty hiring and retaining full-time Licensed Vocational Nurses (LVN’s). There have been multiple full-time LVN positions that have remained vacant despite continuous recruitment efforts; in addition, when full-time positions are filled, the department has noticed rapid turnover rates largely due to incumbents desiring to continue their education simultaneously. To attract and retain new staff, the Martinez Wellness Center is requesting to cancel one of their vacant full-time Licensed Vocational Nurse positions and add two part-time Licensed Vocational Nurse positions in its place. These positions will mainly be responsible for supporting the nursing workflow, facilitating patient care effectively, and assisting with making appointment reach out/reminder calls.
2. In December of 2022, the Department’s Medical Social Services Unit went through organizational changes and several positions were unfunded. After a thorough review of the unit’s current staffing and operational needs, it was determined that priority should be given to community outreach efforts and client support services. As such, Medial Social Services is requesting to add four Community Health Worker I positions, which would be responsible for arranging patient transportation; providing substance use resources; checking insurance coverage; and assisting with shelter/respite placement and the In-Home Support Services (IHSS) process. In addition, the unit has identified three vacant Medical Social Worker II positions that will be canceled to offset the cost of adding these new positions.
3. The Concord Health Center has seen an increase in incoming calls and patient referrals for outside specialty care in recent months. Because of the increased clerical work involved with processing these referrals in a timely manner, as well as ensuring that calls are answered and patient inquiries are addressed appropriately, the part-time incumbent of Clerk - Experienced Level position #15782 has consistently been working full-time hours. The incumbent has requested to permanently increase their hours from part-time to full-time, which the department has determined would be a benefit to operations.
4. The Martinez Wellness Center has been operating with low numbers of nursing staff, making it difficult to sustain daily clinical operations. Because of this, the part-time incumbent of Registered Nurse position #15807 has consistently been working full-time hours. The incumbent has requested to permanently increase their hours from part-time to full-time, which would allow them to continue providing additional support for patient lab result resourcing and patient education.
CONSEQUENCE OF NEGATIVE ACTION:
If not approved, the Martinez Wellness Center and Concord Health Center will continue to have insufficient staff to maintain operations, resulting in increased wait times for patients and longer turnaround times for processing requests. In addition, the Medical Social Services unit will continue to house vacant positions that are no longer needed, while not having the appropriate classifications to perform community outreach and patient support services.