To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Reassign 21 Positions and their incumbents in a Substance Use Unit from the Public Health Division to the Behavioral Health Division in the Health Services Department
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ADOPT Position Adjustment Resolution No. 26203 to reassign:
• two (2) Mental Health Community Support Worker IIs (VQVB) and their incumbents in position numbers #16916 and #16917 in salary plan and grade TC5 0968 ($3,896 - $4,735);
• six (6) vacant Mental Health Clinical Specialists (VQSB) in position numbers #16439, #16919, #16918, #16920, #16921, #16922 in salary plan and grade TC2 1384 ($6,059 - $8,994);
• one (1) Mental Health Clinical Specialist (VQSB) and its incumbent in position number #16822 in salary plan and grade TC2 1384 ($6,059 - $8,994);
• nine (9) Substance Abuse Counselors (VHVC) and their incumbents in position numbers #16820, #16928, #16929, #16931, #16932, #16933, #16934, #16935, and #16937 in salary plan and grade TC5 1436 ($6,192 - $7,526);
• two (2) vacant Substance Abuse Counselors (VHVC) in position numbers #16927 and #16936 in salary plan and grade TC5 1436 ($6,192 - $7,526); and
• one (1) Substance Abuse Program Manager (VHGE) and its incumbent in position number #16843 in salary plan and grade ZA5 1750
from the Public Health Division to the Behavioral Health Division in the Health Services Department. (Represented).
FISCAL IMPACT:
All positions will reassign from PH 0450, cost center 5754 to BH 0467, cost center 5960. Upon approval, this action will incur a cost of $3,189,304 including pension costs of $465,924 for the Behavioral Health Division and a resulting cost savings for the Public Health Division in the same amount.
BACKGROUND:
In 2022, the State Department of Health Care Services (DHCS) initiated CalAIM in with the focus of improving the quality of life and health outcomes of Medi-Cal Members. An important feature of CalAIM was the implementation of the statewide availability of Enhanced Care Management (ECM) in the Medi-Cal managed care delivery system.
The Health Services Department has assessed its operational efficiencies of Medi-Cal service deliverables for clients with substance use hardships and severe mental disorders. As a result, the department decided to reassign the Substance Abuse program from the Public Health Division to Behavioral Health Division.
This reassignment is necessary due to the new model for Enhanced Care Management (ECM). ECM serves Medi-Cal patients with highly complex needs, including those with Substance Use Disorder and/or Severe Mental Illness. This category of clientele has much tighter linkages to the Behavioral Health Services System of care. The Behavioral Health Division has robust staffing with expansive clinical expertise and intensive supervision that will be tremendously beneficial to ECM participants. As such, to ensure the department can surpass its ability to provide the required level of care with the Department of Health Care Services, the department will reassign the Public Health Division’s Substance Abuse program to the Behavioral Health Division.
CONSEQUENCE OF NEGATIVE ACTION:
If the action is not approved, the department will not be able to accomplish its goal of expanding the most relevant clinical expertise to ECM participants.