To: Board of Supervisors
From: Ann Elliott, Human Resources Director
Report Title: ADOPT Position Adjustment Resolution No 26379 to Establish the Classification of Medical Social Worker II - Per Diem in the Health Services Department
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ADOPT Position Adjustment Resolution No 26379 to establish the classification of Medical Social Worker II - Per Diem (X4VJ) (represented) at salary plan and grade 255-1002 ($11,422.67) in the Health Services Department.
FISCAL IMPACT:
Establishing this per diem classification will incur varying costs depending on the department’s changing and unpredictable staffing needs. Various departmental funding sources.
BACKGROUND:
Contra Costa Health (CCH) operates the Contra Costa Regional Medical Center (CCRMC) and health centers which provides a well-known and sought after service in the community. CCRMC is the county’s 166-bed full-service hospital that operates 24 hours per day, seven days per week and is the central hub of Contra Costa Health's nine outpatient health centers.
CCRMC and the health centers are committed to providing its patients with safe, high-quality care that engages individuals in a positive care experience. Additionally, the hospital and health centers must adhere to mandated State and federal regulatory compliance requirements to maintain accreditations and recognitions. To accomplish this, CCH largely relies on meeting staffing needs to ensure there is adequate staff to provide the best and safest quality of care to patients and clients.
Through the years, to mitigate staffing shortfalls, CCH has utilized several staffing and registry contracts. These contracts have allowed CCRMC and the health centers to respond quickly to filling unexpected and unintended staffing gaps. Most recently, the department’s union and labor relations partners have raised strong concerns about the heavy utilization of staffing contractors used to perform work duties that would otherwise be performed by union represented employees. These partners have been persistent in their position that the department needs to lessen its use of staffing and registry contracts and redirect attention to hiring County employees to perform these duties.
Recruitment and retention difficulties and obstacles also challenge the department. The department’s recruitment efforts are centered around public sector recruitment methods which are based on merit system principles and structured rank-driven selection processes. The administrative time needed to adhere to these recruiting philosophies are often linear and time consuming. In conjunction, retention challenges often result because the department brings in entry-level permanent staff who find other career opportunities with healthcare competitors that can provide more lucrative compensation packages and employee perks. Again, in these cases, the staffing and registry contracts have assisted the department greatly in alleviating immediate staffing gaps.
After careful review, the department pursues to create per diem classifications for roles in nursing assistance, ancillary, and patient/client support services. Several advantages will emerge with the establishment of these per diem classifications. First, per diem scheduling is well-known to help in filling staffing shortfalls. By adding additional per diem classifications, the department will be better equipped to mitigate staffing needs for direct patient care operations. This is particularly beneficial to CCRMC, and other department facilities and programs that operate 24 hours per day, seven days per week (including detention health facilities, crisis response programs, etc.) Second, we anticipate applicant pools will increase as more potential candidates seeking per diem assignments will be attracted to apply for employment with CCH. Lastly, the department’s utilization of staffing and registry contracts will noticeably lessen since operational focus will redirect heavily towards normalized use of per diem employees to resolve scheduling needs.
CONSEQUENCE OF NEGATIVE ACTION:
If this request is disapproved, the department will continue to lack the resources to quickly remedy staffing shortages in CCRMC and the health centers. Moreover, the department will continue regular utilization of staffing and registry contracts and temporary and agency staff.