The total cost of the position is $500,000, including $98,000 in pension costs. The position is budgeted within the Hospital Enterprise Fund I.

It is recommended that the unrepresented classification of Director of Health Services-Exempt (VCA1) be reallocated from a single step class ($17,944.42) to a three step class ($28,025.27 to $30,897.86).  
  
The County retained Neher and Associates to recruit for a new Health Services Director. The job announcement was advertised on-line and with a wide variety of organizations (over 70) including organizations such as the American Public Health Association (APHA), the American Hospital Association (AHA), the National Association of Health Services Executives (NAHSE), the American College of Healthcare Executives (ACHE), the Medical Group Management Association (MGMA), American Association of Managed Care Nurses (AAMCN), National Hispanic and other Medical Associations, California and numerous other State Hospital Associations, National Association of Healthcare Leaders, the National Association of County & City Health Officials (NACCHO) and many more. Job announcement brochures were also e-mailed or mailed to a large number of Professional Associations and individuals as part of the recruitment/networking.]. Over 104 candidates applied by the final filing date of the recruitment. Neher and Associates screened applicants and 15 leading candidates were forwarded to the County for review. Seven semi-finalists were then selected for additional interview on December 15, 2017, with the County Selection Committee comprised of David Twa, County Administrator, Dianne Dinsmore, Director of Human Resources, Jeff Smith, County Executive, Santa Clara County, and Rebecca Rozen Regional Vice President, Hospital Council of Northern & Central CA. Interviews were held on December 15, 2017. Following those interviews, three finalists were forwarded to the Board of Supervisors for consideration.  
  
Ms. Roth has served as Chief Executive Office of Contra Costa Regional Medical Center and Health Centers for nine years. She holds a master’s degree from the University of California, San Francisco, and a Master in Public Health from Harvard University. She is a registered nurse with more than 30 years of health care experience and is an Institute for Healthcare Improvement Quality Improvement Fellow. Ms. Roth is a leader in system redesign and innovation and a strong advocate for the inclusion of patients, families and the community as full partners in the delivery of health services. In addition to Ms. Roth’s healthcare experience, she has also held executive leadership roles locally, statewide and nationally as board member and chair of both the Essential Hospitals Institute and the California Health Care Safety Net Institute. Roth is also a lecturer at the UC Berkeley School of Public Health.  
  
I am recommending Anna Roth be appointed Health Services Director at Step 1 of the salary range effective February 1, 2018.  
  
I am also recommending Ms. Roth be appointed to the Office of Public Guardian and the Office of Public Administrator effective February 1, 2018. These appointments are required to be made by resolution. Attached Resolution No. 2018/61 fulfills that requirement.  
  
This action also find that the best interests of the County are served by this waiver of the requirement of county residency for the appointment of this county officer, as authorized by Government Code section 24001.

The position will remain vacant causing continued stress on the administration of the department.