Agenda

Return

C. 47

To:	Board of Supervisors
From:	Anna Roth, Health Services
Date:	February 7, 2023

Contra

Costa

County

Subject:

Add 232 positions in varied classifications in the Health Services Department

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 02/07/2023

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Ken Carlson, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Jo-Anne Linares, (925) 957-5240
cc:	Linh Huynh Kathi Caudel

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: February 7, 2023
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

Adopt Position Adjustment Resolution No. 26116 to add 232 positions for a total of 219.18 Full Time Equivalent positions in varied classifications (represented) for the Detention, Public Health, Alcohol and Other Drugs, Contra Costa Health Plan (CCHP), and Contra Costa Regional Medical Center and Health Centers (CCRMC/HC) divisions in the Health Services Department as outlined in Attachment A.

FISCAL IMPACT:

If approved, the total salary and benefit cost for the Health Services Department will increase by approximately $39 million, which includes approximately $6 million in pension cost. The cost increase will be offset in the budget by a vacancy factor with no impact to the general fund subsidy. The cost breakdown by division is as follows:

FISCAL IMPACT: (CONT'D)

Health Services Division

Position Count

FTE Count

Salary Cost

Health, Dental, and other Salary and Benefits Cost

Pension Cost

Total

CCRMC/HC

186.00

173.38

22,101,700

6,406,669

5,185,501

33,693,870

CC Health Plan

16.00

1,113,745

478,584

261,307

1,853,637

Public Health

15.00

960,015

447,081

225,239

1,632,335

AODS

10.00

9.80

630,842

292,498

148,008

1,071,349

Detention

5.00

468,940

168,159

110,023

747,123

Total

232.00

219.18

$25,275,243

$7,792,992

$5,930,078

$38,998,313

The department is submitting fiscal year (FY) 2023-24 baseline and recommended budgets that include these positions. The positions when filled will be fully funded by various funding sources within the divisions, which include third party-revenue, increasing Medi-Cal reimbursements due to benefit expansions and the transition of Contra Costa Health Plan to a single plan model that will offset some of the costs for CCRMC/HC, CCHP and Behavioral Health, and reductions to registry, temporary employee, and overtime expenditures when permanent staff are hired into the positions. The addition of these positions will not require any change to the department’s existing budgeted County subsidy.

BACKGROUND:

The County Administrator’s Office advised Department Heads of the County’s transition to a position level budgeting and control that tracks authority for full-time equivalent (FTE) positions by department and job class. Departments obtain operationally necessary position authority through the annual budget process or by obtaining Board approval through Position Adjustment Resolutions. The Health Services Department has obtained position authority by both processes, while also maintaining the vacant unfunded positions that are typically eliminated through the budget process or administratively.

During the initial phase of the FY 2023-2024 budget development process, Health Services and the County Administrator’s Office worked through solutions to address the approximate 478 vacant FTEs the department unfunded during prior budget development cycles yet maintained in the position system of record (PeopleSoft). In December, the department identified a total of 80.97 vacant unfunded FTEs for elimination within the Public Health (36.68 FTE), California Children's Services (0.5 FTE), Mental Health (4.0 FTE), and CCRMC/HC (39.79 FTE) divisions. The department further reviewed their vacant unfunded positions during the salary and benefit forecasting budget activities for FY 2023-24 and identified 325.17 FTE in CCRMC/HC for elimination. This resulted in a total FTE count of 406.17 to be eliminated departmentwide.

The amount of FTE eliminations submitted by the department were done in error due to a misunderstanding over the revised process of handling unfunded vacant positions. Traditionally, vacant positions were removed from the department's recommended budget but remained available in PeopleSoft for the department’s immediate use as needed to address conversion of registry staff to permanent employment; filling positions to decrease the need for costly overtime; and hiring temporary and contractors on a permanent basis to address service level demands. Hiring permanent staff to fill these positions was always contingent on identified cost savings or the availability of external funding sources.

The department has determined there is a need to retain a portion of the previously eliminated positions in order to meet its operational needs. Accordingly, the department is submitting the attached Position Adjustment Resolution with a list of the 232 positions to be added for a total of 219.18 FTEs. The Board’s approval will provide the position authority the department has requested of the County Administrator’s Office and will eliminate position and FTE discrepancies currently in PeopleSoft due to the significant volume of vacant unfunded positions the department had previously maintained. Additionally, the department is engaging with County administrative staff to move forward with a more appropriate position management and control approach, which establishes vacancy factors within the budget to account for attrition and acknowledgment of the various staffing approaches the department utilizes to maintain operationally necessary staffing levels.

Approval of this request will allow the department to utilize the positions necessary for on-going operations and will require no change to the department’s existing budgeted County subsidy. As the department continues to engage in position reconciliation activities within its various divisions, it may bring further Position Adjustment Resolutions to the Board for consideration.

CONSEQUENCE OF NEGATIVE ACTION:

There will not be sufficient positions to meet the operational demands which adversely affect patient care services in Contra Costa.