Agenda

Return

C. 26

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	April 20, 2021

Contra

Costa

County

Subject:

Establish the Classification of Associate Medical Director-Exempt (VCS4) and Add Two Positions; and Cancel 3 Clinical Positions

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 04/20/2021

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
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Lauren Ludwig, (925) 957-5269
cc:	Sylvia WongTam Lauren Ludwig

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: April 20, 2021
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

ADOPT Position Adjustment Resolution No. 25702 to establish the classification of Associate Medical Director-Exempt (VCS4) at Salary Plan and Grade B85 1013 ($20,096 - $24,428) and add two (2) positions; cancel one (1) vacant Hospitalist-Exempt (VPT3) (represented) position #9978 at Salary Plan and Grade 1PX 1004 ($17,054 – $19,380) and two (2) vacant Primary Care Provider-LMTD-EX (VPT6) (represented) positions #9178 and #8234 at Salary Plan and Grade 1PX 1000 ($17,464 – $19,917) in the Health Services Department.

FISCAL IMPACT:

Upon approval, this request will result in an annual cost savings of approximately $61,503, which includes pension costs of $23,851. The addition of these new positions will be fully offset by eliminating three current, vacant positions. (Hospital Enterprise Fund I)

BACKGROUND:

There has been a significant increase in demand for various healthcare services over the past year due to COVID-19, resulting in a need for additional clinical leadership to help in the day-to-day management of different service areas; most notably, ambulatory care and inpatient care. A classification study was completed, during which comparable management classifications were identified in similarly structured external agencies. We found that all comparable organizations that currently have a Medical Director classification, also have some form of Associate/Assistant/2nd level Medical Director in place to support the overall management functions of organization. While Contra Costa County Health Services has been operating without this 2nd management level up to this point, with the increased healthcare demands since the onset of the coronavirus pandemic, this organizational structure is no longer sustainable to maintain operations within the department.

The Health Services Department is requesting to establish the classification of Associate Medical Director-Exempt, which is intended to add an additional layer of executive management to support the current Medical Director classification. This request also includes adding two positions; one of which will be assigned to support ambulatory care, and the other to support inpatient care. These new Associate Medical Director positions will help improve access to vital services, increase visits, oversee quality and improvement projects, manage physician and clinic service lines, support telehealth services, etc. This has been identified by the Chief Executive Officer, Contra Costa Regional Medical Center, Health Centers & Detention Health, as operationally critical in order to continue providing quality care to the communities we serve.

A salary study was conducted to determine the salary range for this new classification, which is in line with Contra Costa County's general salary structure for progression from one management level to the next. In addition, when comparing to similar classifications in external agencies, the suggested salary for the Associate Medical Director-Exempt will fall directly in line with both the mean and median in the field as a whole, allowing Contra Costa County to remain competitive in recruiting and hiring highly qualified talent for these new positions. In order to offset the cost of establishing and adding two positions, the department will be eliminating three vacant clinical positions (one Hospitalist-Exempt position and two Primary Care Provider-Limited-Exempt positions), which will ultimately result in an annual cost savings to the County.

CONSEQUENCE OF NEGATIVE ACTION:

If this action is not approved, the Health Services Department will have insufficient executive staff to properly maintain operational functions, which will result in decreased availability of critical health care services to the communities of Contra Costa County.