Agenda

Return

C. 48

To:	Board of Supervisors
From:	William Walker, M.D., Health Services
Date:	September 12, 2017

Contra

Costa

County

Subject:

Add four (4) permanent full-time positions in the Health Services Department.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 09/12/2017

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:

Shelanda Adams, 925-957-5263

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: September 12, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

ADOPT Position Adjustment Resolution No. 22149 to add two (2) full-time Health Plan Authorization Representative (VRTA) positions at salary plan and grade level 3RX-119 ($3,601 - $4,599) and two (2) full-time Registered Nurse (VWXG) positions at salary plan and grade level L32-1880 ($8,554 - $10,683) in the Health Services Department. (Represented)

FISCAL IMPACT:

Upon approval, this action has an approximate annual cost of $719,636 with a pension cost of $129,064 included. The cost of this action will be offset 100% by Contra Costa Health Plan member fees.

BACKGROUND:

Contra Costa Health Plan (CCHP) Authorizations/Utilization Management(UM)unit is requesting to add two permanent full-time Health Plan Authorization Representative and two permanent full-time Registered Nurse positions. The two (2) Health Plan Authorization Representative positions are needed to help alleviate the overwhelming amount of referrals sent into the unit. Contra Costa Medical Center (CCRMC) membership accounts for 70% of all requests that have been delegated in the past. The unit has seen an influx of over 2,400 new referrals per month since 02/2017 and is currently working seven (7) days a week with excessive overtime to meet state mandated turnaround time. Authorizations/UM unit is currently failing to meet the mandated turnaround time for their referral authorizations. Referrals and Prior Authorizations requests will continue to increase because of back log of services at CCRMC. The need to refer patients to contracted community providers has resulted in an increase of work for the Authorization/UM department. The two (2) Registered Nurse positions are needed due to an increase in the volume of work in the unit. On average, the unit is spending $13,000 a month on overtime, resulting in over $156,000 a year. Currently CCHP is unable to meet the mandated state turnaround requirements with the current staff, they are sending out over 200 deferrals per month. CCHP is currently failing to meet this mandated turnaround time of the referral authorizations. Referrals and Prior Authorizations requests will continue to increase because of back log of services at CCRMC increasing the need to refer RMC patients to contracted community providers resulting in added work for CCHP Authorization/UM.

CONSEQUENCE OF NEGATIVE ACTION:

If this action is not approved, the Contra Costa Health Plan Health Plan Authorizations/UM unit will not have adequate staff to meet the influx of referral care services, nor will the unit have enough staff to meet the mandated turnaround time for referral authorizations.