Agenda

Return

C. 27

To:	Board of Supervisors
From:	William Walker, M.D., Health Services
Date:	September 26, 2017

Contra

Costa

County

Subject:

Add Nutrition Assistant positions in the Health Services Department

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 09/26/2017

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

ABSENT:

Federal D. Glover, District V Supervisor

Contact:

Jo-Anne Linares, 957-5240

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 26, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

ADOPT Position Adjustment Resolution No. 22163 to add nineteen (19) full-time Nutrition Assistant positions (1K7B) at salary plan and grade level TC5-1086 ($3,494 - $4,247) in the Health Services Department. (Represented)

FISCAL IMPACT:

Upon approval of this action, an annual cost of approximately $1,457,624 with $343,752.18 in pension costs already included. Since the Department is transitioning to the Women, Infant and Children's Program Nutritionist Assistant model, the cost will immediately be offset by approximately $1,406,398 due to the subsequent cancellation of clerical and community health worker positions as explained in the background section of this Board Order. The remaining annual cost of approximately $51,226 will be further offset with Women, Infant and Children's Program revenues.

BACKGROUND:

The Women, Infant and Children's Program (WIC) within the Public Health Division is a federally funded preventive and supplemental nutrition program providing basic nutrition education, breastfeeding support, healthy food vouchers, and community resources referrals to eligible participants. It operates in four sites located in Concord, Brentwood, Pittsburg and Richmond. The program staff consists of varied classifications including Clerk-Sr Level, Community Health Worker I & II, Home Economist and Public Health Nutritionist. The program utilizes a 'two-step' process with clerical staff reviewing applications, and nutritionists completing the assessments and nutrition education of all participants.

In January 2015, the State WIC Program Reviewers surveyed the County WIC Program and strongly recommended the adoption of the State's WIC Nutrition Assistant (WNA) model to improve program efficiencies. The WNA model is a one-step process with the expanded role of certified Nutrition Assistants in processing all low-risk participants while the Nutritionists process the high-risk participants. By April of 2015, staff completed the required 8-month training and became WNA certified. In September 2015, the County's Nutrition Assistant classification was updated to include the WNA assignment. At present, the Department has finally completed the necessary steps to move forward in adopting the State model with the addition of these positions and transition of staff. Duties and responsibilities include determining eligibility of applicants, providing basic nutrition education, referring high risk participants to the Public Health Nutritionists, promoting and supporting breastfeeding, offering community resources and participating in outreach activities.

Contra Costa County WIC Program is the last local agency to adopt the State WNA model. Effective October 1, 2017, the new one-step process will enhance program efficiency by reducing the total wait time for participants, decreasing redundancy in the steps, and increasing accuracy and timely overall nutrition assessment and education to program participants. The Department has discussed the WIC program restructure with staff and their respective unions and agreements have been reached on transfer opportunities, including the Nutrition Assistant positions requested in this Board Order. Once the Nutrition Assistant positions are filled by staff transfers, the Department will return to the Board in October to cancel the vacant clerical and community health worker positions.

CONSEQUENCE OF NEGATIVE ACTION:

If this action is not approved, the County WIC Program will continue utilizing an outdated 'two-step' process with lengthy wait time for its participants, and under utilize trained and certified staff.