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Adopt a resolution approving an amendment to the Alphabetical Listing of Classes and Salaries to add two new classifications with monthly salary ranges as follows: Chief Deputy Behavioral Health - $13,837.86 - $16,820.00, Chief Medical Officer - $20,943.83 - $25,457.36, and to delete the classification of Deputy Director H&SS - Medical Services Officer - $20,943.83 - $25,457.36; and Adopt a resolution approving an amendment to the Position Allocation List to: Delete 1.0 vacant FTE Deputy Director H&S - Medical Services Officer and add 1.0 FTE Chief Medical Officer
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Human Resources recommends that the Board of Supervisors adopt a resolution approving an amendment to the Alphabetical Listing of Classes and Salaries to add two new classifications with monthly salary ranges as follows: Chief Deputy Behavioral Health - $13,837.86 - $16,820.00, Chief Medical Officer - $20,943.83 - $25,457.36, and to delete the classification of Deputy Director H&SS - Medical Services Officer.
The Department of Human Resources also recommends that the Board of Supervisors adopt a resolution approving an amendment to the Position Allocation List to: Delete 1.0 vacant FTE Deputy Director H&S - Medical Services Officer and add 1.0 FTE Chief Medical Officer by August 9, 2020 to initiate the first-year actions to implement the proposed reorganization of the Department of Health and Social Services to support client/population-centric service delivery.
The 1.0 FTE position tentatively titled Behavioral Health Chief Deputy-TBD was approved on Resolution No. 2019-127 and will be classified as Chief Deputy Behavioral Health, removing the to-be-determined status
SUMMARY/DISCUSSION:
The Health and Social Services Department received Board approval of the proposed reorganization to create a more effective organizational structure and strengthened leadership to support client/population-centric service delivery, and associated position allocation changes on June 4, 2019. The Health and Social Services Department requested that Human Resources Department develop the classifications for the leadership positions needed to strengthen cross-functional leadership capacity. The new classifications of Chief Medical Officer and Chief Deputy Behavioral Health were developed as part of the first-year actions to implement the proposed reorganization.
The Department was allocated one full-time equivalent (FTE) position on resolution 2019-127 tentatively titled Behavioral Health Chief Deputy-TBD, which when classified as Chief Deputy Behavioral Health will remove the to-be-determined status. The Chief Deputy Behavioral Health will serve as the highest-level manager over behavioral health services for the County and report to the Director of Health & Social Services. The Chief Medical Officer (CMO) replaces the Deputy Director - H&SS Medical Services Officer to serve as CMO over the County’s clinic operations and will report to the new Chief Deputy Health Officer, a classification to be developed.
Behavioral Health has experienced a significant increase in oversight and increased program caseload. The Chief Deputy Behavioral Health position will be responsible to assist with this oversight. Examples of the oversite and expanded programs include: oversight of children’s Mental Health (MH), adult MH, acute and crisis MH services, Quality Management for the County Mental Health Plan, providing services through both County and contract agencies; MH Diversion from Courts which is a new caseload and involves more interaction with courts, Public Defenders, etc. and additional reporting, for both felony and misdemeanor crimes; oversight of programs and services associated with housing and homelessness, and the interaction of those issues with service delivery; No Place Like Home and other housing initiatives which require additional service contracts and service provision for clients placed (and commitment to services for 20 years); Drug Medi-Cal Organized Delivery System (ODS) oversight; this expansion of system of substance use disorder services through Partnership Health Plan requires substantial oversight of the contract and system of services; California Health Facilities Financing Authority (CHFFA) grant implementation (Beck campus building) which includes project coordination with County and contractors as the build occurs, then securing a vendor, contracting, and providing oversight; Department State Hospitals grant implementation for felony diversion program for high risk clients at risk of Incompetent to Stand Trial where clients require intensive services, close monitoring, and reporting to DSH; Assisted Outpatient Treatment (AOT)/Laura’s Law which was implemented locally and receives referrals from a variety of law enforcement, mental health providers, and family members; Intended implementation of Mobile Crisis program, dependent upon securing a successful proposer; increased interface with law enforcement regarding mental health clients and homeless clients; increased interaction with local hospital Emergency Departments due to statewide trend of more Behavioral Health clients presenting to hospital; and increased interaction with the Behavioral Health Directors Association due to numerous changing regulations and laws and monitoring potential legislation and impacts.
FINANCIAL IMPACT:
The anticipated net financial impact for these classifications is $201,840 annually in base wages, as well as any additional costs associated with taxes, benefits and negotiated cost of living adjustments. The cost will be funded with H&SS Intergovernmental Revenue (IGT). The costs associated with preparing the agenda item are nominal and absorbed by the Department’s FY2020/21 Preliminary Budget.
ALTERNATIVES:
The Board of Supervisors could elect to not amend the Alphabetical Listing of Classes and Salaries to add the classifications at the recommended salary ranges; however, this is not recommended as the Human Resources Department met its obligation under Government Code section 3500 et. Al. with Professional and Technical Engineers Local 21.
The Board of Supervisors could elect to not amend the Position Allocation List; however, this is not recommended as Health and Social Services Department has received direction from the Board to implement the approved reorganization to support client/population-centric service delivery.
OTHER AGENCY INVOLVEMENT:
Human Resources worked with staff from the Health and Social Services Department in creating the new class specifications of Chief Medical Officer, and Chief Deputy Behavioral Health.
On June 29, 2020, the Director of Human Resources notified all County bargaining units that the Director intended to assign the classifications of Chief Medical Officer, Clinic Operations Officer, Chief Deputy Behavioral Health, and Behavioral Health Operations Officer to bargaining Unit 19 - Executive and Senior Management.
On June 30, 2020, the Director of Human Resources notified Professional and Technical Engineers Local 21, the exclusive representative of bargaining Unit 19, of the proposed classifications and wages. Local 21 and the County met and conferred on July 9 and July 17, 2020, and July 24, 2020 regarding the proposed classification specifications and wages. The parties concluded the meet and confer process on July 24, 2020.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION