Title
Adopt a Resolution to:
a. Amend the Monterey County Health Department’s Behavioral Health Bureau FY 2023-24 Adopted Budget (4000-023-HEA012-8410) to add one (1.0) FTE Departmental Information Systems Specialist (DISS) position, add six (6.0) FTE Behavioral Health Aide (BHA) positions, add two (2.0) FTE Public Health Vocational Nurse (PHLVN) positions, add three (3.0) FTE Social Worker III (SWIII) positions, reallocate two (2.0) FTE Psychiatric Social Worker II (PSWII) positions to two (2.0) FTE Senior Psychiatric Social Worker (Sr. PSW) positions, and reallocate one (1.0) FTE Social Worker III (SWIII) position to one (1.0) FTE Chronic Disease Prevention Coordinator (CDPC) position as indicated in Attachment A; and
b. Amend the Monterey County Health Department’s Public Health Bureau FY 2023-24 Adopted Budget (4000-001-HEA003-8124) to add two (2.0) FTE Health Program Coordinator (HPC) positions and one (1.0) FTE Chronic Disease Prevention Specialist II (CDPS II) position as indicated in Attachment A; and
c. Amend the Monterey County Health Department’s Administration Bureau FY 2023-24 Adopted Budget (4000-001-HEA014-8438) to add one (1.0) FTE Departmental Information Systems Coordinator (DISC) position, reallocate one (1.0) FTE Business Technology Analyst IV (BTAIV) position to one (1.0) FTE Business Technology Analyst II (BTAII) position, add two (2.0) FTE Personnel Analyst, and one (1.0) FTE Senior Personnel Analyst position, as indicated in Attachment A; and
d. Amend the Monterey County Health Department’s Clinic Services Bureau FY 2023-24 Adopted Budget (4000-001-HEA007-8592) to add one (1.0) FTE Clinic Operations Supervisor (COS) position, as indicated in Attachment A; and
e. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Behavioral Health Bureau FY 2023-24 Adopted Budget (4000-023-HEA012-8410); and
f. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Public Health Bureau FY 2023-24 Adopted Budget (4000-001-HEA003-8124); and
g. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Administration Bureau FY 2023-24 Adopted Budget (4000-001-HEA014-8438); and
h. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Clinic Services Bureau FY 2023-24 Adopted Budget (4000-001-HEA007-8592).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors Adopt a Resolution to:
a. Amend the Monterey County Health Department’s Behavioral Health Bureau FY 2023-24 Adopted Budget (4000-023-HEA012-8410) to add one (1.0) FTE Departmental Information Systems Specialist (DISS) position, add six (6.0) FTE Behavioral Health Aide (BHA) positions, add two (2.0) FTE Public Health Vocational Nurse (PHLVN) positions, add three (3.0) FTE Social Worker III (SWIII) positions, reallocate two (2.0) FTE Psychiatric Social Worker II (PSWII) positions to two (2.0) FTE Senior Psychiatric Social Worker (Sr. PSW) positions, and reallocate one (1.0) FTE Social Worker III (SWIII) position to one (1.0) FTE Chronic Disease Prevention Coordinator (CDPC) position as indicated in Attachment A; and
b. Amend the Monterey County Health Department’s Public Health Bureau FY 2023-24 Adopted Budget (4000-001-HEA003-8124) to add two (2.0) FTE Health Program Coordinator (HPC) positions and one (1.0) FTE Chronic Disease Prevention Specialist II (CDPS II) position as indicated in Attachment A; and
c. Amend the Monterey County Health Department’s Administration Bureau FY 2023-24 Adopted Budget (4000-001-HEA014-8438) to add one (1.0) FTE Departmental Information Systems Coordinator (DISC) position, reallocate one (1.0) FTE Business Technology Analyst IV (BTAIV) position to one (1.0) FTE Business Technology Analyst II (BTAII) position, add two (2.0) FTE Personnel Analyst, and one (1.0) FTE Senior Personnel Analyst position, as indicated in Attachment A; and
d. Amend the Monterey County Health Department’s Clinic Services Bureau FY 2023-24 Adopted Budget (4000-001-HEA007-8592) to add one (1.0) FTE Clinic Operations Supervisor (COS) position, as indicated in Attachment A; and
e. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Behavioral Health Bureau FY 2023-24 Adopted Budget (4000-023-HEA012-8410); and
f. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Public Health Bureau FY 2023-24 Adopted Budget (4000-001-HEA003-8124); and
g. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Administration Bureau FY 2023-24 Adopted Budget (4000-001-HEA014-8438); and
h. Authorize and direct the Auditor-Controller, Human Resources Department, and the County Administrative Office to incorporate these position changes in the Monterey County Health Department’s Clinic Services Bureau FY 2023-24 Adopted Budget (4000-001-HEA007-8592).
SUMMARY/DISCUSSION:
The Health Department (Department) requests the Board of Supervisors approval to amend its FY 2023-24 Adopted Budget to add new positions and reallocate others in response to receipt of new Future of Public Health (FoPH) funding to improve public health infrastructure and services, and business need to revise staffing model to better meet needs of primary care and behavioral health clients. The Department’s ongoing annual FoPH allocation is $2,563,477 resulting from the successful approval of the Public Health Equity and Readiness Opportunity Initiative by the State Legislature and Governor, which commits $200M to local health departments and $100M to the California Department of Public Health funded by State General Funds. This ongoing source of revenue will cover both, the operational and associated overhead costs.
Since the adoption of the FY 2023-24 budget, the Department was awarded the FoPH state funding and successfully competed for other grant funds, which have been brought individually to the BOS for acceptance. The FoPH funding is to support the rebuilding of local health department’s infrastructure. Through the Public Health Bureau, this funding provides the Department the opportunity to expand Violence and Injury Prevention efforts with the addition of 2.0 FTE (HPC and CDPC) positions and addition of 1.0 FTE (HPC) position to support its ability to meet requirements in the California Department of Public Health Office of AIDS and the Sexually Transmitted Disease Control Branch’s California Strategic Plan Implementation Blueprint. In the Health Administration Bureau, this funding will support the addition of three (3.0) FTE Human Resources (HR) positions to provide additional staff to meet the increased demand for services, and to better manage the high level of complex, critical, and necessary Departmental HR tasks and responsibilities, particularly increasing capacity, and efficiency to fill critical vacant positions and reduce the vacancy rate.
The Department seeks to add and reallocate positions using FY 2023-24 budgeted Departmental revenues. The Department seeks to add 1.0 FTE (COS) in the Clinic Services Bureau to better support the management needs of the Alisal Health Center. Additionally, the Department seeks to reallocate three (3.0) positions and add an additional 12.0 positions (Attachment A) to better meet the case management and medical needs of Behavioral Health Bureau consumers and to ensure compliance with the 21st Century CURES Act which requires enabling the patient portal of the electronic health record, compliance with meeting new 24/7 mobile crisis service Medi-Cal benefit, improving post hospitalization services in partnership with area hospitals, and system transformation required under CalAIM, including better supports for justice involved individuals to ensure Medi-Cal coverage post incarceration.
The Department continued to assess staffing needs and has identified additional position changes to meet operational needs. A request for the additional positions will be brought before the Board in the weeks ahead.
This recommended action supports the Monterey County Health Department 2018-2022 Strategic Plan Goals: 3) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services; and 4) Engage Monterey County Health Department workforce and improve operational functions to meet current and developing population health needs.
OTHER AGENCY INVOLVEMENT:
The Monterey County Administrative Office and the Monterey County Human Resources Department have reviewed and approved the proposed position reallocations and additions. This item was presented to and was supported by the Budget Committee at the November 17, 2023, Special Meeting.
FINANCING:
There is no impact to the General Fund contribution.
The cost of the additional Behavioral Health Bureau positions is estimated at $518,318 in FY 2023-24 and $1,280,615 in FY 2024-25 which will be financed by a combination of Federal Financial Participation, 2011 Realignment and Mental Health Services Act funds.
Clinic Services Bureau’s costs for the addition of one position is estimated at $94,774 in FY 2023-24 and $195,234 in FY 2024-25 which will be financed with Departmental revenues.
Health Administration’s additional costs for positions is estimated at $378,501 in FY 2023-24 and $730,559 in FY 2024-25 which will be financed by FoPH grant revenues and inter-departmental reimbursement.
The costs of the additional Public Health positions are estimated at $235,051 in FY 2023-24 and $493,608 in FY 2024-25 and will be financed by FoPH grant revenue in FY 2023-24 and by 1991 Health Realignment in FY 2024-25 and future years. Public Health Bureau will manage estimated cost increases within the Adopted Budget for FY 2023-24.
The Department will monitor its Adopted appropriations and revenues may seek an increase in for FY 2023-24 in the coming months. For FY 2024-25 and thereafter, costs and revenue will be part of the Department’s Requested Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability, and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses, and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Miriam Y. Mendoza, Finance Manager, 755-4622
Approved by:
___________________________________ Date _________________________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Attachment A - New Positions
Attachment B - Summary of Changes
Board Resolution