Title
Adopt a Resolution to:
a. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 2.0 FTE Health Education Assistants as indicated in the Attachment A; and
b. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 1.0 FTE Patient Services Representative II as indicated in the Attachment A; and
c. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 1.0 FTE Senior Clinic Nurse as indicated in the Attachment A;
d. Amend the (FY) 2019-20 Natividad Medical Center Budget 451-NMC001-8328 to delete the 1.0 FTE Outpatient Services Manager II, 1.0 FTE Patient Account Representative II, 1.0 FTE Health Education Assistant, 1.0 FTE Nurse Practitioner II, 1.0 FTE Licensed Vocational Nurse, 1.0 FTE Nursing Assistant, 1.0 FTE Clinics Operations Supervisor, and 1.0 FTE Psychiatric Social Worker I; and
e. Direct the County Administrative Office and the Auditor-Controller to incorporate the position changes in the FY 2019-20 Adopted Budget and the Human Resources Department to implement the changes in the Advantage HRM system. (4/5TH vote required).
Report
RECOMMENDATION:
Adopt a Resolution to:
a. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 2.0 FTE Health Education Assistants as indicated in the Attachment A;
b. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 1.0 FTE Patient Services Representative II as indicated in the Attachment A; and
c. Amend the Fiscal Year (FY) 2019-20 Health Department Budget 4000-HEA007-8098 to add 1.0 FTE Senior Clinic Nurse as indicated in the Attachment A; and
d. Amend the (FY) 2019-20 Natividad Medical Center Budget 451-NMC001-8328 to delete the 1.0 FTE Outpatient Services Manager II, 1.0 FTE Patient Account Representative II, 1.0 FTE Health Education Assistant, 1.0 FTE Nurse Practitioner II, 1.0 FTE Licensed Vocational Nurse, 1.0 FTE Nursing Assistant, 1.0 FTE Clinics Operations Supervisor, and 1.0 FTE Psychiatric Social Worker I; and
e. Direct the County Administrative Office and the Auditor-Controller to incorporate the position changes in the FY 2019-20 Adopted Budget and the Human Resources Department to implement the changes in the Advantage HRM system. (4/5TH vote required).
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Health Department) operates ten newly designated Federally Qualified Health Center (FQHC) primary care clinic sites which provide preventive, primary, and specialty medical care services. Operating FQHC clinics provides the opportunity for the County to serve the most vulnerable populations in the community with eligibility to access to federal funding under Section 330 of the Public Health Service Act for the purpose of enhancing and increasing medical service delivery to Monterey County residents.
The new FQHC clinics’ designation was achieved after the County’s successful application for a New Access Point Grant (NAP) through the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA). A NAP is a new service delivery site offering comprehensive primary health care services to underserved populations. As part of the Health Department’s application, Natividad Immunology Division Outpatient (NIDO) was proposed as a new service delivery site, in addition to the Health Department’s existing nine clinics.
On September 11, 2019, the Health Department received notification from HRSA that the Health Department was awarded the NAP Grant in the amount of $650,000 per year from September 1, 2019 through August 31, 2021, totaling $1.3 million. As a result of this award, the Health Department clinics and NIDO clinic were designated as FQHC Grantees. However, in order for the NIDO clinic to transition as a FQHC site under this grant, management of the clinic had to be transferred to the Health Department. Accordingly, on November 19, 2019, the Board of Supervisors approved the transfer of management of the NIDO clinic from Natividad Medical Center (NMC) to the Health Department.
Following the Board’s transfer of management approval, the Health Department, NMC, labor groups, County Employee Relations, and NIDO employees have discussed the transfer of NMC employees to the Health Department and have worked together to develop a staff transition plan for the continuation of primary care services at the NIDO clinic.
The NIDO clinic at NMC was staffed with seven (7) employees. This included approximately two (2) Health Education Assistants; two (2) Patient Service Representative II; one (1) Senior Clinic Nurse; one (1) Medical Assistant; and one (1) Clinic Operations Supervisor. The Health Department already has one Medical Assistant, one Patient Service Representative II and one Clinic Operations Supervisor position vacant and available to use for the transfer. Action items a-c in this report request the approval to add the remaining allocations of positions required to complete the transfer of the NIDO clinic to the Health Department which include two (2) Health Education Assistants; one (1) Patient Service Representative II; and one (1) Senior Clinic Nurse. Action item d removes all the allocations allocated to the NIDO clinic from Natividad’s budget.
Approval of the recommended actions in this report will complete the execution of this staff transition plan and will facilitate the transfer of NMC employees who have agreed to transfer to the Health Department. Any NMC employee who has decided to remain at NMC will remain at NMC in the same job classification. This transfer of existing staff will allow for the continuous provision of patient care without disruption to patients. The Budget Committee supported the recommended actions during their February 26, 2020 meeting.
OTHER AGENCY INVOLVEMENT:
The Health Department has worked with SEIU and the Monterey County Registered Nurses Association (MCRNA) to address questions and concerns of NIDO employees regarding the transfer. The County Administrative Office Budget Office, Auditor-Controller, County Counsel, and Human Resources have reviewed the recommendations. The Budget Committee supported the recommended actions during their February 26, 2020 meeting.
FINANCING:
The Health Department was awarded the HRSA NAP grant in the amount of $650,000 per year from September 1, 2019 through August 31, 2021, totaling $1.3 million. As an FQHC Grantee, the County clinics have the opportunity to apply for additional funding to enhance services provided to the community. The FY 2019-20 Health Department Budget includes sufficient appropriations and corresponding revenues to cover costs associated with the approval of this action. Therefore, there will be no financial impact to the General Fund resulting from the approval of the recommended actions.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Mark a check to the related Board of Supervisors Strategic Initiatives
X Economic Development: Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
X Administration: Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
X 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: Sheena Morales, Management Analyst III, 755-1393
Approved by:
______________________Date:_________
Elsa Jimenez, Director of Health, 755-4526
Gary Gray, NMC Chief Executive Officer
Attachment:
Resolution on file with the Clerk of the Board