Title
Adopt Resolution to:
a. Amend Personnel Policies and Practices Resolution (PPPR) No. 98-394 and Appendices A and B to create the classifications of Interventional Radiologic Technologist, Interventional Radiologic Technologist-Per Diem and Senior Interventional Radiologic Technologist with the salary ranges as indicated in the attached Resolution;
b. Amend Natividad (Unit 9600) FY 2021-22 Adopted Budget to approve reallocation as indicated by position numbers in Attachment A;
c. Authorize the Auditor-Controller to incorporate the approved changes in the Natividad (Unit 9600) FY 2021-22 Adopted Budget;
d. Direct the County Administrative Office to incorporate the new classifications and approved position changes in the Natividad (Unit 9600) FY 2021-22 Adopted Budget; and
e. Direct the Human Resources Department to implement the changes in the Advantage HRM System.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Adopt Resolution to:
a. Amend Personnel Policies and Practices Resolution (PPPR) No. 98-394 and Appendices A and B to create the classifications of Interventional Radiologic Technologist, Interventional Radiologic Technologist-Per Diem and Senior Interventional Radiologic Technologist with the salary ranges as indicated in the attached Resolution;
b. Amend Natividad (Unit 9600) FY 2021-22 Adopted Budget to approve reallocation as indicated by position numbers in Attachment A;
c. Authorize the Auditor-Controller to incorporate the approved changes in the Natividad (Unit 9600) FY 2021-22 Adopted Budget;
d. Direct the County Administrative Office to incorporate the new classifications and approved position changes in the Natividad (Unit 9600) FY 2021-22 Adopted Budget; and
e. Direct the Human Resources Department to implement the changes in the Advantage HRM System.
SUMMARY/DISCUSSION:
The Interventional Radiology department currently supports all interventional procedures performed within Natividad with the majority being outpatient procedures. An $18.4 million radiology upgrade to modernize and offer “state-of-the-art” technology has been underway since mid-December 2018 and is now in the final stages of completion. The upgrade is designed to reduce the movement of patients through the hospital and speed up the diagnosis process in support of the hospital’s Level II trauma center and other hospital services. With the addition of a new Interventional Radiology suite and a 3 Tesla MRI scanner, two 128-slice CT scanners and a SPECT-CT Nuclear Medicine camera, both the volume and complexity of radiologic procedures performed will be able to increase.
With the new, state-of-the-art technology, Natividad is preparing for the expansion of the interventional procedures service line to improve the support of the Trauma Center initiatives and stay ready to support future decisions to pursue a designation as either a Primary or Comprehensive Stroke Center. The availability of providing advanced imaging techniques, including MRI/MRA (magnetic resonance imaging/magnetic resonance angiography), CTA (computed tomographic angiography), DSA (digital subtraction angiography) and TCD (transcranial Doppler), on a 24/7 basis is all required for certification and will be possible if properly staffed once the modernization of the department is complete.
The new technology will enable the mobilization of both a cardiac catheterization lab that can perform tests and procedures including ablation, angiogram, angioplasty and implementation of pacemakers / ICDs as outpatient procedures to ensure door-to-balloon (D2B) time is measured and meeting the national standard (less than 90 minutes) and an interventional radiology lab that focuses on trying to improve minimally invasive, image-guided therapies.
Natividad currently utilizes the Radiologic Technologist classification within the Interventional Radiology department as that is the only classification that exists within Monterey County’s current structure for duties pertaining to diagnostic imaging. The Radiologic Technologist classification is generalized and incorporates all the various modalities of standard diagnostic imaging examinations performed throughout the hospital but does not address the specialization of interventional, neurovascular and vascular procedures that the Interventional Radiology department is responsible for supporting in the day-to-day operations of the department. Conditions of employment consist of registration with ARRT and state certification as a Radiologic Technologist along with one year of experience performing diagnostic imaging examinations in an acute care hospital setting with a requirement of the performance of standard x-ray procedures. Some familiarity with bone density, CT scan, MRI and mammography procedures is desirable.
Currently, there is no existing County of Monterey classification that describes the proposed Interventional Radiology Technologist (IRT) duties. The Interventional Radiology department requires staff that is dedicated to performing various interventional radiology procedures with IR physicians, assisting vascular surgeons with cases performed in the operating room, providing advanced scrub assistance, including patient positioning, prep, table set-up, draping, and supply selection during advanced procedures and performing 3-D reconstruction with CT images.
In accordance with the Monterey County Compensation Philosophy, a salary survey was conducted and three comparable positions were matched within the County’s list of comparable agencies with hospital facilities (a minimum of two matches is required for validity for hospital specific classifications) resulting in sufficient labor market data to formulate a market-based salary recommendation for the proposed journey level classification of Interventional Radiologic Technologist.
There is also a need to create a lead level classification of Senior Interventional Radiologic Technologist with a salary set by applying the existing spread between the journey and lead level classifications in the Radiologic Technologist classification series.
Natividad also recommends the creation of a per diem pay in lieu of benefits position for Interventional Radiologic Technologists in order to recruit and retain qualified employees. The salary recommendation for this new classification is proposed at 19% above the benefited salary range similar to the other per diem classifications utilized by the hospital.
Temporary Interventional Radiologic Technologists will be used when staff is unavailable for work (e.g., vacation, illness) in the Interventional Radiology Department in order to maintain appropriate staffing levels to provide essential services. This classification is needed to recruit, retain and appropriately compensate per diem employees for Natividad.
Lastly, Natividad recommends the reallocation of the 3.9 FTE Radiologic Technologist positions in the Interventional Radiology Department to the newly proposed classification of Interventional Radiologic Technologist and 1.0 FTE Radiologic Technologist position to the newly proposed classification of Senior Interventional Radiologic Technologist in the Interventional Radiology Department.
For these reasons, it is recommended that your Board approve these actions.
OTHER AGENCY INVOLVEMENT:
The Human Resources Department has reviewed and concurs with the recommendations. The Service Employees International Union (SEIU) Local 521 was notified and concurs with the recommendations.
FINANCING:
There is an annualized cost of approximately $129,139 as a result of these actions for Natividad Medical Center (Unit 9600) FY 2021-22 Adopted Budget. Approval of the above actions has no impact on the General Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This recommendation supports the Board of Supervisors’ Strategic Initiatives by providing consistent, high-quality patient care through County & hospital supported programs, and promoting access to equitable services to improve the mental health of patients in the community.
__Economic Development
__Administration
X Health & Human Services
__Infrastructure
__Public Safety
Prepared by:
Jennifer Lusk, Senior Personnel Analyst, (831) 783-2764
Approved by:
Janine Bouyea, Hospital Assistant Administrator, (831) 783-2701
Dr. Charles Harris, Interim Hospital Chief Executive Officer, (831) 783-2553
Attachment:
Attachment A
Resolution