Title
Adopt a Resolution to:
a. Amend the Monterey County Health Department’s Behavioral Health Bureau Fiscal Year (FY) 2022-23 Adopted Budget (4000-023-HEA012-8410) to reallocate one (1.0) Full-Time Employment (FTE) Psychiatric Social Worker II (PSWII) position to one (1.0) FTE Social Worker III (SWIII), reallocate one (1.0) FTE Behavioral Health Group Counselor II (BHGCII) to one (1.0) FTE Social Worker III (SWIII), add two (2.0) FTE Patient Services Representative II (PSRII), add one (1.0) FTE Management Analyst II (MAII), and reallocate one (1.0) FTE Patient Financial Services Specialist II (PFSSII) to one (1.0) FTE Senior Patient Financial Services Specialist (SPFSS) as indicated in Attachment A; and
b. 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 2022-23 Adopted Budget (4000-023-HEA012-8410).
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 2022-23 Adopted Budget (4000-023-HEA012-8410) to reallocate one (1.0) FTE Psychiatric Social Worker II (PSWII) position to one (1.0) FTE Social Worker III (SWIII), reallocate one (1.0) FTE Behavioral Health Group Counselor II (BHGCII) to one (1.0) FTE Social Worker III (SWIII), add two (2.0) FTE Patient Services Representative II (PSRII), add one (1.0) FTE Management Analyst II (MAII), and reallocate one (1.0) FTE Patient Financial Services Specialist II (PFSSII) to one (1.0) FTE Senior Patient Financial Services Specialist (SPFSS) as indicated in Attachment A; and
b. 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 2022-23 Adopted Budget (4000-023-HEA012-8410).
SUMMARY/DISCUSSION:
The Monterey County Health Department’s Behavioral Health Bureau (BHB) is requesting the reallocation of 1.0 Psychiatric Social Worker II (PSWII) to a 1.0 Social Worker III (SWIII), the reallocation of a 1.0 Behavioral Health Group Counselor II (BHGCII) to a 1.0 SWIII, the addition of 2.0 Patient Services Representative II (PSR II), the addition of 1.0 Management Analyst II (MAII) and the reallocation of 1.0 Patient Financial Services Specialist II (PFSSII) to 1.0 Senior Patient Financial Services Specialist (SPFSS) in order to address ongoing needs in the Bureau.
The BHB currently has 194 PSWII positions, of which 148 are filled and 46 are vacant. The request to reallocate a vacant PSWII to a SWIII is due to sustained needs within the Quality Improvement department to support the clinical development, implementation, and quality monitoring of Specialty Mental Health and Drug MediCal services across Monterey County in accordance with new CalAIM mandates. This position will also provide critical coverage to Patient Right’s Advocacy needs.
The BHB currently has 1 BHGCII position which is currently vacant. The request to reallocate a vacant BHGCII to an SWIII is due to the fact that demand for Mental Health Services continues to increase in both quantity and severity. Clinical staff requires support at a level outside of the scope of a Behavioral Health Group Counselor, particularly in the areas of case management and linking clients to community resources. Without this reallocation, operations will be inefficient and unable to meet the needs of the community, as clinical positions will have to absorb lower-level duties. This Social Worker III position will add support for clients and clinical staff and is vital in helping meet the increasing demand for behavioral health treatment.
The BHB currently has 17 PSRII positions, of which 15 are filled and 2 are currently vacant. The request to add 2 additional PSRII positions is a necessary improvement to client care to support the Child and Adolescent System of Care. These PSR's will support staff and processes in the delivery of psychiatric services to those with behavioral health needs throughout the county. This will create increased efficiency, provide acceptable workloads for all PSR staff, and will allow clinicians more time to provide clinical care.
The BHB currently has 11 MAII positions, of which 9 are filled and 2 are currently vacant. The request to add 1 additional MAII position is to provide ongoing program services coordination, implementation, and evaluation of Behavioral Health Children's System of Care (CSOC). Numerous legislative mandates and CSOC Grants require increased levels of program evaluation and analysis activities, contract management, and program development. This position will work closely with the Deputy Director of CSOC, Behavioral Health Services Managers, and the Finance Manager.
The BHB currently has 5 PFSSII positions of which 4 are filled and 1 is currently vacant. The request to reallocate this vacant PFSSII to a SPFSSII is needed within the Bureau’s billing department. When CalAIM payment reform goes into effect on 7/1/2023, there will be a greatly increased need to update training materials and provide on-demand training and troubleshooting support to the billing team beyond the capacity available from current personnel. There will be an additional need to resolve older claims that will still follow previous billing rules and material while making active workflow changes to streamline the revenue cycle for the bureau.
As shown in Attachment A, the combined costs of the requested position changes are estimated at $90,988 for FY 2022-23, assuming a hiring date of April 8, 2023, and the full costs for FY 2023-23 are estimated at $406,793.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan Initiative: 1, Empower the community to improve health; and 2, Enhance public health and safety through prevention. It also supports one or more of the ten essential public health services, specifically: 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable, and 8. Assure a competent public and personal health care workforce.
OTHER AGENCY INVOLVEMENT:
The Human Resources Department have reviewed and approved the proposed position reallocations and additions. This item was supported by the Monterey County Board of Supervisors’ Budget Committee at its January 25, 2023, meeting.
FINANCING:
There will be no impact to the General Fund from approval of this action. The estimated cost increases will be financed with a mix of revenues which may include Medi-Cal, Realignment, Mental Health Services Act (MHSA), and grant funds. There are sufficient appropriations in the BHB’s FY 2022-23 Adopted Budget to accommodate the increase costs $90,988), and for FY 2023-24 the full increase costs of the positions ($406,793) will be included in the FY 2023-24 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: Jon Drake, Assistant Bureau Chief, 755-4357
Approved by:
______________________________Date:_________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Board Report
Attachment A
Resolution