Title
Health and Human Services Agency and Human Resources Department recommending the Board:
1) Approve and adopt the revised Health and Human Services Agency department-specific class specification: Public Health Nursing Manager (title change from Community Public Health Nursing Division Manager); and
2) Adopt and authorize the Chair to sign Resolution 105-2021 to:
a) Approve the abovementioned title change; and
b) Approve the addition of one (1.0) Full Time Equivalent (FTE) Public Health Nursing Manager allocation and one (1.0) FTE Administrative Assistant I/II allocation in the Health and Human Services Agency.
FUNDING: 100% Epidemiology and Laboratory Capacity round-2 funding through December 2024.
Body
DISCUSSION / BACKGROUND:
On March 2, 2021, the Public Health Division was awarded a second grant award of $6,503,584 through the Epidemiology and Laboratory Capacity (ELC) for Prevention and Control of Emerging Infectious Diseases program. The grant is made available through the Centers for Disease Control and Prevention (CDC), however it comes to El Dorado County through the State of California as a pass-through. Per the State approved ELC work and staffing plan, the Health and Human Services Agency (HHSA) has worked with Human Resources to determine the appropriate classifications required to carry out the various COVID relief ELC work plan objectives, a Public Health Nursing Manager and an Administrative Assistant I/II.
Specific to the Public Health Nursing Manager classification, after discussion and consultation with the Public Health Division, Human Resources made revisions to the current Community Public Health Nursing Division Manager class specification to identify areas of clarification and improvement to better represent the utilization of this classification, as well as the qualifications, knowledge, and abilities to do such which are reflected in the updated class specification and titling. This position is necessary to fulfill the ELC work plan objectives because Public Health currently has only one manager position allocated to the entire division of 62 staff. The active manager position is a non-licensed classification, responsible for the Division’s Health Promotion programs. As Public Health Nurses make up approximately 66% of the division, and with only one active manager currently in the division who is non-licensed, a current management gap exists, creating challenges in ensuring adequate oversight of nursing staff in their day-to-day activities. This includes oversight of activities that are necessary to achieving ELC work plan objectives.
Specific to the Administrative Assistant I/II request, HHSA worked with Human Resources to perform a classification study which determined that this particular classification was most appropriate in South Lake Tahoe to support the Eastern Slope Public Health Communicable Disease program in meeting ELC work plan objectives and other various objectives required by the COVID relief funding. This position will provide programmatic support by coordinating Case Investigation and vaccination efforts. Additionally, it will enhance the division’s ability to track and monitor data, perform quality assurance, and maintain and update Communicable Disease policies and procedures.
The future of Public Health is headed in a direction where the capacity to respond to and mitigate emerging infectious diseases will remain a Federal and State priority. Stemming from the COVID response, updates to mandates and expectations have increased the complexity and demand of Public Health services, which are anticipated to continue evolving and changing. These described changes are creating an environment where the need for licensed, nursing management has never been greater. Additionally, the variety of grants related to COVID response received by the Public Health Division all have specific work plans and deliverables which require careful nursing oversight, enhanced coordination of case investigations and vaccination efforts, more regular and meticulous monitoring of data, and more, in order to maintain compliance. As such, the Public Health Division requests approval to add a licensed management position to our workforce to ensure that:
1) Nursing practices are adhered to and are compliant with healthcare laws and statutes;
2) Public Health Nurses and their scope of work are in alignment with all grant funding requirements; and
3) Necessary workforce development and capacity building is achieved so that Public Health can adequately respond to any future event while remaining compliant with Federal and State mandates and expectations(Public Health and Safety Staff, Pg. 20 ARPA Interim Final Rule).
Additionally, and as such, the Public Health Division requests approval to add an Administrative Assistant I/II position to ensure that:
1) The Eastern Slope has adequate coverage in the coordination of Case Investigation and vaccination efforts;
2) El Dorado County data is maintained and monitored, effectively; and
3) Quality Assurance work is conducted regularly to continually improve Public Health processes and services, for the benefit of the community.
By approving these staff allocation requests, the ELC grant can ensure that the Public Health Division establishes an enhanced foundation of services for the community through December 2024. By Fiscal Year 2024-2025, ongoing funding is expected to be allocated to Public Health Departments across California by both the Federal and State Governments for the purpose of ensuring that investments made from ELC Rounds 1 and 2, American Rescue Plan Act (ARPA), Coronavirus Aide, Relief, and Economic Security (CARES) Act, and other COVID response grants are maintained to the greatest extent possible, thereafter. To maintain these positions thereafter, starting in January 2025, these new funding streams received by Public Health will be utilized to sustain the classifications. As needed, Public Health Realignment funding can also be used, only if necessary.
ALTERNATIVES:
Should the Board decline to adopt the attached Personnel Allocation Resolution, HHSA would be unable to meet ELC work plan objectives, putting at risk the grant award. Public Health would continue to provide services at the current levels, which is not only insufficient in meeting ELC grant obligations, it is insufficient to appropriately support nursing and other program activities required by the ongoing impact of COVID-19 and other emerging infectious diseases.
PRIOR BOARD ACTION:
June 22, 2021; Item 21-0994, Agenda No. 4; Resolution 064-2021- FY 2021-22 Personnel Allocation
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Human Resources
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no impact to Net County Cost. These positions would be funded entirely by ELC Round-2 through December 31, 2024; thereafter, Public Health anticipates receiving additional, ongoing funding by Fiscal Year 2024-2025 from the State and Federal Governments to support Public Health mandates. Starting in January 2025, those new funding streams would be utilized to pay for these positions, thereafter. Only if necessary, Public Health Realignment funding could be used to support these positions as well. ELC Round-2 funding was included in the Fiscal Year 2021-22 Recommended Budget. Salary and benefit appropriations were added to the budget without adding allocations while the classification analysis was completed; so no budget amendment is necessary for these allocations.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on the attached Personnel Allocation Resolution.
2) Clerk of the Board to return one (1) certified copy of the signed Resolution to HHSA Contracts Unit at 3057 Briw Road, Placerville.
3) Clerk of the Board to submit one (1) certified copy of the signed Resolution to Human Resources (Jordan Meyer)
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Don Semon, Director