To: County of Sonoma Board of Supervisors and Board of Commissioners of the Community Development Commission
Department or Agency Name(s): Department of Health Services and Sonoma County Community Development Commission
Staff Name and Phone Number: Barbie Robinson, 565-7876
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Department of Health Services and Community Development Commission Staffing Allocations
End
Recommended Action:
Recommended action
A) Adopt a personnel resolution amending the Department of Health Services allocation list, adding 11.0 full-time equivalent positions, adding 1.0 time-limited full-time equivalent position, and deleting 2.0 full-time equivalent positions as detailed in the attached resolution, effective December 15, 2020.
B) Adopt a personnel resolution amending the Sonoma County Community Development Commission allocation list, adding 2.00 full-time equivalent positions and 1.00 time-limited full-time equivalent position as detailed in the attached resolution, effective December 15, 2020.
C) Adopt a resolution adjusting the fiscal year 2020-2021 adopted budget by increasing revenues and expenditures in the Department of Health Services by $937,986 to support additional position allocations. (4/5th Vote Required)
end
Executive Summary:
The Department of Health Services and the Community Development Commission have identified a number of position allocations that are necessary to meet client needs, and goals, objectives and strategies. For the Department of Health Services Behavioral Health Division to meet Mental Health Plan Final Rule regulations and to continue implementing the goals, objectives and strategies detailed in the Department’s Strategic Plan, the Department of Health Services is requesting the following positions (class title, full-time equivalent (FTE) allocation): 1) Patient Care Analyst (1.0 FTE), 2) Program Planning and Evaluation Analyst (1.0 FTE), 3) Administrative Aide (2.0 FTE), 4) Senior Office Assistant (2.0 FTE), and 5) Adult, Youth And Family Services Section Manager (2.0 FTE). The Department of Health Services is also requesting the following positions for the Administration Division (class title, full-time equivalent (FTE) allocation): 1) Program Planning and Evaluation Analyst (2.0 FTE, one time-limited), 2) Accountant II (1.0 FTE), and 3) Administrative Services Officer II (1.0 FTE). In addition, the Department of Health Services is requesting the deletion of the following Behavioral Health Division positions (class title, full-time equivalent (FTE) allocation): 1) Behavioral Health Clinical Specialist (1.0 FTE, vacant) and 2) Secretary (1.0 FTE, vacant).
Community Development Commission positions being requested are as follows (class title, full-time equivalent (FTE) allocation): 1) Administrative Aide (1.0 FTE, time-limited), 2) Department Analyst (1.0 FTE), and 3) Department Information Systems Technician II (1.0 FTE).
This report provides details regarding the need, job duties, and funding of each position.
Discussion:
The Department of Health Services and the Community Development Commission have identified a number of position allocations that are necessary to meet client needs, and goals, objectives and strategies. A total of 12.0 full-time equivalent positions, one of which is time-limited, are being requested for the Department of Health Services. A total of 3.0 full-time equivalent positions, one of which is time-limited, are being requested for the Community Development Commission. In addition, a total of 2.0 full-time equivalent positions, both vacant, are to be deleted as part of this item. The requested effective date for all position changes is December 15, 2020. This report provides details regarding the need, job duties, and funding of each position.
Department of Health Services - Behavioral Health Division Administration
A) Patient Care Analyst Addition - Funded with Mental Health Services Act Community Services.
B) 2.0 Adult, Youth and Family Section Manager Addition - Funded with Direct Service MediCal Federal Financial Participation, Mental Health and/or Behavioral Health Realignment and Mental Health Plan Utilization Review Funding.
C) 1.0 Behavioral Health Clinical Specialist Deletion
A) Patient Care Analyst
The Department is requesting the addition of a Patient Care Analyst to lead the Mental Health Services Act Workforce Education and Training Program, including coordinating a Masters Level Student Internship Program, and Cultural Responsiveness Committee as the Division’s Diversity, Equity and Inclusion Manager.
B) Adult, Youth and Family Section Managers
The current Adult and Acute & Forensic Services Section Manager has administrative responsibility for over 25 programs and service contracts, which is far more than 1.0 FTE can adequately administer. The new Adult Services Manager (AYFS Section Manager) position will allow the Division to split these services between two positions: Adult Services Section Manager & Acute and Forensic Services Section Manager.
C) Behavioral Health Clinical Specialist
The Department is also requesting deletion of vacant Behavioral Health Clinical Specialist position.
The Youth and Family Services Section is currently being overseen by the BH Division Director, acting in dual roles as the Section Manager. The new Youth Section Manager (AYFS Section Manager) position will allow the Division to adequately support the Youth Services programs and allow the Division Director to focus on Division strategic priorities and initiatives.
With more appropriate workloads, the Division will provide stronger administrative support to the programs, improving their performance across clinical and operational functions. These positions will allow us to provide improved administrative support and oversight designed to track programs’ performance relative to meeting mandates, hitting budget and performance targets, identifying client and program risks, directing HR and staff coaching activities, and supporting program improvement.
The Adult, Youth and Family Services Section Managers will have management responsibility for programs that promote mental health recovery and wellness through treatment, advocacy and education especially as it relates to high risk adults, youth and families. Incumbents will organize, plan and supervise all programs and services provided by the section; ensure efficient operation of the section; monitor programs and services through data collection; develop, interpret, and apply policies and procedures for the program areas; and participate in administrative and planning meetings with the Division Director Under the general direction of the Behavioral Health Director, these positions will supervise and direct program managers and other multi-disciplinary staff providing behavioral health services. These positions negotiate and monitor contracts for mental health services; act as a consultant to the Behavioral Health Director, other sections, and other organizations on matters related to client services; provides training to departmental staff in program areas; and works with community collaborative partners such as Education, County Human Services, and the Probation Department to plan and implement behavioral health services to shared clients. Section Managers may provide coverage for the Behavioral Health Director during vacations and/or absences.
Department of Health Services - Behavioral Health Division Quality Assurance and Performance Improvement (QAPI) Section
A) Program Planning and Evaluation Analyst, Funded with 25% 2011 Realignment and 75% state and federal funds through the Mental Health Plan Utilization Review and Administrative Billing processes.
B) Administrative Aide, Funded with 25% 2011 Realignment and 75% state and federal funds through the Mental Health Plan Utilization Review and Administrative Billing processes.
C) Senior Office Assistant, Funded with 25% 2011 Realignment and 75% state and federal funds through the Mental Health Plan Utilization Review and Administrative Billing processes.
On April 25, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the Medicaid and CHIP Managed Care Final Rule (2016 Final Rule), which aligns the Medicaid managed care program with other health insurance coverage programs. In California, the 2016 Final Rule regulations are applicable to Medi-Cal Managed Care Plans, County Mental Health Plans, Drug Medi-Cal Organized Delivery System, and Dental Managed Care Plans. In order to fulfill and maintain these new State and Federal regulatory requirements, the Department has determined that it needs to hire additional Quality Assessment & Performance Improvement (QAPI) staffing resources.
As part of this, the Behavioral Health Division will be tasked with additional activities, including but not limited to the following:
• Performance Improvement Projects specified by the state and, if applicable, CMS;
• Collection and submission of performance measure data to the state;
• Evaluate and update mechanisms to detect under and over utilization of services;
• Ongoing assessment of the quality and appropriateness of care furnished to enrollees with special health care needs;
• Develop a methodology for overpayment requirements, and a process for monitoring the annual report of overpayment recoveries;
• Adopt and disseminate evidence-based clinical practice guidelines;
• Each MHP must follow a documented process for credentialing and re-credentialing of network providers;
• Developing and implementing procedures and processes for tracking, reporting and monitoring beneficiary requests for service, notices of adverse beneficiary determinations, grievances and appeals.
• New mandatory activity including validation of MCO, PIHP, and PAHP network adequacy during the preceding 12 months; and
• New EQRO-related activity to assist with the quality rating of MCOs, PIHPs and PAHPs consistent with the Quality Rating System;
These new Final Rule requirements have already been published by DHCS and CMS, and the Behavioral Health Division is in immediate need of resources to bring the Division into compliance. Continued inability to meet these requirements under mandated regulations and contractual agreements put the County at high-risk for fines and suspension of federal and state payments for services.
In order to meet the needs of these Federal and State requirements, the Division is requesting additional staffing resources: that specialize in complex evaluation and analysis of systems, data, policies and regulations; provide technical administrative support; and technical clerical office support.
A) Program Planning and Evaluation Analyst
The 1.0 FTE Program Planning and Evaluation Analyst (PPEA) position will provide complex data gathering and analysis of systematic evaluations. Incumbent will provide technical assistance to contractors and county employees, and will be tasked with developing applicable policies and procedures regarding the new mandates and how the programs either operated by or on behalf of the County comply with the new requirements. Incumbent will act as the Division’s subject matter expert regarding Medicaid Managed Care Final Rule and, as such, they will be responsible for reviewing current and future DHCS Information Notices and/or regulatory updates regarding Final Rule for content analyses to determine any necessary action steps for the Division, and will provide recommendations on necessary changes and approaches.
Within the QAPI section, the PPEA is expected to spend 70% of their time supporting Quality Improvement unit and 30% of their time supporting the Auditing and Monitoring unit. The PPEA will:
• Design and develop database systems to support implementation and monitoring of Final Rule requirements.
• Extract and analyze system data for various reporting including state requirements.
• Participate in the optimization of the electronic health record to meet the requirements of Final Rule, including report design and data dashboards.
• Produce public facing reports utilizing technical writing skills.
• Provide complex data gathering and analysis of systematic evaluations.
• Provide technical assistance to contractors and county employees, and will be tasked with developing applicable policies and procedures regarding the new mandates and how the programs either operated by or on behalf of the County comply with the new requirements.
B) Administrative Aide
The 1.0 FTE Administrative Aide position will perform paraprofessional and technical administrative work in support of the QAPI team to successfully fulfill and maintain new State and Federal regulatory requirements. Incumbent will coordinate complex agendas and subsequent work plan/action items for multiple QAPI policy workgroups, maintain Mental Health Plan and Drug Medi-Cal programmatic audit tools and database; and support the development and monitoring of Beneficiary Request for Service contractual agreements.
Administrative Aide typical duties include, but are not limited to the following: assists in various aspects of general administrative processes such as: program operations, customer service, public information, and other areas; gathers, tabulates, displays and assists in analyzing factual data; drafts reports, tables, and other documents; answers correspondence; performs the technical administrative work of a small service program; prepares necessary reports and documentation necessary to administer the program; provides and recommends solutions to complex problems within program; reviews, analyzes, and interprets current legislation for program compliance; reviews documents for legislative compliance; collects, assembles, analyzes, and interprets data relating to departmental and interdepartmental operations including policies, functions, organization, staffing, program evaluations, forms and procedures, work output and workload, space and physical layouts, and effectiveness of equipment; participates in meetings and presents data to assist managers in making operations and administrative decisions.
C) Senior Office Assistant
The 1.0 FTE Senior Office Assistant (SOA) will perform clerical tasks in support of the QAPI team to successfully fulfill and maintain new State and Federal regulatory requirements. Specifically, incumbent will support hospital inpatient concurrent review and treatment authorization request (TAR) activities and manage and track official correspondence for Mental Health Plan and Drug Medi-Cal programmatic audits.
SOA typical duties include, but are not limited to the following: assist clients and members of the public by answering phones and responding to questions; assist with preparing and maintaining program and/or client files; maintain and process a variety of records and transactions; enter and retrieve data from electronic data processing systems; compile information to be used in reports; operate a variety of office machines and equipment; scheduling appointments; perform various office/clerical related tasks and attend meetings and/or trainings.
Department of Health Services - Behavioral Health Division Substance Use Disorder and Recovery Services (SUDS) Section
A) 1.0 Senior Office Assistant, Funded with 80% Substance Abuse Prevention and Treatment Block Grant (SABG) and 20% revenue from court- and state-mandated Driving Under the Influence Programs.
B) 1.0 Administrative Aide Addition and 1.0 Secretary Deletion - Funded with Internal Division Administrative Allocation through Reimbursement from the Division’s Programs’ Funding
A) Senior Office Assistant
The SABG funded Sonoma County Alcohol and Other Drugs Prevention Program is mandated as part of the block grant and this position provides the administrative support for the activities of the State-approved 5-year Strategic Prevention Plan. California Title 9 Code of Regulations requires that Counties in California provide a DUI court mandated program that is licensed by the California Department of Healthcare Services for convicted offenders of driving under the influence. These programs are either administered by the Counties or are outsourced to local community based organizations and then contract managed by the County. In Sonoma County, this program is administered by the County of Sonoma. The Sonoma County DUI Program is a revenue generating program through the collection of negotiated and approved fees by DHCS.
By providing this permanent SOA position, this staff person will be able to complete the necessary and dedicated duties for the DUI Program and the AOD Prevention as outlined in the strategic plan. In addition, this position will assist with the administrative tasks needed for the required expansion efforts of the multiple prevention programs such as Friday Night Live, POLD Survey and [Cannabis] Decoded prevention campaign.
Under general supervision, this position will act as a lead on reviewing and preparing information, data, and documentation for reports and audits; providing support for community outreach and trainings; taking minutes, coordinating set-up, and providing other necessary support for meetings with stakeholders. Other duties assigned to Senior Office Assistants include: responsible for answering phones; taking messages; responding to client inquiries; corresponding with clients and cooperative agencies; processing client payments; preparing program documents; assisting with schedules and appointments; data entry; pulling files; preparing files; and other assorted tasks.
B) Administrative Aide
The Behavioral Health Division has around 260 FTE, almost $50 million dollars out in contracts, and multiple, highly regulated and complex funding streams and grants. Currently the majority of contract development and performance monitoring activities, grant/revenue agreement management and administrative duties relating to program staff for the entire Behavioral Health Division section have fallen on three FTEs - 1 ASO II, 1 Department Analyst and 1 Administrative Aide. This has created a critical bottleneck, with some high priorities always taking a back seat to “crisis of the day” management, an unrealistic workload and a lack of cross training which is not supportive of staff work/life balance or sound sustainability planning. In addition, by having administrative work concentrated into such a small unit, the department has had to request that multiple grant and report deadlines be extended. In addition, with passage of Measure O, the Substance Use Disorder and Recovery Section is about to enter an intense planning and expansion period that will require substantial administrative support.
In order to address these issues and better support the needs of the division and the department, the Behavioral Health Division Program Support Team will need to expand to ensure that each section has a dedicated administrative aide that will support the Section Manager in completing contract development and performance monitoring activities, grant/revenue agreement management and administrative duties relating to program staff. The BHD Program Support Team Administrative Service Officers and Department Analysts will shift their focus to being the subject matter experts for their areas (contracts, recruitment, budget, safety, etc.) to support the Section Managers and Administrative Aide who will now take point on their section’s issues. Instead of working on the entire division’s activities, the Administrative Aide will focus on the Section’s 35+ FTE and $8 million in contracts.
The Administrative Aide assigned will perform paraprofessional work and general administrative support, research on a wide variety of special and ongoing projects; and performs related duties as required. Specifically, this position will be supporting the administrative work of the Substance Use Disorder and Recovery Services (SUDS) Section by supporting the section manager with the following:
• Contract Development and Performance Monitoring Activities
o Preparation of SOW
o Contractor Activity & Outcome Tracking
o First point of contact for contractor
o Grant/Revenue Agreement Management
o Coordinate collection of information for grant applications
o Track program activities and outcomes related to grants
o Manage reporting timelines, compile and submit reports, as appropriate
• Administrative duties relating to program staff
o Recruitment paperwork, organization of process, interview
o Completing and implementing safety plans, tracking completion of trainings, etc.
o Monitoring and tracking supply expenditures, maintain inventories
o Tracking of equipment usage (computers, phones, cars, etc.), first program point of contact for ISD concerns (triage and refer)
o Supervise clerical, as needed
o Track time coding, direct service time, overtime use, extra help, etc.
Department of Health Services - Administration Division
Program Planning and Evaluation Analyst (1.0 FTE), Funded with Internal Administrative Allocation through Reimbursement from the Departments’ Program’s Funding
The Program Planning and Evaluation Analyst is needed to oversee the functions and administration of revenue from the recently passed Measure O, which is estimated at $25 million dollars annually for 10 years ($250 million total). Measure O is a quarter-cent sales tax for the provision of local mental health and addiction services and facilities for children, adults, veterans, seniors and those experiencing homelessness. The primary duties for this position include standing up and staffing an oversight committee, organizing and tracking how funds are being spent including requests for proposals and community engagement around new programming, creating public and internal content for reporting on measure spending and outcomes. This position will be funded with the administrative allocation based upon work performed for the Behavioral Health Division. Support expenditures may be paid for with Measure O; the department will evaluate the option of funding with Measure O the Program Planning and Evaluation Analyst in the upcoming months as part of the Measure O planning and implementation phases.
Administrative Services Officer II (1.0 FTE), Funded with Internal Administrative Allocation through Reimbursement from the Departments’ Program’s Funding
The Administrative Services Officer II is needed to oversee the functions and administration of the Fiscal and Revenue Management Units within the Administrative Division. The Administrative Services Officer II reporting to the Chief Financial Officer will plan, organize, perform, and/or supervise budgeting, accounting, management, and fiscal contract development and monitoring for the Department of Health Services with annual budget of over $270 million. The Administrative Services Officer II will provide leadership and oversight to staff members who are responsible for performing complex fiscal and administrative assignments, including forecasting federal, state and local revenue, federal/state claiming, fiscal reporting, fiscal analysis of provider contracts, development of departmental fiscal policies and procedures, and monitoring of federal and state fiscal requirements for county and provider operated programs, for the Department of Health Services and Community Development Commission. The Administrative Services Officer II will oversee the process for establishing full recovery billing rates to the extent possible for various programs including MediCal and other third-party billing, and oversees the impact analysis and management reporting of current and future billing rates on revenue for the Department. The Administrative Services Officer II will assist the Chief Financial Officer with developing short-term and mid-term revenue strategies for the Department and ensure that sound internal controls are in place to maximize revenue recovery from federal funding sources. The Administrative Services Officer II will supervise a staff of professional, technical and office support staff performing administrative support functions; and performs related duties as required. This position will be direct charge to divisions based upon work performed to the extent possible, and funded via the administrative allocation based upon work performed for the divisions. This position may be able to leverage federal financial participation through the Medical Administrative Activities Program dependent upon specific work performed.
Accountant II (1.0 FTE), Funded with Internal Administrative Allocation through Reimbursement from the Departments’ Program’s Funding
Health Services is requesting to add 1.0 FTE Accountant II. This position will be assigned to audit functions within the Fiscal and Revenue Management Units. This position is needed in addition to the current 1.0 FTE Accountant II position to perform fiscal and cost report audits of Specialty Mental Health Medi-Cal and Substance Use Disorders contracted providers as well as Medi-Cal Administrative Activities contracted providers. Position also performs reviews of subrecipient single audit reports and confirms awards were properly reported in financial statements. Position performs other fiscal and department audits and performs training to contractors on fiscal/cost report audit requirements. Accountant II acts as liaison to all 25 Medi-Cal contractors, AMR staff, and Single Audit contractors for fiscal questions and consultation. If the position is not filled, there is increased risk to the Medi-Cal program as the current back log would not be caught up until 2022 which could result in fines and interception of our Medi-Cal claims. This could have negative impact on the cash flow of the Department due to audit exceptions found on contracted providers. The Behavioral Health contract with the State of CA/DHCS requires monitoring/auditing of CBO's and internal programs and if not filled we are not meeting our compliance requirements. This could also result in Single Audit findings for non-compliance to subrecipient monitoring. This position is essential to confirm that department controls are working, and not filling this position could also result in findings in grant invoicing and reporting, leading to decreased revenue and revenue pay backs. There also would be lack of training and communications to contractors, AMR staff, and Single Audit contractors on fiscal questions and concerns. This position will be allocated via the Administrative Allocation based upon work performed (and budgeted based upon estimated time working towards divisional goals.
Program Planning and Evaluation Analyst (1.0 FTE, Time-Limited), Funded by Community Development Commission ESG-CV Grant
The Department requests an allocation for a 2‐year Time‐Limited (1) Full‐Time Equivalent Program Planning and Evaluation Analyst (PPEA). Under direction of a Health Program Manager and the Ending Homelessness Manager this position will act as the primary liaison and support for high‐profile committees, working directly to lead the Community Development Commission’s partnership with a number of governmental and community organizations. Key to this role is ensuring the input and direction of community stakeholders is integrated into the strategic direction of the Community Development Commission. The position will be responsible for analyzing, researching, planning, developing, monitoring, and evaluating the efforts of these committees and other Community Development Commission programs and policies, to ensure their success. This position will fulfill requirements regarding collaborative processes for developing centralized and countywide housing and homelessness solutions, receive and distribute funding, conduct and analyze the homeless count, etc. Additionally, this position will convene and lead meetings with community stakeholders, manage communications with stake holders, other partners, and the community at large, and ensure that these bodies are compliant with the state and federal regulations and directives that mandate them to ensure the County and our systems of care are in compliance. This position will be funded through a memorandum of understanding with the Community Development Commission with funding from the Emergency Solutions Grant via the CARES Act (ESG‐CV).
Sonoma County Community Development Commission Positions
Administrative Aide (1.0 FTE, Time-Limited), Funded by Community Development Commission ESG-CV Grant
The Department requests addition of a 2-year Time-Limited 1.0 FTE Administrative Aide allocation. This position will provide a higher level of administrative support by assisting the Continuum of Care Board and Working Groups, preparing agendas, written materials, and drafting reports. The position will provide core administrative support to the Ending Homelessness Unit, including the Manager, Continuum of Care Coordinator, and Senior Community Development Specialist by coordinating meetings, documenting and disseminating meeting minutes internally and externally, and referring individuals experiencing homelessness, to appropriate resources. This position will oversee Brown Act Meetings, to include meeting coordination, assembling and distributing participant packets, regulating participation, and documenting and disseminating meeting notes. The Community Development Commission has been awarded an Emergency Solutions Grant via the CARES Act (ESG-CV) in the amount of $790,600. The grant will be funding 1.0 Full Time Equivalent position for a time limited Administrative Aide Position for 2 years.
Department Analyst (1.0 FTE), Funded by County Funds Approved during FY 20-21 Budget Hearings in September 2020
The Department request an allocation for a 1.0 Full‐Time Equivalent Department Analyst. This position will provide support to the coordinated entry (CE) functions in partnership with the ACCESS IMDT, sheltering and housing providers, and community stakeholders by: Analyzing current policies and procedures to further develop and implement in order to ensure compliance with federal and state requirements; Assist with annual reviews of the CE process and implement new policies and procedures as needed; Coordinate with IMDT to support assessment activities by designing policies and procedures for assessment; Partner with Continuum of Care (CoC) Board to oversee the redesign of the function and transition of the CE activities to County; Oversee, analyze, and evaluate the effectiveness of the CE system. This position is critical in meeting federal requirements for having a standardized way of providing supports to individuals seeking housing and services. The Department Analyst will be funded with Discretionary General Fund on an ongoing basis.
Note: During FY 20/21 budget hearings the Board provided ongoing Discretionary General Fund to create positions to End Homelessness within the CDC department. The Department Analyst position is 1 of 2 positions within CDC funded with General Fund by the Board. The other position established in the Ending Homelessness program to be funded by the Board is a Homeless Program Design Manager.
Department Information Systems Technician II (1.0 FTE), Funded by Federal Continuum of Care Program
Requesting the addition of a Department Information Systems Technician (DIST) to assist with the Homeless Management Information System (HMIS), with a particular focus on technical support duties involving the operation, installation, maintenance, and support of software systems. The Department Information Systems Technician will provide: Training and technical assistance to a user community of 300+ persons in 25 or more agencies; create reports in Efforts to Outcomes (EtO), HMIS software, and Business Objects; customize and maintain the EtO software; troubleshoot problems within the software systems; communicating factual/procedural information to end users; gather and analyze basic facts to draw conclusions and develop action steps to facilitate improvements; evaluate, design, and integrate system relationships among software systems; train Community Development Commission (CDC) and partner agency staff on software and system changes; and develop report methodologies to ensure efficiency as well as data reliability. The full time Department Information Systems Technician position is to be funded through the Continuum of Care (CoC) Program HMIS Expansion 2019 award with annual renewals. The Commission has committed to an annual match of $35,000 to support this position. Match funds are contributed to the grant by participation fees from all HMIS participating partners based on a formula that incorporates the number of users, amount of CoC and other homeless funding, bed capacity, clients served, and data quality. The CDC does not request any additional funds for this position. During the 2019 CoC Program Competition, the Commission applied for additional funds to support this position and has a current award of $139,250 which is annually renewable. Because this request relies completely on new Federal Continuum of Care Program Dollars, there is no General Fund impact.
Prior Board Actions:
N/A
Fiscal Summary
|
Expenditures |
FY 20-21 Adopted |
FY 21-22 Projected |
FY 22-23 Projected |
|
Budgeted Expenses |
|
|
|
|
Additional Appropriation Requested |
937,986 |
2,488,500 |
2,518,817 |
|
Total Expenditures |
937,986 |
2,488,500 |
2,518,817 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
699,455 |
1,452,200 |
1,430,710 |
|
Fees/Other |
238,531 |
1,036,300 |
1,088,107 |
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
937,986 |
2,488,500 |
2,518,817 |
Narrative Explanation of Fiscal Impacts:
Department of Health Services - Behavioral Health Division
A total of 8.0 additional positions and 2.0 position deletions for the Behavioral Health Division are being requested as part of this item.
The following 6.0 Behavioral Health positions have a total estimated cost for FY20-21 of $507,100: 2.0 Section Manager, 1.0 PPEA, 1.0 Administrative Aide, and 2.0 SOA. Funding for these new allocations will come from Mental Health Services Act 14%, Federal Financial Participation/State Participation Final Rule 30% (Medi-Cal, Utilization Review, Final Rule), Substance Use Disorder grants 7%, Behavioral Health internal Administrative allocation 19%, and use of Mental Health/2011 Realignment funds 30.0% (matching source). This use of Mental Health/2011 Realignment funds is expected to be offset by additional MediCal revenue generated by the quarterly billing of Specialty Mental Health Administrative Cost, monthly billing of Utilization Review Cost, and previous years unexpected revenue from Specialty Mental Cost Settlements. The Department began the practice of billing Department of Health Care Services for the Administrative Cost in the third quarter of fiscal year 2020-2021 and also began submitting the Utilization Review invoices timely. This change in the billing practice will allow the Department to recover costs in the year the costs are incurred rather than at the interim and final settlements of Specialty Mental Cost Reports, which generally occur four to seven years after the close of the fiscal year. The change in invoicing timeline will increase cash flow in current year while waiting for cost settlement and reduce the use of realignment fund balance for ongoing costs.
In addition, the Department is requesting to add 1.0 Administrative Aide, add 1.0 Patient Care Analyst, delete 1.0 Secretary, and delete 1.0 Behavioral Health Clinical Specialist for a net estimated expense change for FY20-21 $29,680. In addition the Department will transfer 1.0 Department Analyst position allocation and a 1.0 Administrative Aide position allocation within the Administration unit to Behavioral Health with a total estimated cost for FY20-21 of $171,330. These add/transfer positions are funded with the same funding sources noted above.
Department of Health Services - Administration Division
Administration is requesting to add 3.0 new Permanent allocations and 1.0 time-limited allocation - 1.0 Administrative Services Officer II, 1.0 Accountant II, 1.0 Program Planning Evaluation Analyst that will be budgeted via the Administration allocation and will leverage additional funding sources as appropriate. The estimated net cost for these new allocations in FY20-21 is $136,242. The time-limited allocation is a 1.0 Program Planning Evaluation Analyst that will be time limited through December 14, 2022 funded through Community Development Commission Memorandum Of Understanding of $93,640 (funding via Emergency Solutions Grant COVID-19).
Sonoma County Community Development Commission
Your Board approved $355,985 in revenue and expenditures appropriations for the Ending Homeless Staff Unit during the FY 2020-2021 budget hearings in September 2020, which included the addition of 1.0 Department Analyst for a total cost of $163,065. The 1.0 Program Planning and Evaluation Analyst and 1.0 Administrative Aide Analyst are to be funded with the Emergency Services Grant - COVID in the amount of $303,873, which will be reflected in the next Quarterly Consolidated Board Appropriations. The latter positions are time-limited for a duration of two years. There is no fiscal impact as the funding was approved during the FY 2020-2021 budget hearings in September 2021. Appropriations will be included in CDC’s FY 2020-21 Budget of $466,938.
Note: Health Services continues to analyze and monitor revenues and will take necessary steps to ensure a balanced sustainable budget.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Administrative Aide (BH) |
4,713.41 - 5,729.14 |
2.0 |
|
|
Behavioral Health Clinical Specialist (BH) |
6,972.72 - 8,473.71 |
|
1.0 |
|
Patient Care Analyst (BH) |
8,325.43 - 10,022.11 |
1.0 |
|
|
Program Planning and Evaluation Analyst (BH) |
6,443.98 - 7,831.92 |
1.0 |
|
|
Secretary (BH) |
4,033.36 - 4,902.99 |
|
1.0 |
|
Senior Office Assistant (BH) |
3,737.68 - 4,451.23 |
2.0 |
|
|
Adult, Youth And Family Services Section Manager (BH) |
8,811.12 - 10,708.66 |
2.0 |
|
|
Program Planning and Evaluation Analyst (DHS Admin) |
6,443.98 - 7,831.92 |
1.0 |
|
|
Administrative Services Officer II (DHS Admin) |
8,085.85 - 9,826.86 |
1.0 |
|
|
Accountant II (DHS Admin) |
5,664.79 - 6,887.50 |
1.0 |
|
|
Program Planning and Evaluation Analyst (DHS Admin) |
6,443.98 - 7,831.92 |
1.0 |
|
|
Administrative Aide (CDC) |
4,713.41 - 5,729.14 |
1.0 |
|
|
Department Analyst (CDC) |
5,963.95 - 7,247.52 |
1.0 |
|
|
Department Information Systems Technician II (CDC) |
5,049.09 - 6,136.13 |
1.0 |
|
Narrative Explanation of Staffing Impacts (If Required):
These are all new positions and the Departments will work with the Human Resources Department to begin the recruitment process for the positions listed in this item as soon as the position allocations become effective.
Attachments:
Attachment 1 - Personnel Resolution - Department of Health Services
Attachment 2 - Personnel Resolution - Sonoma County Community Development Commission
Attachment 3 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None