To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services, Human Services Department
Staff Name and Phone Number: Barbie Robinson, 565-7876; Karen Fies, 565-6990
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Department of Health Services Public Health Staffing Allocations
End
Recommended Action:
Recommended action
A) Adopt a personnel resolution effective October 9, 2019 restoring 4.0 full-time equivalent Social Service Worker III allocations to support the Teen Parent Program and 0.80 full-time equivalent Public Health Nurse II to support the Home Visiting Initiative Program within the Department of Health Services through June 30, 2020.
B) Authorize the Department of Health Services and the Human Services Department to adjust their fiscal year 2019-2020 budgets through the first quarter consolidated budget adjustments process.
end
Executive Summary:
During the June 2019 budget hearings, the Department of Health Services recommended that the Teen Parent Connections Program and the Home Visiting Initiative Program be eliminated to balance the Department’s fiscal year 2019-2020 Budget. The Board of Supervisors directed staff to try and identify ongoing funding to restore the positions supporting these programs before final layoff proceedings begin in October. These programs leverage significant federal, state, and other funds to provide targeted home visiting and case management services to our county’s most vulnerable babies and families and the Department is requesting that the Board of Supervisors restore these positions through June 30, 2020 to enable the County to continue service delivery for one more year and the provide the additional time to identify ongoing match funding. The Department recommends the use of 1991 Health Realignment Fund Balance for the match funding requirements for fiscal year 2019-2020.
If approved by the Board, this item would restore 4.00 full-time equivalent Social Service Worker III allocations for the Teen Parent Connections Program and a 0.80 full-time equivalent Public Health Nurse II allocation for the Home Visiting Initiative Program through June 30, 2020. The item also authorizes the Health Services and Human Services Departments to adjust their fiscal year 2019-2020 budgets during the 1st Quarter Consolidated Budget Adjustment process to accommodate this request. In total, the Department will need to replace one-time funding of $277,713 with an ongoing funding source as part of the fiscal year 2020-2021 recommended budget.
Discussion:
As identified in the Department of Health Services’ June 11, 2019 Budget Memo to the Board of Supervisors, the Department’s fiscal year 2019-2020 budget was facing an $11 million revenue gap including $8 million in its Behavioral Health Division and $3 million in its Public Health Division. Factors contributing to the revenue gap included flat growth in a major funding stream, 1991 Realignment; increasing costs (i.e., labor, residential care facility contracts); and decreasing revenue (e.g., Medi-Cal, Mendocino Laboratory services contract).
To address the fiscal year 2019-2020 revenue gap, the Department’s fiscal year 2019-2020 Recommended Budget proposed a series of difficult reductions to programs and services. Behavioral Health Division reductions included the following: 1) elimination of residential care facility supplemental payments; 2) reductions to peer and family support contracts; and 3) reductions to Adult Services Team and Outpatient Contracts. Public Health Division reductions affected the Disease Control Unit; Emergency Preparedness; Nurse Home Visiting Team; and the Teen Parent Program.
During the fiscal year 2019-2020 budget hearing process the Board approved a total of $6.8 million in restoration funding including $6.01 million in Behavioral Health restoration funds and $823,000 in Public Health restoration funds. Attachment 1 provides a summary of the restoration funding approved by the Board.
One of the proposed reductions in Public Health that was not recommended for prioritized funding by the Department was the elimination of 4.0 full-time equivalent Social Service Worker III filled positions in the Teen Parent Program. The Teen Parent Connection Program supports approximately 120 teen parents age 18 years and younger providing case management services with the goal of maximizing their educational potential and self-sufficiency. Without the program, teen parents would be more likely to not graduate from high school, have a second teen pregnancy, become homeless, enter child welfare system, enter juvenile justice system and require other County services that lead to increased long-term County costs for safety net services (including human services, behavioral health, criminal justice, child support, child protective services, etc.).
While gap funding for the Teen Parent program was not authorized during the budget hearing process, the Board directed the Department to return with a report on efforts to identify funding to maintain the Teen Parent program. All four of the Social Worker allocations were deleted in the Department’s fiscal year 2019-2020 budget and absent mitigation will result in layoffs in October 2019.
The annual cost of the 4.0 full-time equivalent Social Service Worker III positions is $560,798. While the Department was unable to fully identify an ongoing funding source for the positions, it was able to identify $428,826 in funding sufficient to fund the positions through fiscal year 2019-2020 allowing additional time to identify a long-term funding solution for the program. The funding includes $169,210 in 1991 Health Realignment fund balance as a result of prior year unanticipated surplus and $259,616 in Targeted Case Management funding, which is an ongoing source of federal funding that requires match funding. The Department will work to identify ongoing funding of $169,210 for fiscal year 2020-2021.
In addition, the Department’s fiscal year 2019-2020 budget approved by the Board did not restore a 0.80 full-time equivalent Public Health Nurse II allocation in the Public Health Field Nursing Program. Staffing in the Field Nursing Program has been significantly reduced over the last several years.
Subsequent to the budget hearings, in July 2019 the Department received notification of additional fiscal year 2019-2020 Home Visiting Initiative funding availability from the Human Services Department. Through an agreement with the Human Services Department, $108,503 in one-time funds can be utilized to fund the reinstatement of the vacant 0.80 full-time equivalent Public Health Nurse II position in the Field Nursing Program through the end of fiscal year 2019-2020. The state has notified the Department that it will be accepting applications for the next Home Visiting Initiative funding cycle (2020-2022) in fall of 2019 and both Departments are hopeful that funding will be re-authorized.
Prior Board Actions:
In June 2019 the Board approved the fiscal year 2019-2020 County budget.
Fiscal Summary
|
Expenditures |
FY 19-20 Adopted |
FY 20-21 Projected |
FY 21-22 Projected |
|
Budgeted Expenses |
0 |
|
|
|
Additional Appropriation Requested |
537,329 |
|
|
|
Total Expenditures |
537,329 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
259,616 |
|
|
|
Fees/Other: CalWORKS Home Visiting Initiative (one-time) |
108,503 |
|
|
|
Use of Fund Balance: 1991 Health Realignment |
169,210 |
|
|
|
Contingencies |
|
|
|
|
Total Sources |
537,329 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
Funding for the 4.00 full-time equivalent Social Service Workers III is from the federal Targeted Case Management program with a one-time local match requirement from available 1991 Health Realignment 2018-19 year-end surplus. Targeted Case Management is a reimbursement for units of services based on a rate established via a cost reporting process. The annual Targeted Case Management rate is calculated using the last completed and approved cost report. Restoring the Social Service Workers will generate additional Targeted Case Management revenues by providing approved services to clients.
Funding for the 0.80 full-time equivalent Public Health Nurse II is from additional one-time FY 19-20 CalWORKS Home Visiting Initiative funding passed through a memorandum of understanding with the Human Services Department.
The Department of Health Services and the Human Services Department will request appropriations through the first quarter consolidated budget adjustments process to accommodate additional staffing expenditures and associated revenue.
|
Staffing Impacts: |
|
|
|
|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
|
Social Service Worker III |
5,053 - 6,141 |
4.00 |
0 |
|
Public Health Nurse II |
7,060 - 8,582 |
0.80 |
0 |
Narrative Explanation of Staffing Impacts (If Required):
The Social Service Worker positions are currently filled. Should the Board not approve the requested position restorations, lay-off notices with an effective date of October 8, 2019 will be issued to staff filling these positions. If approved, the Department plans to begin the hiring process for the Public Health Nurse as soon as the position allocation becomes effective.
Attachments:
Personnel resolution, Summary of Fiscal Year 2019-2020 Restoration Funds
Related Items “On File” with the Clerk of the Board:
None