COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

January 21, 2003

BOARD MEETING DATE:

February 4, 2003

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Medical Center Reorganization

Recommendation

Adopt an Amendment to the Master Salary Ordinance deleting the Chief Operating Officer and Financial Services Manager I and adding a Financial Services Manager II, Deputy Director of Administration, and a Management Analyst III to the Medical Center; and Deleting the Deputy Director of Community Clinics and adding a Management Analyst III to the Community Clinics.

Background

In August 2002, the Board of Supervisors approved the addition of a new position, the Deputy Director of Ancillary Services. In October 2002 the Board of Supervisors granted early retirement to the Chief Operating Officer position, thereby effectively eliminating that position. The purpose of both these actions was to flatten the organizational structure and set the stage for a reorganization of the Medical Center.

Discussion

The goal of this change is to improve communication and develop clear lines of accountability. The proposed reorganization has 6 directors reporting directly to the Chief Executive Officer:

· Medical Director of Quality

· Director of Inpatient Services

· Director of Ancillary Support

· Medical Director of Ambulatory Services

· Director of Finance

· Director of Administrative Services (new)

In addition to the above, the major changes in the structure are as follows:

1. Elimination of the Deputy Director of Community Clinics and addition of an analyst position. The Medical Director of Ambulatory Care would assume management of all clinics, in addition to the current responsibilities as Clinics Medical Director. An analyst position is requested for support of this position. The goal of this change is to flatten the clinic organizational structure and align reporting relationships such that all clinics report to one individual.

2. Addition of a Management Analyst Position to the Division of Finance and reclassification of the Financial Services Manager I.

The reclassification of the Financial Services Manager I to a II level is being recommended since the duties as Budget Coordinator have been considerably expanded to include additional financial analysis and planning functions. The new management analyst position's responsibilities will include financial reporting, productivity reporting and the creation of the annual Medical Center's budget. This position will enable the Financial Services Manager II to provide support for the analysis of new services, cost containment activities, physician compensation and contract analysis.

3. Addition of a Director of Administrative Services.

This new position will assume responsibility for a number of functions that are essential to a successful organization, but are currently not being handled. These functions include:

_ Public Relations

_ Communications

_ Legislative Analysis

_ Planning

_ Grants Development

_ Organizational Development

This reorganization is anticipated to provide better organizational control, improved communication, clearer lines of authority and accountability, further aligned structure and function and provide the organization with the ability to meet mission and vision.

The Medical Center's Board of Directors has reviewed and approved this reorganization.

Vision Alignment

This reorganization will allow the organization to keep the commitment of Ensuring Basic Health and Safety for All and goal number 5: Residents have access to healthcare and preventative care.

Fiscal Impact

The fiscal impact of these changes is minimal, resulting in an annual savings of $8,116. Savings from the deletion of the Deputy Director of Community Clinics and the Chief Operating Officer offset the increased expense of adding the two Management Analyst III's, the Deputy Director of Administrative Services and the reclassification of the Financial Services Manager.