Clinic Management Structure Last year, your Board approved a reorganization of the Clinics Division at the Main Campus Clinics, in order to improve efficiency and reduce cost. The organization structure was flattened, reducing layers of supervision and increasing local accountability and authority. This strategy has been successful in accomplishing more with fewer staff and lower cost. It is now recommended to extend this strategy to the South County Clinics: Willow and Fair Oaks Clinics. · Currently, there is one Clinic Manager in the South County overseeing five separate clinics in five separate locations: Willow, Fair Oaks, Fair Oaks Children's Clinic, Sequoia Teen Center, and Belle Haven Clinic. To manage that volume, on-site Administrative Assistants have been utilized but this has created excess layers of bureaucracy with insufficient local authority and presence. · The recommendation is to flatten the structure by replacing the two Administrative Assistants with a single, additional Clinic Manager. This will allow one on-site Manager for each major clinic, Willow and Fair Oaks, and their respective satellites. This will bring the volume of patient visits, budgets, and staff supervised in line with the rest of the Medical Center Clinics and Clinic Managers as shown below: Current South County Work Load per Manager South County Work Load after recommended split North County Workload Per Manager Mid County Workload Per Manager Annual Visits 70,000 35,000 34,000 48,000 Approximate Annual Budget $10M $5M $6M $5.4M Approximate Number Of Employees 120 60 60 60 Mid-County Extra-Help Conversion Currently there are a number of Extra Help staff in the Clinics Division that are functioning as core, permanent staff. They have permanent duties, regular weekly schedules, work 50% time or more, and have remained in their posts for at least 6 months or more. These staff were initially hired as Extra Help several years ago in order to keep pace with clinic volume and service expansion. It is now recommended that new permanent positions be created to reflect the Clinics' permanent staffing needs. The reasons for the conversion are: · To protect the work site from the severe operational disruption of constant turnover as these Extra Help employees take permanent positions elsewhere in the organization. · Analysis of staffing ratios, using the most efficient sites as benchmarks, indicates that these positions are requisite as core staffing for the current workload and volume. · To give these employees the same benefits and status as their co-workers for performing similar work. The specific positions recommended for conversion are two half-time Staff Nurses, one Medical Service Assistant, and two Patient Service Assistants.
Prenatal Counseling StaffingIn order to improve the quality of pre-natal care as well as maximize available sources of reimbursement, it is proposed to internally reassign two Community Workers from the South County to the Main Campus OB Clinic in order to implement the State CPSP pre-natal counseling and care program. Redeployment of resources will net approximately $120,000 annually in additional Medi-Cal revenue. Healthcare for the Homeless ProgramIn the Health Care for the Homeless Program, deletion of the position of Community Program Specialist is recommended. This is an efficiency measure to meet budgetary targets for this fiscal year. The duties will be assumed by the current program manager. Food and Nutrition Services Deletion of one Food Services Supervisor position is recommended. There are currently three full-time supervisors in this department. A reorganization of their staffing schedule, following union meet and confer requirements, would eliminate redundant coverage while still fully meeting the department's needs. | 