Inter-Departmental Correspondence

Health System



November 12, 2010


December 14, 2010







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer
San Mateo Medical Center


Position changes at San Mateo Medical Center



Adopt an Ordinance amending the Master Salary Ordinance to add and delete positions in the San Mateo Medical Center division of the Health System.



The Case Management Department at San Mateo Medical Center (SMMC) has been overseen by a nursing supervisor. The complexity of cases and of regulations requires the skills and abilities of a Clinical Service Manager II (CSM II) to oversee the increasingly complex day-to-day functions of patient flow through the continuum of care, and includes the staff of the Social Work Department. A Clinical Services Manager I (CSM I) position is currently vacant at Burlingame Long Term Care (BLTC), and the responsibilities of the position are being reevaluated in light of the changes in the census.



Management oversight in the Case Management Department was by a nursing supervisor. This position has remained unfilled for over one year. The Medical Center conducted an assessment of need and will now combine Case Management and Social Work into one department and add additional responsibilities consistent with achieving the goals of the Medical Center, which include improved quality, efficiency and patient experience.


CSM I position at Burlingame Long-Term Care will be deleted and a CSM II position will be added to Case Management. This action will not impact any other filled position within the Health System.


The vacant nursing supervisor position will be available for assignment as needed in SMMC or at BLTC.


The salary ordinance changes herein represent the:

addition of one position; and

deletion of one position.



Delete: One (1) vacant position of D144 Clinical Services

Manager I.

Add: One (1) position of D154 Clinical Services Manager II.


The CSM II will have a direct managerial responsibility over Case Management and Social Worker Department functions and supervise the personnel involved in these activities. These changes represent an estimated annual salary and benefits cost of $18,090 with no change in the total of authorized positions.


The Salary Ordinance amendment has been reviewed and approved by the County Counsel.


This Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by accurately reflecting the now vacant position and the duties needed to successfully perform this job. It is anticipated that this change will help move patients seamlessly through the continuum of care, promote quality, achieve cost-effective outcomes, and decrease administrative days in acute care by 50%. Reduction in Administrative Days is a measure of successfully placing patients in a level of care appropriate to their diagnoses and conditions.


Performance Measure:


FY 2009-10

FY 2010-11

Administrative days in acute care


660 days (50%)



This action represents an estimated increase in monthly salary and benefits cost of $1,507 or an annual cost of $18,090. The difference will be covered by salary savings and is included in the SMMC FY 2010-11 Adopted Budget. Expenses at SMMC are covered by fees for service or third party payers, whenever possible. The portion of expenses for services provided to the medically indigent, or to those covered by programs that do not meet the full costs of care, are covered by the County’s General Fund contribution to SMMC.