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HEALTH SERVICES AGENCY / PERSONNEL - Executive Director Jayme Bottke
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Requested Action(s)
recommendation
a) Request approval of a new classification specification of Patient Navigator I/II within the Joint Council bargaining unit, effective 3/19/24
b) RESOLUTION - Request adoption of a resolution amending the FY 23/24 Position Allocation List (PAL), (Reso #2023-88) by deleting eight (8.00 FTE) Medical Assistant I/II Bilingual allocations, adding seven (7.00 FTE) Patient Navigator I/II Bilingual allocations at Joint Council Salary Ranges 23/27, deleting one (1.00 FTE) Supervising Institutional Registered Nurse Bilingual allocation, and adding one (1.00 FTE) Supervising Institutional/Crisis Health Registered Nurse Bilingual allocation, effective 3/19/24
c) Request approval to reclassify one (1.00 FTE) Medical Assistant II incumbent as a Patient Navigator II, two (2.00 FTE) Medical Assistant I Bilingual incumbents as a Patient Navigator I Bilingual, two (2.00 FTE) Medical Assistant II Bilingual incumbents as a Patient Navigator II Bilingual, and one (1.00 FTE) Supervising Institutional Registered Nurse as a Supervising Institutional/Crisis Registered Nurse, effective 3/19/24
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Financial Impact:
The requested action of reclassifying the current Medical Assistant II incumbent to a Patient Navigator II, two (2) Medical Assistant I Bilingual incumbents to a Patient Navigator I Bilingual, and two (2) Medical Assistant II Bilingual incumbents to a Patient Navigator II Bilingual is an annual increase of approximately $176,235. The requested actions will have no impact to the General Fund.
These positions will be allocated to multiple budget units. Costs for budget unit 40251 will be funded in part by Health Realignment funds, patient fees, Medi-Cal, Medicare, and grants. Costs for budget unit 40131 will be funded in part by Medi-Cal, Medicare, Mental Health Realignment funds, MHSA, client fees, and grants. Costs for budget unit 40261 will be funded by AB 109 funds.
Background Information:
The Tehama County Health Services Agency is requesting approval of a new classification specification of Patient Navigator I/II within the Joint Council bargaining unit. The reason for the requested changes is due to the necessity of having a more flexible way of staffing medical support staff within the Medical Clinic, Behavioral Health medication support and the County Jail. The Agency needs their medical support staff to begin working in new and sometimes highly complex roles due to the move to the County Organized Healthcare System (COHS) with Partnership HealthPlan for Medi-Cal Managed Care and the addition of new Medi-Cal benefits under CalAIM. In the past, the Agency has struggled to fill grant funded positions that require a “patient care coordinator” and the agency has tried to fill those needs with the Medical Assistant classification. This was not ideal for the Medical Assistants as they typically preferred to work directly in a clinical setting with the provider staff.
The new classification of Patient Navigator I/II would replace the Medical Assistant I/II and allow a better opportunity to support patients served by the agency in new ways. The Patient Navigator I position does not require medical assisting training, but candidates must have the knowledge and ability to work one-on-one with patients to navigate them through the complexities of the medical system. The Patient Navigator II will require candidates to have both medical assistant training and state certification. The higher-level staff will handle increasingly responsible tasks required in the new relationship with Partnership Healthplan. These tasks include extensive processing of referrals and authorizations, which is part of the responsibility of the primary care providers in managed care, and not only increases the volume of work, but it also increases the complexity of work. There is additional training and experience required to become proficient in these processes, and this same group of staff will be involved in assisting Medi-Cal patients as they engage in the new CalAIM benefits as they continue to roll out. These new responsibilities are added on to the already fast-paced, heavy load that these staff carry currently.
Considering the addition of duties outlined above, the recommended salary placement for the Patient Navigator I is Joint Council Range 23 and Joint Council Range 27 is recommended for the Patient Navigator II. This placement is consistent with the internal salary relationships for similar positions at this level as well as other comparator counties.
Should the classification be approved, the Tehama County Health Services Agency requests to amend the Position Allocation List (PAL) by deleting eight (8.00 FTE) Medical Assistant I/II Bilingual allocations and adding seven (7.00 FTE) Patient Navigator I/II Bilingual allocations at Joint Council Salary Ranges 23/27 and reclassifying the current Medical Assistant I/II incumbents to the respective Patient Navigator I/II classification. The current incumbents are qualified for the Patient Navigator level they will be placed at.
In addition, the Tehama County Health Services Agency is requesting to delete one (1.00 FTE) Supervising Institutional Registered Nurse Bilingual allocation and add (1.00 FTE) Supervising Institutional/Crisis Health Registered Nurse Bilingual allocation to their PAL as a corrective action to item #24-155 that was previously approved by Board on March 5, 2024. If approved, the Department requests to reclassify the current Supervising Institutional Registered Nurse incumbent to a Supervising Institutional/Crisis Registered Nurse. There will be no financial impact as a result of these changes as the salary range placement will remain the same.
The Joint Council bargaining unit met and conferred with the County over the proposed actions and is in agreement on this matter.