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2022-449-Resolution No. 2022-076 Recorded 12/15/2022Recorded in Deschutes County C J2022_449 Steve Dennison; County Clerk 1 Commissioners' Journal 2/15/2022 3:43:43 PM �c\,,\Irs Co y� IIIIIII"�I'II'II��I�II' � �I� REVIEWED 2022-449 LEGAL COUNSEL For Recording Stamp Only BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON A Resolution Increasing FTE Within the 2022-23 * RESOLUTION NO. 2022-076 Deschutes County Budget WHEREAS, Deschutes County Health Services presented to the Board of County Commissioners on 12/7/2022, with regards to extending seven (7) Health Services Limited Duration FTE and creating one (1) new Limited Duration FTE in support of continuing the Covid- 19 recovery step down, and WHEREAS, Deschutes County Policy HR-1 requires that the creation of or increase in FTE outside the adopted budget be approved by the Board of County Commissioners; now, therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON, as follows: Section 1. That the following FTE be increased..: Job Class Type Duration if Limited Duration FTE PH Manager (3030) LTD Extend to 12/31/2024 Supervisor, Health Services (2837) LTD Extend to 6/30/2024 Public Health Ed II (2843) LTD Extend to 6/30/23 Public Health Ed II (3075) LTD Extend to 6/30/24 Public Health Ed I (NEW) LTD End 6/30/24 1.0 Public Health Nurse II — Clinical (2812) LTD Extend to 6/30/24 Project Coordinator (3032) LTD Extend to 6/30/24 Public Health Nurse 11- Outbreak Mgmt. (2844) LTD Extend to 12/31/23 Total FTE 1.0 Page 1 OF 2-Resolution no. 2022-076 Section 2. That the Human Resources Director make the appropriate entries in the Deschutes County FTE Authorized Positions Roster to reflect the above FTE changes. DATED this-� day of December 2022. � AyTTEST: l)-) tTfi-at Recording Secretary Page 2 OF 2-Resolution no. 2022-076 BOARD OF COUNTY COMMISSIONERS OF DE HUTES COUNTY, OREGON PAT 'I ADAIR, Chair Z&Zk� ANTHONY DEB O V,— ire -Chair PHIL CHANG, Commissioner COVID Response and Recovery Unit - Funding and Expenditures by Fiscal Year (FY) Updated 11.16.22 FY23 FY24 FY25 RESOURCES F E MA 498,198 ARPA - COVID Unit Team (approved) 497,244 - ARPA - COVID Unit Team -Reserve * Requesting Approval - 485,756 88,940 PE01-09 748,306 305,319 - PE01-10 680,136 152,363 COHC-COVID QIM 300,000 9,031 - 2,723,884 952,469 88,940 REQUIREMENTS PERSONNEL MANAGER & ADMIN SUPPORTS 3030 PH MANAGER 2836 MANAGEMENT ANALYST 3032 PROJECT COORDINATOR 2959 ADMIN SUPPORT SPECIALIST 2841 ADMIN SUPPORT TECH 2988 0.5 MANAGEMENT ANALYST COMMUNITY ENGAGEMENT TEAM 2837 SUPERVISOR, HLTH SERVICES 2843 PUBLIC HLTH ED II 3075 PUBLIC HLTH ED II NEW PUBLIC HLTH ED I OUTBREAK RESPONSE TEAM 3031 SUPERVISOR, HLTH SERVICES 2733 PUBLIC HTH EDUCATOR II 2732 PUBLIC HTH NURSE II VACCINE DELIVERY 2835 SUPERVISOR HLTH SERV 2812 PUBLIC HTH NURSE II 2929 PUBLIC HTH NURSE II 2844 PUBLIC HTH NURSE II 2815 0.1 HLTH OFFCR MATERIALS AND SUPPLIES Temporary Staff Communication & Outreach Miscellaneous, Materials and Supplies Wraparound Supports Isolation - Franklin Shelter * Extend through 12/31/24 * Extend through 6/30/24 * Extend through 6/30/24 * Extend through 6/30/23 * Extend through 6/30/24 * New FTE: 6/1/22 - 6/30/24 * Extend through 6/30/24 * Extend through 12/31/23 1SS,367 60,928 71,675 82,344 66,438 68,302 131,075 106,063 73,702 7,677 110,703 77,007 30,591 140,808 112,569 83,679 89,136 17,165 166,243 115,679 45,158 140,250 127,072 109,653 120,449 63,584 508,598 100,000 - 250,000 22,774 120,000 - 130,200 INDIRECT 129,858 41,607 TOTAL REQUIREMENTS 2,723,884 952,468 & * FY23 personnel estimates do not reflect annual cost per employee. Some positions were vacant for a period of time, so numbers reflect reasonable estimates of actuals to be incurred during FY. 88,940 E S CpG2a o < BOARD COMMISSIONERS MEETING DATE: December 7, 2022 SUBJECT: Request approval for extension of 7 limited duration Covid-19 positions and 1 new position to continue Covid-19 recovery step down RECOMMENDED MOTION: 1) Move approval of acceptance of $574,696 from ARPA reserves for the purposes of Covid-19 recovery within the Health Services department. 2) Move approval of Resolution No. 2022-076 to extend seven limited duration positions (LTD) and create one new LTD Public Health Educator I position within the Health Services Fund. BACKGROUND AND POLICY IMPLICATIONS: January 2022, the Board of County Commissioners approved a standalone structure to address continued high demands for Covid-19 services. This included 16 limited duration (LTD) employees and financial support for a robust temporary workforce. The unit was responsible for Oregon Health Authority requirements and was organized into four sections; Community Engagement/Hotline, Clinical Services, Outbreak/Case Management, and Administration. Although work volume continues to be inconstant (shown below), dedicated Covid-19 staff leverage experience, create efficiencies and cross train where possible. This allows teams to continue to provide high quality required services while decreasing necessary funding. As of November, we no longer rely on temporary staff funded by ARPA. Covid-19 Teams NJoil< Volumes M 15" M W m. Homne Calls ® Reperte0 Cases — 011treaks open — Doses Given al Cml -ty C! — ® Wese . InCi'. dols Rea&.. V12022 511,2022 7112022 911IW22 Week Covid-19 Recovery - Recommendation for a Stepped Down Approach to Staffing Deschutes County Health Services (DCHS) recommends continued strategic workforce reductions in a step down approach. The unit would be reorganized into a Covid-19 Recovery Unit, reduced from the January 2022 level of 16 full time equivalent (FTE) LTD, to 8.0 FTE LTD employees June 2023 through December 2023, 6.0 through June 2024 and 1.0 FTE through December 2024. The unit would rely on core staffing and volunteers, eliminating the previously used temporary staffing model by July 2023. This model includes shifting temporary promotores de salud, or community health workers, to one new FTE Public Health Educator to serve the need for community health outreach. The proposed unit will continue to address ongoing community health measures related to Covid-19 that are required by Oregon Health Authority, including: • Social Services and Wrap Around, including Isolation supports • Infection prevention and control for high -risk populations • Testing assurances Covid-19 Vaccine and Planning Distribution Community Education including culturally and linguistically responsive community outreach and education related to Covid-19 In addition to the mandatory activities above, teams will support department- and community -wide Emergency Preparedness activities, using lessons from Covid-19 to prepare for emerging community health issues. This includes supporting community organizations to plan for public health emergencies, internal emergency preparedness and training, and adapting the volunteer pool established to support Covid-19 vaccination efforts into a formal Deschutes County Medical Reserve Corps. The chart below illustrates filled FTE and the equivalent FTE from temporary staff (i.e., temporary and limited duration), and total expenditures for April 2022 to October 2022. Projected FTE and expenditures for the proposed strategic reductions are shown for November 2022 through December 2024. Covid-19 Unit Employee and Temporary Staff (fulltime equivalent) by Team, including expenditures, by Quarter April 2022 to December 2024 30.0 25.0 20.0 `L 1— 15.0 10.0 5.0 0.0 Administration m Community Engagement Community Engagement Temp Clinical Services ; P M Clinical Services Temp Outbreak Management Outbreak Management Temp Cost 1,000 � 900 800 0 s 700 ~ .:......... 11 11 April- July - Sept Oct - Dec Jan - April - July - Sept Oct - Dec Jan - April March - July - Sept Oct - Dec June 22 22 22 March 23 June 23 23 23 24 June 24 24 24 DCHS's proposed Covid-19 Recovery Unit aligns with Board stated Fiscal Year 2023 goals and objectives for Safe Communities and Healthy People. Specifically, it aligns with the objectives to "Collaborate with partners to prepare for and respond to emergencies, natural hazards and disasters," and "Continue to support pandemic response and community recovery, examining lessons learned to ensure we are prepared for future events." The chart below shows the proposed Covid-19 Recovery Unit team extensions and new 1.0 FTE LTD Public Health Educator I. To fund these positions, DCHS will use the remaining Covid-19 funds through Oregon Health Authority, PE01-09 and PE01-10. Furthermore, DCHS requests use of the $540,032 of American Rescue Plan Act (ARPA) Funds the Board set aside as "COVID Unit Team -reserve" funds as well as $34,664 of the "Public Health Response Contingency." Proposed Extension of Covid-19 Employees APPROVED REQUESTED EXTENSION POSITION I END DATE END DATE FUNDING SOURCE ADMINISTRATION PH Manager 6/30/2023 12/31/2024 ARPA COMMUNITY ENGAGEMENT TEAM Supervisor Health Services 6/30/2023 6/30/2024 ARPA Public Health Ed II 12/31/2022 6/30/2023 PE01-09 & PE01-10 Public Health Ed II 6/30/2023 6/30/2024 PE01-09 Public Health Ed I — (start 6/1/23) NEW 6/30/2024 PE01-09 (Start 6/1/2023) CLINICAL Public Health Nurse II 6/30/2023 6/30/2024 PE01-10 Project Coordinator 6/30/2023 6/30/2024 ARPA OUTBREAK MANAGEMENT —HIGH RISK SETTINGS Public Health Nurse II 3/31/2023 12/31/2023 ARPA Program Element (PE) 01-09 is for COVIO-19 active monitoring: cultural and linguistic competency and responsiveness, testing coordination, case investigation; contact tracing; isolation and quarantine; wraparound supports, infection prevention and control for high -risk settings; and community education. PE01-10 is for vaccine planning and delivery: collaborating with partners; assuring cultural and linguistic access; assuring populations most impacted by COVIO-19 are served; promote vaccines and improve vaccine confidence in communities of color, Tribal communities, disability communities and others. BUDGET IMPACTS: Extension of 7.0 FTE and addition of 1.0 FTE Public Health Educator I. Approval of $540,032 of the "COVID Unit Team -reserve" and $34,664 of the "Public Health Response Contingency" within the ARPA reserves. No additional FY23 appropriation needed in Health Services Fund. Please see attached budget. ATTENDANCE: Emily Horton, Public Health Program Manager Janice Garceau, Health Services Director Cheryl Smallman, Health Services Business Officer Dan Emerson, Budget Manager Laura Skundrick, Management Analyst