REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
October 27, 2020
FROM
DIANE RUNDLES, Director, Human Resources Department
BOB WINDLE, County Labor Relations Chief, County Administrative Office
SUBJECT
Title v
Arrowhead Regional Medical Center - Classification Actions and Side Letter Agreements Supporting EPIC Electronic Health Records System - Clinical Informatics
End
RECOMMENDATION(S)
Recommendation
1. Approve proposed Side Letter Agreement between the County and Teamsters Local 1932 supporting the Electronic Health Records System - Clinical Informatics in Attachment A.
2. Approve proposed Side Letter Agreement between the County and California Nurses Association supporting the Electronic Health Records System - Clinical Informatics in Attachment B.
3. Approve proposed terms and conditions for classifications in the Professional Unit as provided in Attachment C.
4. Establish new classifications and salaries, as detailed in Attachment D, as a Minute Order Amendment to the Salary Ordinance.
5. Authorize the addition of new positions as detailed on Attachment D.
6. Approve Technical Title Changes for certain classifications as detailed on Attachment D.
(Presenter: Diane Rundles, Director, 387-5570)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like Manner
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost) as the total annual cost of $4,869,048 is funded by State Medi-Cal, Federal Medicare, private insurances, other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2020-21 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Effective August 6, 2019, Arrowhead Regional Medical Center (ARMC) entered into an agreement with EPIC Systems Corporation to provide ARMC with a single, intuitively integrated Electronic Health Records (EHR) system for the purpose of unifying providers across all patient care areas and helping to improve performance for achieving and reporting quality and efficiency metrics. The new system will improve patient safety by providing a seamless transition of information between hospital, patient’s provider group and outpatient clinics, which will increase the overall patient and provider satisfaction. The new system will replace the outdated and soon to be unsupported MediTech EHR system.
ARMC worked closely with Human Resources and County Labor Relations to ensure a successful migration and implementation of the new EHR system. Effective January 7, 2020, the Board of Supervisors (Board) approved agenda item No. 6, which recommended the establishment of six new classifications to support the initial phase of EPIC systems implementation. The recruitment effort began immediately following Board approval of the new classifications and was successful in attracting highly qualified applicants. Unfortunately, due to the COVID-19 pandemic, ARMC’s focus temporarily shifted away from filling EPIC position vacancies and moved towards diligently combating the spread of COVID-19 and treating and educating patients and the public regarding the virus. Recently, ARMC informed Human Resources of the need to resume the recruitment process to ensure new hires begin training for EPIC certification by March 2021.
This agenda item includes recommendations that will address ARMC’s second phase of EPIC systems implementation. Human Resources provided recommendations for establishing multiple series of classifications to accommodate ARMC’s need for clinical informatics. Six new classifications are necessary to ensure the hospital’s EHR is implemented and maintained appropriately by EPIC certified clinical informatics experts. The new classifications impact three different unions (Teamsters Local 1932, Service Employees International Union Local 721, and California Nurses Association) and, specifically, the following bargaining units: Nurses Supervisory & Management, Professional, and Nurses as expertise is required from classifications within each of these units.
Upon notice to the unions, Teamsters Local 1932 (Teamsters) and California Nurses Association (CNA) requested to meet and confer with the County regarding new EPIC classifications and differentials.
The County and Teamsters reached an agreement to establish the following:
• An EPIC Supervisor/Project Manager-RN classification (salary range 74A) and an EPIC Manager-RN classification (salary range 77C) with Nurses Supervisory level benefits.
• A differential of 4% of employee’s salary for EPIC Systems Analyst II assigned as Lead EPIC Analyst.
• A differential of 2.5% of employee’s salary for EPIC Supervisor/Project Manager and EPIC Manager who are licensed Pharmacists, Physician Assistants, Chiropractors, or Medical Doctors and assigned to oversee clinical modules and teams.
Additionally, the County and CNA reached an agreement to establish the following:
• An EPIC RN Analyst I classification (salary range 8A) and an EPIC RN Analyst II classification (salary range 2).
• A differential of 4% of employee’s salary for EPIC RN Analyst IIs who are licensed Nurse Practitioners IIs or Clinical Nurse Specialists assigned as Lead EPIC RN Analysts.
The Service Employees International Union Local 721 (SEIU) did not request to meet and confer; therefore, the County recommends that the Board adopt the terms and conditions provided to SEIU in Attachment C, which are consistent with the terms agreed to with Teamsters and CNA.
The recruitment effort to fill positions in the new classifications is expected to commence immediately following the Board’s approval of this item. The new structure is designed to ensure ARMC’s needs are met during EPIC implementation as well as for the long-term.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Jamie Ryan, Deputy County Counsel, 387-3088) on October 19, 2020; Human Resources (Gina King, Employment Division Chief, 387-5565) on October 20, 2020; Labor Relations (Sandra Wakcher, Senior Labor Relations Analyst, 387-3105) on October 13, 2020; Arrowhead Regional Medical Center (Chen Wu, ARMC Finance and Budget Officer, 580-3165) on October 19, 2020; Finance (Yael Verduzco, Administrative Analyst, 387-5285 and Jessica Trillo, Administrative Analyst, 387-4222) and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on October 20, 2020.