REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 19, 2023
FROM
DIANE RUNDLES, Assistant Executive Officer, Human Resources Department
SUBJECT
Title
Side Letter Agreement with California Nurses Association
End
RECOMMENDATION(S)
Recommendation
Approve a Side Letter Agreement between San Bernardino County and the California Nurses Association for the implementation of a Clinical Ladder Nursing Program, effective December 16, 2023.
(Presenter: Diane Rundles, Assistant Executive Officer, 387-5570)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Create, Maintain and Grow Jobs and Economic Value in the County.
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like Manner.
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
FINANCIAL IMPACT
Approval of this item will not result in the use of additional Discretionary General Funding (Net County Cost). The cost related to this Side Letter Agreement (Agreement) is $1.1 million ongoing. Sufficient appropriation is included in Arrowhead Regional Medical Center’s (ARMC) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Clinical ladder programs are frequently used by hospitals to provide nurses and other medical professionals career advancement opportunities while remaining in their clinical settings providing patient care. These programs provide employees opportunities to advance in their profession without entering supervisory or management roles. Clinical ladders also benefit hospitals by increasing job satisfaction, supporting recruitment efforts, and decreasing employee attrition by providing employees financial incentives and recognition to continue developing in their profession.
To provide nurses opportunities for professional development, while also addressing recruitment and retention, ARMC collaborated with Human Resources Labor Relations to develop a clinical ladder program for nurses at ARMC.
The Meet and Confer process between the County and the California Nurses Association (CNA) resulted in the proposed Agreement to establish the Clinical Ladder Nursing Program (Program), which includes the following:
• Three defined levels of advancement for employees in the Nurses Unit and Per Diem Nurses Unit (Units) based on employees’ years of work experience, education, state/national certifications, competencies, work performance evaluations, and organizational contributions.
• The following wage differentials for levels one through three of the Program:
o A $1.00 per hour wage differential for Nurses at level one.
o A $2.00 per hour wage differential for Nurses at level two.
o A $4.00 per hour wage differential for Nurses at level three.
• A Program review committee to oversee the admission and advancement of nurses in the Program.
If approved, the Program will become effective December 16, 2023.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Cynthia O’Neill, Principal Assistant County Counsel, 387-5455) on October 31, 2023; Human Resources (Leonardo Gonzalez, Labor Relations Chief, 387-5568) on October 30, 2023; Finance (Abigail Grant, Administrative Analyst, 387-4603) on November 1, 2023; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on November 2, 2023.