REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
March 10, 2020
FROM
DIANE RUNDLES, Human Resources Director
BOB WINDLE, County Labor Relations Chief, County Administrative Office
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title v
Arrowhead Regional Medical Center Classification Actions
End
RECOMMENDATION(S)
Recommendation
1. Establish classifications and salaries for the new classifications, as detailed on Attachment A, as a Minute Order Amendment to the Salary Ordinance.
2. Authorize the addition of 64 new positions as detailed on Attachment A.
3. Authorize the deletion of 50 positions as detailed on Attachment A.
4. Approve equity adjustments for the classifications as detailed on Attachment A.
5. Approve a side letter agreement with the California Nurses Association to establish a differential for the new Registered Nurse III classifications.
(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). The full annual cost of the classification actions and side letter agreement is approximately $2.2 million, which will be funded by State Medi-Cal, Federal Medicare, private insurances, and 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) 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
In 2017, representatives of the County, under direction of the Board of Supervisors (Board), commenced negotiations with representatives of Teamsters Local 1932 (Teamsters) and the California Nurses Association (CNA) on the impact of the County’s proposed nursing management reorganization at ARMC.
After more than a year of bargaining the proposed reorganization, the County and Teamsters were successful in reaching an agreement. However, the County was unable to reach agreement with CNA and, after reaching impasse, the County implemented its proposed nursing management reorganization. CNA thereafter filed an action with the California Public Employment Relations Board (PERB) contesting the County’s newly implemented nursing structure. Shortly after the conclusion of a hearing before PERB, the CNA and the County engaged in further discussions in an effort to reach agreement on certain aspects of the reorganization impacting employees in the Nurses Unit. After several bargaining sessions the parties reached agreement on the negotiable items impacting the Nurses Unit, including the creation of proposed new full-time Registered Nurse III (RN III) classifications, as detailed in Attachment A. ARMC utilizes 26 distinguishable patient care units to serve patients in the areas of medical surgery and telemetry monitoring, critical care, emergency care, and specialty care. The RN III classifications will be primarily responsible for carrying out the hour-by-hour care provided by staff. The request to add 49 RN III positions will provide adequate daily coverage to these patient care units, and will further improve accountability, continuity of care, and delivery of patient services at ARMC.
Further, the County proposes to delete 50 Assistant Unit Manager I (AUM I) positions currently allocated to the day shift as they become vacant, and also add 15 Assistant Unit Manager II (AUM II) positions aimed at providing more supervisorial and managerial support for the 26 nursing unit managers who oversee approximately 2,228 employees. Additionally, the County analyzed the nursing structure and salary spread between classifications incorporating the proposed new RN III classifications, and identified that the proposed new RN III classifications would result in compaction with the AUM I classifications.
As a result of the proposal to increase the salary of the AUM I classifications and the proposed addition and elimination of positions, the County met and conferred with Teamsters. After exhausting the meet and confer process the County and Teamsters were unsuccessful in reaching an agreement. The County is therefore seeking to implement its proposed nursing management structure, including the addition of 15 AUM II positions, the deletion of 50 AUM I positions as they become vacant, and the proposed equity increase for the AUM I classifications to become effective upon completion of the filling of positions assigned to the RN III classifications.
Additionally, to assist during the transition period the County and CNA reached an agreement to provide AUM I’s who voluntarily demote to a RN III classification with a pay differential to provide additional training and support in the specialty areas, for a period not to exceed 12 months or until the employee moves to the next step on the RN III range, whichever occurs first.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Cynthia O’Neill, Supervising Deputy County Counsel, 387-5455) on February 25, 2020; Human Resources (Mark DeBoer, Assistant Director of Human resources, 387-6051) on March 2, 2020; Labor Relations (Bob Windle, County Labor Relations Chief, 387-3101) on February 24, 2020; Finance (Jessica Trillo, Administrative Analyst, 387-4222 and Amanda Trussell, Principal Administrative Analyst, 387-5423) on March 2, 2020; County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on March 2, 2020.