HomeMy WebLinkAboutMINUTES - 11092010 - C.30RECOMMENDATION(S):
Adopt Position Resolution No. 20848 to add thirty (30) Registered Nurse-Experienced
Level (VWXD) (represented) permanent full-time positions at salary level L3H 0400
($6952.21 -$7748.81) in the Health Services Department.
FISCAL IMPACT:
The total annual cost associated with this action is approximately $4,406,670, of which
approximately $931,720 is attributable to pension costs. This expense will be offset from
savings in the reduction of temporary, registry, per-diem and overtime expenses.
BACKGROUND:
The Health Services Department is requesting the addition of thirty (30) Registered Nurse
positions to more effectively utilize resources while continuing to provide safe and effective
patient care at Contra Costa Regional Medical Center. A study and analysis of current
Registered Nurse staffing patterns shows that the Department has become overly dependent
upon the use of overtime, termporary, registry and per-diem staff to meet requisite staff to
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 11/09/2010 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Gayle B. Uilkema, District II
Supervisor
Mary N. Piepho, District III Supervisor
Federal D. Glover, District V
Supervisor
ABSENT:Susan A. Bonilla, District IV
Supervisor
Contact: Jo-Anne Linares Health Services
(925) 957-5246
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes
of the Board of Supervisors on the date shown.
ATTESTED: November 9, 2010
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: EMY L. SHARP, Deputy
cc: Health Services , Human Resources, Malinda Brown, Otilia Parra
C.30
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:November 9, 2010
Contra
Costa
County
Subject:P300 #20848 Add 30 FTE Registered Nurse-Experienced Level Positions in the Health Services Department
patient ratios.
Furthermore, appointment of permanent staff to these new positions will provide a more
consistent and reliable continuum of care to patients. Due to an insufficient number of
permanent full time Registered Nurse positions the hospital has been using a combination of
agency nurse registry employees, Registered Nurse overtime, and Staff Nurse Per Diem
positions to supplement the current permanent employed nursing staff (see expenditure
chart below). The use of these temporary employees is required to comply with the State
mandated patient-to-nurse staffing ratios.
The intent is to transfer funding between the various payroll accounts (overtime, temporary
help, etc.) to enhance the quality of nursing care by having a stable work force and to
potentially save money by decreasing the use of premium pay and to decrease training costs
due to turnover. The worst case is a break even situation.
No additional funding is requested or required. Although it is a favorable recruitment market
it is somewhat unlikely that all positions will be filled.
In addition to this proposal being at worst case cost neutral, the hospital expects to achieve
other benefits through the recruitment of the proposed permanent staff.
Training Costs – The hospital spends approximately $25,000 per year in training costs for
each Per Diem Nurse. A turnover rate of 10.2% among per diem nurses results in a loss of
18 nurses each year. That represents $450,000 of lost training costs. The turnover rate for
permanent nursing staff however, is only 4.8% and should half the lost costs invested in
training. Finally, and more importantly, there are other issues that result from the use of
agency nurses and per diems that directly impact the quality of patient care. The nurses,
often by choice, do not desire to work full time, or in some cases, do not desire to work at
the same location for any extended length of time. The result is a lack of a routine work
schedule; commitment to departmental goals; attendance at annual competency training;
remaining current with our specific patient care policy and procedure changes; etc, all of
which creates an environment in which it becomes difficult to provide safe, effective,
efficient, timely and patient centered care. The employment of permanent full time staff
would help in meeting all of these challenges.
The cost of an RN, inclusive of benefits is approximately $63.77 per hour. The hospital
currently pays its nurse registry agencies $72 to $79 per hour to supply an RN. The hospital
currently pays existing staff $71 per hour for any overtime that is worked.
BACKGROUND: (CONT'D)
CCRMC Temporary Staffing
Fiscal 2009-10 Actual
Overtime Registry Per Diems
Inpatient medical $862,545 $983,533 $4,522,698
Inpatient psych $211,274 $6,552 $1,961,688
OR/Recovery $486,981 $457,108 $0
Emergency $338,897 $222,835 $2,380,307
Total $1,899,697 $1,670,028 $8,864,693
Grand Total $12,434,418
CONSEQUENCE OF
NEGATIVE ACTION:
If these positions are not
added, the Department's use
of overtime, temporary,
per-diem and registry
personnel will remain to be
ineffective.
CHILDREN'S IMPACT
STATEMENT:
Not applicable.
ATTACHMENTS
P-300 #20848