October 06, 2015
The Honorable Board of Supervisors
County of Los Angeles
383 Kenneth Hahn Hall of Administration
500 West Temple Street
Los Angeles, California 90012
Dear Supervisors:
COUNTYWIDE CLASSIFICATION ACTIONS TO
FACILITATE JAIL HEALTH CONSOLIDATION AND
THE OFFICE OF DIVERSION AND RE-ENTRY
(ALL DISTRICTS - 3 VOTES)

SUBJECT
This letter and accompanying ordinance will update the tables of classes of positions and the
departmental staffing provisions by adding new classifications and positions, and by reclassifying
positions in the Sheriff Department to facilitate the implementation of the Jail Health Consolidation
Plan and the new Office of Diversion and Re-entry.
IT IS RECOMMENDED THAT THE BOARD:
Approve the accompanying ordinance amending Title 6, Salaries, of the County Code to add five (5)
new classifications and positions in the Department of Health Services (DHS) and to reclassify three
(3) positions, currently in the Sheriff Department, to facilitate the Jail Health Consolidation Plan and
establishing the Office of Diversion and Re-entry.
PURPOSE/JUSTIFICATION OF RECOMMENDED ACTION
Your Board of Supervisors (Board) has requested submission of classification letters on a periodic
basis throughout the year to facilitate consideration of classification and compensation
recommended actions in a timely manner. Approval of the recommendation will provide the
ordinance authority for the Departments of Health Services (DHS) and Sheriff to implement the
classification recommendations in this letter.

The Honorable Board of Supervisors
10/6/2015
Page 2
The recommendations will ensure the proper classification and compensation of positions based
upon the duties and responsibilities assigned to these jobs as performed by incumbents
(Attachments A and B). This is a primary goal of the County¶s classification and compensation
system.
We are recommending these actions based upon generally accepted principles of classification and
compensation. Furthermore, these actions are important in implementing high-priority Board
initiatives. The proper classification and compensation of positions facilitates good business
operations and can reduce the number of costly personnel-related problems.
New Classifications ±Department of Health Services
On June 9, 2015, your Board approved the proposed Jail Health Services Structure and the related
implementation plan. For the first six months we are in Phase Zero which includes the
establishment, recruitment, and hiring of new leadership positions and the proper alignment of the
rest of the management team. This letter recommends all the classification actions that will facilitate
the achievement of this goal in a timely matter.
Specifically, we are creating four (4) new, highly-specialized leadership classifications (Attachment
A). The Correctional Health Director (UC) will be an unclassified position which, under the direction
of a DHS Deputy Director and an Assistant Sheriff, will have responsibility for the management of all
healthcare services within the Los Angeles County jails. This position is the sole authority on health
care within the County jails. The Director, Substance Use Disorder Treatments, will be responsible
for developing, implementing, and administering a comprehensive, coordinated and integrated
continuum of care for substance use disorder treatment in the County correctional health care
system, linking in-custody services with out-of-custody services. The Director, Care Transitions, will
be responsible for ensuring that an integrated, efficient and comprehensive care team model is in
place to strengthen effective discharge planning and linkage to community health care and other
services. And finally, the Program Director, Jail Mental Health, will work with the Chief, Psychiatrist
to develop, implement, and administer all mental health aspects of the integrated jail health services.
We are also creating a new class Director, Office of Diversion and Re-entry (UC), which will report to
the same Deputy Director as the Correctional Health Director. This position will direct and oversee
the County¶s jail diversion efforts, which are dedicated to preventing or reducing the needless
incarceration of individuals with mental illness and/or substance use disorders. The position has full
responsibility for guiding the strategic, operational, and administrative alignment of diversion
activities and decisions with the goal of reducing the incarceration and recidivism of mentally ill
and/or severely addicted residents of Los Angeles County.
Reclassifications ±Sheriff Department
We are reclassing three (3) positions (Attachment B) currently in the Medical Services Bureau of the
Sheriff Department, which will be moving to DHS within Phase One. All three (3) positions are being
reclassed based on their new and expanded duties and responsibilities as part of the new DHS
leadership team for integrated jail health care.
Implementation of Strategic Plan Goals
Your Board¶s approval of the accompanying ordinance is consistent with the County Strategic Plan
Goal 1 - Operational Effectiveness. The new leadership team established by these actions will
develop a transformative, integrated health care system throughout the County¶s correctional

The Honorable Board of Supervisors
10/6/2015
Page 3
facilities, and will help prevent or reduce the needless incarceration of individuals with mental illness
and/or substance use disorders.
FISCAL IMPACT/FINANCING
The projected budgeted annual cost associated with filling the five (5) new leadership positions is
estimated to total $1,030,420 and the projected budgeted annual cost resulting from the
reclassifications recommended is estimated to total $175,207. The cost increases for the Jail Health
Services (JHS) related items are expected to be fully covered by the integrated JHS budgets across
the four impacted departments. The Chief Executive Office (CEO) will continue to work with DHS
and the impacted departments to evaluate the integrated budget as the consolidated JHS program is
transferred in phases to DHS. The CEO will notify your Board of any additional funding needs to
ensure DHS has sufficient funding to cover the total cost of the integrated JHS program. The cost of
the Director of the Office of Diversion and Re-entry will be covered by funding included in the new
Diversion and Re-entry budget unit that was created as part of the Fiscal Year 2015-16
Supplemental Budget changes. There is no net County cost associated with this action at this time.
FACTS AND PROVISIONS/LEGAL REQUIREMENTS
The County Charter authorizes the establishment and maintenance of ³a classification plan and the
classification of all positions.´This responsibility is further delineated in Civil Service Rule 5.
The accompanying ordinance implementing amendments to Title 6, Salaries, of the County Code
has been approved as to form by County Counsel.
IMPACT ON CURRENT SERVICES (OR PROJECTS)
Your approval of these classification recommendations will provide for a leadership team that will
greatly enhance the health care received by inmates throughout the County¶s correctional system, as
well as other individuals with mental illness and/or substance use disorders.

The Honorable Board of Supervisors
10/6/2015
Page 4
Respectfully submitted,

SACHI A. HAMAI
Interim Chief Executive Officer
SAH:RM:SJM
AE:KP:mmg
Enclosures
c:

Executive Office, Board of Supervisors
County Counsel
Auditor-Controller
Human Resources
Sheriff Department

Attachment A
CLASSIFICATIONS
RECOMMENDED FOR ADDITION
Proposed
Savings!
Cafeteria
Benefit Plan

Item
No.

Title

Salary
Schedule &
Level

Savings!
Megaflex

4554

Correctional Health Director (UC)

N23

R19*

Savings!
Megaflex

4562

Director, Care Transitions

N23

S13

Savings!
Megaflex

4583

Director, Office of Diversion and Re-entry (UC)

N23

R19

Savings!
Megaflex

4561

Director, Substance Use Disorder Treatments

N23

S13

Savings!
4584 Program Director, Jail Mental Health
N23
S17
Megaflex
*
If the incumoent is ‘icensed to practice medicine in the State of California or is a
registered nurse in the State of California, a provision in the County Code creates an
extended range that is 7.5 % higher at the top.

Attachment B
SHERIFF DEPARTMENT
No
of
Pos.
1

—

MEDICAL SERVICES BUREAU

Present
Classification
Chief Physician Ill
Item No. 5459A-55
N42
Non-Represented

No
of
Pos.
I

Classification
Findings
Medical Director I
Item No. 5463A
N42 E24
Non-Represented

I

Clinical Nursing Director III
Item No. 5300A
N23S16
Non-Represented

I

Chief Nursing Officer II
Item No. 5308A
N23S17
Non-Represented

I

Staff Analyst, Health
Item No. 4593A
NM98F
Non-Represented

1

Senior Staff Analyst, Health
Item No. 4594A
NMIO5G
Non-Represented

Medical Director I
As part of the leadership team, directly reporting to the Correctional Health Director
(CHD), the Medical Director I is the top ranking physician leader in the jail. The Medical
Director is responsible for the clinical care program on the front line including intake
within the inmate reception center at both the men’s and women’s facility; the primary
care clinics scattered across all Sheriff custody institutions; the specialty care
throughout all of the Sheriff custody institutions; the urgent care program at Twin
Towers; the Correctional Treatment Center which is a 150 bed skilled nursing facility
and the coordination with the 24-bed LAC+USC jail ward. The Medical Director has
ultimate responsibility over the clinical program, the staffing of clinicians in these areas,
the interactions of clinicians with other disciplines such as pharmacy and laboratory,
death review and peer review and ultimately the Quality Improvement (QI) program at
the jail. Many of these functions closely interact with the CHD but they ultimately are
the responsibility of the jail medical director.
These increased responsibilities are in line with the Medical Director I classification,
which states that the position “acts as the head of the medical department in one of the
smaller County hospitals or a medically-related program for DHS.” Therefore, we
recommend upward reclassification to Medical Director I.

HOA.1221151.1

Attachment B
SHERIFF DEPARTMENT

—

MEDICAL SERVICES BUREAU (Continued)

Chief Nursing Officer II
As part of the leadership team, reporting directly to the Correctional Health Director, the
Chief Nursing Officer II (CNO II) is responsible for nearly 1300 nursing staff, covering
five (5) different Sheriff facilities and many clinical areas. The CNO II must manage two
(2) areas that operate on a 24/7 basis as well as a number of clinical areas which
operate seven (7) days a week approximately ten (10) hours per day.
The
responsibilities include: (a) creating and maintaining nursing protocols, (b) managing a
complex “sick call” system; (c) augmenting the physician led Quality Improvement
infrastructure at the jail by organizing the data analytics functions for jail health services;
(d) managing the daily operations of the 150 bed Correctional Treatment Center; (e)
recruitment and hiring for the jail nursing structure; (f) working directly with medical and
mental health providers to ensure timely provision of care and prescribed medications;
and (g) developing a nursing leadership and training program to ensure jail health
service nursing staff remain current with their skills and knowledge.
These expanded duties are in line with the classification CNO II which states as follows:
“directs the nursing services of an autonomous County acute or rehabilitative medical
center with responsibility for 501 to 2500 full-time equivalent subordinate positions.”
Therefore, we recommend upward reclassification to Chief Nursing Officer II.
Senior Staff Analyst, Health
The Senior Staff Analyst, Health reports to a Captain and is responsible for directing,
through two (2) subordinate supervisors, multiple units comprised of budget, personnel
operations, contract, procurement and other administrative services. Duties include
serving as project manager for the Bureau’s Electronic Medical Record project;
reviewing reimbursement rates annually for payments to thirty-three (33) contracted
hospitals; collaborating with the Auditor-Controller’s Office on a new patient accounting
system; and coordinating audits related to budget and staffing.
The duties and responsibilities meet the classification standards for Senior Staff
Analyst, Health, a class responsible for supervising professional employees in the
research, analysis, and preparation of recommendations regarding the use and
deployment of resources and the implementation and improvement of operations and
programs having department-wide impact.
Therefore, we recommend upward
reclassification to Senior Staff Analyst, Health.

HOA. 1221151.1