Human Resources Committee 6/5/25
Good morning. I FOILed for a staff list at the Adult Care Center in March, and what I received listed 160 employees, half of which were county employed and half through a variety of private agencies, predominately Infinitecare’s agency, Frontline. Apart from one ward secretary, all the agency staff listed by name and position were medical, mostly CNAs and nursing staff. Medical staff such as doctors, nurse practitioners, phlebotomists, physician assistants, pharmacy, therapists and others were not included on the staffing list as they are now all subcontractors to Infinitecare. The Director of Nursing or Assistant Director of Nursing was not identified on the list either, although I’m told that position is held currently by one of the agency RNs who is listed as a unit leader. A Director of Nursing who is employed by a temp agency is obviously not in the residents’ best interests as she is not accountable to the facility operator. Of course, all of the staffing is paid for by the county, but we have to take it on trust that Infinitecare is effectively screening and overseeing these subcontractors, since we don’t know who they are and their job performances are not audited by the county. I’d like to ask this committee to think about whether that trust is warranted, based on the results of four years of Infinitecare’s mismanagement of the human and other resources at our facility, as the trajectory of the ACC’s ratings continues to slide downhill.
Having more than half of the staff temporarily employed as per diems by a variety of staffing agencies at work within the same facility as county employees has generated persistent personnel problems and poor morale and performance. It has not saved the county money or improved the quality of patient care. Few people predicted that Infinitecare would not receive their CON to lease the facility, but as time goes by, leaving only 2 more years until their CON application expires, the odds are growing against the application ever being reconsidered after the CON application was not recommended by the Committee in November 2023. Encouraging agency employees to seek the safety of employment with the county with benefits and retirement is in the best interests of the facility and residents as well as the individual employees, and those positions are available through the county website. Hiring only county employees provides the staff with uniform performance standards and a chain of command that applies to everyone. Several years ago, the Deputy County Manager and the Commissioner of Human Resources met repeatedly with staff at the ACC to urge them to transfer their employment to Frontline and the other agencies, or to transfer to other available county positions. They told the staff that when the CON was approved, which they expected to happen expediently, the employees might not be able to keep their positions at the ACC if they didn’t transfer. I suggest that you reverse that recommendation now, and make it clear to agency staff that they can apply for their positions through the county website. Having a stable, permanent staff, which is subject to civil service regulations and county oversight is very much in the best interests of the residents’ quality of care and it is also the most prudent and responsible use of the taxpayer’s funds.