Thursday, January 19, 2012

Dental Director Position, Physician Assistant and Pay Level, Road Commission, MLK Jr Day

While I will normally have two committees in the first and third weeks of the month, this week we only had County Services. Human Services was rescheduled to next Monday because of Martin Luther King, Jr. Day.

The first big item up in County Services dealt with restoration of the Dental Director position, which was eliminated in 2005 as a cost saving measure. According to the Health Department, since 2005 the number of dental patients has grown by more than 3,000 patients as the dental health centers have expanded their service areas to include both local elementary schools and community events. The Community Health Center supervisor and Dental Health Center staff have requested the supervision of a Dental Director to direct the dental health center staff. A dental professional is needed to respond to clinical oral health concerns such as the appropriate course of treatment or proper infection control measures. The restoration of this position will result in an increase in productivity and a consistent standard of care across the health center network. The Health Director identified funding for this by converting a vacant dentist position (which has been vacant since May 28) to a Dental Director/Dentist position, and increasing it one level on the pay scale. The additional salary on the pay scale would come from the Healthy Smiles Dental Center budget, which was formerly dedicated to the University of Michigan School of Dentistry (UMSD) program. The Health Department terminated this agreement with UMSD effective August 31, 2011 due to lack of physical space for the interns to work within the dental centers. We had some good debate about this position. We had many questions about how this would work, and we were assured it would be both a dentist and administrator position. We asked if this would reduce the backlog, and why not just add a new dentist with the money. We were told that it will not greatly reduce the backlog, which is large, because we would need many new dentists to do that. We were also told that there are administrative needs so the staff is asking for the position. I was uncomfortable moving the position to the higher level, and asked for the scoring that was used by our human resources department. They didn’t have that, and other agreed with me that they would like to see that information. I also pointed out that we are only 17 days into the budget and are already being asked to add a new position and have money moved around. There was no good answer as to why this was not done during the budget process last year. As such, I moved to table this item until can have the answers to the scoring and budget questions.

The second controversial Health Department resolution was to hire a new Physicians Assistant, but to have her come in at the Step 5 (highest) pay level. In public comment, we heard from the UAW representative who said that they are being asked for pay cuts and step freezes and other concessions in negotiations, and it is not right to bring someone new in at the highest pay level. Our Health Department representative said that they are not at full capacity and that they constantly struggle to bring in P/A’s, nurse practitioners, and physicians. Our salary level is greatly below what they can make in the private sector, so positions stay open. And when people do agree to come, they want to come in at the highest level. The person being considered for this position has 11 years of experience and likes the population that we are working with, but is taking a large pay cut to come here. We were told that this person would not come for anything but the highest level available, and if we did not approve that then she would walk away and we would continue to have an open medical position. Many of us complained that we have to bring people in at Step 5 and asked, once again, for a study to be done to see if we can re-adjust the pay scales for the jobs that we have people doing. Our new Human Resources director said that this study is being done, and they would have the information for us in a few months. I offered an amendment to reduce the offer from the top of the scale to the second highest because I believe that we should at least try to offer somewhat less than the top amount. I have great concerns that we are asking our current employees to freeze step increases. As was pointed out last week, this means that those hired in at the lower end of the scale and work their way up will take a salary hit, but those that are at the top (usually administrators) will continue to get the top. A step freeze really does seem to be discriminatory against those who make less. This amendment was defeated on a 2-3 vote. With the defeat of the amendment, our choice was to approve or not approve the highest salary. As was pointed out by the Health Department, not approving this salary will leave the position vacant. Doing that would hurt the residents of the community that need the medical services. In addition, doing this would cost the county $400,000 in revenue (reimbursement from the federal government) because of a few thousand dollars in a step increase. Our medical providers are reimbursed by the federal government at a high level because they are federally qualified health department providers. Most of us were not willing to cost the county up to $400,000 in revenue or lose the potential aide to our residents, so we approved the resolution on a 4-1 vote (Vickers opposing). I am looking forward to seeing the study, and to the opportunity to re-evaluate these and other positions to make sure that they are appropriately compensated in relation to the private sector and other public sector jobs (as the budget will allow, of course!).

We took up a few other resolutions, but nothing really too controversial. We reviewed the recent road commission legislation, where there has been no change. We also talked about the road commission hiring new employees in human resources and finance, and there was discontent about this hiring with the status of the road commission in question. I pointed out that the new Chair of the Road Commission has expressed interest in coming to County Services to talk about his views on the potential future of the road commission, and said that I hope that he can be invited to the committee at the next regular meeting. I believe the Chair of the committee, Dianne Holman, is planning to have them in to discuss their plans and how they would like to move forward. So, with the Legislature not taking any action, we will continue to talk to the Road Commission members and assess our options as a County Commission to decide what further actions we intend to take.

I hope everyone had a great MLK, Jr Day and remembered the great man and his message of equality for all. My family watched the “I Have a Dream” speech and my children really enjoyed hearing it and learning more. We are proud that they are learning about his message of equality and diversity in the Lansing Public Schools.

I hope everyone has a great weekend, and I will report on the Human Services committee and the Board of Commissioners meeting next week!


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