Report 2014-111 Recommendation 8 Responses

Report 2014-111: California Department of Public Health: It Has Not Effectively Managed Investigations of Complaints Related to Long-Term Health Care Facilities (Release Date: October 2014)

Recommendation #8 To: Public Health, Department of

To protect the residents in long-term health care facilities from potential harm, Public Health should ensure that its district offices have adequate staffing levels for its licensing and certification responsibilities, including staffing levels that allow prompt investigations of complaints. Specifically, Public Health should continue working with CalHR to complete the reclassification of district offices' investigator supervisor and manager positions and then quickly fill the vacant positions at district offices.

Agency Response*

Annually, the Center for Health Care Quality (CHCQ) allocates district office surveyor positions based on a workload needs analysis to ensure staff allocations are appropriate to promptly address all licensing and certification workload, including the investigation of complaints.

Public Health continues to look for ways to expedite the hiring process to fill vacant positions. Public Health's Human Resources Branch staff and CHCQ meet at least monthly to address barriers to hiring. In addition, CHCQ executed two consultant contracts in April 2016 to provide recommendations to improve CHCQ recruitment and onboarding practices.

To date, Public Health has filled 136 of the 240 approved positions from the 2015-2016 Budget Act.

  • Response Type†: Annual Follow Up
  • Estimated Completion Date: June 2018
  • Response Date: September 2016

California State Auditor's Assessment of Status: Not Fully Implemented


Agency Response*

The 2015-16 Budget Act increased CDPH's positions by 240 to complete licensing and certification workload. Of these 240, on July 1, 2015, 77 health facilities evaluator nurse (HFEN) position were authorized. As of November 6, 2015, CDPH has 21 completed and 17 pending hires of HFENs

The Center will address ongoing recruiting, onboarding and retention issues through two consultant contracts. The Center expects to execute a recruitment contract, and an onboarding and retention contract by December 2015.

CDPH continues to work with CALHR to complete the reclassification of district office investigator, supervisor, and manager positions.

  • Response Type†: 1-Year
  • Completion Date: October 2015
  • Response Date: November 2015

California State Auditor's Assessment of Status: Partially Implemented

Public Health identifies this recommendation as fully implemented. However, Public Health's response states that it continues to work with CalHR to complete the reclassification of district office investigator, supervisor, and manager positions. Therefore, we have assessed this recommendation as partially implemented.

  • Auditee did not substantiate its claim of full implementation

Agency Response*

Based on the L&C Program November Estimate, the January 2015 Governor's Budget includes a request for additional staff and funding to complete licensing and certification workload.

CDPH continues to work with CALHR to complete the reclassification of district office investigator, supervisor, and manager positions.

CDPH has established a workgroup to look into ways for expediting filling vacant positions at district offices.

  • Response Type†: 6-Month
  • Estimated Completion Date: Unknown
  • Response Date: June 2015

California State Auditor's Assessment of Status: Pending


Agency Response*

On November 19, 2014, CDPH posted on our website "Vacancy Rates by Position Classification for the Center of Health Care Quality" with data as of September 30, 2014.

CDPH will continue to post this information quarterly.

As of December 1, 2014, CDPH completed examinations for Health Facilities Evaluator II (Supervisor), Health Facilities Evaluator Manager I, and Health Facilities Evaluator Manager II. Certification lists for these classifications are now available and district offices are recruiting for these positions.

  • Response Type†: 60-Day
  • Estimated Completion Date: Unknown
  • Response Date: December 2014

California State Auditor's Assessment of Status: Pending


All Recommendations in 2014-111

†Response Type refers to the interval in which the auditee is providing the State Auditor with their status in implementing recommendations made in an audit report. Auditees must submit a response regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year or subsequent to one year.

*Agency responses received after June 2013 are posted verbatim.


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