Mariposa County Health Department

Maintain the current organizational structure requiring the Health Department to have a Health Officer (medical doctor) to head the health department, or;

Approve a County Health Administrator (CHA) who would serve as department head and a medical officer would be hired as part time and be subordinate to the CHA. As of the writing of this report the Board of Supervisors has voted to pursue option one based on an on-going contract for advertising, outreach and recruitment for a Health Officer. Over time, some primary responsibilities listed in the Health Officer job description have been delegated to subordinates which appears to be a contributing factor in the conflict within the Health Department and with other departments. The previous Health Officer reportedly did not like modern conveniences, such as email, and chose to run the department in a way that would appear somewhat antiquated. Numerous interviewees indicated that there has been little to no updating or modernizing office procedures over the past fifteen (15) or more years. Suggestions to update procedures resulted in an overall attitude of unwillingness to change. The Environmental Health Manager and Senior Environmental Health Specialist positions were originally contract positions with the State of California. The County of Mariposa reimbursed the State for these costs. In 2010 the State drastically increased the cost to Mariposa County for these positions. Subsequently, the Medical Officer recommended, and the Board of Supervisors approved with Resolution 2010-322, that the two State contracted employees be designated as County employees effective July 1, 2010. Job descriptions for the two positions were approved by the Board of Supervisors in December 2010 with Resolution 2010-563. Due to time constraints of the state contract expiration, these positions were not advertised and recruitment was not done within the local community. The Environmental Health Supervisor and Senior Environmental Health Specialist did not receive training for supervisory or management positions and apparently did not have adequate supervisory experience. During interviews conducted by the Grand Jury it was disclosed that the Environmental Health Manager actually supervises one of the Registered Environmental Health Specialists (REHS) and the Senior Environmental Health Specialist supervises the other REHS. However, the organizational chart does not reflect that reality. Additionally, while the Environmental Health Manager and the Senior Environmental Health Specialist are both tasked with supervising all Environmental Health employees, including support staff, the organizational chart shows the two Development Services Technician positions assigned to Environmental Health are supervised by the Public Health Office Technician who is located in a separate facility. Overall, the separate locations of the two divisions of the Health Department presents specific challenges. The Environmental Health Manager, by also having the title of Director of Environmental Health, is easily confused with the Public Health Department Director. In the past the Health Officer has tasked the Environmental Health Manager to represent the Health Department in meetings of department directors which has contributed to the conflict within the departments. The department directors need to speak freely with each other and cannot do so when the representation in a meeting is not equal or among peers. This is especially vital for policy and personnel issues. As reported by interviewees, little or no cross training is conducted. It is suggested by some that specific training and experience is denied to certain employees, thus making advancement impossible and negatively affecting moral. For example, the two Registered Environmental Health Specialists (REHS) are not encouraged to get the training and/or certifications for the Environmental Health Manager and Senior Supervising Environmental Health Specialist positions. Should either of these two previous state contracted employees choose to leave Mariposa County for whatever reason, the two subordinate REHS who have been dedicated to serving Mariposa County would not qualify to be promoted. This investigation revealed that promotions to management or supervisory positions appear to be given to employees based on their length of service without consideration given to manager/supervisor abilities. An employee who performs the job well may not necessarily possess the knowledge, skills, or personality to be a good supervisor or manager. Training for management and supervisory positions has not been offered or required. This investigation revealed numerous accounts of the following: Employee turnover due to bullying by supervisors. A toxic work environment with supervisors acting with hostility. Supervisors do not effectively or adequately address conflict and tolerate inappropriate behavior. Unequal treatment among equivalent status employees. Heavy handed and dictatorial management. Instances of high stress, reducing employees to tears resulting in the need to retreat to compose themselves. The job descriptions/responsibilities for each position is not accurately reflected in the organizational chart and does not indicate a clear chain of command. Some employees expressed concern about repercussions if they brought any issues to management. Some stated that complaints been brought to management but have not been acted upon. Some employees were hesitant to talk with the Grand Jury or meet with the Grand Jury even under the protection of confidentiality. 12