dramatically our business processes in determining eligibility of clients for all of our programs. in the old model, every client or customer in a human services agency had a case worker for each of the programs that he or she was involved in. so there was a food stamps eligibility worker, a medical eligibility worker or a cal works eligibility worker so a family or single adult would go to several offices and meet with several different case workers to deal with either problems with their benefits or to apply for benefits. as funding from the state started eroding over time our case loads for those case workers would increase significantry. you are not doing any case work if you have four or five hundred clients. what we have done, merely

mirroring with a lot of counties in california have done, is move to a service center approach. you as a client can go to any office and get assistance from any case worker who may be available to help us. a case worker merely has to go on the computer and look it up to provide assistance. i talked about horizontal integration a bit ago, someone can come in thinking they are just applying for medical but once we're fully operational in service enter gracious, in that same transaction they can leave our building with medical, cal fresh and cash assistance. that's the idea, that's the goal. we're not fully there yet. in order to make this a good customer experience for our clients, we've developed a lot of technology, a lot of information technology tools to help our clients. we have lobby navigation software, we have work force management software, we have what's called

task management assignment tools. it's very, very data intensive but what it attempts to do is sort of balance the workload across our offices based on the needs of the clients. so for example if we see any given week a huge spike in the number of people applying through the phone or through the internet we're able to quickly redeemploy rr people from front end lobby or if we have a huge increase in lobby like we did with medical we would assign people to the front. so it's constantly looking at the thousands of transactions we're doing daily for the hundreds of clients we're serving daily. in order to do this --. >> please continue. >> in order to do this we are proposing, again funded with state dollars, to hire analytical and systems support team of 11 individuals, program support analysts, business process analysts, then headed

by an 0923 manager to really be able to fully realize this service integration vision that we have and it's not yet fully realized but these positions are critical in being able to manage the work force in order to deploy them in order to serve the needs of the client. >> mr. rourke, through the chair, i wanted to thank you for explaining the staffing needs. i know the budget analyst had raised some questions about justification but this is helping me understand the service structure and the staffing structure and the horizontal integration you are talking about and that i know for cal fresh from the food security task force that you mentioned food security task force needs especially for the cal fresh positions, so this is really helping me understand the staffing needs. and i know when workloads are so overwhelming for your staff that they really need reinforcements, but your restructuring of how you use your money and resources so efficiently is really helpful

for me. so thank you for explaining that. >> great. yeah, it is more difficult to explain. for every 200 new clients we need x more case managers, that's just not the world we are operating in any more. so the next slide is our family and children's services area. so the big impetus for our additional staff here is what's called the katy a lawsuit. in 2008 the state settled this lawsuit and basically what the lawsuit said or the suit was about lack of access to mental health services for kids in foster care or for kids who are potential candidates for foster care. the settlement basically established mental health services as an entitlement for kids in foster care and for children who are candidates for foster care. it seems like a no-brainer, right, if a child has to be removed from his or her birth

parents it's a traumatic experience, not just the instance that led to the removal but the removal itself. so the notion that mental health services should be available at the ready almost immediately upon removal is almost a no-brainer and we're pleased that the settlement worked out the way it did but it does increase the workload for our staff. we've been working hand in hand to implement the katy a requirements. so what we're really seeing is the need for our child welfare workers, all of whom are masters level social workers, so they are clinically trained, over time because of workload demands and because of administrative requirements, our case workers are spending too much time doing what i would call administrative duties and less clinical work with children who are in foster care. because of

the mental health needs and mental health mandates it's important our case workers be retrained and refocused on not necessarily providing intensive mental health needs but to be able to look through a mental lens and identify the needs of those children. so we're looking at providing additional case workers to relieve that administrative burden of our clinical case workers. the 7fte would allow them to free themselves to do more of that clinical work. in addition we want them to do more work in the field, so providing mobile tools such as tablets and cell phones to be able to access the statewide data base mobilely rather than come back to the office again with an eye toward having our child welfare workers, our social workers out in the field

with the families and kids they are tasked to serve. the third bullet is compliance monitoring unit that was recently highlighted in a state audit of our agency that was just released a few weeks ago. what the audit noted is that we are lacking in policy oversight and quality assurance of the work in child welfare, meaning we don't have a robust enough infrastructure to make sure what we are doing is consistent with state law, federal law and regs. the audit didn't find that we were violating laws and regulations, it found we didn't have enough infrastructure to make sure. they did note that we need this. what was interesting is we had noted that we needed this long before the audit occurred so the timing is actually good. the next area is in home supportive services. again, similar to medical, similar to

cal fresh, the case load for ihhs has grown significantly over the last 10, 12 years. our fte, our social workers charged with implementing ihhs within the agency, they had grown along with that case load through about july of 07. once the recession hit and we had to, we were getting cuts from the state as well as cuts locally, that fte dropped and has since leveled off. so the implication of that is that we're not able to keep up, you can see in the first bullet, keep up with the required work in the ihhs program and notably every consumer on ihhs, and we have over 21,000 of them, they have to be reassessed annually for their needs, reassessed to make sure the number of service hours they are authorized to receive is the appropriate number of hours, is it high enough, is it too high, is it

too low, and be able to assess is that individual still able to live and thrive in the community and in their home. so you can see with case loads of about 390 we are on time with our assessments in a little less than half of our cases. this isn't putting clients at risk, it's simply not meeting the state mandates around annual reassessments. client are seen, they are just not seen within a year so they could be seen at 15 or 16 month intervals and that sort of thing. so what we're proposing is adding 8 social workers, 2 social worker techs and an ihhs nurse to be able to catch up with the need for annual assessments. >> can i ask through the chair, mr. rourke, miss hinton is here as well that the projections for the senior prop police station are exploding and i'm just wondering why the numbers of case load are not going up higher given the baby

boomers turning into seniors really really rapidly and it just seems like we need to project out as the baby boom generation will fill out in about 10 years. >> right. >> so that we are ready for the huge increase in seniors. >> that's correct, supervisor. san francisco, about 18 percent of our population is 65 and older. statewide average is about 14 percent of the population, so we see here a disproportionate number of seniors. in terms of why it's leveled off, i think there could be a lot of explanations, demographickly or program wise, i think we did a fantastic job increasing our penetration rate over the last 10 years, we're really reaching through community partners, through partnerships with hospitals, through our own internal staff, at reaching folks who need ihhs. i'm still confident we are reaching folks who need

these services to remain in their homes but with the additional staff i think you are right, we will be better positioned to hit that next uptick which i think is coming. i want to mention sort of the question may come up, why not go to a service center model or service center model with ihhs, and it's a different type of program than your typical eligibility program. it's not just getting you on cal fresh benefits or getting you cash assistance. our social workers are doing case work and working with clients and consumers every day. they are building relationships. it's really by its nature a case load design program so it really doesn't lend itself to the more generic services as our other eligibility programs. so the last two slides are really what i've called the tech nical slides. first is

our cal end information system, the information system that we use to determine eligibility for our benefits, medical, cal fresh, cal works and cap. because of the significant changes needed to this information system to implement the affordable care act, the state has provided additional funding to do these software changes and upgrades and you can see they are listed out there but this is basically just spending authority for the almost $2 million from the state to make the changes to our system. and the last slide, although it's a big number, it is really just an accounting ear technical change that reflects the new way that the ihhs program is funded. so the old way, which is reflected in our budget now, is the county expends dollars locally on the program for the staff, our contractor, then we snit a claim to the state and then they reimburse us with federal and state dollars for their

share. so there still is a county share of about 27 million but we get reimbursement from the state and the feds. that share in the old world, the cost to the county could fluctuate, go up and down based on growth in the case load or decreases in the case load in the old funding model. in the new funding which is based on what's called maintenance of effort, the county share does not fluctuate any more. there is an annual 3 percent escalator, but in terms of we see a significant growth in the case load, to your point, supervisor mar, we are not going to see a commensurate increase in county costs. it's fixed at that 27 million number again with a small escalator. but because of the maintenance of effort it changes the way we submit our bills to the state, if you will. we still have the local costs, we have our case workers, we have our consortium and the public authority that total about $107 million. our county share of 27 million is

still fixed but we not only need to pay the contractor and our staff but we also have to provide this maintenance of effort payments to the state. so basically what this piece of the legislation does, it gives us the spending authority to provide that $27 million to the state but then it also gives us the revenue, realizes the additional $27 million in revenue that comes back from the state. so you can see the table, we outlay $107 million for our services, 27 million to the state as our maintenance of effort payments, we continue to draw the share so it's a wash. it's general assembly cost accounting. this is an overview on what

will supplemental is. i'm sure we will discuss when mr. resolution gives his report, but i do want to leave you with this. the way that county human service agencies work and are funded, everything we do, we are a political subdivision of the state, we are required in state code, every county has to have a human services agency, the state is who decides how much funding we get. they look at case loads, they look at new cal works mandates and they decide how much we should be funded. in this case they decided we need 8 million more in cal worbs, they decided we need 7 million more to manage our cal fresh case loads and the like, and they are providing that money to counties. if we don't use the money essentially what we are telling the state is we don't need your money, it's okay, thank you, but -- i understand mr. rose

and his team are doing their analytics and they are doing their rigorous work, they are not looking at whether it's county drars or state dollars or federal dollars, it's all taxpayer dollars and their analysis are sound. but i want to leave you with that, it's a message to the state that we don't need the money to support our most vulnerable is difficult when we are back lobbying saying we need this, we need this, and the governor can say, well, you didn't spend the money we already allocated to you. i will leave you with that as a thread of discussion looking forward to the budget analyst. >> thanks. any other questions right now? >> you said thread or threat? >> thread, with a d >> just joking. >> okay, if nothing else at this point, i know we will come back. mr. rose, can we go to your report, please? >> yes, mr. chairman, members

of the committee, first of all let me state that san francisco residents, supervisors, as you know pay federal, state and local dollars. they are all taxpayers' dollars so, yes, mr. rourke is correct that we look at these reports to determine whether or not the funds are justified. it doesn't make any difference if it's local, state or federal, it's still taxpayer dollars being paid by san francisco residents. in fact, under that theory, we shouldn't look at the airport or the port. those are not general fund dollars. i just want to emphasize that. and so the fact that the state allocated the money and said this is what you need, maybe the state needs a budget analyst. i don't know. >> we can recommend you, mr. rose, if you want to go to sacramento. >> thank you, supervisor. now getting to the details of our report on page 5, the bottom of page 5, as shown in

table 4, the proposed ordinance would appropriate 31.5 million and that's as mr. rourke indicated for new state and cal revenues ascribed to 5 different hsa programs to pay for different expenditures including contractors, client services, training and marketing and that's shown as i say in table 4 on page 6. on page 8 of our report, we note that table 6 details the 68 total positions being added by program for a total of 16.85 fte's for fiscal year 13-14. and on page 9 we note that the salary and benefit costs for the proposed fte's in 13-14 would be funded by hsa existing salary savings in the hsa 13-14

budget. as a matter of fact, the department has a total of surplus funds of 10.8 million. so mr. chairman and members of the committee, you might want to criticize, you might criticize the budget analyst for why we did not make further recommended reductions for this fiscal year. we always attempt to be conservative, anything we recommend we are very very conservative and are quite certain that what we have recommended will be far less than what the department could absorb and in this case they've got millions of dollars worth of unexpended savings in salary savings. by the way, that's been consistent, i might add, for the past several years in this department. >> when you ask the department why there is such a big

increase, what is their response? >> in terms of the salary savings? >> salary savings. >> basically, it's a problem throughout the city. it's with the human resources department it's difficult, there is turnover, when you have 27,000 employees in an operation, it is very difficult and there is attrition on an on-going basis, it is difficult to fill all the positions at any given time. >> mr. rose, hold on one second. mr. rourke, is there something specific just on that point? >> with an fte number of about 2,000 in our agency our natural rate of attrition is about 100, 110 positions, people resigning, it takes months to fill them, you go to a list, if there's not a list you go to an exam, so there is always this vacancy churn but it's important to note that's not the same 110, 150 positions, right? it's different

vacancies over time. you take a snapshot, you say there's 150 vacancies. if you take a snapshot two months later, there may still be 150 vacancies but they're different vacancies. >> what is different now these past 3 or 4 years compared to the years before that we didn't have any salary savings. >> we are now at a vacancy level of, i believe, 170. two years ago we were well over 220, 230, and that was a function of the recession years and trying to contain costs. we intentionally kept positions rather than laying people off, we intentionally kept positions vacant to give us flexibility when times are good we leave the position in the budget and then we can fill it when we have funding available. we've slowly been catching up. even with aggressive hiring,

we still have resignations, we still have retirements, so now we are slowly catching up. the process of the mayor's office has been much quicker but it does take time to catch up because we were so significantly basically understaffed for many years during the lean years. >> so do you have a timeline, a plan, for catching up? next fiscal year or is it going to be -- there is a general attrition that happens but it seems like we have vacancies that are well above what that is. >> we certainly have vacancies above the natural rate of attrition. some of that is because we intentionally kept positions vacant to control costs. we are hiring in both groups. we hired a lot of folks for the affordable care act. our training and staff development team is more robust now so we think we will be caught up and sort of achieve our natural

rate of attrition i would guess by the end of the summer, maybe the fall. because we are doing such an aggressive work in our internal hr department and in partnership with dhr and the mayor's office to fill funded positions and certainly as i showed in the presentation, the work is there. our case loads are growing across are growing across the agency . >> i am not being critical of the agency. we're not saying not give them positions. the positions, existing positions and in this case in specific positions that they are being requested which are vacant, can be filled from existing positions rather than creating new positions. let me just continue my presentation. >> let's have you finish first.

>> so we've identified, supervisors, on page, the bottom of page 10 of our report, the last paragraph there where it says that hsa has a total of 157.2. the department provided us with updated information and we now would revise that number to 152.2, or 5 positions less than the 157.2, and these are across the relevant classifications that we're talking to today. on page -- well, i can go now to our recommendations. first of all our first recommendation on page 12 is to reduce this requested supplemental appropriation by 1349.58, as i understand the department concurs with our recommendation. that's recommendation no. 1. on recommendation no. 2, we're recommending with respect to

all of these positions that instead of a hire date of april 1st that it be may 1st. as i understand it, the department concurs with that recommendation. so it is the third recommendation that we have a disagreement on. and in that third recommendation, based on the new information provided by the department that there are 5 positions which we had previously identified as being vacant which are in fact filled positions, therefore we concur with the hsa on the need for those 5 positions so we're withdrawing 5 positions from our recommendation. however, we continue to recommend a total reduction in the annualized positions by a total of 22 instead of 27, resulting in the reduction from 68 to 46 instead of 68 to 41.

and we continue to recommend that those 22 positions be deleted. i might also add, supervisors, you are going to get a budget in a very short period of time and if the department can justify the need for those 22 positions at that time we'll take another look at it and report back to you. so those are our recommendations and we would be happy to respond to any questions. >> so, mr. rose, i get no. 1, no. 2 i'll get back to you, but i want to ask mr. rourke about that. so you are not discussing about reducing 22 more. is what you are saying is those positions, each one of those actually has equivalent fte slot that exists today that are not being filled? >> in some cases there are existing vacant positions and in other cases, supervisor, we find that the positions are not justified. again, we made a

budgetary review like we do during the annual budget and we saw that there was not a need based on workload for certain positions. we have a disagreement. and again i want to emphasize i understand this is state funds, but we look at it from the perspective of justification because it's still taxpayers' funds. >> thank you, mr. rose. mr. rourke, as you are up here, first of all i get pushing from april to may 1. at best we'll get this through early may now. >> we could probably push to june 1. >> just on an honest realistic, you get funding today, really given the articulation, i get it, i get the frustration, how soon can you on board people? >> many of the positions are actually the fte that appear as vacant, what's appearing as vacant is the permanent civil

service position, for example the 2905 civil service position was showing as vacant when in fact that position is filled by a temp person. there's actually a body in the seat. what we hope to do is they've already been trained, they are already doing the work, is transition that person into the permanent civil service position. we have enumerated how many are filled with temps, how many have been tx'ed into another position. >> do you agree with that? >> supervisor, we got detailed information yesterday show wag we identified as vacant, what they identified as vacant, and we reviewed all of that. it is true some are filled by temporary positions but that doesn't mean that you need a new fte in the annual salary ordinance to hire that temporary position. that temporary position could be filled with the vacant position

they are currently filling. >> i'm not mr. rourke, how does that work, you have a temporary position, you want to move a person from a temporary position to a permanent position, do we still have room in our budget funding there to fill any other temporary position that could continue to arise? >> we don't have, if you go classification by classification, enough vacancies without adding new fte, enough vacancies to do that transition as miss campbell said. a lot of our positions have been tx'ed to entirely different classifications. as you roll through the 7 or 8 more more different classifications --. >> so you are going to see as you are moving some people from temps to --. >> into the new fte as authorized by the supplemental. >> so you will see --. >> they go away.

>> they go away. can someone from the controller's office verify this is the process for temporary positions versus permanent positions? >> i think it's a crux that we have here today. we have temporary positions that and we have permanent positions we want to create with the aso amendment and we have money for that. once staff from a temporary position moves to a permanent position, that temporary position would no longer be around any more. i'm concerned that we're getting double counted here from the budget analyst, i want to verify whether we're getting double counted or not, hoping you might be able to clarify how this process might work. >> i'm lisa sandler with the controller's office. with this particular supplemental we have not looked yet at the portion