2017-124 Audit Scope and Objectives

San Diego County Health and Human Services Agency—Public Health Nurse Staffing Levels

The audit by the California State Auditor will provide independently developed and verified information related to San Diego County Health and Human Services Agency (HHSA) policies, procedures, staffing levels, and vacancy levels for public health nurses (PHN). The audit's scope will include, but not be limited to, the following activities:

  1. Review and evaluate the laws, rules, and regulations significant to the audit objectives.
  2. Determine whether HHSA is meeting its statutory obligation to provide care and appropriate staffing levels to San Diego County's children in foster care by performing the following:
    1. Identify the average foster care caseload for HHSA's PHNs over the last three years.
    2. Identify what actions, if any, HHSA has taken to reduce the ratio of foster children to PHNs.
  3. Evaluate HHSA's allocation of its PHN resources by determining the following:
    1. Whether HHSA's PHN allocations comply with state guidelines and time frames. Further, identify the average caseload for HHSA's PHNs over the last three years.
    2. To the extent possible, whether HHSA's PHN allocations are appropriate in relation to current public health impacts.
    3. Whether HHSA has adequate financial resources to address PHN staffing deficiencies, if any exist.
  4. Evaluate HHSA's PHN staffing levels and vacancies by determining the following:
    1. Whether HHSA has developed and implemented recruiting programs, policies, procedures, and hiring practices to ensure there are appropriate levels of county PHNs available to serve the public.
    2. Whether HHSA has adequately staffed its facilities with PHNs and filled its PHN vacancies.
  5. Review and assess any other issues that are significant to the audit.

California State Auditor's Office
8/24/2017


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