Report 2015-507 Recommendation 8 Responses

Report 2015-507: Follow-Up—California Department of Public Health: Laboratory Field Services Is Unable to Oversee Clinical Laboratories Effectively, but a Feasible Alternative Exists (Release Date: September 2015)

Recommendation #8 To: Public Health, Department of

To ensure it can provide effective oversight of labs as state law requires, Laboratory Services should address staffing issues by preparing and resubmitting to Public Health a recruitment and retention proposal, developing a succession plan, and taking necessary steps to implement its planned reorganization.

Annual Follow-Up Agency Response From September 2021

LFS is currently updating the recruitment and succession planning guide that was originally drafted and completed in 2017. That guide has allowed LFS to work to fill vacancies and attend outreach events in Southern and Northern California to help recruit for hard to fill Examiner positions. Due to the ongoing COVID pandemic, we are still limited in our options to reach potential applicants but have worked with Human Resources Division (HRD) to find creative ways to post vacancies in other forums besides Cal Careers. LFS is committed to finding ways to recruit and retain qualified staff and is currently exploring other avenues such as classification reviews with CALHR or professional salary surveys as an option to help LFS fill positions.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From October 2020

Our previous response submitted on 9/2/20 is still current.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From September 2020

LFS has had increased success with recruitment and retention during the past year. By accelerating its hiring process, it has seen a decrease in the number of top candidates who have taken job elsewhere before LFS could make an offer or schedule an interview. Turnover has also decreased considerably as many staff are teleworking and no longer have lengthy daily commutes, which in the past has played a key role in people seeking other employment. In FY19-20, turnover went down to 10%, with three staff members getting promotions elsewhere (two within CDPH), three people retiring, and one person choosing to work closer to home (pre-COVID 19). One of the staff members who retired has returned as a retired annuitant. Within the past year, five staff members have received internal promotions. Among supervisors and managers there were no turnovers. While LFS is happy with the progress that it's made in the past few years, it still needs to develop a long-term strategy for recruitment and retention.

LFS does have key staff with significant state service time who are near retirement age and are in hard-to-fill classifications. It has previously enlisted the assistance of a Clinical Laboratory Technical Advisory Committee subcommittee on recruitment and retention. They found that salary ranges being offered for those state classifications were not competitive when compared to the private sector and was causing difficulty in filling those positions. Addressing this will be a significant component of the succession plan.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From September 2019

Public Health continues to prioritize recruitment and retention. Increased training opportunities, promotion pathways, and improved onboarding have reduced staff turnover rates. The program has seen its turnover rate decrease from 20.5% in 2015-2016 and 26.9% in 2016-2017 to 16.9% in 2018-2019. Of the 12 staff members who left during 18-19, four retired. Since 2017-18, 16 (22.5%) staff members have received promotions, supporting retention. Of our management and supervisory team, LFS retained 90% from 2016-17 to 2017-18, and 80% from 2018-19, with two departures due to retirement. LFS has strengthened its recruitment and retention efforts and stabilized its workforce, and is now working to complete a succession plan by the end of 2019.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From October 2018

CDPH submitted its last annual follow-up in September 2018. No further changes have been made since the last response. However, CDPH anticipates to fully implement CSA's recommendations by December 2018 as stated in the last response.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From September 2018

During the past two years, Laboratory Field Services (LFS) has taken many steps to stabilize its work force. It has begun an aggressive approach of developing policies and procedures - nearly 80 have been completed and 100 are under development. Additionally, the program has developed onboarding materials, promoted cross-training within the program, encouraged training opportunities for staff, and placed staff in positions where they have sufficient qualifications and experience and encouraged vertical growth. Since fiscal year 2015-16, LFS has promoted 21 staff members in Los Angeles and Richmond - 10 within the examiner series, six within the analyst series, and five within the program technician series. Promoting internal candidates has allowed us to maintain continuity with many of our projects, help provide a level of organizational stability that we have not had previously, and reduce the need to continually train new employees. In 2017, the program initiated a strategic planning process. One recommendation was to open a field office in Sacramento. Examiner positions have been hard to fill because state government salaries are behind those of the private sector and because LFS' offices are located in the two most expensive regions in the state. Opening a Sacramento office will broaden the pool of examiner candidates, enhance recruiting abilities, and allow us to conduct inspections of Northern California laboratories more easily. To support this effort, LFS has actively recruited at public health laboratory events throughout the state. Establishing the Sacramento office, along with the call center and the internal reorganization (see response to Recommendation #9), are the three major components of LFS' proposed overall reorganization. A succession plan was drafted in 2016 but due to changes in personnel, the Branch has decided to revise it. A survey that was used for the 2016 plan was revised and was sent out in summer 2018.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From September 2017

LFS continues to use an enhanced recruitment and retention plan, and continues to revise policies and procedures, as well as workflow processes to optimize use of clerical and analytical support for administrative functions. LFS, working with the Department's Human Resources Branch (HRB) and Office of Quality Performance and Accreditation, has completed a succession plan. HRB continues to hold the Examiner classification exam on a continuous (quarterly) basis, and it is available online. In addition, LFS contracted with a facilitator to do strategic planning and succession planning. After a series of off-site meetings with the management staff, LFS is finalizing the operational aspects of the re-organization and strategic planning.

In SFY 2016/17, LFS initiated twelve new requests for personnel actions for examiners, and completed ten. Nine separations occurred. A total of 32 applications were received, 18 interviews were conducted, and 4 new examiners were added. LFS attended five recruitment events in SFY 16/17, and implemented one recruitment activity that included mailing out thousands of postcards to all active clinical laboratory scientists and public health microbiologists to advertise Examiner classification exams and vacancies.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

1-Year Agency Response

Laboratory Field Services (LFS) continues to make progress addressing staffing and recruitment issues for the program.

LFS implemented the recruitment event calendar and made progress on the recruitment plan reported in the March 2016 update to this audit. LFS also revised numerous policies and procedures and workflow processes to optimize use of clerical and analytical support for administrative functions. This frees examiners to focus on the clinical technical aspects of their job.

In September 2016, LFS filled the Branch Chief position, two Examiners positions (an Examiner I and an Examiner III), a Supervising Program Technician II position, and a Program Technician II position.

LFS has approved two additional Accreditation Organizations (AO) applications during SFY 2015/2016. This enables the AOs to perform more inspections and complaint investigations for effective oversight of labs. The required routine clinical laboratory facility inspections will be performed by AOs or in coordination with Laboratory Services federal Clinical Laboratory Improvement Amendments surveys.

Rather than acquiring a consultant to develop a succession plan, LFS will work with the Department's Human Resources Branch, Office of Quality Performance and Accreditation, and CalHR to develop a succession plan specific to LFS's recruitment and retention needs. It's anticipated that this could be completed by July 2017.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

Laboratory Services has taken some steps to address staffing and recruitment issues as recommended. It continues to work on its succession plan.

6-Month Agency Response

Laboratory Field Services Branch (LFS) is actively recruiting for its vacancies and all positions have hiring packages. LFS hired an Examiner III and an SSA. LFS is waiting on final HRB approval for two additional Examiner I positions and one AGPA. The Branch Chief position is in an "open exam" phase concluded March 1, 2016, and HRB is reviewing the exam applications. LFS developed a final recruitment event calendar and developed a draft recruitment and retention plan.

LFS continues to work with upper management and the Department's Contract Management Unit on the Scope of Work for acquiring consultant services to assist LFS in addressing this recommendation.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CDPH is in process of hiring a candidate for the position of Examiner III (Section Chief) for on-site facility inspections of licensed laboratories. This position is responsible for AO application reviews, civil money penalties, and ensuring timely performance of on-site inspections. In addition, CDPH is in process of hiring an Examiner II, and has already filled several clerical positions, as well as the personnel liaison position. CDPH will continue to look for candidates for a vacant Examiner I position.

To address recruitment and retention challenges, CDPH has taken the following actions:

- In October 2015, LFS participated in a statewide annual conference of the California Association of Public Health Laboratory Directors, with the goal of increasing LFS' visibility as a desirable career.

- LFS has implemented new policies related to training. Information technology classes such as MS Word, Outlook, and Excel have been held on the Richmond campus for the first time in over six years. In addition, LFS staff is encouraged to attend career related and growth trainings provided by CalHR, and to pursue career growth opportunities. Currently, two existing Examiners and one analyst are pursuing graduate degrees.

- LFS management, in coordination with the new personnel liaison, is working on developing a formal recruitment and retention proposal, succession plan and reorganization.

California State Auditor's Assessment of 60-Day Status: Pending

The California Department of Public Health (Public Health)'s response discusses various plans for taking corrective action. We will re-evaluate the status of this recommendation once Public Health substantiates the steps it has actually taken.

All Recommendations in 2015-507

Agency responses received are posted verbatim.