Orange County officials are hiring more recruiters, studying their pay scale and looking to partner with educational institutions such as UC Irvine in an effort to fill hundreds of vacancies in the OC Health Care Agency.
But staffing positions in the agency may continue to be a challenge in the next few years, Director Dr. Clayton Chau said, with many agencies looking to fill out their pandemic-depleted rosters and Gov. Gavin Newsom’s proposed budget including $200 million to improve public health systems across the state.
“I have to beef up my infrastructure,” Chau said. “It means everybody else is doing the same thing, too, so the competition’s going to be even stiffer.”
While turnover of 10% or more a year isn’t uncommon in county government, the health agency’s current 20% vacancy rate is higher than the county’s overall (it’s about 11%), county CEO Frank Kim said.
In December, Kim said HCA had 589 vacant jobs out of 2,928 budgeted positions in the department. Some of the biggest gaps are in correctional health, which provides medical staffing for the county’s jails; behavioral health, which deals with mental health and substance abuse; and public health, which includes a clinic and lab and communicable disease prevention services.
Kim and Chau said a number of factors have led to the high vacancy rate. Early in the pandemic, facing uncertain revenue forecasts, the county announced a hiring freeze – and then, to save money, it offered all county employees an early retirement or voluntary departure incentive program.
The pandemic also has been especially hard on public health workers, who have suffered burnout and in some cases harassment and abuse from a public angry about mask mandates, business and school closures and other measures.
News stories from the last two years described high-profile public health professionals quitting or being fired in record numbers; OC’s former health officer, Dr. Nichole Quick, resigned in June 2020 after protesters showed up at her home and she reportedly received threats.
With the hiring freeze lifted, Kim said the county also recently added positions to the health agency – about 70 in the past year – to respond to community needs, but that also meant even more people to recruit.
But Chau said one of the big reasons OC has had trouble filling public health vacancies is that some are positions requiring specialized skills and training, such as psychiatrists and social workers who handle some of the most difficult cases.
The county pays mental health professionals to get licenses, but once they’ve got some experience under their belt and their license in hand, Chau said many leave for better pay in the private sector.
In some cases, the county has contracted out to fill public health positions. That prompted District 2 Supervisor Katrina Foley to ask Chau about long-term solutions at a Dec. 14 Board of Supervisors meeting.
“It does concern me that we continue to extend these ‘temporary’ contracts and they’ve turned into permanent contracts,” she said at the time.
Officials are taking several approaches to reduce the number of open positions in public health.
Last year the county hired five recruiters to work with the health agency, and it planned to bring on several more this month, Kim said.
They’ll be updating a salary study of behavioral health professions to see how competitive the county’s pay is, and they’re trying to learn more about why people are leaving so they can address any complaints, Kim said.
Kim and Chau both said they don’t think the staffing situation has prevented the county from responding appropriately to the pandemic, and Kim said officials should have a better handle on the health agency’s long-term needs in coming months.
“We’re going to be less in crisis mode and more in ‘this is our new world that we’re living in’ mode,” he said.
“We’ve already put a lot of positions in health care and we’ll continue to invest in it.”
