Sherburne County considering adding assistant HHS director

Managing Editor

The Sherburne County Board of Commissioners wrestled at a Feb. 21 work session with what it would mean to the county to adopt a proposal to create an assistant director of health and human services post and a public health nursing supervisor position.
The cost of such a move could top $90,000 in 2018 and significantly impact the county’s tax levy. Determining the exact cost is complicated by a mix of moving parts, including retirements, potential hirings that could save money and reimbursements that flow to the county to cover a variety of initiatives. Shifting responsibilities would require reconfiguring the means to secure those funds.
County commissioners would like a better handle on how those things would shake out and a careful assessment of the department’s staffing.
County Board members will take up a more formal request on the matter at its March 14 meeting.
Commissioner Tim Dolan, however, would like the administration to go one step further and begin to look at a longer-range plan.
“I don’t want to sound like I don’t support this,” Dolan told Mary Jo Cobb, the director of health and human services. “I understand they’re needed.
“I have a problem not having a long-term plan and having to piecemeal this together. It’s a lot easier for me to justify in my own mind and to explain to taxpayers this is the growth plan we’re following.”
Dolan would like to see a plan that highlights when the health and human services director would be back asking for staff and administrative help. Such a plan would say when the county hits this number, this is what they’re adding to best serve the community.
Dolan and Commissioner Lisa Fobbe both expressed concern over staffing and administrative ratios, starting at the top where Cobb now has 13 direct reports.
Sherburne officials have run comparisons with other counties and have found their organizational chart leaner than most. Stearns County officials have said their rule of thumb to adding an assistant is after a director has five to seven direct reports.
Without wanting to sound critical, Dolan asked how the county got to this point.
Cobb explained how the department has built over the years, starting with the merging of county social services and public health. Increasing demands and growing caseloads have been dealt with mostly on the front lines and by adding supervisors when the number of unit employees grows beyond 20.

Merger
Sherburne County merged its public health and social services departments in 2011.
Public health had two units then along with two supervisors, and social services had eight units and eight supervisors. That left the health and human services director with 10 direct reports, about three to five more than comparable counties.
Since then, three more units have been created, giving the Sherburne County’s director of health and human services 13 direct reports.
The additional units were created when the number of reports supervisors had pushed past 20. The first to be added was a clerical supervisor and the decision was made to split the accounting clerical supervisory duties.
The county also reorganized some of its child protection efforts when the state provided additional funding for child protection investigations.
The most recent change was splitting the aging and disabilities unit, for which one supervisor was responsible for 25 staff.
“All of these units were split when they had at least 20 or more staff in them,” Cobb said.
The state recommends a supervisor-to-staff ratio of about 1 to 8. Cobb estimates Sherburne County Health and Human Services averages about 1 supervisor to 12 employees.
As demands have grown, Cobb said she has focused on adding caseworkers first and supervisors when they reach a breaking point.
She now feels her own position is at a breaking point. Recent retirements – including another this week that bids goodbye to Cindy Bayles, a 35-year employee of the county – create new issues as their work gets shuffled, absorbed or handed off to new employees and young recruits fill in spots previously held by experienced employees.
Today six of Cobb’s supervisors have less than two years’ experience in their position and soon there will be a seventh and possibly and eighth.
“I was blessed in the beginning to have staff that were very, very experienced,” Cobb said. “They taught me a lot.”
But retirements have changed the dynamics and there has also been turnover of some new recruits. Cobb said two, maybe three, have left in part because they didn’t feel they were supervised enough.
One employee on an exit interview said she felt like she was ready for more responsibility but hardly saw her supervisor.
Another trouble spot for Cobb was created when Kathy Landwehr retired as a public health supervisor. She wore multiple hats and Cobb has had to don at least one of them that the Department of Health has said it will tolerate on an interim basis but not permanently. She lacks the experience required by state law in public health supervision. Cobb said she has the degree needed and management experience, but not in public health.
Her proposal is to add an assistant director who could focus on public health as well as supervise four social services units and to add a public health nursing supervisor who can supervise nurses, handle day-to-day operations and be out in the public.
The assistant director could help ensure the county is able to manage various demands like the Community Health Assessment, the  Statewide Health Improvement Plan and the Quality Improvement Plan, Cobb said.
“I could use some help,” Cobb said. “I have 13 reports right now, the demands are greater. The rules are tougher. We have 175-plus staff.”
One of Cobb’s goals for her department is to establish a community advisory committee, but there hasn’t been enough time to do it.
“While I much prefer to invest in more staff to do our caseloads, I just cannot do this job the way it needs to be done,” she said.
County Administrator Steve Taylor agrees.
His sense since arriving here a few years ago is there has been a hesitancy because of the cost and impact on the levy to deal with middle management needs.
“It’s a hard ask,” he said. “It’s a hard thing to support. My concern is staff is burning out.”