Senator Hueso Issues Statement on State Audit of San Diego County Health and Human Services Agency

July 26, 2018

San Diego, CA – July 26, 2018 – In response to the California State Auditor’s audit report finding that the San Diego County Health and Human Services Agency (HHSA) cannot demonstrate that it employs the appropriate number of public health nurses to efficiently serve its residents, State Senator Ben Hueso (D-San Diego) today issued the following statement:
“In August 2017, after stakeholders in San Diego County provided information to our office that showed staffing deficiencies for public health nurses within HHSA, I submitted a letter to the State's Joint Legislative Audit Committee requesting an audit of the agency.
The audit report released today confirms that there were, in fact, inadequate levels of staffing of public health nurses to efficiently serve San Diego County’s residents. This is clearly a concern because county public health nurses play a critical role in promoting health, preventing disease and increasing healthcare access for under-served and at-risk populations, and a consistent lack of adequate staffing levels can lead to a public health crisis if not remedied.
Despite these inadequate staffing levels, I’m happy to see in the audit’s findings that HHSA implemented its draft Public Health Personnel and Infrastructure Surge Capacity Plan (surge plan) in response to the Hepatitis A outbreak. In addition, they formally adopted the draft surge plan and added 12 new public health nurse positions in June 2018.
However, I am disappointed that HHSA disagrees with the recommendations of the audit and has declined to establish protocols to measure and assess efficiency of public health nurses, including such factors as caseload, case complexity and overtime, despite the fact that the audit revealed 81percent of nurses surveyed said their caseload was too high and 50 percent said they could not effectively accomplish their jobs. They also could not account for why the state’s recommended nurse-to-patient ratio of 1:200 was exceeded in five of their six regional departments in foster care and children’s services.
The number one responsibility of state and local government is the health and safety of the public. We need to ensure the county does its job and invests the appropriate resources where it matters most.
We will be looking at possible legislative solutions to address the current lack of statewide efficiency measures for public health nurses in an effort to ensure consistency across California."

The full audit report can be found here: