County workers urge board to delay ECM layoffs, warn of patient‑safety and homelessness risks

An extended public‑comment period at the Feb. 10 Contra Costa Board of Supervisors meeting drew dozens of county staff, union leaders and clinicians who urged the board to halt or delay proposed layoffs and restructuring in the Enhanced Care Management (ECM) program.

Speakers included union representatives, coordinated entry specialists, public health nurses, program managers and physicians who submitted letters of support. They described the ECM workforce as providing intensive, clinically informed case management to medically and behaviorally complex residents and warned that replacing experienced public‑health nurses with community health‑worker contractors would degrade care, increase hospital and emergency department utilization, and risk patient safety.

"Layoffs don't just reduce staffing, they create internal displacement due to seniority rules," said Britney Ferguson, a coordinated entry specialist, explaining how layoffs could disrupt ongoing housing and treatment cases. Several clinicians read letters from physicians attesting that ECM nurses prevent rehospitalizations and provide critical medication reconciliation and follow‑up.

Union leaders and employees asked the board for several actions: extend the layoff notice period to allow time to find internal reassignments; prioritize transfers and hiring freezes that preserve existing staff; and direct county leadership to exhaust alternatives before layoffs. One union speaker characterized the staffing reductions as the result of management decisions rather than federal cuts and asked the county to explore alternatives.

Board members acknowledged the concerns, thanked staff for their service and reiterated that the county seeks to minimize layoffs where possible and identify redeployment options. The board did not take a final vote on ECM staffing at this meeting; staff and supervisors said they will continue discussions and consider the workforce implications in coming weeks.

Next steps: staff and labor representatives indicated they will meet to explore alternatives, and the board signaled interest in keeping employees "in the county family" where feasible while addressing budget and program needs.