Budget committee pauses $59.7M Cross Country Staffing increase for DPH registry contract

The Budget and Finance Committee on Dec. 1 continued a proposed expansion of the Department of Public Health’s contract with Cross Country Staffing after supervisors sought more data on vacancy rates, hiring timelines and the tradeoffs between registry (temporary) staff and permanent hires.

The resolution before the committee would amend the existing Cross Country Staffing agreement to increase the not‑to‑exceed amount by roughly $59.7 million and extend the term two years to June 30, 2024. Terry D’Antoni, who introduced the request as the department’s chief nursing officer, told the committee the increase responds to actual expenditures and continued pandemic‑era needs: “This contract has been integral to the success achieved by the department in its response to COVID‑19,” she said, noting the department expects lower registry spend in later years but needs capacity now.

The Budget and Legislative Analyst recommended approval with amendments requiring DPH to report actual contract spending so the office can review it during its annual budget process. Vice Chair Asha Safai pressed DPH for more specific workforce figures — including current RN vacancy numbers and average time‑to‑hire — arguing the city must reduce reliance on agency nurses. DPH said its Zuckerberg San Francisco General vacancy was at 4% (with higher rates at some facilities) and provided a citywide DPH vacancy rate of 8.49 (about 263 vacancies), while describing accelerated hiring events and training partnerships with local universities.

Committee members said they were sympathetic to DPH’s staffing pressures but worried about long‑term reliance on temporary staff and the size of the proposed contract. After voting to accept the BLA’s amendments requiring spending reports, the committee voted to continue the item to the Dec. 8 Budget and Finance meeting to allow DPH to provide HR and spending details requested by supervisors.

The continuation preserves the department’s ability to return with amended language while ensuring the board receives more detailed evidence on the costs and staffing tradeoffs before a final recommendation to the full Board of Supervisors.