Investigation: Overtime, Temps Add Major Costs to Prison Health Care
Excessive overtime and an overreliance on temporary workers could be contributing to inadequate care and ballooning costs in California's prison health care system, according to a recent Sacramento Bee investigation.
California is paying out large sums for inmate health care at the same time the state is facing a severe budget crunch. For the fiscal year ending in June 2008, California spent about $2.1 billion on prison medical care.
Of that sum, about $60 million went to overtime wages for medical workers. The total does not include the $111 million in overtime wages paid to guards who protect health workers in the prison system.
In California, overtime accounts for nearly 20% of all wages for prison nursing care.
Some of the factors accounting for the high overtime rates include:
- High compensation rates for overtime work;
- Staffing gaps for prison health workers;
- The suicide watch program, which requires health workers to monitor inmates at risk of harming themselves; and
- Union contracts that allow for unlimited voluntary overtime.
Experts say excessive overtime can threaten patient safety because exhausted health workers tend to be more prone to medication mistakes and other lapses (Piller, Sacramento Bee, 12/13).
Not only is California's prison system spending significant sums on overtime wages, the state also is paying out large fees to employ temporary health workers.
From July 2008 through May 2009, California spent $152 million on temporary prison health workers. The state could have reduced spending by $22 million if state employees had done the work the contractors undertook, according to the Bee.
In March of this year, federal receiver J. Clark Kelso imposed new rules that capped temporary workers' hours at 975 per year. The new regulations also allow prisons to employ significantly more temporary workers.
Kelso said the new rules are designed to cut costs and decrease prisons' dependence on temporary workers.
However, the Bee reports that the regulations could swell the ranks of temporary workers from 1,700 to 2,800, thus causing the prison health care payroll to grow by at least $60 million.Observers say an increase in the number of temporary workers could threaten patient safety because it could impede continuity of care (Piller, Sacramento Bee, 12/14). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.