PEF testimony highlights need for more health care public employees in state prisons
By DEBORAH A. MILES
Testifying October 30 before a state Assembly Committee on Healthcare in New York Correctional Facilities, Steven Drake, a PEF Executive Board member and statewide labor-management chair for the state Department of Corrections and Community Supervision (DOCCS), focused on the problems associated with short staffing in the state prisons’ medical units.
“The lack of an adequate number of health care professionals serves as an obstacle to those who have chosen providing state health care services within these facilities as their career. These PEF members include nurses, doctors, dentists, psychiatrists, physical and occupational therapists, vocational instructors, teachers and drug treatment specialists. Everyone plays a critical role in ensuring that DOCCS is able to provide comprehensive health care coverage for incarcerated individuals.”
Drake told the committee co-chairs Assemblymen Richard Gottfried and David Weprin that PEF has testified twice before at legislative hearings about the severe negative effects short staffing and mandatory overtime cause on both the staff and inmates.
He cited reports from the Division of Health Services on a number of topics including vacancy rates.
“The nurse 2 title appears to be the driving force behind these high vacancy rates. For some facilities this shortage has meant that there are four health care professionals for 3,000 inmates,” Drake said.
As a vocational instructor at Mohawk CF and a more than 23-year DOCCS employee, Drake pointed out problems at various facilities such as the absence of a dentist at Clinton CF for a year and a half.
“The severe shortage of dentists has had a ripple effect on the other health care professionals. Inmates are going to nurses to have their dental issues tended to, which is out of their scope of practice and puts their license at risk,” he said.
Drake pointed out that health care costs for inmates in state prisons have steadily increased, reaching nearly $381 million in 2015-16, with approximately $28 million dedicated to female health care services.
He said prison health care professionals attend to those with high rates of infectious diseases and serious chronic illnesses, including HIV and hepatitis-C.
“In spite of these serious medical needs, DOCCS Division of Health Services recently authorized the temporary reduction of nursing sick call and closure of infirmaries in select facilities as a result of the nursing staff shortages,” Drake said.
He shared examples with the Assembly Committee about pharmacies being overwhelmed, missing consultation reports, delays in inmate surgeries due to a lack of staff for pre-op blood tests and crowded schedules causing long delays for post-surgery physical therapy.
“Delaying medically necessary care because there is not enough staff to meet all of the necessary protocols or requirements is inexcusable and preventable. Due to a shortage in staff and funding, facilities have to make difficult decisions on how to provide one health care service over another. The shortage also has a direct impact on the health care professionals, who are overworked and experiencing fatigue. This can contribute to medication errors and the ability to provide quality care for each individual inmate,” Drake said.
From 2012 to 2015, DOCCS increased its overtime payments for all titles by 45 percent. Since 2009, there have been 4,654 incidents of mandatory overtime involving DOCCS nurses reported. From January to April 2017, there were 407 incidents of mandatory overtime.
“If that doesn’t illustrate the dire working conditions, then the fact that DOCCS is known as the lead violator of the “No Mandatory Overtime” law should.”
Downfalls of agency nurses
Tim Quain, a nurse 2 who works at Clinton CF and PEF co-chair of the Nurses Committee, responded to questions from the Assembly members regarding the discrepancy in pay for state nurses versus private-sector agency nurses.
“At Sing Sing CF, when a private-agency nurse is needed, they get $70 to $80 an hour. I earn $37 an hour as a PEF nurse,” Quain said.
Drake added, “The ongoing and widening gap between DOCCS nursing salaries and community salaries continues to make recruiting and retaining quality nurses nearly impossible.
“With a growing vacancy level of nurses in the face of geographic differentials, we ask that the state fund an increase in the pay of a nurse from grade 16 to a grade 18, and that the change goes into effect immediately. This salary increase would improve the recruitment and retention of qualified nurses within these facilities.
“Local facilities also continue to adjust minimum staffing levels forcing nurses to work shorthanded. There are registered nurses working 16-hour shifts, off for eight hours, and return for another eight-hour shift with the possibility of getting stuck for another eight hours. And due to shortage of staff and funding, facilities must make tough decisions on how to provide one care service over another.”
Drake also testified about how DOCCS uses contract nurses to fill in the gaps, instead of filling vacancies with state employees.
“The state currently has 20 contracts with at least 13 consultants to provide a variety of nursing services to DOCCS facilities.
“DOCCS procedures and protocols are not something that is part of a typical nurse training. The protocols provide direction on what to do in the event of a workplace assault, how to report one and subsequent steps to take. Not knowing this puts those contract nurses and other DOCCS employees at an increased risk for injury on the job, especially those due to assaults. There were nearly 759 assaults on correctional staff statewide in 2016, a 45 percent increase since 2012. Being fully trained and aware of workplace violence prevention procedures is imperative within the agency.”
Drake ended his testimony saying it would be in the best interest of the state and those who are served by DOCCS to continue to use and expand the state workforce, and for the state to invest in all of the DOCCS health care professionals.