courtesy of CT-N
Dr. Byron Kennedy, the DOC’s chief medical officer (courtesy of CT-N)

HARTFORD, CT – A health care staff shortage in the state Correction Department is driving up overtime costs and creating a dangerous situation for staff who say they are often required to work 16-hour days, union officials said.

It’s been 19 months since the DOC terminated the University of Connecticut Health Center’s contract for inmate care, and the department has more vacancies now (139) than it did in 2018 (120).

In the current staffing situation, the work is “more dangerous for the employees, for the inmates, and for the state,” said Pedro Zayas, communications director for the New England Health Care Employees Union 1199 SEIU which represents about 600 to 700 DOC health care workers. “You can see the lawsuits that are coming in.”

Shocking Overtime Costs

Head nurses, nurses, and licensed nurse practitioners are among the 20 top wage earners in the agency based on their overtime pay, according to state Comptroller Kevin Lembo’s OpenPayroll website.

In some cases nursing staff are making more than physicians when their overtime is added to their base pay. At least three nurses or Licensed Practical Nurses (LPNs) are making twice their annual pay in overtime. The highest paid nurse, whose pay ranks 14th among the highest paid DOC employees, brought in $130,092 in overtime in 2019 above her base pay of $76,667, according to OpenPayroll.

The median income for the 6,732 employees at the DOC is $68,773, according to OpenPayroll.

The highest paid employee is a physician whose base pay was $225,449 in 2019. The physician also received $64,580 in pay from the “other” category, which includes travel and meal expenses and payouts for unused vacation and sick time.

The top paid LPN, who was also among the department’s top-20 wage earners, made a total of $204,665 in 2019 including $121,357 in overtime above a base pay of $50,316. The next highest LPN made a total of $200,041, including $113,981 in overtime above a base pay of $57,359 and $28,791 in the “other” category.

The DOC is $17 million over budget midway through the 2020 budget year, largely because of overtime and increased pharmaceutical costs, the state Office of Policy and Management reported earlier this month. During the last fiscal year, newly hired DOC Commissioner Rollin Cook told the Appropriations Committee that the agency had a $38-million deficiency, with the bulk of the money directly tied to overtime for health care staff based on vacancies and escalating health care costs.

Cook was appointed Commissioner of the DOC in January 2019, mid-way through the agency’s first year following the termination of the UConn Health Center’s contract to provide inmate health care.

Calls for that change came after the legislature heard reports – and the state faced lawsuits – from the families of inmates who claimed their loved ones received negligent care that led to deaths or injuries while incarcerated.

A year-and-a-half later, staff members say the transition has been rocky, with health care workers leaving, leadership positions going unfilled for months, and no opportunities for professional development, which had been available through UConn.

One of the first things Cook did when he arrived in the commissioner’s office was to hire Dr. Byron Kennedy to oversee inmate health care as the DOC’s chief medical officer.

Last week, Kennedy told lawmakers that there are no national standards for medical staffing of correction facilities, but Cook said the agency was struggling to hire nursing staff.

And unfortunately that difficulty in hiring may be causing more departures.

“We are exhausted, we are burnt out, but we are giving the best quality of care we can,” said Bianca Stedman, a nurse at the Garner Correctional Institution.

Stedman contends that the DOC has only hired 25 new health care employees since July 2018, when the agency took over health care for inmates from UConn’s Correctional Managed Health Care unit. Since then, Stedman said she is aware of at least 55 health care workers who have left the agency. The union and Stedman said that the DOC needs to hire another 150 health care workers to meet adequate staff-to-inmate ratios.

courtesy of CT-N
Number of staffers who have left. (courtesy of CT-N)

Cook told legislators during last year’s budget deliberations that the agency had hired 34 new staff, had another 10 slated to start soon, and another 84 in the pipeline.

Last week, DOC officials told members of the Black and Puerto Rican Legislative Caucus that there were 139 positions vacant out of 843 budgeted. Cook said during the meeting that when he started 18 months ago, in his 30 years working as a corrections professional and consultant, he had never seen “an organization that had as many lawsuits coming out of one unit.”

When he took over in January 2019, there was no chief medical officer and no plan for moving forward during the transition from UConn to the agency taking over health care on its own, Cook said. The challenges he faced were “staggering,” he added.

“The agency has seen a significant amount of positive activity associated with recruitment, hiring, and on-boarding of new health care staff,” said DOC spokeswoman Karen Martucci in a response to an information request about health care staffing. “With that being said, maintaining one hundred percent staffing thresholds for a twenty-four hour operation with a hazardous duty retirement comes with its challenges.”

At the same time, as soon as staff is hired, others retire or transfer to other state agencies such as the Department of Mental Health and Addiction Services, Martucci said. DOC hazardous duty retirements allow staff to leave after 20 or 25 years, depending on the contract under which they were hired.

“Essentially as quickly as employees enter the agency, we lose a fair amount on the back end to retirement, which in our case allows for people to retire much sooner than those in similar job classifications working in a traditional community hospital setting,” Martucci said.

The agency lost 83 health care employees in 2019, including 27 who transferred out, 17 who took the hazardous duty retirement, four who took voluntary retirement, 10 who were “discharged,” and seven who resigned “not in good standing,” according to figures provided by Martucci. She did not provide any figures on how many health care workers were hired in 2019, but said that the agency was using per diem employees to fill shifts.

Mandatory Versus Voluntary Overtime

“We laugh when we hear emergency department nurses working at hospitals talk about 12-hour shifts,” Stedman said. “We know that when we come in at 7 a.m. every day that we could be required to work until 12 a.m.”

There are two types of overtime, voluntary and mandatory, according to Deb Cruz, a head nurse with the DOC. Staff can agree to work voluntary overtime to help fill in for shift shortages, she said. But health care staff members are also required to mandatory overtime, which they cannot refuse without risking disciplinary action, Zayas said.

Voluntary overtime is paid at a rate of one-and-a-half times a DOC health care employee’s regular pay. Mandatory overtime is paid at a rate of two times a DOC health care employee’s regular pay, Zayas said.

“This year has been exceptionally difficult due to staffing shortages,” said Cruz, who has worked for the DOC for 13 years.

While working the 11 p.m. to 7 a.m. shift, she would be repeatedly required to stay until 3 p.m. since there often aren’t enough health care employees to safely staff the day shift. Staff support each other and if someone has already worked an eight-hour shift and is required to stay on for another eight hours, their workload is altered during the second shift to maintain safety standards, Cruz said.

“A person who worked overnight and must stay on won’t be handing out medications during the 7 a.m. shift,” she said. “Instead they would be doing sick calls when inmates have a medical complaint.”

Cruz requested and received a transfer to days in October, but wasn’t allowed to transfer until Jan. 17 because of staffing shortages, she said.

She estimated that she works mandatory overtime, requiring her to stay for another eight hours after already working an eight-hour shift, at least three times during the agency’s two-week pay period.

“We take a great deal of pride in what we do as nurses, as X-ray technicians, as mental health clinicians, but we are constantly doing a lot more with a lot less,” she said. “That doesn’t bode well for retention (of staff) or for the health of employees who are staying on.”

Jack Kramer contributed to this report.