By Madeline Shannon
Hundreds of millions of taxpayers’ dollars are being saved by not hiring staff to fill vacant health care roles, the California State Auditor says.
Three state government agencies in California have left many staff health provider roles vacant and instead hired contract workers to fulfill those tasks, the auditor wrote in a recent report. However, even if that saves the state millions of dollars, legal requirements aren’t being met that mandate these departments to hire staff to fill these roles, the report also stated.
The big picture: “The California Department of Corrections and Rehabilitation (CDCR), the Department of Developmental Services (DDS), and the Department of State Hospitals (DSH) have a responsibility to provide medical and mental health care to individuals who are incarcerated in or committed to the facilities they oversee,” the auditor’s report read. “Although the facilities have taken some steps to broaden their recruiting efforts, they could take additional action to make themselves more attractive to potential job candidates, such as offering more scheduling flexibility.”
- Challenging work environments, a shortage of health care professionals and cost-of-living issues are some of the reasons for why it is often difficult to hire qualified staff to fill health care roles at these facilities, the report went on to say.
- According to the State Auditor’s report, the Department of Corrections and Rehabilitation increased its use of contract workers at the Salinas Valley State Prison 46% since July 2019, while the Department of Developmental Services increased its use of contract workers at the Porterville Developmental Center by 172%. The Department of State Hospitals increased its use of contract workers at its Atascadero State Hospital by 79%, the report says.
- In that time, staff role vacancies have increased, despite each of the three facilities trying to bulk up its recruitment strategies to attract and hire workers for those roles. To fill the gap, contract workers have been used, the report says.
- Millions of dollars were saved by not filling vacant staff roles, the report detailed. The Atascadero State Hospital saved $247 million between the 2019-20 fiscal year and the 2024-25 fiscal year, while the Salinas Valley State Prison saved $188 million during the same time frame. The Porterville Developmental Center saved $157 million during that same time, according to the State Auditor’s report.
- Each of these facilities have been the target of lawsuits over the course of 35 years that allege that adequate medical care is not provided at those facilities, the report said. Federal court orders mandating that the Department of Corrections and Rehabilitation fill at least 90% of vacant mental health care roles at health facilities run by the department have not been carried out, according to the state auditor’s report, resulting in more than $95 million accumulated fines to the department.
What they’re saying: “CDCR/CCHCS is committed to providing adequate health care for the incarcerated population, while ensuring fiscal responsibility,” wrote Kyle Buis, a public information officer on health care communications for the California Department of Corrections and Rehabilitation, in an emailed statement to The Center Square. “We thank the State Auditor for their work on this important issue.”
Go deeper: Recommendations from the auditor included requiring the state government’s human resources department, CalHR, to step up recruitment efforts to attract and retain health care and mental health care workers to state facilities. The report also recommended that the Salinas Valley State Prison track what recruitment strategies are successful and how much they cost, seeking affordable housing options for health care workers who would be interested in working for the prison and to implement flexible work shifts for employees.
- “The Department remains committed to enhancing recruitment, retention, and operational effectiveness across all employee classifications, beyond clinical and mental health roles, to maintain optimal and consistent staffing levels,” Jennifer Ayari, public information officer for the Department of Developmental Services, wrote to The Center Square in an email on Monday. “These recommendations will support this ongoing work.”
- The report also recommended that the Department of Corrections and Rehabilitation track staffing levels by shift, whether each shift’s workers are state employees or contract workers, and if each shift had its required minimum number of staff working in each shift versus contract workers who worked the same shift.
- Officials from the Department of State Hospitals said in an emailed response to The Center Square on Monday that the department agreed to implement many of the auditor’s recommendations.\
- “As DSH stated in our response to the report, our hospitals regularly meet or exceed mandated staffing minimums and have self-reported rare occurrences where they have not due to extraordinary circumstances,” officials from the Department of State Hospitals said in the statement. “The audit report acknowledges the significant efforts made by DSH to recruit medical and mental health care professionals using a broad spectrum of strategies, despite unique challenges posed by the nature of forensic mental health treatment.”
- Officials with the Department of Developmental Services also said they concurred with the auditor’s findings.
