CALIFORNIA, USA — Prison psychiatric nurses with badges and guns — who exist only in California — clocked $6.7 million in overtime last year, more than a decade after a federally appointed receiver decided the dual role should be eliminated.
According to salary data obtained by CalMatters, the California Department of Corrections and Rehabilitation paid overtime to approximately 250 employees who functioned as both nurses and correctional officers at three psychiatric programs in the prison system.
A nurse-guard who more than tripled his salary working extra hours at California Medical Facility, the state’s flagship prison hospital in Vacaville, was the top overtime earner in 2019.
Overall, the corrections department ponied up $491 million in overtime last year to employees of its adult and juvenile justice systems, nearly twice what it paid in total salaries and $9 million more than 2018.
The state’s prison system has been accused of excessive overtime spending for at least 20 years.
In response to a public records request, CalMatters received salary data covering the past two years, which indicated that overtime pay rose millions of dollars as California’s prison population increased by fewer than 200 inmates.
Nurse-guards accounted for 17 of the top 100 overtime earners last year, doubling their representation from 2018 and coming in second behind correctional workers, a field that included officers, sergeants and lieutenants and accounted for 70 of the 100 biggest overtime earners last year.
In late 2006, a federal receiver responsible for ensuring the corrections department complied with a class action settlement regarding medical care eliminated the dual position, noting that it was “a form of nurse/police officer that is not used in any other prison system in the United States.”
Classified as “medical technical assistants (psychiatric),” the combo nurse-guards are sworn peace officers who also are either registered nurses, licensed vocational nurses or licensed psychiatric technicians, according to an expired job posting from the California Department of State Hospitals, which supervised the position until 2017. They provide psychiatric care while also supervising inmate-patients for security reasons.
The murky demarcation between helper and jailer caused confusion for inmates who weren’t sure whether they were confiding in healthcare providers or dealing with agents of their incarceration, said Michael W. Bien, lead counsel in a 1990 federal civil rights lawsuit that exposed inhumane mental health conditions in the prison system. The settlement terms of that lawsuit and two other class action cases related to inmate healthcare are still being remediated today.
“In other words, sometimes they were in correctional roles, sometimes they were in medical roles and a patient needs to know that someone is one or the other,” Bien said.
The phaseout caused a hiring freeze that “temporarily increased the need of overtime … to ensure proper patient care was provided,” California Correctional Health Care Services said in an emailed statement to CalMatters.
Fewer nurse-officers worked heavier hours last year. Overtime for the hybrid jobs dropped roughly 34 percent last year; in 2018, 344 nurse-officers earned $10.2 million in overtime. But last year more nurse-officers appeared in the top 10 and top 100 overtime earners.
In an emailed statement, Deputy Press Secretary Terry Thornton said the corrections department, which had a $12.6 billion budget last year, “strives to limit overtime” by closely tracking job vacancies, but that it’s “sometimes unavoidable and a natural part of the operation of a 24-7 public safety organization.”
Thornton added that more lucrative labor contracts, expanded rehabilitation requirements, unpredictable wildfire seasons and an aging prison population in need of greater medical care all contribute to increased demand for overtime.
This year, COVID-19 outbreaks behind bars forced the early release of 16,000 inmates and required correctional employees to pick up the slack of nearly 2,000 infected co-workers. Thornton said the department couldn’t provide an estimate of overtime costs as it continues to respond to the unfolding health crisis.
Financial management of the state’s prison system is not a new concern.
In 2009, the California state auditor warned that expenditures were rising significantly even as the inmate population was declining. More than 8,400 correctional officers earned higher salaries than superiors two levels above them in 2008.
The leader of the California Senate challenged the prison system to be mindful of its expenditures during a statewide fiscal crisis.
“The department needs to do more to keep overtime as low as possible without compromising adequate staffing for services and jeopardizing the health and safety of the public, staff and inmates,” state Senate Pro Tem Toni Atkins said in an emailed statement to CalMatters. “Further, this year’s budget reduced salaries for most state employees, including CDCR staff.”
A psych nurse with a gun
Thomas L. Dewitt was the top overtime earner in 2019, raking in nearly $186,000 in overtime pay last year as a psychiatric medical technical assistant at the California Medical Facility. He was paid overtime of more than double his $90,800 annual salary, bringing his total to $292,000. According to state nursing records, Dewitt is licensed as a vocational nurse through August 2021.
Dewitt, who ranked fifth in overtime pay the previous year, wasn’t the only person in his field to pull in six digits from extra shifts.
Psychiatric nurse-officers made up five of the state corrections department’s top 10 overtime earners last year. Dewitt’s coworker Renato Rivera pulled in nearly $158,000 at the California Medical Facility, ranking third in overtime last year. Nkemjika T. Anyanwu fell just behind Rivera at Salinas Valley State Prison. Another Salinas Valley MTA, Josephine A. Elelleh, ranked sixth with just over $137,000, while Ekow-Yartel Cudjoe, a California Medical Facility MTA, placed eighth with $136,000 in OT.
Prison healthcare officials said nurse-officers who were being phased out of psychiatric inpatient programs in adult correctional facilities would have to transfer to one role or the other.
Bien said the prison system didn’t accurately predict how many employees would choose a correctional role over a healthcare one, and that led to shortages in nurses.
“In all of the mental health positions, there have been shortages and they’ve not been able to hire to fill positions,” he said. “That’s been especially true in the mental health program. It’s a big problem.”
As the independent Little Hoover Commission found in 2015, Bien said the corrections system relies on overtime and registries to fill its healthcare employment gap on a temporary basis at extraordinarily high pay scales.
“There’s always been a pattern of not filling the full-time positions and using overtime and registry instead,” Bien added.
The large amount of overtime paid to nurse-guards raises questions of employee burnout and patient care. Thornton noted that the corrections department was “looking to address situations of excessive overtime” through recruitment and retention efforts. Nearly a thousand job vacancies were posted on Aug. 8, including 330 nursing positions and more than 300 mental health ones.
The California Correctional Peace Officers Association and its president Glen Stailey didn’t respond to multiple requests for comment.
While the corrections department paid more in overtime last year, the money was spread around more. Last year, 53 correctional employees raked in more than $100,000 in overtime, while another 55 clocked between $90,000 and $100,000 in OT.
That’s downright temperate compared to 2018, when 227 correctional employees earned more than $100,000 in overtime. A correctional lieutenant named — perhaps appropriately — Fred Money II at the minimum security California Correctional Center in Susanville was the top overtime earner that year, making $197,825.52 of his $308,200 in total wages via extra hours. He fell to 168th place last year.
Last year’s 100 top overtime earners were scattered across 30 institutions, with the California Medical Facility hosting the most at 13 employees, all but one of them psychiatric medical technical assistants.