|Budget Issue:||Additional nursing positions for medication distribution|
|Program:||Department of Corrections and Rehabilitation|
|Finding or Recommendation:||Reject Governor's proposal for an $11.9 million General Fund augmentation for an additional 211.3 nursing positions to distribute medication to inmates, given that none of the additional nursing positions authorized in the 2010-11 budget for this purpose have been filled. Reduce the Receiver's inmate medical services budget by $6.7 million to reflect that these funds that are no longer needed--as indicated by the Receiver--for the purposes that they were provided for in the 2010-11 budget.|
Governor’s Proposal. The 2010-11 Budget Act included a $10.1 million General Fund augmentation for 145 additional nursing positions to distribute medication to inmates in a more timely and efficient manner, as part of the federal-court appointed Receiver’s inmate medical services program. For 2011-12, the Governor’s budget proposes an $11.9 million General Fund augmentation for an additional 211.3 nursing positions for medication distribution. (Unlike the 145 nursing positions provided in 2010-11, the requested positions would be for a two-year limited term basis.) In addition, the Receiver proposes to redirect 50.8 nursing positions and $6.7 million to support medication distribution that were authorized in the 2010-11 budget specifically to help meet other workload needs, but that are no longer needed for those other purposes. According to the Receiver, the additional positions are needed in order to reduce the current use of overtime and registry nurses, which generally are more expensive, on an hourly basis, than using department staff.
Previously Approved Positions Remain Unfilled. At the time of this analysis, staff to the Receiver report that none of the additional 145 nursing positions funded for in the 2010-11 budget have been filled. In addition, we were recently informed that—when these positions are filled—the Receiver intends to consolidate the additional nurses at six prisons, rather than across 22 prisons as was initially proposed. According to the Receiver, this new staffing plan will result in greater overtime and registry savings.
Recommendation. Since none of the additional nursing positions authorized in the 2010-11 budget for medication distribution have been filled, we believe that it would be premature at this time to authorize an additional 211.3 positions for the same purpose. Moreover, until the previously approved positions are filled, there is no way for the Legislature to know whether those positions resulted in state savings from a lesser reliance on overtime and registry nurses. Accordingly, we recommend that the Legislature reject the Governor’s proposal to add 211.3 new positions and $11.9 million from the General Fund for medication management. We further recommend that the Legislature reduce the budget for the Receiver’s inmate medical services program by $6.7 million to reflect that these funds—as indicated by the Receiver—are no longer needed for the intended purposes that they were provided for in the 2010-11 budget. To the extent that the Receiver is able to fill the existing nursing positions for medication distribution and provide sufficient data on actual savings during budget deliberations, the Legislature could reconsider the request for additional nursing positions at that time.