California State Senate Fails to Pass Prison Health Construction Bond: Federal Court Receiver Demands $3.5 Billion, With More to Come, Worsening State Budget Deficit

Maybe it is the intentional result of CA's "Reich Stag" to go ahead with AB 1965 while remaining faithful to their base by declaring they are once again "raped victims" of the Judicial Tyranny from the left. I hope Kelso sticks to his guns and follows Lady MacBeth's advice to "screw [his] courage to the sticking place".. or better still.. Ahnold's arse.

$7 billion is definitely alot of money. Of course much of this money is going toward the exhorbitant salaries of the psychiatrists and psychologists, as well as the registered nurses and the Medical Technical Assistants employed in the Dept. of Mental Health. The Medical Technical Assistants,in particular, are paid salaries comparable to registered nurses in the private sector. This, combined with their average overtime pay,rivals some physician salaries.

A more fiscally responsisble approach would be to hire licensed vocational nurses and psych techs. to replace the overpaid MTA's. A State LVN's base salary is roughly half of that of an MTA's. Yet each class maintaines basically the same licensure. This approach was accomplished in the California Dept. of Corrections with mixed results, but still better than what was expected.

If the State is truly interested in wrestling with the budget, then I would think that it would want to take a long look at what I have just outlined.

Excuse me, Mr. Laughton but there are only 300 or so MTAs in the state. So to claim that "much of" the $7 billion CDCR budget is going toward the salaries of those 300 people is simply dishonest and irresponsible.
Furthermore, the approx. $150,000 year earned by a small minority of MTAs who work large amounts of overtime, hardly "rivals" the base pay of state physicians which, last time I checked, was somewhere in the neighborhood of $250,000.

It also needs to be emphasized that as the only inpatient psych units found in the prison system, DMH units fill a unique niche in the delivery of mental health treatment for CDCR inmates. Inpatient psych facilites provide treatment 24 hours a day. That's 24 hour a day monitoring, assessment and intervention much of which is accomplished through routine interactions between licensed nursing staff and patients. In inpatient psych units these interactions with patients are the domain of licensed nursing staff because they represent an opportunity to clinically monitor, assess and intervene. Because they are not 24 hour a day psych treatment facilites, in all other prison settings (CCCMS. EOP, mainline etc.) such routine interactions are the domain of correctional officers. But correctional officers are not licensed nursing staff and so cannot perform this function in an inpatient psych setting. On the other hand, in a prison DMH unit, nurses without peace officer status (without custody authority) cannot effectively perform the function of inpatient psych licensed nursing staff. This is because without badges in a prison inpatient psych setting licensed nursing staff's authority (and therefore the ability to intervene therapeutically) will be usurped by correctional officers. The prison DMH unit's unique blending of prison and state hospital custody requires a unique blending of nurse and correctional peace officer, the MTA-P. The unacceptable alternative is for non-licensed staff to perform the function of licesed nursing staff in an inpatient psych setting.

Responding to Salinas MTA-P comments:
1) I was referring to the private sector California physicians whose average salary, according to California Healthline, is $146,405. Not sure what Salinas MTA-P is referring to when he calls my statement "dishonest and irresponsible". If anyone should have the ambition to see just how much these psychiatrists, psychologists, social workers, MTA's and others employed by the Dept. of Mental Health draw, be my guest. It will astound you. It's all listed on the California State Gov't website.

2) The security of the DMH units can very easily be handled by State Correctional Officers (C/O's). Salinas MTA-P would have you believe that only a badged LVN can perform that function. This is at best poppycock. It's just all part of the bureaucratic sham to employ MTA's. There is no law that I am aware of that states that badged LVN's are the only employees who can administer psychiatric care to inmate psychiatric patients. This is ludicrous!

The botom line is that these DMH units located on CDCR grounds are the best kept secret for employees employed there. For us taxpayers it is just another state government slot machine that pays off handsomely.

MTA's really don't have anything to do with or benefit from the salaries of psychiatrists, psychologists and social workers. But if you insist on lumping in other state expenditures with MTA salaries next thing you know you'll be complaining about the pensions of state employees. I wonder how much the state could save by cutting your state pension down to zero? I know it wouldn't be "much of" a savings in the grand scheme of things but it would be a moral victory for the taxpayers. Why don't you head on down to CalPers tomorrow and, in the name of fiscal responsibility, tell them you don't want that check anymore? After all, your retirement check probably rivals that of the average retired California physician (private sector only, of course).

PRISONS NEED STAFF PHYSICAL THERAPISTS

The most important essential medical need in Prison Reform is being overlooked....that of having staff physical therapists to work daily with those in Prisons. Many prisoners need physical therapy treatment modalities and procedures, services, on a regular and frequent basis to assure good physical and mental health and welfare. Only the physical therapist, as a member of the medical team, can assess and plan treatments for many conditions sustained in varying diagnosis, especially in the Prisons.

Hiring a PT Registry (Contracting Out at about $90-$120 million annually) for needed physical therapy services is NOT THE WAY TO SAVE MONEY for repeated mandatory services. I could not locate any staff positions at this time (June 2008) for physical therapists and physical therapist assistants in the 32 California Prisons. I checked with the Prisons directly and with the Headquarters, in the Dept. of Corrections and Rehabilitation, in Sacramento. No hiring of and no positions for physical therapists could be identified.

The clinical physical therapy registry is millions of dollars more expensive than hiring staff physical therapists in the Prisons. A decent salary and benefits for staff PTs would seriously reduce the costs of care and still provide regular and frequent, daily in some cases, needed physical therapy services.

Just think about it: wouldn't you rather have a staff physical therapist readily available on a daily or "as needed" basis, at a modest cost, than have a registry person who must be contracted and paid an enormous fee and still not be available when needed most. The PT Registry does not know from day to day who will be sent to the Prison. Many times the registry therapist is not familiar with the medical condition needing attention and the progress notes from the previous registry therapist are incomplete or scribbled.

Mr. J. Clark Kelso, federally appointed receiver, should demand physical therapy staff positions in the Prisons and really be serious about getting the Best Practice for the Best Health Care at the Best Price: hire staff PTs.

The Department of Corrections and Rehabilitation in California cannot expect successful health services and benefits for prisoners if it does not establish the appropriate relationship.....which is - MAKE STAFF POSITIONS AVAILABLE FOR PHYSICAL THERAPISTS IN THE PRISONS.

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