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Report shows 46 percent of medical positions in Illinois prisons are unfilled

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Illinois

Nearly half of all medical positions inside Illinois prisons are currently unfilled, according to a new report from a court-appointed monitor that found the staffing shortages are a “crisis” that “threatens the safety” of people locked up.

The monitor was assigned to evaluate prison conditions as part of a court settlement. Attorney Harold Hirshman who worked on the lawsuit over prison health care said the monitor’s report was “terrible, as usual” and undercuts the state’s positive rhetoric. […]

The damning monitor’s report comes more than a decade after a federal lawsuit alleged medical care in Illinois prisons was so poor it violated the constitution. The lawsuit settled in 2019, but the monitor says at least some aspects of the prison health care system are actually worse than they were then. Meanwhile, the private company in charge of providing medical care inside Illinois prisons recently saw its contract expire, and the state is now soliciting bids for a new health care contract.

The state generally declines to respond to questions related to litigation and neither the Illinois Department of Corrections nor Gov. JB Pritzker responded to requests for comment.

* From the report…

IDOC has made progress and improvements in several areas. But, IDOC is approaching the fourth year under the Consent Decree that is expected to last ten years. After nearly four years, few of the major deficiencies and fewer of the essential elements that resulted in the Consent Decree have been corrected and some have worsened. Though IDOC said it needs more than 300 additional staff, there are fewer health care staff working now than before the Consent Decree was signed. Fifty percent of physician positions are vacant. Forty six percent of total health care positions are currently vacant. There are significant vacancies of supervisory staff at all levels including facility Directors of Nursing, supervising registered nurses, Medical Directors, and Health Care Unit Administrators. The statewide Infection Control Coordinator and Quality Improvement Coordinator positions are both temporarily assigned and lack qualifications for the position. Neither of these programs are fully operational. This staffing shortage is critical and results in patients not receiving adequate care.

The electronic medical record is still not implemented, furthermore there is no contract for an electronic record vendor. If a contract were signed today, it will likely take an additional two or more years to effectively implement the electronic record. This would likely be in the seventh year of Consent Decree.

* WGLT…

Work on mandated policies and procedures is “sporadic and disorganized,” said the report. Among those reports is a required review of inmate deaths. The average number of inmate deaths for the past six years is about 90, the report noted, but has varied considerably due to the COVID pandemic.

All deaths should include an autopsy and be included in a comprehensive quarterly report, the monitor recommended, with an opportunity for staff to “provide anonymous information regarding events surrounding a death with an aim toward improving patient safety.”

Specific examples of alleged failures by IDOC to care for inmates who died in prison are cited in the report. A man identified as Mortality Patient 9 arrived at the state’s Northern Reception Center in Joliet on June 3, 2021 with three prescriptions for psychotropic medications. He refused to take the drugs on June 29 and 30 and accepted his final dose on July 2 before his transfer to Shawnee Correctional Center six days later.

The paperwork for the man’s transfer did not include the fact that his medication had expired six days earlier and that he had twice refused to see a psychiatrist the week before. A nurse noticed the lapsed prescription and another order was written but he did not receive the pills until July 15, a lapse of 13 days without the medications.

In December, Mortality Patient 9 was moved to Menard Correctional Center with paperwork that omitted major factors related to his medications and declining mental health, the report noted. Three months later, he committed suicide. A suicide review stated that the record sent to Menard “was missing documentation that would have indicated the need for crisis follow-up,” said the monitor’s summary.

posted by Isabel Miller
Tuesday, Apr 18, 23 @ 9:27 am

Comments

Would be interesting to see how this compares to the health care position vacancy rate in the community. May not be all that much different, especially in certain areas of the state.

Comment by Magic Dragon Tuesday, Apr 18, 23 @ 9:52 am
There are a lot of factors behind this, but part of it is that the State is not a competitive employer for medical professionals regardless of the salary.

Case in point, I’ll reference this family medicine posting which tops out at $201,960 — which is a joke salary offer for a physician that is able to complete a residency program. Any residency program, and that’s the top salary band.

https://illinois.jobs2web.com/job/Chester-PHYSICIAN-SPECIALIST-OPTION-A5-RESIDENCYFAMILY-PRACTICE-IL-62233-2542/962503600/

Governor Pritzker is willing to shell out of his pocket to pay his Chief of Staff substantially more than the Chief of Staff to the President of the United States making a claim about competitive salaries, he’s willing to sign legislation to raise the salary of his highest appointees and the legislators, but where is action on salaries for medical professionals?

This salary wasn’t competitive before the pandemic. It wasn’t competitive before our recent inflation, and it is certainly not competitive now.

===This would likely be in the seventh year of Consent Decree.===

This administration and its appointees simply do not care about the constitutional rights of people they are responsible for regardless of the kind of institution they are held in.

I am excited to see what the Governor’s reaction to his responsibility for this absolute lack of human decency and denial of basic human rights.

None of this is very presidential.

He’s on year 5. He can’t keep passing the buck.

Comment by Candy Dogood Tuesday, Apr 18, 23 @ 9:54 am
===Would be interesting to see how this compares to the health care position vacancy rate in the community.===

This is an apples to oranges comparison because the State has a legal obligation to provide healthcare to people in state custody.

You should compare to staffing levels at other states that aren’t doing such a bad job that the federal government forced them into a consent decree.

The Pritzker administration has done such a terrible job at hiring in general that the staffing level is not that different from the staffing levels for correctional officers at several facilities.

Comment by Candy Dogood Tuesday, Apr 18, 23 @ 10:01 am
==This is an apples to oranges comparison because the State has a legal obligation to provide healthcare to people in state custody.==

So if these people don’t exist in sufficient numbers….then what? There is an overall lack of health care professionals.

Comment by Magic Dragon Tuesday, Apr 18, 23 @ 10:09 am
Maybe it’s time to break the stranglehold the union has on state employment? Where else are physicians locked into collective bargaining agreements?

Comment by What's the point? Tuesday, Apr 18, 23 @ 10:18 am
Private industry struggles to replace those lost in various medical professions due to the pandemic and many people’s reaction to it. With shortages everywhere, who wants to work in corrections health care? They have plenty of other options.

Comment by Lincoln Lad Tuesday, Apr 18, 23 @ 10:20 am
Is there any state whose DOC is anywhere close to the standards of most wealthy countries? The US has historically always undervalued treating convicted (or even just jailed) citizens as human beings, and often just shrugs when stories of mistreatment or neglect are in the news.

Comment by Homebody Tuesday, Apr 18, 23 @ 10:22 am
The vacancy rate is directly correlated to the fact to the pool of QUALIFIED applicants that want to work in a prison facility when they can find less stressful/less dangerous employment outside a facility setting. It’s a horrible situation for sure. And Wexford isn’t the answer. They’re hiring standards are less than DOC’s and it’s apparent.

Comment by Alice Childress Tuesday, Apr 18, 23 @ 10:50 am
Come work for the State. You’ll be underpaid and Tier 2.

That is not a good combo for any Agency but now add the leadership and working conditions of DOC, and a disaster is abrewing.

Comment by Lurker Tuesday, Apr 18, 23 @ 11:00 am
===Maybe it’s time to break the stranglehold===

Were you on Saturn between 2015 and 2019?

Comment by Rich Miller Tuesday, Apr 18, 23 @ 11:12 am
DOC and medical contractors cannot conjure up enough medical providers to fill the need. What doctor/nurse etc would choose to make less money to work in a prison setting? DOC would have to vastly overpay to get sufficient quality staffing.

Comment by Original Anon Tuesday, Apr 18, 23 @ 11:55 am
“Maybe it’s time to break the stranglehold the union has on state employment? Where else are physicians locked into collective bargaining agreements?”

That’s an “interesting” take. Most people prefer to be in positions protected by the unions, not excluded from them. The State has a habit of not giving raises to non-union staff.

Like with most State positions, CMS is not offering salaries, benefits, and working conditions that can incentivize enough people to apply. Unions try to improve all three of those, so I’m not sure why anyone would think they are the problem when it comes to the State’s ability to hire.

Comment by NickNombre Tuesday, Apr 18, 23 @ 12:29 pm
The Tier 2 component is huge. Those hires get to see all the benefits afforded to the Tier 1 employees around them and are like, nope, it’s not worth it, working in a security facility.

Comment by Alice Childress Tuesday, Apr 18, 23 @ 1:17 pm
As for Afscme’s role in this. I do wonder if the State needs to negotiate a means of correlating professional pay to the market. MD’s and nurses pay have jumped considerably. I know AFSCME would like to see everyones pay jump I’m not sure it’s fiscally responsible to jump the pay of a CO the amount it would take to bring a MD back into a competitive rate of pay. The state has quite a few professionals that it will need to replace while the Rauner years and across the board raises haven’t kept up with the Professional market.

Comment by Mason born Tuesday, Apr 18, 23 @ 2:10 pm
Is the goal of this to increase staffing or release more inmates? It is time for IDOC to build a true hospital / nursing home to allow for proper staffing of one location to treat the most informed. Too bad tax payers and politicians don’t want to shell out the money for what that would cost.

Comment by I Love Decatur Tuesday, Apr 18, 23 @ 2:22 pm
It’s not necessarily any scarier for a doctor or nurse to work at a correctional facility, vs. a downtown Chicago hospital: the prison medical staff don’t go into the cell blocks, they have a personal armed escorting officer with them at all times, prisoners are brought to the secure jail clinic section one at a time, and guarded/restrained while being worked on. Arguably, the medical staffer in a correctional facility could sometimes be safer than one working in a regular city E.R., where the security is not at the same level, situations of assaults from patients are not unknown, and you have all kinds of potential crazies coming in to be treated, with minimal vetting.

Something that might help with recruiting to make the job more attractive is to adjust the rules for advancement so that the medical staffer can climb their professional ladder faster, with their continuing education and certifications, etc.

I don’t tend to blame the existing medical staff themselves but rather, their management and administration, and an uncaring bureaucratic attitude of bunker mentality and custodial rather than restorative and reformative attitudes. When it’s “us against them”, you’re not likely to get as much honest work done caring for “them”. It becomes a human warehouse at best, maintaining people at the bare minimum, not a place to reform people to re-enter society.

Comment by Give us Barabbas Tuesday, Apr 18, 23 @ 6:07 pm
=== the prison medical staff don’t go into the cell blocks, they have a personal armed escorting officer with them at all times, prisoners are brought to the secure jail clinic section one at a time, and guarded/restrained while being worked on. Arguably, the medical staffer in a correctional facility could sometimes be safer than one working in a regular city E.R., where the security is not at the same level, situations of assaults from patients are not unknown, and you have all kinds of potential crazies coming in to be treated, with minimal vetting.===

I worked in DOC for nearly 30 years. I don’t know a thing about Chicago ER, but I can tell that you have zero clue about the function of medical staff in a correctional facility.

Comment by Southern Dude Wednesday, Apr 19, 23 @ 7:22 am
===but I can tell that you have zero clue===

If you’re gonna make a comment like that here, then explain yourself or go back to Facebook.

Comment by Rich Miller Wednesday, Apr 19, 23 @ 7:57 am
=== If you’re gonna make a comment like that here, then explain yourself or go back to Facebook.===

Very well - anyone who believes prisoners are escorted by armed guards in a correctional facility has no knowledge of the prison system.
Prisoners do not go to the “secure jail clinic section” one at a time - there are Health Care Units with dozens of prisoners walking around to their appointments. Only a small fraction of the prisoners are restrained during their appointments.

Comment by Southern Dude Wednesday, Apr 19, 23 @ 8:20 am
Southern Dude is spot on. And when there’s an emergency outside the the HCUs, they’re exposed to the general pop, even though they are escorted. Generally speaking, the minimum level facilities are tame. It’s the med and high security facilities that have the greatest need for medical staff. And if you think these offenders are all kind to the staff, grab an application and go work for DOC.

Comment by Alice Childress Wednesday, Apr 19, 23 @ 8:40 am