Report 2009-107.2 Recommendation 8 Responses

Report 2009-107.2: California Department of Corrections and Rehabilitation: Inmates Sentenced Under the Three Strikes Law and a Small Number of Inmates Receiving Specialty Health Care Represent Significant Costs (Release Date: May 2010)

Recommendation #8 To: Correctional Health Care Services, California

To ensure that the total amount of overtime worked by custody staff does not unduly reduce their effectiveness and result in unsafe operations, Prison Health Care Services should monitor overtime closely. If its efforts to reduce the number of referrals of inmates to outside specialty services do not reduce the amount of overtime worked by custody staff for the purpose of medical guarding and transportation, Prison Health Care Services should explore other methods of reducing the total amount of overtime worked by custody staff.

Annual Follow-Up Agency Response From November 2013

Implementation of the CDCR staffing model for community hospital guarding details, combined with the CCHCS Utilization Management Unit implementing an additional review step within the Referral for Services process, has resulted in a reduction of offsite specialty provider referrals, overtime hours and overtime dollars. The total number of CCHCS statewide referrals for offsite provider services in Fiscal Year 2010/2011 equated to 118,910 and have declined to 78,990 in Fiscal Year 2012/2013. Medical Transportation overtime hours for the same time period has been reduced from 451,066 to 377,646. Likewise, hospital guarding overtime hours were reduced from 740,989 to 645,456.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

Annual Follow-Up Agency Response From September 2012

Implementation of this recommendation is contingent upon transition of Health Care Access Units (HCAU) to CDCR and completion of assessment of utilization. The plan for implementing this recommendation is as follows. In order to gain efficiencies in utilization while reducing medical guarding and transportation overtime, CDCR has completed the reassessment and finalization of a policy specific to staffing efficiencies. Given this update in policy, CCHCS in coordination with CDCR, plans to assess utilization of Medical Guarding and Transportation resources this fiscal year with a view towards efficient utilization and reduction of overtime, while exploring options for reducing the total amount of overtime worked by custody staff if deemed necessary. The reason CCHCS has not implemented this recommendation is as follows. The assessment was pending on the completion of the CDCR policy specific to staffing efficiency, prior to assessing the medical guarding and transportation utilization to reduce overtime.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

All Recommendations in 2009-107.2

Agency responses received after June 2013 are posted verbatim.