CA auditor confirms unions’ concerns that contractors are taking state jobs
Several state medical and correctional facilities in California failed to meet required staffing levels, a recent report from the California State Auditor found. The audit, which was pushed by state worker unions, confirmed labor groups’ concerns that departments are filling vacancies with contracted workers, instead of public employees.
Despite recruitment efforts by departments that oversee state hospitals and prison, vacancy rates at each of the three facilities that were audited have increased in the last five years. The private contractors departments have come to rely on typically cost more than state workers and provide less continuity of care due to their shorter tenures, state auditors reported.
“Because of the decades-long difficulties the facilities have had in filling vacant health care positions and a current and projected health care professional shortage, the State should consider facilitating a statewide campaign to draw medical and mental health care workers to California’s civil service,” California State Auditor Grant Parks wrote in a Dec. 4 letter to state leaders.
The audit focused on facilities run by three departments: the California Department of Corrections and Rehabilitation, the Department of Developmental Services and the Department of State Hospitals.
Juan Del Toro, the president of AFSCME Local 2620, said the audit confirmed the union’s position that departments’ reliance on contracted workers undermined the state’s merit-based civil service system. The union represents over 5,000 health and social service professionals.
“Instead of hiring qualified full-time civil service staff, these agencies have opted to privatize public services at two to three times the cost,” Del Toro said in a statement. “This places an unnecessary burden on taxpayers. The departments don’t have a plan to fix it.”
The departments’ responses to the audit varied. DDS and DSH both partially agreed with the report’s recommendations and provided detailed responses to the audit’s finding. Ralph Montano, a DSH spokesperson, said in a statement, “The audit report acknowledges the significant efforts made by DSH to recruit medical and mental health care professionals using a broad spectrum of strategies, despite unique challenges posed by the nature of forensic mental health treatment.”
CDCR responded with a brief letter that said the department “is committed to providing adequate health care for the incarcerated population, while ensuring fiscal responsibility.”
Use of contract workers surged during COVID-19
The reliance on contracted employees by state departments worsened during the COVID-19 pandemic after there was a surge in the number of people leaving state medical and correctional facilities, said Coby Pizzotti, a lobbyist for the California Association of Psychiatric Technicians, which represents roughly 6,000 state employees.
“A lot of our members decided to retire,” he said. “They said, ‘That’s it, we’re out, why would we want to endanger our lives?’”
Since the pandemic began, departments have continued to use contracted workers to fill vacant posts, Pizzotti said. He said the union observed contracting agencies advertising positions at facilities where their members worked, offering better pay and benefits than what the state provides.
Pizzotti said CAPT and several other public sector unions representing mental health and medical professionals successfully petitioned the Joint Legislative Audit Committee to launch an investigation into the labor trend.
Vacancies driven by competitive salaries and challenging work environments
The audit focused on three state facilities run by three departments: CDCR’s Salinas Valley State Prison, DDS’ Porterville Developmental Center and DSH’s Atascadero State Hospital.
In the last fiscal year, the vacancy rates were over 30% at Atascadero, 36% at Porterville and more than 50% at Salinas Valley.
Auditors cited several reasons for these high vacancy rates. The facilities can be dangerous and challenging to work in. The report cited a riot in Salinas Valley in October involving roughly 90 incarcerated men in which several people were injured. Additionally, there is a broader shortage of health care workers and competition with other state and private health facilities, the latter of which often pay more.
For example, staff in Atascadero reported it was extremely difficult to fill psychiatrist vacancies because a nearby private hospital was offering $90,000 signing bonuses to new doctors, while the state hospital could offer a bonus of $10,000 at most.
Facilities have not met staffing miniums
Staffing requirements at all three departments have been the subject of federal litigation for decades. As of this year, CDCR has been required to pay almost $100 million in fines for failing to hire adequate mental health staff, the auditors reported.
Departments have turned to contracting agencies to fill those gaps, auditors found.
Contracted workers only make up a fraction of the facilities’ total staff — 10% of the authorized positions at Salinas Valley were filled by contracted workers last fiscal year. Of the mental health and medical positions analyzed, facilities relied on contracting agencies to fill nursing vacancies the most. At Porterville, 87% of the hours worked by nurses between 2019 and 2025 were filled by contracted workers.
Those vacancies have resulted in savings to those facilities. The auditors reported, Atascadero has saved nearly $250 million between 2019 and 2025 by not filling those positions.
“You’re saving money, but to be fair, you’re not supposed to be saving money. These are budgeted positions,” Pizzotti said. The vacancies are preventing departments from providing adequate care, he said.
Auditors reported that despite the persistently high vacancies, none of the departments requires facilities to report whether they meet shift-staffing requirements. The auditors said this prevents CDCR, DDS and DSH from being able to conduct oversight of mental health and medical care.
Pizzotti said the union hopes to work with lawmakers to enact some of the auditor’s recommendations, including a requirement that these departments track and report staffing levels in facilities.
