Staffing shortages leave behavioral health services in Nebraska prisons ‘at tipping point’


It is recognized that a high percentage of offenders entering the Nebraska prison system suffer from mental health and behavioral health issues.

Yet, of 18 staff psychologist positions within the Nebraska Department of Corrections, only six are currently filled. And the three clinical psychiatrist positions are also open.

“I think we’re at a tipping point right now,” a prison worker said in a recent opinion poll. “If we lost one more psychologist, things would really start to go downhill.”

State senators told a hearing Thursday that such shortages of behavioral health personnel must be addressed if inmates are to be rehabilitated and the public protected. Lawmakers and others have also offered a common refrain on how to close these gaps: offer more pay.

“We know the formula – it’s about raising wages,” said Sen. Steve Lathrop of Omaha, chairman of the Legislative Judiciary Committee. “The goal is rehabilitation, not stockpiling people.”

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State corrections officials have acknowledged the staffing shortages, but said they take the health needs of inmates seriously.

“While our health care staff do an outstanding job of handling a multitude of situations around the clock, it is true that staffing issues are of concern,” said Diane Sabatka-Rine, acting director of corrections.

She described recruiting people to work in the prison system as “difficult”. But she also said the state was providing “robust” medical assistance and clinical treatment.

The state uses a number of strategies to ensure prisoners’ health needs are met, she said, including contracting with outside providers and using overtime.

The hearing came a month after a state watchdog cited critical shortages of health care workers within the state prison system.

Nebraska’s Office of the Inspector General of Corrections said closing the gaps is essential not only for the well-being of prisoners, but also for the safety of correctional staff and the public.

Now the inspector general has opened an investigation into whether the correctional service is meeting the required standard of care for inmates, said Zach Pluhacek, deputy inspector general. Inmates are essentially entitled to the same level of care that would be provided to anyone else in the community.

The question of whether the state meets that standard was raised last week by an inspector general’s report on a 40-year-old inmate who died of cervical cancer. She had been detained for almost 10 years before having a Pap test, a preventive screening that could have revealed her treatable cancer.

Sabatka-Rine, a longtime state prison administrator who took over as acting warden earlier this month, said the corrections department was actively working to develop an electronic health records system. Such a system – which could track necessary health screenings – was required by the legislature seven years ago.

Struggling with the growth of prisons at the forefront of the country, Nebraska officials are looking for ways to expand the state’s problem-solving courts as a potential solution.

Pluhacek also suggested that it might be time for the state to ask the University of Nebraska Medical Center to conduct an assessment of the level of care provided in correctional facilities. Lathrop agreed and said the Legislative Assembly next year should initiate such a review.

Sabatka-Rine said staffing issues are largely rooted in the lack of health care providers nationwide.

She said the department has launched targeted recruiting campaigns, offered hiring bonuses and raised wages in a bid to attract more workers.

Last year, a new labor contract increased the wages of workers in certain health categories by 30%. The department also has some discretion to offer higher pay for certified positions like psychiatrists.

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The inspector general said a survey he distributed earlier this month also revealed morale issues among health and behavioral health staff.

While most said they liked coming to work and felt safe, less than 10% were confident that they were supported by corrections headquarters. A worker suggested that central office makes clinical decisions without consulting the mental health team.

Another issue causing morale problems is the higher salary offered to outside providers who come to help with care.

A nurse said the placement agency nurses who worked alongside her were paid $65 to $75 an hour. The state’s most recent labor agreement with prison workers offers registered nurses a base wage of $25 to $46 an hour.

Currently, only half of the RN positions in the prison system are filled. The executive director of the state employees union said that sometimes nurses even quit state jobs to take better paid jobs with recruiting agencies.

“It’s a scam,” said Justin Hubly of the Nebraska Public Employees Association. “Let’s fix this. … Pay a fair wage and staff the facility.

Hubly noted that the state has come a long way toward eliminating security personnel shortages by offering pay raises of up to 40 percent. Now, the same must happen in the fields of medical and behavioral health.

“When you raise wages, it works,” he said. “I have the receipts now.”

While no one has an exact figure on the percentage of inmates with health needs, the state’s chief justice said up to 80% of justice system members have behavioral health issues. or addiction. Those needs must be met, said ACLU lobbyist Spike Eickholt.

“We don’t want them to come out worse than they came in,” he said.

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