California $382,519 Prison Doctor Shows Budget Gaps Don’t Bar Big Salaries

Jeffrey Wang closed his struggling medical practice in Visalia, California, in 2007 to take a job as a physician treating inmates in Corcoran State Prison, where murderer Charles Manson is locked up.

“The first few months I regretted it,” the 54-year-old Wang said in telephone interview from the prison, about 175 miles (280 kilometers) northwest of Los Angeles. “But the pay was much higher and the benefits were much better.”

Wang made $382,519 in 2010, including overtime and extra- duty compensation. He was one of almost 100 doctors, dentists and other medical practitioners in the state who got at least $300,000 last year to work behind bars, according to the controller’s office.

California prison doctors earn more than counterparts in New York, Texas and Florida, data compiled by Bloomberg show. The highest-paid physician in New York’s penal system in 2010, for instance, collected $200,147, including overtime, according to the state comptroller’s office.

The most that a Texas prison doctor can make is about $220,000 annually, corrections officials said. The top compensation for a medical employee in Florida was $230,711 in fiscal year 2011, with no overtime, a corrections department spokeswoman said.

“The job markets recognize that these are not nice places to work,” said Stuart Bussey, president of the Union of American Physicians and Dentists, the Oakland-based labor organization for prison health professionals. “These doctors are working in places that are not desirable to live, working up to 12 hours a day and with clients that they would never have to work with in private practice. It’s almost like war pay.”

Court Orders

California prison officials say they’ve had to boost wages to comply with federal court orders and because of the difficulty recruiting doctors to work in crowded facilities filled with violent offenders. One psychiatrist earned $566,029 last year, including overtime and extra-duty pay.

California taxpayers shelled out $770 million to medical, dental and mental-health staff to care for convicts last year, even as lawmakers slashed programs for poor children and the elderly to erase a $20 billion deficit.

The compensation discrepancy underscores a broader trend in California, where government workers are paid more than in other states for similar duties. From city managers who make more than the governor to prison guards who earn double what their counterparts in Texas do and Los Angeles firefighters who collect twice the national mean, high salaries prevail in a state with persistent budget shortfalls, officials including Governor Jerry Brown, a 73-year-old Democrat, have said.

Weak Recovery

The weak recovery from the recession that ended in June 2009 has churned up a backlash against the pay and benefits of public workers nationwide, as taxpayers saw their own job prospects and 401(k) retirement-plan balances shrink.

States had to deal with initial fiscal 2012 budget gaps estimated at $103 billion, according to the Washington-based Center on Budget and Policy Priorities. That is drawing attention to pay packages on the public purse that outstrip those outside government.

“A felon in Florida or New York is the same as a felon in California,” said David Kline, a vice president with the Sacramento-based California Taxpayers Association. “They commit the same crime, yet in Florida and other states they are able to keep their prisoners behind bars for less.”

$9.8 Billion

California runs the nation’s largest corrections system, with about 161,000 prisoners. The state will spend $9.8 billion on its prisons and parole system this fiscal year, about 11 percent of an $85.9 billion budget. That’s up $224 million from last year but shy of the record of $10.1 billion set in fiscal year 2008.

California’s prisons are at 175 percent of capacity, according to the state Corrections and Rehabilitation Department. The U.S. Supreme Court this year ruled that the state must comply with a court order to reduce its prison population by 37,000 inmates within two years.

A federal judge took over the prison health-care system in 2005 as a result of class-action lawsuits filed by inmates, alleging that inadequate care amounted to cruel and unusual punishment. The court said prison care was so poor that an inmate needlessly died on average once every week.

To improve care, the court ordered the state to hire more staff and attract better doctors by raising pay. The state didn’t oppose the raises.

‘License and Pulse’

Before the court order, the state was “basically employing as doctors anybody who had a license and a pulse. That was the way it was talked about,” said Clark Kelso, the court-appointed receiver in charge of California’s prison health-care. “The problem that the prison system had here was attracting qualified clinical personnel.”

Today a prison doctor in California can earn $248,172 a year plus overtime or extra-duty compensation. A chief physician can make as much as $265,648 plus extra pay. According to the Bureau of Labor statistics, the mean annual wage of a physician in the U.S. in 2009 was $180,870; in California, it was $191,650.

Last year, when Wang made $157,263 in overtime at Corcoran State Prison, almost half of the medical staff positions there were vacant.

“If I’m going to need to hire a doctor in prison, it makes no sense to say I’m going to pay him 20 percent less than the private sector but say public service is the reason they should come in and work anyway,” said Kelso, who was appointed in 2008 after his predecessor ordered the medical pay increases. “If I am going to get a competent doctor, I’ve got to price my compensation package to attract them.”

Clinical Staff

The pay of clinical staff in places like Texas is less, in part, because Texas prison doctors aren’t unionized and the cost of living in the state is lower. Medical employees haven’t been granted a raise in at least two years, said Owen Murray, vice president of offender health services at the University of Texas Medical Branch, which oversees the care of about 80 percent of state prisoners.

A dentist in a California prison can earn as much as $288,636 a year plus overtime and extra duty pay, according to figures from the state Corrections Department. In Texas, prison dentists can make as much as $150,000, while in New York, it’s $141,585, according to figures provided by those states.

$1.46 Billion

Kelso, the California receiver, has a $1.46 billion budget for the fiscal year that began July 1, including $1.3 billion for inmate medical care and $127 million for pharmaceuticals and medical supplies, according to the state Finance Department. Under court control, the vacancy rate for most clinical staff dropped to about 8 percent from as high as 50 percent in 2005, in part because of the higher wages and better benefits, Kelso said. Still, the medical department suffers 15 percent annual turnover.

Kelso is only responsible for the medical care of inmates. Dental and mental-health treatment is still controlled by the Corrections Department.

Of almost 100 California health-care professionals who were paid more than $300,000 in 2010, the top earners included doctors who were paid lump-sum settlements or who retired and cashed out stockpiles of unused vacation, Kelso said. Those figures are not typical of what most doctors earn, he said.

Competency Concern

One doctor, Jeffrey Rohfling, was paid a record $777,423 in 2010 even though, until this month, he wasn’t allowed to treat a patient in six years because of concerns about his competency, the Los Angeles Times reported in July.

Rohfling, whose base salary was $235,000 a year, was awarded the rest of the money last year when the state settled a lawsuit claiming he had been fired unfairly in 2007, state records show. He was reinstated at High Desert State Prison in Susanville and awarded two years of back pay. Rohfling’s attorney, Joseph Polockow, didn’t return calls for comment.

More than 750 employees, or 10 percent of those working for Kelso, have amassed 712,240 hours of unused vacation that they must take or cash out when they retire, according to an internal report obtained by Bloomberg. One doctor who has worked for the prisons for 31 years built up almost three years of time-off, the data shows.

Vacation Cap

State policy says workers shouldn’t accumulate more than 640 hours a year of vacation time. When workers break the cap, managers are supposed to develop a plan to draw down the time. But the law doesn’t forbid employees from banking the hours if they don’t use them.

Much of the backlog accumulated when former governor Arnold Schwarzenegger in 2009 ordered all state employees to take three days of unpaid furlough each month in an attempt to shave $1.7 billion from payroll costs.

While most state agencies shut down operations for those three days, prisons had to remain open. So guards and the doctors, dentists and other clinical staff were told to accrue the furlough days and take them instead of vacation days at a later date.

California needs to examine all prison operations, including health care, to figure out why costs are so high and where money could be saved, said Kline of the California Taxpayers Association.

“We are far above the national average and we need to take a look at why,” Kline said. “Other states are not under court order and are paying less, so there is a way to do it. It’s just a matter of figuring out why we haven’t found that way, too.”

To contact the reporter on this story: Michael Marois in Sacramento at mmarois@bloomberg.net;

To contact the editor responsible for this story: Mark Tannenbaum at mtannen@bloomberg.net.

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