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Nurse at county jail and union rep urge Commission to address incarceration and staffing gaps
Summary
A jail health nurse thanked the Commission for a resolution recognizing incarceration as a public health issue and outlined recent clinical improvements; an SEIU representative presented DPH documents alleging a discrepancy between nursing vacancies and $62M annual per-diem spending, calling for staffing and hiring reforms.
Public comment at the start of the meeting highlighted jail health-care improvements and raised concerns about staffing and heavy reliance on per-diem nurses.
Joe Duncan, a registered nurse at the San Francisco County Jail, opened public comment by praising Resolution 19-5 and stating, "Incarceration is a public health issue." He described clinical changes in Jail Health Services, including expanded use of buprenorphine, increased methadone maintenance, revamped alcohol withdrawal protocols and faster initiation of psychiatric medications. "We have decreased the use of safety cells and decreased our 5,150 sendouts," Duncan said, and urged the Commission to maintain focus on the continuing work needed for patients in jails.
Nato Green, representing SEIU, submitted two DPH documents and called attention to an apparent inconsistency: a Zuckerberg San Francisco General vacancy report listing 68 full-time equivalent nurse vacancies versus a DPH per-diem budget/actual report showing a per-diem nurse budget of $17,000,000 in FY2017–18 and an actual per-diem expenditure of $62,000,000. Green said, "It is not possible for there to be only 68 nursing vacancies while the department is spending $62,000,000 a year on per diem nurses," and argued the likely explanation is that the budget document undercounts true labor needs and that the hospital is effectively operating on large numbers of temporary nurses.
Green urged the city to fix hiring and budgeting problems and to move toward filling positions with civil-service full-time nurses, warning that reliance on temps affects scheduling, overtime, trauma response and disaster preparedness.
What happens next: Commissioners acknowledged the comments. The issues raised about vacancies and per-diem spending will be matters for DPH and the finance/planning committee to reconcile using department documents and follow-up analyses.
