Health care workers at the Allegheny County Jail report that the facility is understaffed, leaving them overworked and underpaid, and potentially putting incarcerated people at risk, according to a new survey.
Some staff members said they have been asked to do tasks that would put them at risk of losing their medical licenses. Others claimed jail administrators with no medical training routinely interfered with or overrode decisions made by medical professionals.
The results come amid continuing concerns about medical care at the jail raised by incarcerated people and advocates.
The Pennsylvania Interfaith Impact Network administered the survey, the results of which were presented to the county jail oversight board Thursday. A total of 31 permanent health care staff responded out of a possible 39. Staff who work on contract or through an agency did not participate in the survey.
More than 90% of respondents said they “disagree” or “strongly disagree” with the statement: “I feel valued and respected as a health care employee at the Allegheny County Jail.”
More than 93% said staff morale is a “major problem” at the facility. Many cited low pay, unsafe working conditions and staffing vacancies as key issues. All respondents said the jail does not have enough health care staff to fill all shifts.
“Staff the building. Employees are hired, they just aren’t able to keep them because of the way they are treated,” one staff member wrote when asked for recommendations for the jail.
“Management does not care about quality of work, all they care about are numbers and how many inmates can be seen in a shift," the staffer wrote. "Inmates are not getting proper care. Management is too punitive and constantly writing employees up for petty things.”
Others described a “toxic” work environment, as well as alleged illegal and unethical behavior by leadership.
When asked why they believe former coworkers chose to leave the jail, one staff member wrote: “Low morale, inadequate staffing, poor/unqualified management, hostile work environment, sexual harassment, management that gossips and repeats personal information to other front line staff, forced to falsify documentation, fear of discipline, fear of targeting if they didn’t agree with an illegal and unethical decision.”
Others cited fears of losing their licenses and inadequate training.
Staff also expressed a lack of confidence in jail leadership, seemingly brought on by what they described as poor communication and “unqualified” non-medical managers making medical decisions.
In response, jail spokesperson Jesse Geleynse said in an email: “All of our protocols have been developed in compliance with the Pennsylvania Nursing Act, which describes scope of practice for nursing disciplines.”
About 87% of the respondents said health care managers at the jail do not communicate effectively and aren’t open to feedback or suggestions. Most said they do not receive information about critical incidents such as deaths or suicides.
“Communication is difficult because we just can’t handle all of the inmate’s needs, many are actually legitimate, and they wait and wait with no end in sight for even a necessary prescription to be filled,” one respondent wrote.
Nearly 97% said they “disagreed” or “strongly disagreed” that the jail health services administrator, Ashley Brinkman, is qualified to make medical decisions about patient care.
“Management needs to change. Having people who have absolutely no medical experience or licensure overseeing and overruling Physicians, Nurse Practitioners, and Nurses’ decisions in patient care is completely out of line, unethical, and unsafe. Management only communicates with each other, not the staff beneath them who are their front line,” wrote one staff member.
In response to a question about Brinkman’s qualifications, Geleynse said in her email: “Dr. Brinkman has a doctorate of philosophy degree — i.e., a Ph.D. — in counselor education. She is [a] licensed independent counselor in both Ohio and Pennsylvania. Her counseling license in Ohio credentials her as a clinical supervisor. She has supervised interdisciplinary staff to include unlicensed paraprofessionals, licensed therapists, registered nurses and licensed practical nurses, medical assistants, certified nurse assistants and prescribers since 2015. It is typical for health care settings to be overseen by anyone with a variety of degrees who work alongside people like medical directors, directors of nursing, etc.”
Complaints from health care staff mirrored statements from corrections officers on a separate survey they completed earlier this year. Both said they’re dealing with inadequate staffing and unresponsive management.
Geleynse said jail administrators “do not have any response to either survey.”
Sister Barbara Finch worked in the jail for 10 years as a sick call nurse. During the public-comment portion of the board meeting, she sharply criticized the jail’s medical care then and now.
“There was an attitude that pervades and still pervades that just because our friends do not take care of themselves on the outside, then we don't have to bother to provide services for them — extended services — inside the jail. We are legally and morally responsible for them,” Finch said. “It doesn't matter what they do on the outside. As long as they're confined and can't do anything for themselves, we're responsible for it.”
Allegheny County Councilor and oversight board member Bethany Hallam read a statement on behalf of council President Pat Catena urging the board to prioritize staff hiring and retention. In the statement, Catena called the survey results a “damning indictment of the working environment at the Allegheny County Jail.”
“The picture it paints is of a caustic, toxic workplace in which inadequate numbers of staff are forced to perform to the point of exhaustion tasks for which they were not trained and in which supervisory staff is unresponsive, unqualified or both,” his statement read.
“We owe our employees a safe working environment, staffed at adequate levels to meet the needs of the facility … We also have a duty to the individuals incarcerated at the Allegheny County Jail. If the goal of the criminal justice system is rehabilitation, we must ensure that individuals' mental and physical health needs are adequately addressed," he said in the statement.
Catena also cautioned that if the oversight board doesn’t ensure changes at the jail, council could “[conduct] an investigation or hold public hearings regarding the Allegheny County Jail.”
Jail liaison officially hired
The oversight board again voted Thursday to hire drug court coordinator and former probation officer Karen Duffola as the jail liaison. The liaison will provide the board with regular assessments of what’s going on at the jail.
The board first voted to hire Duffola in May, but advocates later challenged the decision, alleging that the move violated the Sunshine Act. The board is now being sued due to that vote.
Board member and Allegheny County Common Pleas Judge Elliott Howsie, who is named in the suit, declined to comment on whether the first vote violated the act, which requires government deliberations and decisions to take place in public and with notification in advance.
“There [were] some concerns raised about the votes, so we voted tonight to make sure everyone had an opportunity to offer public comments,” he said after the meeting.
Hallam objected to Duffola’s nomination the first time around. She reiterated her concerns Thursday evening, noting that although County Controller Corey O’Connor’s office drafted a proposed memorandum of understanding that would detail the liaison’s responsibilities, the board has not voted to accept the memorandum.
Another board member, Common Pleas Judge Beth Lazzara, said the job description is public information and urged the board not to delay the hiring any longer.
The liaison will be housed in the county sheriff’s office but report to the oversight board.
Ryan Herbinko, a solicitor for the controller’s office who is standing in for O’Connor while he is on parental leave, said O’Connor — who is also a member of the oversight board — planned to abstain from the vote. Herbinko said the controller and his office have “significant concerns” regarding the lack of discussion about the memorandum and stressed that the board should put the memorandum in place before hiring the liaison.
Board members Abass Kamara, Gayle Moss, Sheriff Kevin Kraus and Judges Lazzara and Howsie voted to hire Duffola. Hallam voted against the hire. Herbinko and county manager Jennifer Liptak, representing County Executive Rich Fitzgerald, abstained. Board member Terri Klein was absent.
