The Brief

Despite spending hundreds of millions of dollars to fill vacant medical and mental health positions at prisons and state hospitals, California has little to show for it, according to a new report from the state auditor.

Job vacancy rates have increased since 2019 at the three facilities examined in the audit, as has the state’s reliance on pricey temporary workers. Atascadero State Hospital, Porterville Developmental Center and Salinas Valley State Prison had health-related vacancy rates topping 30% during fiscal year 2023-24. At Salinas Valley State Prison more than 50% of health positions were unfilled.

Workers contend that the high vacancy rate leads to more on-the-job assaults, mandatory overtime and staff turnover.

“A high vacancy rate is a self-fulfilling prophecy,” said Dr. Stuart Bussey, president of the Union of American Physicians and Dentists, which represents about 1,300 state psychiatrists.

The vacancy rates persisted despite targeted bonuses and wage increases that prison health workers received in contracts and under court order during the Newsom administration. Those included $42,000 bonuses for prison psychiatrists in a 2023 contract and more recently $20,000 bonuses the state had to dole out to mental health workers through a long-running prisoner rights lawsuit.

At face value, some state health workers are comparatively well-compensated. All of the 55 prison employees who earned more than $500,000 in income last year were doctors, dentists, psychiatrists or medical executives, according to state controller data.

A board-certified psychiatrist at Atascadero State Hospital — some of the highest paid state employees — can earn more than $397,000 in base pay. They also retire with pensions through the California Public Employees’ Retirement System. In comparison, the mean wage for a psychiatrist in California is $328,560, according to the U.S. Bureau of Labor Statistics.

But in certain places, local hospitals are offering even more. In Monterey County, $90,000 hiring bonuses are common at private hospitals struggling to fill their own vacancies, staff told state auditors.

Despite the pay, vacancy rates were highest among psychiatrists at Atascadero State Hospital and second highest at Porterville Developmental Center and Salinas Valley State Prison, auditors found.

All three of the audited facilities house individuals who are either incarcerated or institutionalized because they were deemed by the courts to be dangerous or unfit to stand trial. Federal and state law as well as court rulings require the state to provide adequate medical and mental health care. As a result, most of the facilities are required to have vacancy rates less than 10%.

Over the past 30 years, California has consistently failed to meet that standard.

None of the state departments overseeing the facilities have taken necessary steps to ensure adequate staffing, auditors wrote.

The audit found:

• The facilities had a “significant number of vacant positions” that were not filled by temporary workers or staff overtime.
• Neither the Department of State Hospitals nor the Department of Developmental Services, which houses some people with developmental disabilities in Porterville, had procedures to adequately evaluate or budget for staffing needs annually.
• The state hospitals and developmental services departments as well as the Department of Corrections and Rehabilitation have no process to determine whether facilities are meeting staffing minimums during each shift.

In a letter to lawmakers, California State Auditor Grant Parks wrote that the state should conduct a statewide recruitment campaign to hire health care workers “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.”

In response to the audit, the developmental services and state hospitals departments partially agreed with the findings in detailed comments.

The Department of State Hospitals, however, wrote that the vacancy rates covered during the audit period were significantly affected by the COVID-19 pandemic and that salary savings were overstated. “Our hospitals regularly meet or exceed mandated staffing minimums and have self-reported rare occurrences where they have not due to extraordinary circumstances,” department spokesperson Ralph Montano said, in an email to CalMatters. The department has agreed to implement many of the recommendations made in the report, Montano added.

In a statement, the corrections department said it was “committed to providing adequate health care for the incarcerated population, while ensuring fiscal responsibility.”

Workers claim state wastes money to fill vacancies

Coby Pizzotti, a lobbyist for the California Association of Psychiatric Technicians, which represents about 6,000 mental health clinicians, said the audit confirmed what many of the state worker unions had suspected: The state has continually refused to meaningfully improve wages, benefits and working conditions for employees, while spending money on temporary workers. This, the unions contend, makes the vacancy problem worse.

“Effectively, it’s a shadow state employee workforce. They’re just not called civil servants,” Pizzotti said.

The departments saved $592 million in payroll over six years by carrying the vacancies, the auditors wrote. But, auditors criticized the state departments for their inability to specifically track how they later spent that money. The departments counter that, generally, the money can be used to offset other costs or it can be given back to the state.

But they have also poured money into temporary positions to meet court-mandated minimums. During the six-year audit period, the state spent $239 million on contract workers to fill staff vacancies. The departments were authorized to spend more than $1 billion on temporary workers during that time period, though they used only a fraction of the money, according to the audit.

Contract workers, while making up less than 10% of the health care workforce, are paid so much that they cost more per hour than state workers even after accounting for benefits, auditors also found.

State workers’ unions say that’s more evidence toward their argument that these arrangements don’t save the state money.

“Contracting out is not a great way to do business. It’s expensive,” said Doug Chiappetta, executive director of the psychiatrists union.

Instead, state health worker unions want the state to increase salaries and benefits, to make permanent positions more attractive to candidates rather than spending it on highly paid contract workers.

The psychiatric technicians union, psychiatrists union and the state nurses union said that contract workers get paid two to three times more per hour than state employees, according to job advertisements from contracting agencies they have collected. Those companies are also able to offer generous benefits and scheduling flexibility that state jobs don’t have.

“It’s been a slap to our faces to see how the state doesn’t care for our nurses,” said Vanessa Seastrong, chair of Bargaining Unit 17 for SEIU Local 1000, which represents about 5,100 registered nurses. “You’re standing next to a nurse that is doing less work than you and getting paid more than you. How does that bring up morale?”

Bigger problems for recruitment

Even relying on temporary contract workers, the state has in many cases still failed to maintain staffing minimums for health care positions.

Vacancy rates increased significantly between 2019 and 2024. Salinas Valley State Prison saw vacancies jump 62% during the audit period, and more than half of mental health and medical positions were unfilled during fiscal year 2023-24.

Atascadero State Hospital’s vacancy rate rose 39% over the audit period for a total vacancy rate of about 30%. During the last three years of the audit period, Atascadero also lost 90% of its staff to attrition.

Porterville Developmental Center’s vacancy rate increased by just 6% over the audit period, but more than a third of its positions remained unfilled in the final year of the audit.

In interviews with auditors, administrators at the facilities said that the COVID-19 pandemic caused higher staff turnover as well as an increased reliance on contract workers to fill gaps.

All three facilities, which are located along the Central Coast or in the Central Valley, face additional barriers to recruitment.

These areas suffer from health care professional shortages. The area along the coast where Atascadero State Hospital and Salinas Valley State Prison are located faces a medium shortage of behavioral health workers, while Porterville Developmental Center is in an area with a severe shortage, according to the Department of Health Care Access and Information.

“Places like the Central Valley have substantially fewer mental health professionals per population than compared to the rest of the state,” said Janet Coffman, a professor at UCSF’s Institute for Health Policy Studies who studies workforce issues. “Particularly for Porterville, that’s a big part of the issue.”

At the same time, demand for mental health services has increased in the general population, Coffman said.

Combined, that makes it more difficult for the state to compete with the private sector, which is also struggling to hire health care workers.

Other barriers are difficult to address with money alone. The patient population can make the work dangerous. Staff are frequently verbally or physically assaulted. Unsafe conditions make it harder to recruit new workers and sometimes cause long-time workers to retire early.

“There were 2,700 assaults on staff last year. It’s not a matter of if, it’s when,” Pizzoti said.

The audit recommended that the state conduct a market analysis of all health care positions to determine whether payment was competitive, streamline the hiring process, and conduct a statewide recruitment campaign.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

As Los Angeles homeowners grapple with the expense of rebuilding after last year’s devastating fires, an L.A. City Councilmember is putting forward an idea that could lower some costs.

Councilmember Traci Park, who represents the Pacific Palisades, has introduced a motion to explore waiving part of the city’s portion of the local sales tax for fire victims who purchase rebuilding materials in the city.

The 1% of the local 9.75% sales tax that goes into the city’s general fund would be given back to consumers under the proposal. The waiver could apply to lumber, appliances and other rebuilding goods purchased within the city.

The motion, introduced Friday by Park and seconded by Councilmember John Lee, says: “The City should do everything within its power to alleviate the financial burden for these residents and businesses in order to facilitate their return and stabilize the Pacific Palisades community.”

Would it make much of a difference? 

Economists told LAist the proposal could help many homeowners mitigate the high cost of rebuilding, but likely wouldn’t tip the scales for under-insured, under-resourced property owners.

“It wouldn't hurt if it's very well designed and easy to use,” said Alexander Meeks, a director at the Santa Monica-based Milken Institute. “But I'm not sure if it's really going to tackle the scale of the financial challenge that survivors are facing.”

Meeks noted that the tax waiver wouldn’t lower up-front costs such as environmental testing, architectural design and permitting. And it may not help homeowners sourcing raw materials from outside the city.

Zhiyun Li, a UCLA Anderson School of Management economist, said the waiver could help some homeowners justify the additional cost of rebuilding more fire-safe structures.

“Homeowners must typically pay out of pocket to upgrade to IBHS+ standards, which are more stringent,” Li said. “The tax waiver could encourage upgrading to IBHS+ standards or investing more in mitigation, thereby reducing future risk and improving the likelihood of maintaining insurance coverage.”

What’s next for the proposal? 

The proposed tax relief would not be available to properties that have been sold since the fires started in January 2025.

The motion has been sent to the City Council’s budget and fire recovery committees. If approved by the full council, it would require the city administrative officer, the Office of Finance and the city attorney to report back to the council within 60 days on options for crafting a tax relief plan.

The motion calls for the report to consider factors such as how to minimize the burden of administering the tax relief, what documentation homeowners would have to submit and what it would cost the city to oversee the program.

Senate and House Republican leadership have resurrected a stalled plan to fund the Department of Homeland Security after a record 47-day funding lapse.

House Speaker Mike Johnson, R-La., and Senate Majority Leader John Thune, R-S.D., said in a joint statement on Wednesday that the House will take up a measure passed by the Senate last week to fund most of DHS except Immigration and Customs Enforcement and Border Patrol through the end of September.

Republicans would then attempt to fund ICE and Border Patrol for three years using a party-line budget reconciliation bill that would not require support from Democrats.

"In following this two-track approach, the Republican Congress will fully reopen the Department, make sure all federal workers are paid, and specifically fund immigration enforcement and border security for the next three years so that those law-enforcement activities can continue uninhibited," Thune and Johnson wrote.

The agreement comes nearly a week after House Republicans dismissed an identical plan, refusing to take up the Senate-passed measure and instead passing a 60-day short term funding bill for all of DHS that had little chance of overcoming Democratic opposition in the Senate.

Johnson called the agreement a "joke" and President Donald Trump declined to publicly endorse the deal. Trump had previously resisted any package that did not include his push to overhaul federal elections known as the Save America Act.

"I think any deal they make, I'm pretty much not happy with it," Trump told reporters last week.

Democrats welcomed the agreement as in line with their pledge not to give ICE any more money without reforms after immigration enforcement agents killed two U.S. citizens in Minneapolis. But the deal does not include any of the policy demands Democrats are pressing for, such as a ban on masks for immigration enforcement officers and requiring warrants issued by a judge, not just the agency, to enter homes.

"For days, Republican divisions derailed a bipartisan agreement, making American families pay the price for their dysfunction," Senate Minority Leader Chuck Schumer, D-N.Y., wrote in a statement Wednesday. "Throughout this fight, Senate Democrats never wavered."

Trump seemed to bless the revived plan earlier Wednesday, writing on social media that he wants a party-line bill to fund immigration enforcement on his desk by June 1.

"We are going to work as fast, and as focused, as possible to replenish funding for our Border and ICE Agents, and the Radical Left Democrats won't be able to stop us," Trump wrote.

Despite the shutdown, ICE has been minimally impacted because Republican lawmakers approved $75 billion for ICE through another party-line budget reconciliation bill last year.

Congress is on a two-week recess, but the Senate and House could move to fund all of DHS except ICE and CBP as early as Thursday using a procedure known as unanimous consent that allows the chambers to circumvent formal voting as long as no member objects.

Even during a recess when most members are not in Washington, this could be unpredictable, especially in the House, where many hard-line conservatives oppose a deal that does not fully fund DHS.

"Let's make this simple: caving to Democrats and not paying CBP and ICE is agreeing to defund Law Enforcement and leaving our borders wide open again," Rep. Scott Perry, R-Pa., a member of the ultra-conservative House Freedom Caucus, wrote on X. "If that's the vote, I'm a NO."

If a member does object, that could require waiting for another vote when all members are back from recess.

Claudia Grisales contributed reporting.
Copyright 2026 NPR

California clocked its second-worst snowpack on record Wednesday, a potentially troubling signal ahead for fire season.

It’s an alarming end to a winter that saw abnormally dry conditions briefly wiped from California’s drought map in January, for the first time in a quarter-century.

Though precipitation to date has been near average, much of it fell as rain rather than snow. Then March’s record-breaking heat melted most of the snow that remains. The state’s major reservoirs are nevertheless brimming above historic averages and are flirting with capacity, and a smattering of snow, rain and thunderstorms are dousing last month’s heat wave.

But experts now warn that California’s case of the missing snowpack could herald an early fire season in the mountains.

On Wednesday, state engineers conducting the symbolic April 1 snowpack measurement at Phillips Station south of Lake Tahoe found no measurable snow in patches of white dotting the grassy field.

“I want to welcome you call to probably one of the quickest snow surveys we’ve had — maybe one where people could actually use an umbrella,” joked Karla Nemeth, director of the California Department of Water Resources. “We’re getting a lot of questions about are we heading into a hydrologic drought? The answer is, I don’t know.”

State data reports that California’s snowpack is closing out the season at an alarming 18% of average statewide, and an even more abysmal 6% of average in the northern mountains that feed California’s major reservoirs.

Only the extreme drought year of 2015 beat this year’s snowpack for the worst on record, measuring in at just 5% of average on April 1st, when the snow historically is at its deepest.

“I think everyone's anticipating that it will be a long, busy fire season,” said Lenya Quinn-Davidson, director of the UC Division of Agriculture and Natural Resources Fire Network.

“Without a snowpack, and with an early spring, it just means that there’s much more time for something like that to happen.”

‘It’s pretty bizarre up here’ 

In the city of South Lake Tahoe, which survived the massive Caldor Fire in the fall of 2021 without losing any structures, fire chief Jim Drennan said his department is already ramping up prevention efforts.

“It's pretty bizarre up here right now. It really seems like June conditions more than March,” Drennan said. “People are already turning the sprinklers on for their lawns.”

Without more precipitation, an early spring may complicate prescribed burning efforts. But Drennan said fire agencies in the Tahoe basin can start mechanically clearing fuels from forest areas earlier than usual.

“That means we can get more work done,” he said.

It also means homeowners need to start hardening their homes now, said Martin Goldberg, battalion chief and fuels management officer for the Lake Valley Fire Protection District, which protects unincorporated communities in the Lake Tahoe Basin’s south shore.

Goldberg urges residents to scour their yards for burnable materials, create defensible space and reach out to local fire departments with questions. The risks are widespread — from firewood, wooden fences, gas cans, plants, pine needles — even lawn furniture stacked against a house.

“In years past, I wouldn't even think of raking and clearing until May,” Goldberg said. “But my yard's completely cleared of snowpack, and it has been for a couple weeks now.”

‘A haystack fire’

Battalion chief David Acuña, a spokesperson for Cal Fire, said fire season is shaped by more than just one year’s snowpack.

Climate change has been remaking California’s fire seasons into fire years. And California’s recent average to abundant water years have fueled what Acuña called “bumper crops of vegetation and brush.”

“Most of California is like a haystack. And if you’ve ever seen a haystack fire, they burn very intensely because there's layers of fuel,” Acuña said.

Like Quinn-Davidson, Acuña wasn’t ready to make specific predictions about fires to come.

But John Abatzoglou, a professor of climatology at UC Merced, said the temperatures and snowpack conditions this year offer a glimpse of California in the latter decades of this century, as fossil fuel use continues to drive global temperatures higher.

How this year’s fires will play out will depend on when, where and how wind, heat, fuel and ignitions combine. But it foreshadows the consequences of a warmer California for water and fire under climate change.

“This,” Abatzoglou said, “is yet another stress test for the future in the state.”

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.