Filed: Dec. 11, 2019
Latest Update: Dec. 11, 2019
Summary: PHASE 2A ORDER AND INJUNCTION ON MENTAL-HEALTH STAFFING REMEDY MYRON H. THOMPSON , District Judge . On September 6, 2019, the parties submitted stipulations (doc. no. 2606) regarding mental-health staffing. Pursuant to these stipulations, the parties on September 13 filed an agreed-upon mental-health staffing matrix (doc. no. 2618-1). The parties agreed that these stipulations should be reduced to an order, which they agree will be enforceable under the court's initial understaffing remedia
Summary: PHASE 2A ORDER AND INJUNCTION ON MENTAL-HEALTH STAFFING REMEDY MYRON H. THOMPSON , District Judge . On September 6, 2019, the parties submitted stipulations (doc. no. 2606) regarding mental-health staffing. Pursuant to these stipulations, the parties on September 13 filed an agreed-upon mental-health staffing matrix (doc. no. 2618-1). The parties agreed that these stipulations should be reduced to an order, which they agree will be enforceable under the court's initial understaffing remedial..
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PHASE 2A ORDER AND INJUNCTION ON MENTAL-HEALTH STAFFING REMEDY
MYRON H. THOMPSON, District Judge.
On September 6, 2019, the parties submitted stipulations (doc. no. 2606) regarding mental-health staffing. Pursuant to these stipulations, the parties on September 13 filed an agreed-upon mental-health staffing matrix (doc. no. 2618-1). The parties agreed that these stipulations should be reduced to an order, which they agree will be enforceable under the court's initial understaffing remedial order and opinion containing PLRA findings. See Braggs v. Dunn, 2:14cv601-MHT, 2018 WL 7106346 at *1-2 (M.D. Ala. Feb. 20, 2018) (Thompson, J.); Braggs v. Dunn, 2:14cv601-MHT, 2018 WL 985759 at *9 (M.D. Ala. Feb. 20, 2018) (Thompson, J.). The parties further agreed to some clarifications of these stipulations during an on-the-record hearing on December 6. Accordingly, it is the ORDER, JUDGMENT and DECREE of the court as follows:
(1) The stipulations (doc. no. 2606), as clarified during the on-the-record hearing on December 6, 2019, and as attached to this order as Attachment A, are approved.
(2) The mental-health staffing matrix (doc. no. 2618-1), as attached to this order as Attachment B, is approved.
(3) Defendants Jefferson Dunn and Ruth Naglich are ENJOINED and RESTRAINED from failing to comply with the attached provisions (Attachments A and B), as clarified during the on-the-record hearing on December 6, 2019.
IN THE DISTRICT COURT OF THE UNITED STATES FOR THE MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION
EDWARD BRAGGS, et al.,
Plaintiffs,
v. CIVIL ACTION NO.
2:14cv601-MHT
JEFFERSON S. DUNN, in his
official capacity as
Commissioner of
the Alabama Department of
Corrections, et al.,
Defendants.
ATTACHMENT A
A. The Alabama Department of Corrections ("ADOC") Shall amend the current contract for and have mental-health staffing consistent with or greater than the staffing ratios set forth by Drs. Perrien and Metzner and Catherine Knox, (as contained in Doc. 2385-1), except as agreed by the Parties and with the following adjustments
(1) A shift relief factor shall not be applied for Program Managers and Clerks.
(2) Until September 30, 2020 (the end of the initial term of the contract with ADOC's mental-health vendor), ADOC and its mental-health vendor shall apply the following shift relief factors for all other mental health staff
a. A 1.2 shift relief factor for new positions that are staffed five (5) days per week;
b. A 1.68 shift relief factor for all new positions that are staffed seven (7) days per week; and
c. A 1.1 shift relief factor for existing positions.
(3) Starting October 1, 2020, ADOC shall apply an actual shift relief factor determined by Drs. Perrien and Metzner and Catherine Knox no later than September 1, 2020 for all mental-health positions other than Program Managers and Clerks.
B. The ratio of Certified Registered Nurse Practitioner ("CRNP") to psychiatrist shall be 1.25:1 on a statewide basis, but not on a facility by facility basis.
C. All CRNPs working as mental health staff must be approved to work in psychiatry pursuant to applicable Alabama nursing board standards within twelve (12) months of this agreement or, for later employed CRNPs, within twelve (12) months of his or her employment.
D. For eighteen (18) months after the start of his or her employment, ADOC's mental-health vendor may consider an Associate Licensed Counselor ("ALC") as a MHP, provided that the ALC is working toward his or her licensure as a Licensed Professional Counselor ("LPC"). Before becoming a LPC, an ALC cannot complete suicide risk assessments or conduct follow-up examinations on his or her own. The ALC can participate in suicide risk assessments conducted by an independently licensed MHP or another independently licensed mental-health professional such as a psychiatrist, psychologist, or CRNP or other appropriate licensed professional, as a part of the ALC's training. After six (6) and twelve (12) months of employment, each ALC's progress toward meeting the licensure requirements shall be assessed to evaluate his or her progress towards licensure. If the ALC has not reached 600 hours of supervised time toward licensure by the six (6) month assessment, 1,200 hours of supervised time toward licensure by the twelve (12) month assessment, or achieved licensure by eighteen (18) months after commencing employment, the ALC shall no longer be considered or counted as a MHP.
E. Up to ten percent (10%) of the MHPs working in ADOC for the mental-health vendor can be ALCs working towards their licensure as LPCs, as discussed above in the preceding paragraph.
F. Activity Technicians will work two shifts five (5) days per week and at least one shift on Saturdays and Sundays each week.
G. ADOC and its mental-health vendor may substitute MHPs for psychologists on a facility-by-facility basis, provided that the total number of MHPs and psychologists is equal to or greater than the number would be if applying the consultants' ratios. MHPs shall conduct only work for which a doctorate level clinician is not necessary, as determined by ADOC's Director of Psychiatry.
IN THE DISTRICT COURT OF THE UNITED STATES FOR THE MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION
EDWARD BRAGGS, et al.,
Plaintiffs,
CIVIL ACTION NO.
v. 2:14cv601-MHT
JEFFERSON S. DUNN, in his
official capacity as
Commissioner of
the Alabama Department of
Corrections, et al.,
Defendants.
ATTACHMENT B
MENTAL HEALTH Staffing by Facility
Bibb Correctional Facility CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.50 0.00 0.50
Licensed MHP 2.50 2.47 4.97
LPN 1.40 0.72 2.12
Paental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Observer 2.00 0.00 2.00
Psychiatrist 0.50 0.00 0.50
RN 0.00 1.20 1.20
Total FTE's 8.90 4.39 13.29
Bullock Correctional Facility — Inpatient CONTRACT ADDITIONAL EXHIBITA
APRIL 1, 2018 FTE's TOTAL
Activity Tech 6.00 9.53 15.53
Administrative Assistant 2.00 0.00 2.00
Assistant DON 1.00 0.00 1.00
CRNP 1.40 0.72 2.12
Licensed MHP 8.40 5.48 13.88
LPN 11.70 4.78 16.48
liaental Health Clerk 1.00 1.20 2.20
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Observer 6.00 0.00 6.00
Psychiatrist 2.00 0.00 2.00
Psychologist (PhD) 1.00 1.50 2.50
RN 4.20 5.23 9.43
RTU/SU Coordinator 1.00 0.00 1.00
Total FTE's 46.70 28.44 75.14
Bullock Correctional Facility — Outpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 1.00 0.00 1.00
Licensed MHP 4.20 1.20 5.40
LPN 1.40 0.00 1.40
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 1.00 0.00 1.00
RN 1.40 0.00 1.40
Total FTE's 11.00 1.20 12.20
Donaldson Correctional Facility — Inpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
Activity Tech 4.00 9.26 13.26
Assistant DON 1.00 0.00 1.00
CRNP 1.00 0.60 1.60
Licensed
IMP 5.00 11.62 16.62
LPN 9.80 2.02 11.82
Mental Health Clerk 1.00 1.20 2.20
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Observer 8.00 0.00 8.00
Psychiatrist 1.00 0.00 1.90
Psychologist (PhD) 1.00 1.20 2.20
RN 4.20 0.00 4.20
Total FTE's 37.00 25.90 62.90
Donaldson Correctional Facility — Outpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.50 0.60 1.10
Licensed LIHP 2.80 0.00 2.80
LPN 1.40 0.00 1.80
Mental Health Clerk 1.09 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 0.50 0.00 0.50
RN 1.40 -0.40 1.00
Total FTE's 8.60 0.20 8.80
Easterling Correctional Facility CONTRACT ADDITIONAL EXHUBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.50 0.60 1.10
Licensed IMP 2.80 2.11 4.91
LPN 1.40 -0.40 1.00
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 0.50 0.00 0.50
RN 0.00 1.20 1.20
Total FTE's 7.20 8.51 10.71
Fountain Correctional Facility CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 1.00 0.00 1.00
Licensed MHP 2.00 2.59 4.59
LPN 1.00 0.00 1.00
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 0.50 0.00 0.50
Psychologist (PhD') 0.50 -0.50 0.00
RN 0.00 1.20 1.20
Total FTE's 7.00 3.29 10.29
Hamilton A&I Correctional Center CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
Licensed MHP 1.00 0.58 1.58
LPN 0.80 0.24 1.04
Mental Health Clerk 0.50 0.00 0.50
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 0.25 0.06 0.31
RN 0.00 0.60 0.60
Total FTE's 3.55 1.48 5.03
Holman Correctional Facility CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 1.00 0.00 1.00
Licensed MHP 2.00 3.07 5.07
LPN 2.40 -0.40 2.00
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Observer 5.00 0.00 5.00
Psychiatrist 0.50 0.00 0.50
Psychologist (PhD') 0.50 -0.50 0.00
RN 0.00 0.60 0.60
Total FTE's 13.40 2.77 16-17
Kilby Correctional Facility — Outpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
Activity Tech 0.00 1.87 1.87
CRNP 0.75 0.24 0.99
Licensed MHP 5.00 3.60 8.60
LPN 4.00 -2.00 2.00
Mental Health Clerk 2.00 0.00 2.00
Mental Health Sae Program Manager — Licensed 1.00 0.00 1.00
Observer 6.00 0.00 6.00
Psychiatrist 1.00 0.00 1.00
Psychologist (PhD) 1.00 1.20 2.20
RN 1.40 0.72 2.12
RTU/SU Coordinator 1.00 0.00 1.00
Total FTE's 23.15 5.63 28.78
Kilby Correctional Facility — CSU CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.25 0.00 0.25
Licensed MHP 2.40 2.59 4.99
LPN 4.20 0.00 4.20
Mental Health Clerk 0.50 0.60 1.10
Psychiatrist 0.50 0.52 1.02
Psychologist (PhD) 0.50 0.60 1.10
RN 1.40 6.34 7.74
Total FTE's 9.75 10.64 20.39
Limestone Correctional Center CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 1.00 0.00 1.00
Licensed MHP 4.50 3.67 8.17
LPN 2.40 0.72 3.12
Mental Health Clerk 1.00 0.60 1.60
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Observer 3.00 0.00 3.00
Psychiatrist 0.75 0.00 0.75
Psychologist (PhD) 1.00 -1.00 0.00
RN 0.00 1.20 1.20
Total FTE's 14.65 5.19 19.84
St. Clair Correctional Center CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.50 0.00 0.50
Licensed MHP 1.75 2.89 4.64
LPN 1.00 0.00 1.00
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
RN 0.00 0.60 0.60
Total FTE's 5.25 3.49 8.74
Staton/Elmore/Frank Lee Complex CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 1.00 0.00 1.00
Licensed MHP 5.00 1.39 6.39
LPN 2.80 -0.80 2.00
Mental Health Clerk 2.00 0.00 2.00
Mental Health Site Program manager — Licensed 1.00 0.00 1.00
Psychiatrist 1.00 0.00 1.00
RN 2.80 -1.30 1.50
Total FTE's 15.60 -0.71 14.89
Tutwiler Prison for Women — Inpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
Activity Tech 2.00 1.20 3.20
Assistant DON 1.00 0.00 1.00
CRNP 0.25 0.90 1.15
Licensed MHP 6.00 3.30 9.30
LPN 5.70 1.80 7.50
Mental Health Clerk 1.50 2.40 3.90
Mental Health Site Program Manager — Licensed 1.00 1.20 2.20
Psychiatrist 0.50 0.60 1.10
Psychologist (PhD) 1.00 0.00 1.00
RN 4.20 0.00 4.20
Total FTE's 23.15 11.40 34.55
Tutwiler Prison for Women — Outpatient CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.75 0.30 1.05
LPN 1.40 0.00 1.40
Psychiatrist 0.75 0.30 1.05
Psychologist (PhD) 1.00 1.20 2.20
RN 0.00 1.20 1.20
Total FTE's 3.90 3.00 6.90
Ventress Correctional Facility CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
CRNP 0.50 0.00 0.50
Licensed MHP 2.80 1.63 4.43
LPN 1.40 0.12 1.52
Mental Health Clerk 1.00 0.00 1.00
Mental Health Site Program Manager — Licensed 1.00 0.00 1.00
Psychiatrist 0.50 0.00 0.50
RN 0.00 1.20 1.20
Total FTE's 7.20 2.95 10.15
Management Staff CONTRACT ADDITIONAL EXHIBIT A
APRIL 1, 2018 FTE's TOTAL
Administrative Assistant 2.00 0.00 2.00
Administrative Coordinator 1.00 0.00 1.00
Asst Program Director North 1.00 0.00 1.00
Asst Program Director South 1.00 0.00 1.00
Asst Psychiatrist Director (Collaborator) 1.00 0.00 1.00
Clinical Director/Education Training 1.00 0.00 1.00
COI Assistant 1.00 0.00 1.00
COI Manager 1.00 0.00 1.00
Data/Reports Manager 1.00 0.00 1.00
Program Director 1.00 9.00 1.00
Psychiatrist Director 1.00 0.00 1.00
Regional Psychologist 0.00 2.40 2.40
Telehealth Coordinator 1.00 0.00 1.00
Total FTE's 13.00 2.40 15.40
TOTAL FTE's 259.00 115.18 374.18
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