Survey alleges staffing shortage at Allegheny County Jail threatens healthcare employee licensure

Healthcare employees say health services administrator unqualified to make patient decisions

Matt Glover

An Allegheny County Jail healthcare staff job satisfaction survey presented at the Jail Oversight Board meeting Thursday identified 21 instances where staff licenses were threatened working under the warden’s administration.

There are currently 94 healthcare staff vacancies in the ACJ, according to John Kenstowicz who created the survey with Pennsylvania Impact Interfaith Network. The jail’s medical vacancies have hovered around 50 positions throughout 2022, an increase from the nearly 40 reported vacancies in 2019.

Vacancies have repeatedly caused one registered nurse to be responsible for overseeing five mental health units, according to one response. Other responses allege the staffing shortage forces employees to complete tasks outside of their practice, and the intake area is chronically understaffed causing new arrivals to miss medications. 

Kenstowicz and PIIN received anonymous responses from 31 of the 39 healthcare employees. Agency and contract staff were not included in this survey. 

Anonymous participants allege staff are forced to falsify documentation while working under management with no medical background and pre-pour medications which hinders accountability and increases the risk of receiving the wrong dosage.

“Management does not care about the licenses of the employees,” one response said. “They make policies that directly go against nursing licenses, and they knowingly attempt to force people to do things that go against licenses.”

One response alleges the jail health services administration enacted a policy that states an RN and an unlicensed personnel can count narcotics which contradicts Pennsylvania State Board of Nursing policy and American Nurses Association guidelines.

A licensure violation can seriously affect a person’s future, their feeling of stability and control of their job, according to Kenstowicz.

Other responses allege a hostile work environment, sexual harassment, and a fear of retaliation from management and administration if staff refuses to comply.

Of the 31 survey participants, none felt health services administrator Ashley Brinkman is qualified to make medical decisions. Brinkman has a doctorate in philosophy and counselor education and is a licensed professional counselor but has no medical degree.

Brinkman declined to comment. Jail spokesperson Jesse Gelenyse did not respond to request for comment. 

About 87% of participants felt management does not effectively communicate or answer questions and concerns about job duties, and multiple responses said management does not come out of their office or answer emails. Approximately 90% of participants said they are uninformed about corrective information regarding critical incidents like deaths and suicides.

“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,” one response said. “Management only communicates with each other, not the staff beneath them who are their front line.”

Over 93% of participants strongly agreed that staff morale is a major problem at the ACJ. About 90% do not feel valued as healthcare staff, and all participants said there are not enough staff to fill all shifts. Over half said they do not feel safe working at ACJ, and over 80% said the demands of the job have harmed their physical and mental health. When asked by Councilwoman Bethany Hallam why staff morale is low, Warden Orlando Harper had no answer.

About 25 participants said they are not paid fairly for what they are asked to do and feel unable to complete daily activities while providing quality care. One response claims the pharmacy is commonly out of needed medications, and another alleges that medical staff are not given the daily operations report.

According to Allegheny County’s recruitment website, mental health registered nurses at the jail make $26.27 per hour, registered nurses make $24.98, licensed practical nurses make $17.13, and pharmacy technicians make $13.39. Several responses allege agency staff are being paid more.

The ACJ has a no-media policy, so its employees cannot comment.

“This could be a chance for some change with a new county executive and new board, because some people will be stepping down and new people coming on soon,” Kenstowicz said, “It’s an exciting time and an important time for the jail’s history.”

Photography and story by Matt Glover, a Pittsburgh Media Partnership editorial intern. He is a senior at Slippery Rock University.

Title photo:  Shabaka Gay changes the pie charts as John Kenstowicz reads the ACJ healthcare staff survey results. More commenter continued reading after Kenstowicz’s public comment time had ended. 

Aug. 10 Update: This story was updated to clarify that the Allegheny County Jail has a no-media policy. A previous version said the policy was an employee contract clause.