Doctor: Pay not normal

Comp time payment bloated salary

So far in 2011, the state has paid the medical director at Fulton State Hospital $321,000 - more than the highest-paid state employee earned all last year.

One reason Dr. Narayana Adusumilli has earned more than double his listed salary is because in addition to his day shifts, he has often served as the on-call doctor at Fulton State Hospital during off hours. Like other doctors there, when he stays at the facility overnight or on weekends, he's paid $72 an hour, regardless of whether he's working, relaxing, eating or sleeping.

The mental health department has changed its policies on overtime, but one doctor still is required to be on site at the largest three DMH hospitals - Fulton State Hospital, Northwest Missouri Psychiatric Rehabilitation Center and Southeast Missouri Mental Health Center - during nights and weekends.

The department says the shifts are necessary.