Federal receiver: California at risk of sliding backward on prison medical care

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A California Department of Corrections officer speaks to inmates at Chino State Prison

The federal receiver in charge of California’s prison medical care said Friday he won’t return control to the state. He says he first has to get the money he was promised to build new medical facilities and upgrade old ones.

The state says with fewer inmates in prison, there’s not an urgent need for those medical upgrades. But that’s not how the receiver sees it.

Earlier this month, the judge who appointed a federal receiver to fix the prison medical system said it’s time to talk about giving control back to the state. Deadly neglect from malpractice has declined, and the judge said most inmates get better care.

But receiver Clark Kelso says the Department of Corrections has to sustain the improvement after he’s gone. That means finishing a medical hub where inmates with complex medical conditions or serious mental health problems can the care they need. Kelso says he’s getting a lot of pushback from the state.

"We’re at this interesting point where the closer you get to being done, everybody suddenly wants to stop,” Kelso said. “What I want to do is say, ‘No, finish that last 20 percent! Give me the last 20. Don’t pull us up short.'”

“We are building the largest prison hospital in the free world,” said Corrections Secretary Matthew Cate, talking about the 1,700-bed medical facility under construction in Stockton. The state budgeted nearly a billion for it. But in December, the Brown administration halted the last leg of the plan to build a housing and treatment center for inmates with severe mental illnesses.

The state’s prison population’s has dropped by 11,000 inmates since October, thanks to new law that routes low-level felons to the counties. Secretary Cate says it’s time to reassess prison medical needs.

“Part of the problem is the first time we went through we kind of used the gold standard: what would be ideal in a health care facility?" Cate said. "Well in these economic times, what we’re doing now is, ‘What will do? What’s good enough?’”

The state Legislature has also pushed back on the receiver’s plans. Lawmakers have refused to pay for two other big medical facility projects. And they won't release $750 million they promised the receiver to upgrade medical clinics at all California’s prisons.

Most lack the basics for routine medical care. That forces doctors and dentists to treat patients in rooms with no running water, to name one example.

“It’s not population based that upgrade program” Kelso said. “It’s simply based on inadequate facilities that were never designed to have these health care functions. And the delay in moving forward on that delays our wrapping up the case.”

Federal receiver Kelso has waited two years for lawmakers to release the $750 million medical facility upgrade fund. He says he can’t understand the delay. The money won’t come out of the state’s general fund or increase the budget deficit. It's bond money that’s been approved for prison construction under AB900.

Kelso says the drop in prison population won’t solve the prison medical care problem. The inmates that end up in state prisons now are the ones who committed violent crimes. That means they’ll be staying for decades, getting older and sicker.

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