California’s prisons see increased demand for medical care despite population drop

Rich Pedroncelli/AP

In this Aug. 3, 2006 file photo, inmates are seen housed in three tier bunks, in what was once a multi-purpose recreation room at the Deuel Vocational Institute in Tracy, Calif. Though the number of inmates has decreased dramatically, medical costs are going up.

Tens of thousands of inmates in California prisons suffer from complex and chronic diseases. That's unlikely to change much, even with a new law that’s expected to reduce the prison population by 40,000 within a few years. Longer “tough on crime” sentences mean people stay in prison longer and get sicker.

California's “realignment” law only sends people convicted of non-violent, non-serious and non-sexual felonies to county jails instead of state prison. Lawmakers enacted realignment to comply with a court order to reduce overcrowding to improve prison medical care. Since it took effect in October, the prison population has dropped by 17,000. But Federal Receiver Clark Kelso said that hasn’t lessened demand for treatment much.

“The guys who tend to have long-term chronic conditions that require high levels of care, they tend to be older inmates” Kelso explained. “The reason they’re older is they’ve committed violent or serious felonies or sex crimes. They've been given long sentences and they’re not going anywhere.”

A federal judge appointed Kelso to fix prison medical care after a court investigation determined that one inmate a week was dying from poor medical care.

A high percentage of lifers, and second- and third-strikers, end up at California State Prison Solano in Vacaville.

On a windy day in December, Solano's Lori Austin, who oversees medical care at the prison, passed through multiple security gates to get to clinics on the prison yards. “Most of the guys you see out on the yard are the younger guys." she said. "The older guys tend to stay in. We have guys here who are 90-years-old.”

One of the guys staying inside his dormitory is 51-year-old Gregory Johnson of Los Angeles, who’s serving 15 years to life for attempted murder.

From his “home” at bunk number "151," Johnson said he was diagnosed with lymphoma seven years ago. After undergoing a few years of chemotherapy he’s in remission, but still weak.

Johnson pulled a breathing apparatus called a C-PAP out of brown paper bag stashed in his bunk. The machine keeps him breathing at night. Doctors discovered Johnson suffers from sleep apnea after running some tests.

Johnson said that over two nights of observation “I stopped breathing 50 times. I didn’t know I needed this or Ill die in my sleep.”

Chief Medical Officer Dr. Jack McCue said Solano Prison has 1,500 inmates who, ­like Johnson, are over the age of 50.

”That's when chronic diseases start kicking in.” McCue said. “We’ve got one of the oldest populations and one of the sickest populations in the system.”

Because of the high percentage of older, sicker inmates, Solano’s staffed with doctors who specialize in chronic care and complex diseases. Dr Samuel McAlpine, the prison's Chief Physician and Surgeon, is an expert in rheumatic diseases who decided to take the job because he saw a real need. "Solano has 3000 inmate patients with chronic diseases," he said.

You’d think fewer prisoners would equal fewer complex medical cases, but McAlpine and McCue say realignment's had the opposite effect.

“They (CDCR) look at us as a site to send medically complicated patients.” says Dr. McCue.

One of the most common illnesses at Solano is Hepatitis C. Throughout California's prisons, 23,000 inmates have the disease, and the federal receiver expects that number to grow. Treatment cost $5,000 a week, per inmate, but untreated Hepatitis-C leads to liver disease and liver cancer, which is even more expensive to treat.

Fifty-four-year-old Alfredo Monteon of San Fernando Valley said he hopes the state will get the newest drug to treat him. “I already failed standard treatment. I'm already in stage 3 hepatitis C,” Monteon said.

Monteon's serving 28 years for murder robbery and comes up for parole soon.

“I just want to make sure I don't die before I get out of prison,” Monteon laughed.

The Brown Administration estimates it’ll save $100 million a year through reductions in doctors and nurses, once realignment’s fully implemented. But neither Brown's Department of Finance, nor the independent Legislative Analyst has figured out yet how much prison medical care costs will rise as the more serious criminals remain and age in prison.

Federal Receiver Clark Kelso predicts that within a decade, half of the prison population will suffer from chronic diseases or serious mental disorders.

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