California Legislative Analyst Office says state must reel in prison medical costs

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A new report from California’s Legislative Analyst Office says that reeling in prison medical costs would help sustain improvements when the state resumes control.

Seven years ago, investigators found that an inmate a week was dying from medical neglect in California prisons. That got a federal judge to strip control of prison medical care from the state — and hire a receiver to fix it.

Today, inmates get better care from better doctors and nurses. And California pays for it: about $1.5 billion a year – that's $500 million more than it had been before the judge handed over prisoners' medical care.

Now that the system appears on the rebound, the federal judge could soon hand control back to state prison officials.

But Aaron Edwards with the Legislative Analyst’s Office says the cash-strapped state can’t afford to keep paying that much for prison medical care.

"Over time, we’ve been getting closer and closer to the end of the receivership," Edwards says. "It’s even more important for the legislature to be thinking about how they’re going to transition back to state control of the inmate medical care program."

Edwards says the state should hire a single health care provider to tend to all the medical needs of the inmates, then set up an independent board to make sure the care is adequate and affordable.

"It’s the largest correctional medical system in the world. How would we administer that?" asks Nancy Kincaid. Kincaid is a spokeswoman for the federal receiver in charge of California's prison medical care.

"I don’t know that it would necessarily save any more money."

She says the receiver hired HealthNet to handle specialty care for state prison inmates and that the savings from that decision numbers in the millions. But Kincaid says state law won’t let the receiver hire HealthNet or any other healthcare company to provide primary care in prisons. By law, those jobs belong to state workers.

To do what the Legislative Analyst wants, Kincaid says the legislature would have to change the state constitution. But she agrees that prison medical care in California will need independent oversight once the federal receiver returns control.

"You’ve got to make sure the system doesn’t slide back into disrepair or worse: receivership," says Kincaid. "It’s very expensive for the state. The litigation is expensive. That’s not a good use of anybody’s time or money."

Kincaid says prison healthcare costs are higher since the federal receiver took over, but that they’ve come down each year.

This story has been updated.

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