California builds the nation's largest prison medical facility

Arial view of 144-acre construction site for nation’s largest prison health care facility in Stockton, California.
Arial view of 144-acre construction site for nation’s largest prison health care facility in Stockton, California.

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California is building the largest prison medical facility in the nation — and it’s doing it at a record clip. That’s because the state has to comply with a federal court order to improve health care for inmates.

A cluster of a warehouses, bungalows and two-story-high mounds of dirt mark the future home of the California Health Care Facility, just outside of Stockton. Even though the word “prison” isn’t in its name, the 144-acre facility definitely fits the description.

That will be evident soon when the building contractor rings the perimeter with electrified fences and guard towers. The medical hub inside those fences is designed to provide long-term care to 1,700 inmates too sick to live in regular housing.

Mike Meredith with the Department of Corrections and Rehabilitation manages the $900 million project. He says the scale and cost of the Stockton facility dwarfs any commercial project he’s worked on.

There’s good reason for that. As he tours a mock-up of what the main housing will look like once it’s finished, Meredith explains the many aspects of the building designed to support recovery starting at the ceiling.

“It would draw a lot of light down into the day area for patients, a lot of them with mental issues and/or a variety of clinical issues,” says Meredith. “It sort of helps promote healing them and, in theory, gets them back to the general population.”

A series of cells runs on the outside walls down the length of a building. Eventually, nurses stations will be built in the middle of the corridor.

Wider doorways let medical staff move inmates in and out of rooms on gurneys or in wheelchairs. The contractors wired the walls to support major medical equipment. Doing that requires more technology and more square footage than standard prison cells.

Nancy Kincaid, the spokeswoman for the federal receiver in charge of prison medical care, says there's aren't enough ground level cells at other facilities for all the inmates who need them.

“All the facilities out at the other institutions are all two levels, sometime three levels, and you don’t have elevators in housing areas,” she explains. “Because this is long-term care and an aging population, everything is one floor.”

For years, Californians voted to lengthen prison sentences. That means more felons are behind bars well past the age when chronic disease develops. The federal receiver’s office says that more than half the state’s inmates — nearly 70,000 — get treatment for a chronic condition.

The state is legally required to provide adequate medical and mental health care. It didn’t always do a good job at that.

About a decade ago, when lawyers showed that an inmate a week was dying from lack of care, a federal judge seized control of prison medical care in California and appointed the receiver to improve it. Later, a federal court ordered the state to reduce its prison population to improve medical care.

“This is the way forward,” says Nate Elam, warden at the California Health Care Facility and its medical CEO. “This is probably a turning point for the state of California.”

Elam dons a hard hat to tour the skeleton of one of the main medical building. It’s the size of a couple of football fields, flanked by buildings that are just as big. Elam lists the kind of services they’ll be able to offer in these buildings.

“So we’ve got pharmacy and lab and some of those sorts of services over here. We’ve got procedure areas, dental, rehabilitative services.” He asks Meredith, “Where are we putting the dialysis?”

The idea is to hub the sickest inmates in one place, to save on costs and produce better results. Many of the inmates who’ll be sent to the facility in Stockton need 24-hour nursing care. Right now, a lot of those inmates take up critical care bed space at prisons — and that forces the state to send other inmates to outside hospitals at a cost of $2,000 a day.

Kincaid says the Stockton facility will solve that problem.

“This allows us to shift around that population as they age — have mobility issues and need that long-term care setting, to come to a place where they can accommodate that, free up other beds and keep more people out of outside hospitals," Kincaid said.

The federal receiver estimates the California Health Care Facility will save the state $42 million a year, mostly in guarding and transportation costs, after it opens next July.

The Department of Corrections says the facility and an adjacent housing unit will also create 2,200 permanent jobs — and $1 billion a year in economic benefit in the region.