Sillen Unveils Plan to Reform Prison Health Care in California

Two years ago, a federal judge took control of health care at California's 33 prisons, after the Corrections Department failed to improve substandard conditions. On Thursday, the federal receiver in charge of the state's prison medical care released his plan to fix it. KPCC's Julie Small reports.

Julie Small: One inmate a week was dying from curable causes in California's prisons. That revelation led a federal judge to appoint long-time health care manager Robert Sillen to fix what even Corrections officials admitted was a broken and dysfunctional system. One year into the job, Sillen sees a way out of the mess. But it won't come cheaply.

Robert Sillen: It's going to cost more than the state wants to spend and it always has. That's why they've never spent it and that's what got them into the trouble they're in now. I mean, had they made some of these investment they wouldn't have had to deal with me in the first place!

Small: Sillen's plan overhauls financial and administrative systems, launches badly needed construction of modern health care facilities, and creates new management structures to keep it all working. But he says hiring better staff is the most critical component of reforming the system.

Sillen: It's people that make a system run and make a system operate. We need good people, we need well trained people, we need educated people, we need people committed to providing good health care.

Small: To get the best people to work at the most remote prisons, Sillen wants to fly in medical crews to work shortened weeks.

Sillen: I don't care how much we pay some professionals, they're not going to move to Blythe or they're not going to move to Wasco or they're not going to move to Coalinga. I have nothing against those towns. But most people who aren't from a desert town, and who don't want to live in an isolated desert town, won't go there to work.

Small: Sillen says good doctors need access to lab and X-ray results and patients' medical histories. So his second priority is computerizing prison medical records. He says the system will also track how well prison hospitals and clinics care for inmates. He'll use that data to issue monthly report cards to prisons. Lawmakers worry what all this will cost.

Senator Mike Machado: I'm nervous, but I don't think I can do anything about it.

Small: State Senator Mike Machado chairs the budget subcommittee for public safety. He says California has a constitutional obligation to fulfill.

Machado: We have neglected to put the proper resources into our prison systems to provide the proper health care and services, and now we're being required to do this by a federal court. It's not a question of if we're going to do this. It's a question now to carry it out.

Small: The end game of the receiver's plan is to return prison health care management to the state. Senator Machado says the Corrections Department isn't up to the task right now. But he thinks the $7 billion prison plan state lawmakers just passed will help strengthen the agency. Machado thinks a new management team could turn the agency around in about five years.