Federal oversight of California's prison inmate health care may end

Triple tiered bunk beds at Solano Prison in 2006. A federal judge may transition control over the state prison healthcare system back to the state after seven years of oversight.
Triple tiered bunk beds at Solano Prison in 2006. A federal judge may transition control over the state prison healthcare system back to the state after seven years of oversight.
California Department of Corrections and Rehabilitation / EPA

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U.S. District Judge Thelton Henderson’s oversight of California’s prison medical system won’t end tomorrow, and it won’t end all at once. He has to be satisfied that improvements are complete and that they can last.

Prison Law Office Attorney Don Spector said California’s not there yet.

“There are still problems at many prisons, with getting timely access to a physician and timely access to their medications that they need.” Spector said.

Spector sued California nearly a decade ago to improve medical care for inmates. He said the lack of computerized medical records is still a problem. Missing and incomplete records have contributed to deadly mishaps in the past.

Spector said there have been improvements under the receivership. He said one of the biggest was weeding out incompetent doctors and nurses and bringing in more and better-qualified staff.

But receiver Clark Kelso said some of that staff has already quit because of poor working conditions in prison clinics. He worries more will leave unless the state improves things.

“We’ve got doctor’s offices, dentists’ offices in places that they shouldn’t be,” said Kelso. “We have places without hot running water, dirt everywhere.”

California officials oppose upgrading the clinics at all 33 state prisons. The Brown Administration said they won’t need all of those clinics because the state is reducing its prison population by 40,000 inmates to comply with a federal court order to reduce overcrowding to improve medical care. The Governor’s office says a medical facility under construction in Stockton will add 1,700 beds for inmates with chronic conditions.

Even so, Kelso predicts the state will need more acute care beds in about a decade.

“Half the prison population is either going to be needing a high level of medical care because they have serious long-term conditions or they’re going to have serious mental health conditions,” said Kelso.

California’s efforts to reduce overcrowding will also be a key element in Judge Henderson’s deliberations over how quickly to return control of medical care to the state.

But the head of the state prisons said he won’t reduce the population by as much as he’s been ordered to.

Corrections Secretary Matthew Cate said that even if the prisons are a bit more overcrowded, he can still provide good medical care, and save the state billions.

“Corrections doesn’t exist in a vacuum.” Cate told reporters at an April press conference announcing a massive downsizing of the department. “California has needs in higher education, in K-12, health and human services needs — we have folks who have been cut year after year after year. And so the prison system has to live within its means.”

Cate said the state could save a billion dollars a year if it closes the costly California Rehabilitation Center in Norco and brings back 9,500 inmates sent to prisons in other states to ease crowding.

But Kelso worries the state’s efforts to save more money could threaten improvements that have been made.

“We’ve brought it this far, is it really going to be sustainable if the state decides ‘We’re going to stop?’” he asked.

Kelso said that’s a question for Judge Henderson.

“The court’s going to be concerned about ‘When can we let go? When is the state in a position where it’s going to maintain the work that’s been done?’” he added.

Kelso’s already handed the state its first big test. He gave it control over guards who escort inmates to medical appointments. Prisoners used to miss the majority of those appointments and now they make 95 percent of them. Can the state maintain that progress? That’s just one of the many issues Henderson will consider as he decides how quickly to return control over prison health care back to the state.