After years of federal oversight, medical services at a California state prison still fail to meet constitutional standards, according to an inspection released Monday.
Care provided to nearly 4,000 inmates at California Correctional Center in Susanville is inadequate, the state inspector general said. The report blames the prison's remote location in northeastern California for a lack of doctors.
It is a setback for the state's efforts to regain control of the prison medical system, as it's the first failing grade since the prison inspections began this year.
The state will continue to work with a federal court-appointed receiver to return control to the state, Department of Corrections and Rehabilitation spokesman Jeffrey Callison said in an email.
"Our goal is to make sure all of our facilities provide good medical care," added Joyce Hayhoe, a spokeswoman for the receiver's office.
Three other prisons — Folsom State Prison, Correctional Training Facility in Soledad and California Rehabilitation Center at Norco — previously received passing grades. As a result, the receiver returned medical care at the Folsom prison to the Department of Corrections and Rehabilitation last month.
However, the Susanville prison failed in nine of 12 key areas.
Inspectors blamed four "core problems" for the poor performance. That included a lack of physicians, with two doctors on long-term sick leave and a third position vacant.
The prison's "remote locale was a constant barrier to hiring well-qualified and high performing physicians," inspectors wrote of the facility located nearly 90 miles north of Reno, Nevada, and nearly 190 miles northeast of Sacramento. The lack of doctors led to problems including "a widespread pattern of inadequate assessment and decision-making," inspectors found.
In one case, care was delayed for an inmate who had been coughing up blood after two doctors both failed to thoroughly review the inmate's hospital medical records for possible lung cancer, inspectors found. The report says the problem fortunately appeared to be benign.
Other problems included poor nursing documentation, supervision, and accountability in certain medical units, and a staff that "lacked a sense of individual patient ownership and responsibility."
An initial review of patient files led inspectors "to question the basic competency of this nursing group," before they determined through interviews that the problem was poorly kept medical records and not the care itself.
The problems are more notable because the prison's inmates are relatively young and healthy, inspectors noted: The facility houses about 4,000 minimum- and medium-security inmates, many of whom are trained to help fight wildfires.
The federal receiver, J. Clark Kelso, has said he expected some prison medical programs would fail the inspections. He plans to devote more of his office's attention to bringing those programs up to constitutional standards.
U.S. District Court Judge Thelton Henderson of San Francisco found in 2005 that conditions system-wide were so poor that an average of an inmate each week was dying of medical malpractice or neglect. Since then, the state has spent $2 billion for new prison medical facilities, doubled its annual prison health care budget to nearly $1.7 billion and reduced its prison population by more than 40,000 inmates.