Prison Affliction

Medical care inside California's state prisons

A special report by KPCC's Julie Small

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"I invite you to go in to any prison and walk in to any of those medical facilities, and you tell me if it’s not just as good care as you’ll get at Blue Shield or Kaiser or anywhere else."

– Secretary of Corrections Matthew Cate denying allegations in a 2009 federal court ruling that overcrowding in California prisons prevents inmates from getting adequate medical care, "often with tragic consequences."

Part 1: California’s budget woes thwart improvements to prison medicine
Aug. 23, 2010|Julie Small|KPCC

Nearly a decade ago, medical care at California’s state prisons was deadly – bad enough to kill one inmate a week by some accounts. A federal judge ordered it fixed. Read on...

Sidebar: Prisoner's wife talks about her husband's prison cancer treatment

Part 2: Chino prison sees some improvements in medical care
Aug. 24, 2010|Julie Small|KPCC

A federal judge appointed a receiver to fix California's prison medical system. KPCC toured the California Institution for Men in Chino to see whether conditions have improved. Read on...

Sidebar: Report on Chino prison cited problems threatening inmate health

Part 3: California inmates still suffer from lapses in prison medical care
Aug. 25, 2010|Julie Small|KPCC

Today, changes ordered by a federal receiver have brought in better doctors and better care - but inmates continue to suffer misdiagnosis and delays in treatment. Read on...

Sidebar: Chino prisoner's wife's journal shows problems with prison medical care

Part 4: Vacaville's California Medical Facility – The 'gold standard' for prison medical care in California
Aug. 26, 2010|Julie Small|KPCC

The federal receiver in charge of prison medicine considers one facility the gold standard for inmate care. KPCC goes inside a prison hospital for inmates who need constant care. Read on...

Sidebar: Prisoner has trouble getting protection from recurring skin cancer

Part 5: Fewer improvements planned for prison medical care
Aug. 27, 2010|Julie Small|KPCC

KPCC looks at whether the improvements to the prison medical system have improved care enough to satisfy the federal judge and for the receivership to end. Read on...


A decade ago, medical care at California’s state prisons was worse than bad – it was deadly. Attorneys at the Prison Law Office successfully sued the Department of Corrections for violating inmates' constitutional rights to freedom from cruel and unusual punishment (Plata v. Schwarzenegger).

In a 2002 consent decree, California's Department of Corrections agreed to implement new medical care policies and procedures at all state prisons.

But in 2005 it was clear the department had failed to make those improvements.

A court investigation of inmate deaths found that one inmate a week was dying as a result of misdiagnosis, delayed or shoddy treatment or no treatment at all. The findings prompted Judge Thelton Henderson to take the unprecedented step of appointing a federal receiver to run California's prison medical care.

The federal receiver, Robert Sillen, began work in April of 2006. (In 2008 Henderson replaced Sillen with Clark Kelso.) Sillen determined that problems in prison medical care were so innumerable it would take at least a decade and untold billions to fix them.

But only a year later, California officials – including the Secretary of Corrections Mathew Cate, Governor Arnold Schwarzenegger and Attorney General Jerry Brown – claimed that medical care for inmates had reached an acceptable standard. They say it’s time to put California back in charge of it.

Credit: California Legislative Analyst's Office

About the Series

Over a year, KPCC’s Julie Small interviewed state officials, prison medical experts, prison volunteers, inmates and their families, corrections officials and medical staff to determine if the quality of medical care in California's prisons is, as officials claim, "fixed." This investigation found:

Over five days beginning Monday, Aug. 23, 2010, KPCC reveals its findings on-air and online.

Web Resources

Julie Small's reporting on the California prison medical system was undertaken as part of a health journalism program offered through The California Endowment Health Journalism Fellowships, a program of the University of Southern California's Annenberg School for Communication & Journalism. Hear Julie talk about the project on the fellowship Blogtalk radio chat.