California Prison Medical Care a Major Scandal and Disgrace According to Receiver Appointed by Federal Judge

Posted on 06 July 2006

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By Frank D. Russo

Robert Sillen, the receiver appointed by Federal Court Judge Thelton Henderson to take control of the $1.5 billion California Prison medical system, has issued his first report—one that minces no words and indicates the inmates not only receive care below the level required by the US Constitution, but that the prison department is wasteful of taxpayer resources. Solutions are proposed by the receiver are described as beyond “placing bandaids on gaping wounds.”

In light of funding cuts in June from the state’s budget there is a recommendation that the judge issue a “writ of execution for the levy of State funds”—an extraordinary legal remedy tantamount to seizure of state money. This guy isn’t fooling around.

The lack of leadership is so wanting that the receiver actually says that “Inmates are not the only prisoners in the California Department of Corrections and Rehabilitation.” He goes on to state that:

“The Receiver has encountered many CDCR [California Department of Corrections and Rehabilitation] employees, medical providers and correctional personnel who desperately want to do a good job. The medical care crisis in California’s prisons was not created by the men and women who toil in the CDCR trenches….[T]he overwhelming majority of State employees involved in activities essential to the Receiver’s mission are also prisoners.”

This report, issued after interviewing dozens of key individuals, including the Governor himself, and reviewing thousands of pages of documents, finds fault not only with those running the Department, but also the state control agencies. It also does not spare the legislative bodies charged with oversight. It comes on the heels of a report issued by John Hagar, another receiver appointed by Judge Henderson to look into severe problems in the main mission of the Department—corrections itself. The only defense left to the Schwarzenegger Administration, which has had multiple Directors quit in frustration and despair over lack of support for reform, is to try to argue that others share the blame.

But scapegoating individual employees and others will simply not wash given the explicit findings in this report that problems are systemic and begin at the top. Nothing has been done for the last three years other than to change the name of the Department to include “Rehabilitation.” The Governor’s call of a special session of the legislature, only after a series of harshly critical editorials, is clearly an attempt at damage control. Even now, his administration has yet to offer specific suggestions or bill language that takes the first infant steps in dealing with this problem.

Consider these words directly from the receiver’s report:

“The medical services provided by the CDCR are without question “broken beyond repair”... Almost every necessary element of a working medical care system either does not exist, or functions in a state of abject disrepair, including but not limited to the following: medical records, pharmacy, information technology, peer review, training, chronic disease care, and specialty services. …

Instability of Leadership: The Receiver has already dealt with no fewer than three Secretaries of the CDCR. As well, the reassignment, retirement, promotion, or demotion of numerous wardens has significantly contributed to the instability, demoralization and ineffectiveness of the CDCR in both its custody as well as medical care reponsibilities.

Given this state of affairs, and the poor reputation that the CDCR has earned as an employer, raising the medical system to constitutional standards may require removing it from the umbrella of the CDCR.”

The report gives examples of waste of taxpayer resources that involve purchasing equipment that has never been used, contracting out services at much higher costs, the lack of any pharmacy system, filling in with contract medical and pharmacist providers who charge a much higher hourly rate than CDCR employees (even if they were paid wages that could attract and retain them, according to the receiver).

It explicitly states that “no one seriously argues that the compensation presently offered to prison health care personnel is adequate in terms of recruiting, hiring and retaining the quality of numbers of staff needed….It is important to emphasize that no real taxpayer savings result from the intolerably low salaries of prison health care employees. Instead, according to recent audits, the cost of compensation simply shifted from State employees to the private providers.” It finds the annual cost of contract health care services is about $821 million—an increase of 537% from five years earlier.

The report can be downloaded as a PDF file for those who wish to read it. Excellent articles appear in today’s papers across the state.