Posted on 07/05/2006 6:28:19 PM PDT by NormsRevenge
The federal receiver appointed to oversee California's troubled inmate health care system calls conditions inside the state's prisons disgraceful and says they are even worse than he anticipated, according to a report released Wednesday.
"Almost every necessary element of a working medical care system either does not exist or functions in a state of abject disrepair," Robert Sillen wrote in his first report since he began overseeing California's $1.1 billion inmate health care system in April.
Sillen was appointed by U.S. District Court Judge Thelton Henderson, who took over the health care system a year ago, and was ordered to draft a reform plan within seven months of assuming his office.
Sillen's task is to reform a part of the nation's largest prison system that previous investigations determined was killing an average of one inmate a week through malpractice or neglect. He has wide-ranging authority to make changes that could cost California taxpayers hundreds of millions of dollars.
Improving prison medical conditions will require Sillen to sidestep state laws and union contracts that have led to "bureaucratic paralysis," according to his report. It also said the California Department of Corrections and Rehabilitation is in such bad shape that inmate health care may have to be removed permanently from its control.
His report said current restrictions make it "virtually impossible to effectively discipline and/or terminate state employees for poor performance, up to and including incompetence and arguably illegal behavior. The sense of hopelessness this creates ... cannot be overstated."
That atmosphere, he said, has led to "a culture of incompetence and nonperformance."
Union officials representing guards and prison doctors did not immediately return calls seeking a response.
Sillen's report comes two weeks after another federal overseer appointed by the San Francisco-based judge issued a report that was highly critical of Gov. Arnold Schwarzenegger's administration.
That report said Schwarzenegger's prison reform efforts have been backsliding since January, when he appointed Susan Kennedy as his new chief of staff. Kennedy, a top aide to former Democratic Gov. Gray Davis, has been trying to mend fences with the powerful California Correctional Peace Officers Association.
"We're working with the receiver to meet the level of health care called for by the courts," Schwarzenegger spokeswoman Margita Thompson said.
That's why the governor has proposed building new prisons, has $100 million in the budget that took effect Saturday and has a large cash reserve in the budget to meet his other needs, Thompson said.
Using his virtually unlimited authority, Sillen said he can quickly make emergency changes that have thwarted the state's cumbersome prison bureaucracy. He can demand better medical supplies, equipment, staff and the higher salaries needed to recruit and retain qualified health care providers. Vacancies sometimes go unfilled for years.
Comparatively low salaries for health care workers force the department to use expensive private contractors to provide care, driving up the overall cost. Sillen said he will issue a plan to raise salaries within 60 days.
Bureaucratic inertia stretches beyond the department itself to the state's cumbersome bidding and legislative process and collective bargaining agreements with the unions that represent prison guards and medical workers, Sillen said.
"The fact of the matter is some of that stuff has to go," he said in an interview with The Associated Press.
He said reforms could take years but said he will start with a 90-day program to improve conditions at San Quentin State Prison. He wants to use the historic San Francisco Bay prison as a model for all 33 adult prisons in California.
"This is an abomination and an utter failure of state government," Sillen said in the interview. "State bureaucracy is not geared to resolving these issues. We are going to fix it. If it requires court orders to change existing state laws, regulations, processes, etc., that's the way we will go."
He estimated the system wastes "hundreds of millions of dollars" that could go to provide better treatment.
For example, the pharmaceutical system alone costs taxpayers $46 million to $80 million more per year than programs in other states with large prison populations, according to an audit ordered by Sillen.
The federal oversight of California's inmate health care system is part of a settlement between the state and the San Francisco-based Prison Law Office, which sued in 2001 alleging that poor medical care was leading to inmate deaths.
Steve Fama, an attorney with the nonprofit, agreed with Sillen's findings. He said crowding and turnover among top department officials "makes it impossible to adequately run the prisons."
Sillen estimated the budget for his 26-person office alone will be about $8.4 million a year, with about $3.2 million of that money going to outside contractors.
"The receiver is reminding us that it's very expensive to be tough on crime," said Senate Majority Leader Gloria Romero, D-Los Angeles, who has chaired committee hearings into prison conditions. "There is no 'get out of jail free' card when it comes to reforming this humongous, bursting-at-the-seams prison system."
They should get the very basics of medical care and nothing else. No sex changes, etc.
But it's free!
Not a word about who this man is or what his qualifications are to be cancelling state laws etc. Why in the world do people think judges can do everything? Has this judge ever run a prison?
This is what happens when you appoint liberals to do any kind of an investigation.
What, they damn the unions?
A burning issue for me right behind health care for illegals is health care for imprisoned felons. If necessary, just tax the rich.
Billions, yes billions, will be spent reforming health care in California's prisons.
As the prison population continues to expand geometrically these costs will expand exponentially. Higher wages, new diagnostic equipment, expensive, cutting edge medicines and procedures. All without any accountability to the taxpayer. Decisions left to the judgement of an untouchable public servant appointed by a federal judge.
California would save money by simply releasing its prisoners. The level of health care with become so good that folks will enter prison on minor offense just for the medical care that is not otherwise available to them at their local, county hospital.
It will not be uncommon to hear the answer "Pleasant Valley for 90 days" when an indigent or an illegal alien is asked where they plan to go for free, sophisticated, medical procedures.
Maybe they'd feel better if we let them vote?
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