Audit: California Spent Millions on Health Care for Small Inmate Group

Between 2007 and 2008, California spent $734 million on specialty health care for prison inmates, according to a study released Tuesday by State Auditor Elaine Howle, the Sacramento Bee reports (Ferriss, Sacramento Bee, 5/19).

The figure accounts for about one-quarter of the $2.1 billion spent on prison health care during that time period. Contractors provide prison specialty care services, which generally include inpatient acute medical and surgical care.

Audit Report Details

The audit found that 59,000 of the state's 170,000 prisoners received specialty care between 2007 and 2008 (Lagos, San Francisco Chronicle, 5/19).

In addition, about 0.5% of the total inmate population -- or about 1,175 inmates -- accounted for 39% of total specialty care costs (Sacramento Bee, 5/19). Medical services for those 1,175 inmates cost a total of $185 million between 2007 and 2008 (San Francisco Chronicle, 5/19).

The audit also found that nearly 32% of health-related overtime costs were related to guarding and transporting inmates for medical care (Sacramento Bee, 5/19).

Impact of Three Strikes Law

The report suggests that California's "three strikes" law contributes to prison medical costs because the law keeps inmates incarcerated as they grow older and require more medical attention.

The three strikes law is a 1994 voter initiative that requires a minimum sentence of 25 years to life for three-time repeat offenders with prior serious felony convictions.

According to Howle, specialty care provided to prisoners incarcerated under the three strikes law costs 13% more than specialty care for inmates who were not sentenced under the law.

Recommendations

Howle recommended that state officials and J. Clark Kelso -- the federal court-appointed receiver charged with overseeing the prison health care system -- should consider cost-saving measures such as an early release program for terminally ill or incapacitated prisoners (San Francisco Chronicle, 5/19).

Related Legislation

On Monday, the Senate Appropriations Committee approved a bill (SB 1399) by Sen. Mark Leno (D-San Francisco) that would create a medical parole system for inmates in a highly incapacitated state.

The measure also would shift half the costs of care to the federal government because many of the released inmates would become eligible for Medi-Cal, California's Medicaid program.

The federal government would pay the full cost of care for released inmates who qualify for Medicare (Ferriss, "Capitol Alert," Sacramento Bee, 5/18).

The measure could be voted on by the full Senate as soon as Thursday.

Kelso also has expressed support for a bill (AB 1817) by Assembly member Juan Arambula (I-Fresno) that would establish a permanent process for the state to evaluate the necessity of certain medical procedures and treatments in prisons (San Francisco Chronicle, 5/19).