Legislative Hearing Will Address Health Care in State Prisons
One in five of California's prison doctors has been disciplined by the state Medical Board or sued for medical malpractice -- almost five times the rate for other doctors in the state, according to documents obtained by the Los Angeles Times and scheduled to be discussed by state legislators at a hearing on Wednesday.
Some of the state's 302 prison doctors have been convicted of a crime, have a history of cocaine or alcohol addiction or have had their privileges suspended at hospitals, according to the documents.
Sens. Jackie Speier (D-San Mateo) and Gloria Romero (D-Los Angeles) are expected to discuss the documents at the hearing. According to the Times, the hearing "adds another dimension" to a recent focus on the youth and adult state prison systems, joining complaints about inmate abuse, corruption and "other scandals" (Warren, Los Angeles Times, 9/29).
Earlier this month, a U.S. District judge approved an agreement between state officials and a law firm representing prison inmates that requires physicians working in each of the state's prison facilities by 2006 to complete a series of written and oral examinations to assess their medical knowledge. The order enforced a legal settlement in which the state promised to improve health care for prison inmates. The agreement comes after two reports released last month found that the Department of Corrections hired incompetent doctors, resulting in inadequate health care for some inmates.
Doctors who do not pass the exams will be retrained or banned from working with inmates. Department spokesperson Margot Bach said that it is not yet clear whether civil service rules would allow the department to fire doctors who are not found to be qualified or whether they must be moved to another job within the department.
The agreement also calls for the department to develop a plan to assess and train nurses and a proposal to improve doctor and nurse recruiting.
Under the order, department officials must compile a list of inmates with high-risk medical conditions and ensure that they receive care from qualified physicians. Independent doctors approved by the courts will then treat the high-risk patients until the prison system hires enough doctors to provide treatment (California Healthline, 9/23)
An aide to Speier estimates that the first phase of the evaluation process -- which does not include supplemental training -- will cost the state at least $1.5 million. The Department of Corrections spends about 20% of the state prison budget on health care for inmates. Prison doctors' annual salaries average $177,000, the Times reports.
Speier called the problems in the prison facilities "appalling." She added, "In addition to causing tragedies for inmates, this incompetence leads to lawsuits that cost taxpayers even more."
Romero said, "We spend $1 billion each year on health care, and we still have people losing their lives. We've been sued over and over again, but our remedies for this problem never seem to go far enough."
Dr. Renee Kanan, the department's acting chief of health care, said, "We really had various fiefdoms in the 32 institutions." Kanan acknowledged that prison managers have hired some doctors who met only the state's minimum qualifications, rather than versatile physicians with backgrounds in primary care medicine. However, Kanan said that state officials recently have "raised the bar" and now require applicants to undergo a thorough screening and ability test.
Dr. Robert Weinmann of the Union of American Physicians and Dentists, which represents government physicians, said that some prison doctors "are deficient and probably would not have been hired if the state had proper credentialing committees." However, he added that a screening and retraining program for doctors is "incredibly wasteful, insulting and reflective of the poor management that got the department into this mess in the first place" (Los Angeles Times, 9/29).