Report: State Prison Health Care Needs Independent Oversight

California should create an independent board to monitor prison health care after federal oversight ends, according to a report released Thursday by the Legislative Analyst's Office, the AP/San Francisco Chronicle reports (Thompson, AP/San Francisco Chronicle, 4/19).

Background

About six years ago, U.S. District Judge Thelton Henderson appointed J. Clark Kelso to oversee the state's prison health care system after determining that an average of one inmate per week died as a result of malpractice or neglect.

In May 2011, the U.S. Supreme Court ordered California to reduce its inmate population to help improve health care.

Since then, the state has begun shifting low-level offenders to county jails to address prison overcrowding and building new health facilities at prisons.

In January, Henderson said the federal receivership overseeing California's prison health care can end because the state has improved inmate care (California Healthline, 2/24).

LAO released the new report less than two weeks before state officials and attorneys representing inmates are scheduled to recommend to a federal judge whether the receivership should end and whether the state should maintain oversight of prison health care.

LAO Report Details

According to the report, costs have increased under the federal receivership to about $16,000 per inmate for health care services, compared with an average of $5,000 per inmate in other states. In addition, it found that the receivership has not consistently used management safeguards developed to curb health spending.

The report estimates that ending the receivership could save the state money in the "low tens of millions of dollars annually." The savings would come from consolidating the federal receiver position with the California Department of Corrections and Rehabilitation (AP/San Francisco Chronicle, 4/19).

Report Recommendations

According to the report, improvements made to inmate care could dissipate without some form of monitoring, which could prompt renewed scrutiny from federal courts.

It stated, "Given CDCR's poor track record in providing health care to inmates, it would be unwise to return control of the inmate health program to the department without first establishing independent oversight and evaluation." It added, "Failure to establish effective oversight mechanisms could result in a failure of the state to recognize if the department begins to backslide on recent improvements in the quality of inmate health care."

LAO made several other recommendations, such as increasing the use of telehealth services so that inmates and physicians can discuss health problems. The report estimated that the state could "achieve savings in the millions or low tens of millions of dollars annually through the expansion" of telehealth.

Reaction to Report

Receiver J. Clark Kelso said he already is working on some of the report's recommendations. He said in a statement, "We look for every opportunity to save taxpayer dollars, while meeting federal court mandates to improve access to and the quality of correctional medical care" (Megerian, "PolitiCal," Los Angeles Times, 4/19).

Nancy Kincaid -- spokesperson for Kelso's office -- said that medical staff in some prisons should do a better job of following the receivership's policy for controlling health costs.

In addition, Kincaid criticized the report's comparison of California's prison health care costs with those in other states. She said that certain states do not consider administrative, information technology or contract costs in their accounting (AP/San Francisco Chronicle, 4/19).