Federal Receiver Calls for Separation of California’s Prison System from Health Care System
J. Clark Kelso, the federal receiver appointed to oversee California’s prison health care system, has an editorial in today’s Sacramento Bee, excerpted below:
My primary job as a federally appointed receiver is to raise the level of care to constitutional levels and turn back to the state a functioning prison medical care system that the state will be capable of maintaining. …
First, we need to formally remove the operational part of prison health care from the management of the California Department of Corrections and Rehabilitation by establishing an organizationally separate, board-governed health care authority. This can be accomplished without spending more money or creating more bureaucracy. In fact, having a separate authority will make it easier to implement our savings program and to get our fair share of federal dollars in support of health care.
The corrections department’s mission is not health care. It is maintaining custody and control. The reason we have made so much progress on medical care in the past three years is because we have operated independently of CDCR and that independence let us focus on our health care mission. If responsibility for prison health care returns to the department of corrections after the conclusion of the receivership, the most likely result will be backsliding as the health care mission once again becomes subordinate to custody and control. This is not intended as a criticism of the department of corrections and its executive team or staff. It simply reflects the reality of organizational behavior and culture.
Kelso was appointed in 2008 in the course of the ongoing Plata v. Schwarzenegger class action lawsuit, in which prisoners alleged that they were being subjected to cruel and unusual punishment, in violation of the Eighth Amendment, in the form of deliberate official indifference to their serious medical needs. (In 2005, a federal judge found that a California inmate was dying needlessly every 6-7 days.)
California does not dispute the need to improve its prison health care system: the lawsuit reached a settlement in 2002. But litigation has continued over whether California is taking the appropriate remedial measures to fulfill the terms of that settlement. It was in the course of this litigation that a federal receiver was appointed, after the court found that the state had proven unable to devise and implement solutions on its own. Most recently, a panel of three federal judges ordered that the California’s efforts so far have failed to resolve the underlying issue of overcrowding, and that it must take steps to reduce its prison population by about 46,000 inmates. California will challenge that ruling this fall at the Supreme Court.