Wasteful Prison Health Care System

James McGee
Comm/215
7-29-2010
Kevin Maevers Wasteful Prison Health Care System

The State of California is facing a major financial issue, thus making the citizens of California experience a hard time finding jobs and paying their bills. The unemployment rate is at its highest the state of California has ever experienced before. Every citizen is affected by this recession in some shape or form. Cutting costs and freeing up funds is an essential part of relieving the financial crisis. The information gathered during my research is astounding. My research will be discussing the wasteful spending of funds by the California Department of Corrections and Rehabilitation (CDCR) medical services that is offered to the California State Inmate and why it should be revised. Though my own knowledge and experience, I will be informing you on the games inmates play and how they now manipulate the medical system to their advantage. You will be educated on the departmental medical procedures and the politics that takes place within the medical department. There are very few people that know about the life of a California State Inmate. After reading my research you will realize why these inmates continue to keep coming back to prison. It is not because they have no training or education to live a successful life it is because they live an easier life inside of the walls. In concluding my research, I will also be discussing a few resolutions that other state correctional institutions have implemented to cut down on costs and medical staff manipulation. This information should be known by all tax paying citizens because we, the people of California all feel the hardships placed on us by the recession, but do the convicted felons feel it too?
In the year of 1998, CDCR received numerous lawsuits related to the Prisoner Health Care System. To elevate this issue, CDCR paid over 15 million dollars in settlement claims to inmates and the federal courts ordered the department to develop a new medical system. In compliance with the court order, CDCR developed and implemented a new health care system. The federal courts did not approve the new and improved system. The federal government then assembled a team called the Federal Receivership. The federal receivership is formed by several private, federal contracted lawyers and doctors whose combined salary is approximately 35 million dollars a year plus expenses; all paid for by the state of California. This receivership’s job was to audit the department’s medical services and recorded testimonies and ideas from hundreds of inmates on how to improve the medical system. The federal receivership was not trained in detecting staff manipulation by inmates therefore they were mere puppets being played by the inmates. In the year of 2000, the receivership then developed a medical system that completely surpasses that of any civilian medical insurance plan. CDCR reviewed the newly developed medical plan and refused to comply because it would cost the state 60% more then the current medical plan. The federal receivership, not happy with the department’s decision to not implement then new medical plan, decided to file another lawsuit with the federal court system. The federal courts ruled in favor of the federal receivership, fined the department 15 million dollars again paid for by the common citizen and ordered CDCR to comply with the new medical plan with no additional funding from the federal government.
The department, now under the control of the federal receivership was ordered to hire 50% more additional medical staff to which they would oversee the hiring. In addition, CDCR was authorized to hire 15% more custody staff for the security of the additional medical staff costing the state of California another $600,000 a year. The mass hiring of medical staff caused many problems for the safety and security of the affected correctional institutions. The federal receivership wanted quick adherence to the new medical plan and did not allow the state to conduct through background checks on the medical staff applying for positions. The department was forced to unknowingly hire ex-felons and inmate family members. These employees were working inside of the walls where they were introducing contraband into the institution such as: drugs, weapons, hit lists, and cell phones. After several incidents concerning the newly hired medical staff the federal receivership authorized CDCR to conduct an investigation. The investigation determined that approximately 160 doctors and nurses had some sort of medical disciplinary problems. As a result of this investigation CDCR terminated the employments of several medical employees. According to Sunny Kaplan,” some of the people in correctional health care are there because they have difficulty finding employment elsewhere due to medical disciplinary problems.” The federal receivership did not take any blame for this issue instead they fined the department one million dollars for any possible future wrongful termination lawsuits and as stated in January 2009 CA Receivership Report i2008-0805,” any and all added or change to employee contracts or revisions to medical plan without receivership representation, will result in fines not to exceed $2,929,742.” Still today the department faces many obstacles caused by the federal receivership. The receivership realizes that if the department is in complete compliance with the new wasteful medical plan they would not have a job; so they continue conducting extinctive audits and seek new medical contracts to outsource medical procedures, also know as busy work. As stated earlier in my research CDCR’s new medical system surpasses any civilian medical insurance company services. The average American spends a portion of their paycheck to medical insurance, but the average California state inmate pays absolutly nothing. With their medical plan, inmates must be receive an appointment and see a doctor within 24 hours of the request. If the doctor makes a request for a specialist they must be seen with in 48 hours. Inmates pay no co pay even though they have a job and receive funds from their family. The sub-par medical staff, are so worried about the inmates filing lawsuits, they give them everything they request. The inmates are very smart. They know what to say and when to say it. They research symptoms for illnesses that can give them the most medical appliances and strong medication. For example, a 24-year-old male fakes a back injury. He tells a doctor that he is in extreme pain and can’t sleep at night. The doctor does not order an x-ray or even really evaluate him, he will just take his word for it. The doctor orders him another mattress, brand name soft shoes (Nike), and a prescription for a brand name narcotic for pain. Most of us would just take an over the counter pain killer but, this healthy 24 year old inmate will be prescribed morphine or Tylenol 3 with codeine. This inmate will then sell his medication for 10 dollars a pill to other inmates. Custody staff will observe the inmate a week later, playing basketball during their recreation time. Custody staff will document the actions observed by this inmate and report this to the medical staff. Medical staff in fear of a lawsuit did nothing about this issue of obvious staff manipulation. Another example of manipulation of the medical system; a 37 year old inmate was on parole and because he did not take care of his medical condition in the real world he found out that he had to get this leg amputated. He violated his parole and was placed back in to prison. He was serving a four-month violation charge and would be released back into society. He placed a medical request and was seen by a doctor in 24 hours as per policy. The doctor made a request for the inmate to be seen by an outside specialist. The inmate saw the specialist and it was determined that his leg should be removed with in a year. Instead of waiting until the inmate was released he was scheduled for surgery. The inmate received the expensive surgery costing the state $300,000 not to include hospital recovery. After a long recovery the inmate was scheduled to be released from prison. The inmate wanted to receive a prosthetic leg before he was released. The state denied his claim because he was being released. The inmate, two days before paroling, stabbed a correctional officer so he could stay longer to receive his prosthetic leg. The inmate’s plan worked he received an addition year to his sentence and the medical staff granted his request. Two months later he was fitted for a very expansive prosthetic leg costing the state $250,000. The inmate paroled 4 months later because of prison overcrowding. Four days later the inmate, now a parolee was found dead in downtown San Diego because of a drug overdose. These are just a handful of the thousands of cases researched with in the last two years. Cases like these happen every day and no medical staff, nor the receivership report these incidents to the citizens of California.
The current medical polices need to be changed so that CDCR can lower the amount of funds utilized for the medical department and distribute the funds more efficiently though out the department. The department needs to hold inmates accountable for their actions. As part of the rehabilitation process, inmates need to know what it takes to be a productive citizen and learning how the civilian health care system works. Part of that is paying for medical insurance and paying co-pays. As stated by Kaplan (1999),” most states when a co-pay is instituted sick call visits go down initially.” If inmates knew they would have to pay for all of their medical treatments, just like the citizens; then they would only seek medical treatment for real medical concerns. It can be assumed that inmates do not earn an equal salary compared to the average citizen. The department should use the percentage of the average citizens salary allotted for medical insurance and apply it to the inmate population. CDCR needs to conduct their own audit and investigate all incidents of staff manipulation. The medical staff and the federal receivership shall be held accountable for their actions or lack thereof. All incidents discovered need to be documented and brought to the attention of the federal government. If CDCR can prove to the federal courts that this new medical system is throwing away money and not providing a more proficient service to the inmate population, then they should allow CDCR to reform their own medical system with the approval from the federal courts.

References
Kaplan, S. (1999). Health care costs rising as prison population grows and ages. Retrieved from http://www.stateline.org
Receiver’s Fourteenth Tri-Annual Report, 05/15/10