Although there have been significant improvements in the delivery of medical care to California prisoners, “It is clear that much work remains to be done to resolve issues identified,” reported the court-appointed receiver who runs California’s prison health care system .
The receiver identified the following areas in need of improvement:
Implementation of new programs to improve cleanliness and hygiene at all facilities;
Implementation of a population care management system which will, among other things, address difficulties in continuity of care when inmates move between yards and institutions;
Implementation of an Electronic Health Records System (EHRS) to improve scheduling and medication management, among other things;
Implementation of a new layer of regional oversight and assistance.
The Receiver’s Twenty-Sixth Tri-Annual Report identified “two very high profile” cases between health care and custody staff to illustrate some of the problems:
“The Sept. 7, 2013, death of an inmate housed in the Correctional Treatment Center at Mule Creek State Prison and the Oct.15, 2013, death of an inmate at Pleasant Valley State Prison both underscore the interdependence between clinical and custody staff who should be working collaboratively in the preservation of life. In each of these situations, it has been suggested that health care staff were precluded by custody staff from providing the care they were hired to provide.”
According to the court-appointed receiver, many of the past problems continue to improve related to custody and health care operations at California Health Care Facility (CHCF). Nevertheless, the receiver expressed “concerns about whether these improvements are sustainable in the long-term.”
The receiver reported problems implementing the EHRS have caused several months to be lost in adding new medical and mental health beds to the state prison system. Nevertheless, the receiver reported that CHCF should be fully activated by early 2015.
When the receiver analyzed medical facility construction statewide that would address treatment and clinic space, all of the facilities visited had serious upgrade issues. The exception was San Quentin State Prison, which had upgrades constructed under the receivership, according to the report.
The receiver found that California prisons remain significantly overcrowded, and at the end of the reporting period of April 30, 2014, the department’s total custody population stood at 134,888, of which 116,246 were in the state’s 34 prisons. There was also an increase of 639 patient-inmates since the last reporting period of Sept. 1 through Dec 1, 2013.
On Feb.10, the court issued an order granting the state an extension until Feb. 28, 2016, to meet a population cap of 137.5 percent of designed capacity. The order required the state to meet the following interim benchmarks:
143 percent of design bed capacity by June 30, 2014, later extended to August 31, 2014. The court had recently informed CDCR that unoccupied beds at CHCF could not count as part of the department’s overall design capacity so long as CHCF was closed to new medical admissions. As a result, CDCR fell just short of meeting the June 30 benchmark of a prison population at 143 percent of design capacity. When the court issued its order, it also allowed CDCR’s request for a two-month extension.
141.5 percent of design bed capacity by Feb. 28, 2015;
137.5 percent of design bed capacity by Feb. 28, 2016.
The order required the state to immediately implement the following components:
Cap out-of-state placements at 8,900;
Increase credit-earning for non-violent second strike offenders and minimum-custody patient-inmates;
Implement new parole determination process for non-violent second strikers who have served half of their sentence;
Parole certain inmates serving indeterminate terms who have been granted future parole dates by the Board of Parole Hearings;
Expansion of existing medical parole process;
Implementation of a new parole process for patient-inmates 60 years of age or older who have served at least 25 years in state prison;
Activation of new re-entry hubs at a total of 13 prisons to be operational by February 2015;
Expansion of pilot re-entry programs with additional counties/local communities; and expansion of alternative custody program for female inmates,
Submit monthly status reports on its progress to implement the provisions listed above. The court also said that it would appoint a “compliance officer” empowered to order necessary releases. (In a subsequent order, the court appointed the Honorable Elwood Liu as the compliance officer.)
With the implementation of the Affordable Care Act (federal) Covered California (state), prison health care service providers anticipated challenges in recruiting and retaining staff.
Nursing vacancies are posted on multiple websites, including school career websites, www.ChangingPrisonHealthCare.org, www.Indeed.com and www.VetJobs.com.