Prison health takeover looms

By Claire Cooper -- Bee Legal Affairs Writer
Published 2:15 am PDT Wednesday, May 11, 2005

SAN FRANCISCO - A federal judge took the first formal step Tuesday toward placing the California prison health care system in receivership, saying it has killed "a significant number of prisoners" and is sure to kill more without drastic intervention.Senior U.S. District Judge Thelton Henderson issued an order to show cause why the state should not relinquish control of the system to a court-appointed receiver who could be granted the power to direct policy, staff and spending.

Henderson said he'll also consider holding Gov. Arnold Schwarzenegger and members of his corrections team in contempt of court for reneging on reforms promised by the current administration and that of former Gov. Gray Davis.

Prompting Henderson to act, he said, were recent admissions made in his San Francisco courtroom by people representing the Department of Corrections that even stop-gap reforms may be impossible, and "unconstitutional conditions will remain until an outside entity is hired to take over."

"The problem of a highly dysfunctional, largely decrepit, overly bureaucratic and politically driven prison system, which these defendants have inherited from past administrations, is too far gone to be corrected by conventional methods," Henderson said.

Besides the state's admissions in court, Henderson cited reports by panels of court-appointed experts and a personal visit to San Quentin State Prison in February.

The judge said he found "horrifying" conditions, including a main examining room lacking "any means of sanitation - there was no sink and no alcohol gel."

He observed that a dentist "neither washed his hands nor changed his gloves after treating patients into whose mouths he had placed his hands" - a problem that could be fixed, the judge said, without "a budget change proposal, a strategic plan or the hiring of new personnel."

Henderson described other conditions related to serious overcrowding at an institution that was designed for 3,317 prisoners but currently houses about 6,000. Some prisoners live in corridors "where they are subjected to having feces and urine flung at them from above, and where water continually seeps from the walls and collects in pools on the floor," the judge said.

Under both Schwarzenegger and Davis the state has signed a series of legal agreements to improve inmate care. But Henderson, who has been meeting monthly with lawyers on both sides of a suit filed in 2001 by the nonprofit Prison Law Office, said the state failed to follow through on the agreements.

He said the state submitted a document last month referring to prison medical care as a "broken system" with "fundamental barriers" to improvement, including "budget, personnel, contracts, procurement, information systems, physical plant and space issues."

Henderson set a series of court hearings on the receivership and contempt issues, starting May 31, at which he'll take testimony from court experts and state representatives. He also set a timetable running through July 6 for written arguments. His final orders probably would follow within a few weeks.

The Governor's Office referred reporters to the Youth and Adult Correctional Agency, where assistant secretary J.P. Tremblay said, "We do intend to work cooperatively with the court to provide the treatment that's required."

Tremblay acknowledged that reforms have been hindered by "some overly bureaucratic systems." But he noted that Schwarzenegger on Tuesday signed Senate Bill 737, reorganizing the youth and adult correctional systems into a Department of Corrections and Rehabilitation.

The reorganization plan, which goes into effect July 1, creates a division of correctional health care services.

In a signing ceremony outside Folsom State Prison, Schwarzenegger listed health care as one of the top issues he wants legislators to address on a reform agenda for the coming year.

Nevertheless, one key lawmaker called Henderson's proposed takeover "an appropriate course of action."

"What we have seen is that the Department of Corrections has consistently demonstrated its inability to deliver health care," said Sen. Michael Machado, D-Linden, a member of the Senate budget subcommittee on corrections.

Machado said a deputy department director told the subcommittee last week that health care wasn't a priority and the competency of those delivering health care in the prisons wasn't a matter of concern.

Henderson's 18-page written order said that to show confidence in Schwarzenegger and his team and to defer to their expertise and authority, he had been relying for a long time on measures less drastic than the proposed receivership.

He said he was forced to conclude, however, that they lack "the will and capacity to make the necessary changes."

Henderson said that although the state plans to contract out prison health care management services, that process is expected to take at least 18 months, and there's no estimate on how long it will take to improve the standard of medical care.

"In the meantime," he said, "prisoners continue to unnecessarily die, suffer and go unattended." Henderson said the experts advised him that although San Quentin may be in the worst physical condition among the 32 state prisons, "it is paralleled by a number of other prisons in terms of physician and nurse vacancies, incompetent medical staff, lack of supervision and all other aspects of medical care delivery."

The judge said one group of experts attempted to review 193 death records throughout the prison system. Some prisons were unable to locate records. Those records that could be found revealed 34 "highly problematic" deaths, "with multiple instances of incompetence, indifference, neglect and even cruelty by medical staff," Henderson said.

About the writer:
The Bee's Claire Cooper can be reached at (415) 551-7701 or ccooper@sacbee.com. Andy Furillo of the Bee Capitol Bureau contributed to this report.


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