California Receiver Issues Status Report on Prison Medical System

SACRAMENTO, Calif. — The federal receiver tasked with overseeing California’s problem-plagued prison medical system issued his sixth report on the status of changes to the system since he took office last year.

The report claims that Receiver Robert Sillen has had success in many areas including changes to hiring practices and the employment of 400 new medical staff, creation of a multidisciplinary unit to manage healthcare reform at community correctional facilities, and the licensure and operation of dialysis clinics.

The receiver also increased staffing for telemedicine services and converted the general acute care hospital at the California Institute for Men at Chino into an unlicensed infirmary.

The 80-bed hospital was converted to an infirmary for inmates with long-term and subacute needs because it did not meet several licensing requirements for hospitals, according to the receiver’s report.

“We have made significant progress in many areas, and yet, the surface has hardly been scratched,” Sillen says. “There are deep-rooted reasons why the system is as broken as it is. We have identified these over the last year and have begun working to untangle them. The bottom line is that there are no clinical or business systems in place that support good care.”

The report also provided an update on the status of 10,000 new medical beds that are planned for the state. Abt Associates and Lumetra completed the final report on the California prisoner patient population, which provides the basis to build the new beds.

The status report follows another report from the receiver that analyzed inmate deaths in 2006 and found 66 deaths (15 percent) were preventable or possibly preventable.

“This is all about unnecessary human suffering,” says Sillen, who was featured at the Q&A subject in the July/August 2007 issue of Correctional News. “It’s not just about data; it’s an emergency.”

The receivership was created after a 2001 class action lawsuit that found medical care in state prisons in violation of the Constitution. U.S. District Court Judge Thelton Henderson appointed Sillen to the post in April 2006.

Sillen’s priorities for medical system improvements during the next three years include:

• Building up to 5,000 medical and 5,000 mental health beds statewide.
  
• Constructing necessary clinical and support space in existing prisons. This project begins with addition of space at Avenal State Prison.
  
• Piloting a nursing orientation and preceptor program for new hires.
  
• Launching an asthma initiative to provide clinical protocols, case management and training to improve the care given to inmates with asthma. Asthma was the prison system’s leading cause of preventable death in 2006.
  
• Implementing the Health Care Access Unit program at San Quentin, followed by additional prisons. This program assigns correctional officers to medical escort and transport duties, improving access to care.
  
• Beginning to transform information technology in California ‘s prison medical system by establishing a statewide wireless network that connects all prisons to each other, and provides for within-prison connectivity as well.
  
• Continuing the pharmacy system turnaround by Maxor National Pharmacy Services Corp. Pilots in two prisons are under way.
  
• Continuing the Receiver’s San Quentin Project.
  
• Continuing to participate in coordinating the remedial activities taking place in federal medical, mental health, dental and disabled inmates’ cases.