Federal Receiver Suggests New Health Care Authority Position in California

SACRAMENTO, Calif. — Consultants have advised a federal receiver of the California prison health care system to create a new position focused solely on the health care of inmates.

Health Management Associates advised the California Department of Corrections and Rehabilitation (CDCR) in an assessment of its healthcare system, to create the Undersecretary of Health position.

“This structure creates a permanent focus on health care in a manner that precludes dilution of its objectives,” the report said. “It provides protection from the return of pre-receivership conditions, under which health care matters often went unaddressed for long periods.”

The recommendation was one of more than 100 made in the 76-page organizational assessment of the CDCR. Research for the study was conducted from June to August 2012.

U.S. District Judge Thelton Henderson mandated federal oversight in 2006 after finding that on average one California inmate per week died as a result of mismanagement or neglect in a correctional facility.

Though Gov. Jerry Brown attempted to regain oversight from the federal government in January, Special Master Matthew Lopes determined the CDCR would remain in federal oversight.

“[The Undersecretary of Health position] safeguards the sustainability of the gains accomplished under the receivership,” the report said.

The Undersecretary for Health would report directly to the secretary of the CDCR, the report said. Jeff Beard is currently the secretary at CDCR and would therefor manage this new position within the department.

The report also details the effects of the Patient Protection and Affordable Care Act and recommends that the CDCR seek benefits from Medi-Cal if made available to inmates, as most inmates would be eligible during incarceration, at release and parole.

The report also highlights the fact that the California Correctional Health Care Services Department currently collects 50 percent Medicaid match through “a laborious and complex process.” The report suggests that when Medi-Cal expansion takes place and enrollment becomes less complex in 2014, the CDCR should seek a 100 percent federal match.

As health care reform progresses, the study said, there will be higher demand for health care professionals. This will create difficulties given the current demands on health care professionals in the CDCR, the report said.

“CCHCS should anticipate increasing difficulty recruiting and retaining health care professionals as competition for providers grows,” the report said. “This will be exacerbated when hiring returns to CDCR and salaries must conform to the state personnel system.”