State prison healthcare still needs independent oversight, report says UPDATED
California should allow independent oversight of inmate healthcare when the prison medical system is released from federal control, according to a report released Thursday by the Legislative Analyst's Office.
Without some form of monitoring, improvements could evaporate and the state could draw renewed scrutiny from federal courts, the report said.
The report also raised concerns about high spending on inmate health, citing a 2010 national survey showing California spent $16,000 per inmate for medical, mental and dental care -- at least three times the national average. Spending on medical care increased to a peak of nearly $2.3 billion in the 2008-09 fiscal year, but has declined to an estimated $1.8 billion in the upcoming fiscal year.
Prison medical care was placed under the control of a federal receiver in 2006 after a judge said poor healthcare was violating inmates' constitutional rights. Earlier this year, the judge said enough improvements have been made to begin exploring ways to return control back to the California Department of Corrections and Rehabilitation.
[Updated 5:45 p.m. Receiver J. Clark Kelso said he's already working on some of the report's recommendations.
"We look for every opportunity to save taxpayer dollars, while meeting federal court mandates to improve access to and the quality of correctional medical care,” he said in a statement.]
The legislative analyst said any transfer of control should be accompanied by independent monitoring.
"Given CDCR's poor track record in providing medical care to inmates, it would be unwise to return control of the inmate medical program to the department without first establishing independent oversight and evaluation," the report said. "Failure to establish effective oversight mechanisms could result in a failure of the state to recognize if the department begins to backslide on recent improvements in the quality of inmate medical care."
[Updated 11:40 a.m. Corrections Secretary Matt Cate said the inspector general already provides independent oversight.
"As for the idea of creating yet another board or commission, we would need to closely review that," he said in a statement.]
The legislative analyst made several other recommendations, including increasing the use of teleconferencing between inmates and doctors to discuss medical problems. The number of "telemedicine encounters" increased from 9,000 in 2004-05 to 23,000 in 2010-11, but the report said that could be boosted further.
"We estimate that the state could achieve savings in the millions or low tens of millions of dollars annually through the expansion of telemedicine," the report said.
Photo: A clinician takes an inmate's vital signs at Deuel Vocational Institution in Tracy. Credit: Luis Sinco / Los Angeles Times
-- Chris Megerian in Sacramento