Health spending isn't helping state's inmates

By Marisa Lagos

A federal receiver appointed to control mismanagement of inmate health care dramatically increased spending in California's prisons but has so far failed to significantly improve conditions for sick and injured convicts, a state Assembly committee has concluded.



More than $82 million was spent to plan construction projects that were largely abandoned, and that was only a fraction of the amount charged to California taxpayers, according to a report by the Assembly Committee on Accountability and Administrative Review.


The findings, which are were announced during a hearing on Wednesday, show large salaries being paid to construction consultants on an abandoned project, who then turned around and charge taxpayers for housing, meals and dry cleaning. Prison health care spending has also grown by more than 65 percent since 2006, when a three-judge panel appointed the receiver after concluding that substandard medical treatment and neglect were killing one inmate per week.


"We are spending more money and have far more staff devoted to inmate health care than other states like Texas or Georgia, but we aren't seeing improvements in outcomes," said the committee chairman, Assemblyman Roger Dickinson, D-Sacramento. "Especially in this budget environment, when we are talking about cutting child care and putting limits on the number of visits a Medi-Cal patient can make to the doctor. ... We need to rebalance the equation."


One of the most disturbing discoveries, according to committee members, was the fact that three firms were paid a total of $27 million to do construction planning for medical facilities that were never built.


The bill included the following:


-- The housing for five consultants was expensed to the state, including two rental apartments that cost more than $2,200 a month.


-- Four consultants charged the state for dry cleaning, including one that expensed more than $200 in one week.


-- Multiple consultants charged the state $56 a day for food. State travel policy requires state workers to spend $34 or less per day.


-- One firm with five consultants who each earned up to $326 an hour charged the state $21,535 in expenses in a single month.


-- Another consultant earning $3,000 a day charged taxpayers to park her car at the Denver airport for two weeks while she was in Sacramento.


-- Consultants spent $1,200 on books, including "The Toyota Way" and "Embracing Uncertainty: The Essence of Leadership."


Nancy Kincaid, a spokesman for the current receiver, J. Clark Kelso, said Kelso was appointed in 2008 after the contracts in question were already in place. She said all of the expenses paid out by the previous receiver were within federal reimbursement guidelines.


"Those contracts no longer exist, and after Clark arrived he cut back and eventually eliminated all of them," she said.


Kincaid also noted that Kelso has made great strides toward reining in expenses. The overall death rate at prison health care centers has dropped by at least 10 percent since 2006, according to a presentation Kelso is scheduled to make to the committee today.


Don Specter, of the Prison Law Office, which filed the lawsuit that led to the receivership, said all the improvements in medical care in state prisons are the result of increased staffing. He said it's not accurate to compare California's cost with Texas' because California's prisons are more crowded, and the quality of the staff in Texas - including doctors - is not nearly as high.


"Part of the reason care hasn't improved too much is attributable to overcrowding. It's very, very difficult to provide services in such an immensely overcrowded environment," he said. "The facilities are inadequate, many prisons are crumbling, so the extra staff is somewhat an attempt to compensate for the crowding."


Courtesy of http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/01/26/BAK41HE5OQ.DTL