SACRAMENTO, Calif. – The court-appointed receiver overseeing California's prison health care system said Friday the state must keep its promise to spend more than $2 billion for new medical facilities before the federal courts can end an oversight role that has lasted six years.
California committed to spending $750 million to upgrade existing medical facilities, building a new $906 million medical center and converting juvenile lockups at a cost of $817 million. So far, only the new medical center in Stockton is being built.
Receiver J. Clark Kelso told The Associated Press that the state must begin all the upgrades before it should be allowed to retake control of a prison medical system once deemed so poor that it was found to have violated inmates' constitutional rights. They are his first public comments since a federal judge last week told officials to begin preparing for an end to the receivership.
"That leaves a court order that the state is now out of compliance with," Kelso said during the 75-minute interview. "The courts have been promised construction for the last half-decade. Somehow those promises don't get kept."
California officials are analyzing the need for new medical facilities in light of a state law that took effect last year that is sending lower-level criminals to county jails instead of state prisons. Federal judges have ordered the state to reduce its prison population by 33,000 inmates over two years to improve the treatment of mentally and physically ill inmates, a decision that has been upheld by the U.S. Supreme Court.
At its height in 2006, California's inmate population was more than 162,000.
Kelso said the medical center that is under construction in Stockton and the $750 million in upgrades are needed even if the state has fewer inmates. Conversion of the juvenile lockups was to have included new housing and treatment facilities for sick and mentally ill inmates.
Kelso has been negotiating with officials from the state Department of Corrections and Rehabilitation and attorneys representing inmates after a federal judge issued a notice saying it was time to begin ending the federal receivership. Court oversight of medical care in the nation's largest state prison system has led to improvements in inmate health care that have cost California taxpayers billions of dollars.
"We'll just see if the parties can't find a middle ground for agreement," Kelso said.
The pace of those negotiations will determine how quickly the state can retake control of its prison health care operations, he said.
Corrections Secretary Matthew Cate said he wanted to see the receivership end as early as this summer, although he also said it would be appropriate for the courts to maintain some type of oversight role to ensure that inmate care does not deteriorate.
"I think the sooner we return day-to-day operations to the state, the better," Cate told the AP in an interview earlier this week. "We need to work out the construction issues, obviously, and I know that Clark is also concerned about making sure there's a strong structure in place to maintain the strides we've made. But if we can work those issues out, I'd love to see it be this summer."
Kelso said the state also should create a quasi-independent medical bureaucracy within the corrections department to make sure the state doesn't backslide because of budget cuts or a lack of interest.
"A lot of that has to do with budget independence and the independence of the head of prison health care really to control his or her budget," Kelso said. "They can't just get lost in the big haze that is the corrections budget."
He said the corrections department traditionally has focused on keeping inmates safely locked up, with a lesser emphasis on the well-being of those prisoners, and it is unclear if that culture has changed.
Citing inmate overcrowding as the leading cause, the federal courts previously found that medical care for California prisoners was so poor that an average of one inmate a week was dying of neglect or malpractice. It ordered the prison population reduced, prompting the department to send layoff notices this week to 545 employees because fewer workers are needed as the number of inmates declines.
In the notice he filed last week, U.S. District Court Judge Thelton Henderson said conditions had improved enough to consider ending the receivership. He said most of the goals of the federal oversight had been met.
The San Francisco-based judge ordered Kelso, state officials and inmates' attorneys to report by April 30 on when the receivership should end and whether it should continue some role in ensuring that conditions remained constitutional.
"I think this all depends much more on the state's progress than on mine," Kelso said. "Frankly, if the construction had been done as promised, I'd be a hell of a lot closer."