Running head: CALIFORNIA PRISON COSTS

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California Prison Health Care Costs

CALIFORNIA PRISON COSTS Health care is defined as (CDC, 2013) the diagnosis, treatment, and prevention

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of disease, illness, injury, and other physical and mental impairments in humans. Everyone has to deal with it in one way or another. Once a person becomes an adult they are responsible for their own health. Within the state of California, in looking at the stats from the Center for Disease and Control (CDC, 2013) adults from the ages of 18-64, 21.3%, do not have any type of health insurance. 64.2% have private insurance and 15.9% have public insurance. Specifically looking at the California Department of Corrections 100% of all inmates are 100% covered with health care requirements. Currently there are approximately (Onishi, 2013) 120,000 inmates in the 33 California Prisons and the average cost is $16,000 a year per inmate with a state budget of $2 billion dollars. It is absolutely unbelievable to comprehend the situation. In a recent article by KPBS (Faryon, 2010) they identified that Richard Lauranzano an inmate at California Medical Facility, Vacaville, one of 35,000 inmates serving a life sentence learned he had stage 4 non-hodgkins lymphoma. Richard Lauranzano now states "The prison system saved my life. They sent me to outside hospitals, they never hesitated. I went through extreme chemo. And I beat it," said Lauranzano. (Faryon, 2010) stated last year, the state spent $500 million on outside hospital visits for inmates -- about 25 percent of its total health care budget. What is even more astonishing is that a federal judge put a receivership in place in 2006, after a court ruled California prisons were so over-crowded inmates did not have proper access to health care and mental health services -- a violation of their constitutional rights. To put it in perspective Richard Lauranzano is 62, in prison, and is mentioned as saying “it is a struggle in prison” said Lauranzano (Faryon, 2010). In the meantime, Richard

CALIFORNIA PRISON COSTS Lauranzano has developed a heart condition since his cancer has been in remission. He is now meeting with specialists, contemplating surgery. Please know that Richard Lauranzano is serving a 50 year sentence for seven counts of sexual offenses against children and murder. So to put it in understanding this again, in 2006 it was ruled that the constitutional rights of inmates in prison has been violated due to overcrowding and they did not have proper access to health care. (Bunch, 2013) thus there was a requirement imposed by the federal courts to reduce

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the amount of inmates in prison from at the time in 2006 to 173,000 (175%) capacity to 110,000. Currently May 2013, there are right around 120,000 inmates and (Bunch, 2013) The Governor Jerry Brown has stated, “The overcrowding and health care conditions cited by this court to support its population reduction order are now a distant memory. California’s vastly improved prison health care system now provides inmates with superior care that far exceeds the minimum requirements of the Constitution.” There are many ideas which go along with how to solve the problems for example (Kiai, J & Stobo, D., 2010) If California implemented a system similar to the one in Texas, the anticipated yearly savings could be approximately $1.5 billion. If the cost for prison health care in California approached that in New York, the savings could be approximately $993 million. These savings could then be invested in higher education (UC and CSU) where funds are desperately needed to continue providing high quality education to our students. (Kiai, J & Stobo, D., 2010) Gov. Arnold Schwarzenegger recently proposed in a 2010, State of the State address to limit the amount of state general funds given to the prison system (from 10 percent to 7 percent) and to direct these savings to higher education. He also proposed an amendment to the state constitution stipulating that state spending on higher education (University of California and California State University) would not go below 10 percent (it is currently 6-7 percent). This

CALIFORNIA PRISON COSTS proposal is a good first step toward reinvesting in higher education. We agree with the governor’s statement that California should not be spending more money on prisons than it does on higher education. However now Governor Jerry Brown, (Onishi, 2013) may be held in contempt of court simply because the Inmates Constitutional rights may be compromised as identified by a court ruling. What is this state coming to? He states he has been pressing strongly for the end of federal oversight since the beginning of the year, he has also said that the state will appeal the two decisions. Meanwhile, Mr. Brown and other state officials have been given until early May to submit a plan to further reduce overcrowding in the state prisons or be held in contempt of court. (Onishi, 2013) “We’ve spent an awful lot of money,” Jeffrey Beard, the secretary of the California Department of Corrections and Rehabilitation, said in an interview. “Just spending money doesn’t do it, but that’s been translated into vastly improved care.” The judges and lawyers representing inmates said that the improvements had been made only because of federal

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oversight. “We know they’ve needed treatment space for 20 years,” Michael Bien, a lawyer who has long represented inmates, said of the new building here. “It’s just an example of yes, they did it — great. They did it only under compulsion of the law. It wasn’t voluntary.” As far as facilities go, (Onishi, 2013) On the sprawling grounds at the Vacaville California Medical Facility state prison, built here in 1955, a new three-story, $24 million treatment center for mentally ill inmates stands out because of its freshly painted walls and rooftop solar panels. Inside, on a recent morning, psychologists and social workers were leading group therapy sessions for inmates in large, brightly lighted rooms while individual meetings were being held in smaller offices.

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(Onishi, 2013) By all accounts, the opening of the new wing in January, as well as that of a crisis center and a housing unit for more troubled inmates in recent years, has improved the quality of mental health care in this prison, known formally as CMF. In the past, the group sessions were held in a housing unit’s common room and left those not participating locked in their cells, unable to socialize or watch television. The debate goes over the top in a standard California political way but no one can argue over health care coverage as understanding it is personal for many. (Luery, M. 2013) For example, Stephen Komara, a college student and father of three children who battles anxiety. He’s getting help from Wellspace Health in Sacramento, thanks to MediCal. But Komara told KCRA 3 it was easier for him to get treatment when he was behind bars. “The sad thing is, incarceration was horrible. But the treatment was better,” Komara said. “It’s faster. The response time was super quick.” While in prison. There are definitely managerial problems within the state (Luery, M. 2013) reported that State records show: -- Charita Dagcuta, a staff psychiatrist at a state hospital in Vacaville, took home $411,562. -- Hamid Sial, a staff psychiatrist at a state hospital in Salinas, collected $436,603 in total pay. -- Mohinder Kaur, a senior psychiatric supervisor at a secure treatment facility in Coalinga, made $445,323. -- Nadim Khoury, a chief deputy of clinical services, was paid $486,690. But the highest paid of all state employees was a senior psychiatric supervisor, Dr. Mohammad Safi. He earned $803,271 in total pay before he was terminated by the state in March. Safi’s take-home pay was nearly five times Gov. Brown’s salary of $165,288, according to state records. (Luery, M. 2013) “I don’t think it can be justified,” said Michael Bien, the lead attorney who is suing the state over

CALIFORNIA PRISON COSTS prison health care. “It’s evidence the state is mismanaging the system." He blames the high salaries on a shortage of prison psychiatrists and psychologists. “There is a hiring freeze, and

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they say you have to work overtime," Bien said. "So, these doctors that are getting paid a lot, are getting paid overtime.” The Department of State Hospitals denies the existence of a state hiring freeze, but KCRA 3 found several job listings stating a “state hiring freeze restriction” on the Careers in California Government website. (Luery, M. 2013) In an email response to KCRA 3, the Department of State Hospitals stated, “That line is boilerplate language from a previous job listing and is incorrect. Thank you for pointing it out to us. We will change it.” in the meantime, the court battle over prison health care continues. The federal courts are demanding that California reduce the inmate population by nearly 10,000 to ease prison overcrowding and to provide more beds to house the mentally ill behind bars. However ultimately “It’s pretty sad that if I went to prison or jail, I would get better treatment,” Komara told KCRA 3. There are many reasons to see why health care is peaking states (Mikle, J.,2013) The National Institute of Corrections considers prisoners over 50 to be "elderly" or "aging." That's because those who wind up behind bars have more frequently engaged in unhealthy behaviors -like using narcotics or drinking -- than the general population. And they've also been less likely to receive regular medical care. Once they're locked up, the stress of prison life tends to prematurely age people, corrections experts say. Since 1981, (Mikle, J.,2013) the number of prisoners over 55 has grown from about 9,000 nationwide to 124,900 last year. It's estimated to reach more than 400,000 by 2030, according to the ACLU report. Researchers in the study used the 55 and up age group to show

CALIFORNIA PRISON COSTS the dramatic growth in the number of inmates since there is not enough data tracking 50 and up inmates over time. Starting in the mid-1970s, (Mikle, J.,2013) a nationwide push to get tough on crime

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included enactment of mandatory minimum sentences and laws that sends offenders to prison for life if convicted of three serious offenses. The result: The U.S. prison population soared, growing at 11 times the rate of the general population from 1980 to 2010. There are about 2.3 million people behind bars in the U.S., and with more inmates serving longer sentences, the number of elderly prisoners has also jumped. In 2012, (Mikle, J.,2013) more than 70 percent of the inmates in California state prisons were serving sentences that included mandatory minimum terms before parole, according to the corrections department. "We have created this situation where people are destined to do long terms in a criminal justice system that was not designed to be a long-term care facility," Maschi said. (Mikle, J.,2013) Ultimately Elderly are more expensive A 2012 ACLU study estimated that it costs nearly $70,000 a year to house a prisoner over 50, compared with an average of $34,135 for a younger inmate. The increase is primarily driven by much higher health care costs for the older population. Currently (Thompson., 2013) In response to a federal court order, Gov. Jerry Brown pushed a novel approach through the Legislature two years ago to dramatically reduce California's prison population. People convicted of felonies that were considered non-violent, non-sexual and non-serious would serve their sentences in county jails rather than state prisons. Once released, they would be supervised by local probation officers instead of state parole agents.

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The shift in California's penal system, (Thompson., 2013) referred to as "realignment," is one of the nation's largest criminal justice experiments and has done its job in at least one respect: The population in the state's 33 adult prisons has dropped so much that the system now ranks second to Texas in the number of inmates, even though Texas has 12 million fewer residents. But the change has not come without criticism. (Thompson., 2013) Many law enforcement officials, victims' rights groups and Republican lawmakers say crime has increased because of Brown's realignment law, as the wave of new inmates arriving in some county jails is leading to overcrowded conditions and the early release of dangerous felons. Advocacy groups seized on preliminary FBI crime statistics to argue both sides of the issue. (Thompson., 2013) Though still low in comparison to previous decades, property and violent crimes increased in 40 of California's 69 largest cities in the first six months of 2012, the largest such increase in 20 years, and the Sacramento-based Criminal Justice. An expert who has been studying the prisoner shift, Stanford University law professor Joan Petersilia, said the policy is serving as a national experiment about whether prison populations can be reduced significantly without posing a threat to public safety. It is well known (Thompson., 2013) More than 100,000 offenders have been affected by the law, which took effect in October 2011. More than $2 billion has been allocated by the state to help local governments handle their new responsibilities, while another $1.7 billion in state bonds is going to build more county jail space. For all the upheaval, the frustration for Brown is that the shift of tens of thousands of prisoners still has not been enough to satisfy the panel of three federal judges.

CALIFORNIA PRISON COSTS (Thompson., 2013) The state had no choice but to reduce prison crowding after the judges ruled that it was the primary cause of unconstitutionally poor inmate medical and mental health care. The U.S. Supreme Court upheld the decision in 2011, forcing the state to reduce its state inmate population. The realignment law is responsible for reducing the state prison population by 25,000 inmates, to about 119,000. Yet the federal courts say another 9,300 must

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go by year's end and have threatened to hold Brown in contempt if he doesn't comply. California prisons now hold 43,000 fewer inmates than they did at their peak in 2006 -- a 25 percent drop. The inmate reduction is larger than the entire prison populations of 42 other states, according to the latest U.S. Bureau of Justice Statistics figures. "That's a historic change," said Corrections Secretary Jeffrey Beard, who took over California's system in January after heading Pennsylvania's prison system for nearly a decade. "It's huge. Nobody else in the nation has done that." (Thompson., 2013) But the realignment law, known as Assembly Bill 109, has emboldened Republicans, the state's minority party. It passed without GOP support, and now those lawmakers are taking an I-told-you-so approach as they seek legislation to repeal or overhaul it. "In every county of this state, citizens of California have suffered and been victimized by the AB 109ers, as we call them," Republican state Sen. Jim Nielsen, who once headed the state's parole board, said during a recent Capitol news conference. "I'll argue (that) no bill ever passed by this Legislature has had more dire and severe and egregious consequences." Some Democratic state lawmakers also say (Thompson., 2013) several problems need to be fixed, even as they support the overall goal of moving more offenders closer to rehabilitation services in the communities where they committed their crimes.

CALIFORNIA PRISON COSTS References

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Bunch, B (2013). California Governor Challenges Prison Inmate Population Cap. Retrieved from http://ivn.us/2013/01/09/california-governor-challenges-prison-inmate-population-cap/ CDC. (2013). Health Insurance coverage. Center for disease control and prevention. Retrieved from http://www.cdc.gov/nchs/fastats/hinsure.htm Faryon, J. (2010). Health Care Costs Rising As Calif. Prison Population Ages. KPBS. Retrieved from http://www.kpbs.org/news/2010/jan/20/health-care-costs-rising-calif-prisonpopulation-a/ Kiai, J.L., & Stobo J.D. (2010) Prison health care in California. University of California. Retrieved from http://health.universityofcalifornia.edu/2010/01/22/prison-health-care-incalifornia/ Luery, M. (2013). KCRA 3 examines the high cost of prison health care in California. KCRA. Retrieved from http://www.kcra.com/news/kcra-3-examines-the-high-cost-of-prisonhealth-care-in-california/-/11797728/20169080/-/u1e6fu/-/index.html#ixzz2TlSTxcTr Mikle, J., (2013) Health care costs for older inmates skyrocket, USATODAY. Retrieved from http://www.usatoday.com/story/news/nation/2013/03/31/health-care-costs-for-olderinmates-skyrocket/2038633/ Onishi, N., (2013) California Tries to Regain Fuller Control of Prisons. NY TIMES. Retrieved from http://www.nytimes.com/2013/04/21/us/california-strives-to-regain-fuller-controlof-its-prisons.html?pagewanted=all&_r=0 Thompson, D., (2013) California struggles with experiment to shift inmates to county facilities. Associated press. Retrieved from http://www.thereporter.com/rss/ci_23230546?source=rss