Corrections Connection -
[Cached Version]
Published on: 10/14/2004
Last Visited: 10/28/2005
According to Alison Hardy, Staff Attorney for the Prison Law Office in California, which represents the inmates in the class-action case, the problems with health care in California's prisons have been long standing.
"The major problem is the health care program has been the poor stepchild of the Department of Corrections.Their first and foremost concern has been the safety and custody of prisoners.Health care isn't what they consider to be their mission," she said.
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But this lack of support is only the tip of the iceberg, according to Hardy and those who are familiar with the case.
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Beyond the management problems at the department, Hardy said, are issues with staffing and maintaining a professional atmosphere that have also not been addressed.
"The DOC for many years would hire physicians that virtually no one else would hire," she said, adding that many physicians are not board-certified or have had their licenses suspended.
The court's investigation into staffing revealed that more than 80 percent of higher level management positions in the Health Services Division are vacant, that the department has not hired regional directors as ordered by the court - which provide supervision to staff at the institutional level -- and there is no central office leadership in nursing.
"They [the DOC] haven't paid very well and never made it a priority.Not only were they hiring people who weren't good, but they couldn't fill all the positions," said Hardy."There are prisons that have never been able to fill their vacancies."
She added that an independent study of nursing staffing last year showed that the department nurses were being paid 20 to 25 percent less than similar positions in the community.Hardy added these salaries would not support hiring a group of professionals who would probably rather work in the community anyway.
Hardy said that problems of oversight at an institutional level persist as well.
Even as recently as a few months ago, the department had hired two nurse practitioners for one institution, but did not provide a local physician to serve as their supervisor.Hardy said when she asked them who was their supervisor or "proctor" to contact when they had questions or problems, their answer was the health care director of the entire department.They had been given her cell phone.
"That is the level at which they are operating," said Hardy, who added that despite her many other duties, the department's health care director did respond to their questions when they called.
The lack of qualified staff and the lack of oversight over those who treated inmates at the institutions played a major role in the problems revealed in the inmates' case - the most serious of which led to inmate deaths.
"This is the perfect storm of things that could go wrong," Hardy said.