The Tragedy of Prison Health Care in California: An Extended Timeline

April 22, 2014

While the Affordable Care Act has ensured that millions of Californians have access to affordable, quality health care, the same cannot be said for California’s prison and county jail inmates.  This timeline chronicles the fraught history of the state’s prison health care system, from 2002 to the present.

January 30, 2002
Settlement announced for Plata v. Schwarzenegger

Lawyers announce the settlement of Plata v. Schwarzenegger, the largest ever prison class-action lawsuit in which prisoners alleged that the State violated their constitutional right to medical attention, as prison officials inflicted cruel and unusual punishment by being deliberately indifferent to serious medical needs. The settlement agreement requires the Department of Corrections to completely overhaul its prison health care system. The state must phase in new policies over several years, with progress being audited by an independent medical panel.

January 3, 2003
State audit: serious problems in care

The state’s Office of the Inspector General releases an audit of the California substance Abuse Treatment Facility and State Prison in Corcoran, CA, which found “a large number of serious problems,” including “serious deficiencies in the medical care provided to inmates […], placing the health of inmates and staff at risk and exposing the State to possible legal action.”

April 6, 2004
State audit: 77% of contracting done without competitive bidding

At the request of the Joint Legislative Audit Committee, the Bureau of State Audits concludes that “Corrections does not adequately ensure that it enters into medical service contracts that are in the State’s best interest.” The audit found that in the previous five years, 77% of prison contracts for health care services were awarded without competitive bidding, with contract costs increasing by 150%. “Not only is Corrections unable to demonstrate that its contracts are in the State’s best interest, but also its prisons may be paying inappropriate and invalid medical claims.”

August 11, 2004
Federal court report: “The only requirement for hiring is a medical license”

A federal court report finds that incompetent doctors, including some with a history of substance abuse, have been hired by the state’s prison system, contributing to serious deficiencies. After conducting reviews of medical treatment at about half a dozen of the state’s 32 prisons, a panel of two doctors and a nurse practitioner concluded that the department had hired many incompetent doctors with a history of problems, and failed to monitor them: “the only requirement for hiring is a medical license.” Specific examples include:

  • “An incompetent retired cardio-thoracic surgeon manages complex internal medicine patients and makes serious life-threatening mistakes on a continual basis.”
  • Obstetricians treating HIV patients
  • Physicians who are only allowed to conduct exams while inmates are in their cells (only contact is through a 4-inch x 12-inch food port)
  • Corrections official in Sacramento who has authority over hiring physicians but is not a doctor
  • Written requests by inmates to see a doctor “had not been reviewed for months.”
  • At one facility, half of the eight doctors had prior criminal charges, loss of privileges at community hospitals, or mental health problems. At another, seven of 20 doctors had similar problems

September 22, 2004
Prison doctors will be subject to evaluations

Under a court agreement, physicians working in the state’s prison facilities by 2006 must complete a series of written and oral examinations. Doctors who do not pass the exams must be retrained or banned from working with inmates.

September 29, 2004
Los Angeles Times: Prison doctors disciplined or sued five times more than other CA physicians

Documents obtained by the Los Angeles Times shows one in five CA prison doctors has been disciplined by the state Medical Board or sued for medical malpractice, almost five times the rate for other doctors in the state.

October 5, 2004
Family of inmate who died of heart failure after wisdom tooth extraction files wrongful-death lawsuit

The family of a former Solano State Prison inmate files a wrongful-death lawsuit against Governor Arnold Schwarzenegger and two state Department of Corrections officials. Anthony Shumake, age 41, was serving a 12-year sentence for corporal injury to a spouse, stalking, and a drug offense. He died of heart failure on June 28, 2004, less than one week after a wisdom tooth extraction led to an infection and swelling in his neck that made breathing difficult. On the day Shumake died, an ambulance called to the prison arrived 90 minutes later and was sent to a hospital more than 75 miles away. A report by the ambulance company that transported Shumake said he complained that he hadn’t eaten in several days.

April 14, 2005
Expert panel finds that most deaths were preventable, records missing for 30% of inmates

A court-appointed panel of medical experts finds conditions at San Quentin State Prison to “demonstrate multiple instances of incompetence, indifference, cruelty and neglect” in providing health care to inmates. The panel was inspecting progress on the 2002 court order to provide adequate health care to inmates by 2008, found that overall compliance with the court order was “nonexistent.” After reviewing the medical records of 10 inmates who died over the last few years, the panel finds that most deaths were preventable; doctors and nurses misdiagnosed illnesses, gave patients the wrong medications, neglected them for months and even years, or delayed sending them to emergency rooms until they were fatally ill. Doctors reported that records could not be found for at least 30% of the inmates they examined.

May 29, 2005
Los Angeles Times: Scientology-linked rehabilitation programs present in prisons

A Los Angeles Times report finds that hundreds of inmates at Corcoran State Prison have participated in a rehabilitation program through Criminon International, the secular arm of the Church of Scientology, which rejects traditional mental health care, particularly psychiatry and medication as treatment options. Experts interviewed expressed concern that Criminon’s presence could undermine the ability of licensed clinicians to treat mentally ill patients. Authorities at corrections headquarters claimed to have no evidence that has occurred, and were unaware of their presence at prisons.

July 1, 2005
Federal judge orders takeover of prison health care system by federally-appointed receiver

U.S. District Judge Thelton Henderson orders that a federal receiver take control of the state’s prison health care system to correct deplorable conditions and stop the needless deaths of inmates due to medical malfeasance. Experts note that the order was unprecedented in its scope, given that the prison system provides health care to 164,000 inmates at an annual cost of $1.1 billion. Henderson said he was motivated by an “uncontested statistic,” provided by a court-appointed expert, “that a prisoner needlessly dies an average of roughly once a week.”

The full timeline, which continues to 2014, is available for download:
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