U.S. SEIZES STATE PRISON HEALTH CARE

Judge Cites Preventable Deaths of Inmates, 'Depravity' Of System

A federal judge, saying he was acting urgently to stop the needless
deaths of inmates because of medical malfeasance, ordered Thursday
that a receiver take control of California's prison health care
system and correct what he called deplorable conditions.

Experts said the order by U.S. District Judge Thelton Henderson of
San Francisco was unprecedented in its scope given that the prison
system provides health care to roughly 164,000 inmates at an annual
cost of $1.1 billion.

The order also was an embarrassing blow for the administration of
Gov. Arnold Schwarzenegger, which has promised to deliver major
medical reforms for nearly two years but, Henderson said, has utterly failed.

The prison medical system offered "at times outright depravity, and I
intentionally call it that," said Henderson.

He also said the need for action was so dire that he might appoint a
temporary receiver in just weeks to at least begin to limit the harm
to inmates from the poor medical care before a permanent receiver is
put in place.

Inmate families and those who have long fought for change in the
prisons were ebullient.

"It's certainly everything we asked for," said Donald Specter, head
of the Prison Law Office, the prisoner rights group that filed the
suit on which the judge was acting.

Henderson said he would begin the process of selecting a receiver and
defining his or her powers in consultation with state officials and
the inmates' lawyers.

The decision followed weeks of testimony from medical experts that
Henderson described as horrifying in its depiction of barbaric
medical conditions in some prisons, resulting in as many as 64
preventable deaths of inmates a year and injury to countless others.

The state's attorneys have never even bothered to fight those
characterizations or the need for federal intervention in spite of
their damning reflection on prison managers.

"This is humiliating," said James Jacobs, a law professor at New York
University and an expert on court intervention in prison management.
"What's extreme here is, it's like the judge is saying to the state,
'I'm totally giving up on you -- you are unwilling or unable to do
this on your own.' "

Indeed, top prisons officials for months have admitted the department
was incapable of administering the system, a massive and complex
medical program stretching the length of the state, often in remote
locations. The state's lawyers have focused principally on trying to
limit the power of the receiver.

"Nobody can do this by themselves," said Bruce Slavin, the prison
system's general counsel. "A receiver can help us do what we want to
do faster. "

The unions representing prison health workers, who have been at war
with the prisons department, in part over who was responsible for
conditions in the prisons, said they were thrilled at the judge's
decision. The unions had jointly filed a brief in favor of the
appointment of a receiver.

"All the unions are more than willing to work with the receiver,"
said Gary Robinson, the executive director of the Union of American
Physicians and Dentists. "We think the department is incapable of the
reforms that are necessary. The judge's position is absolutely
correct. The management has been incompetent."

Michael Jacobson, the director of the Vera Institute of Justice and
the former head of New York City's jails, said the receiver should
begin a process of deep changes reaching into all levels of
management and the culture inside the prisons.

"Nothing is going to happen for some years," he said. "This has to be
a catalyst for longer-term structural changes. The potential
implications of this are just so humongous."

Henderson said appointing a receiver was a last resort but was a
result of the Schwarzenegger administration's refusal to comply with
his orders to improve the appalling quality of prison medical care. A
federal injunction has been in place for three years requiring
phased-in medical improvements at each state prison, but the
Corrections Department has met none of the goals.

In one case described by court-appointed experts, an inmate's spine
was injured in a fight. A prison doctor refused to believe the
inmate's claim that he couldn't move, and the doctor wrenched the
inmate's head and neck during the examination, aggravating his
paralysis. In a case at San Quentin in January, an inmate reported to
the infirmary seeking emergency treatment with signs of shock. A
doctor already under investigation for two previous suspicious deaths
prescribed antibiotics for what he said was bronchitis. When the
inmate collapsed on the way back to his cell, the guards brought him
back. The doctor ordered that the inmate be given intravenous fluids,
but when the staff could not find a vein, the inmate was simply
returned to his cell. The inmate died the next day from a serious lung ailment.

He indicated that the receiver was likely to have the ability, at the
least, to fire incompetent doctors and hire quickly to fill the more
than 150 positions that have been vacant for years and to order
construction to improve conditions in the state's 33 prisons.

"This is no panacea," said Jacobs. "It's a staggeringly large job."

Henderson was clear that the process is likely to be long and arduous
because of the depth of the problems. In spite of condemning
incompetent doctors described in earlier testimony, Henderson went
out of his way to praise the rank-and-file prison health workers
while excoriating prison managers.

"It's also become apparent that the state has no effective management
structure to offer health care," Henderson said.

He added later in his comments from the bench, "My decision to
establish a receivership is just a start." What happened

A U.S. district judge found that substandard medical care violated
prisoners' rights and has led to unnecessary injuries and deaths in
California prisons. He agreed to appoint an administrator to take
over the health care system.

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WHAT IT MEANS

The administrator will answer to the court, not the Schwarzenegger
administration, and will have the power to order improvements
regardless of how much it costs state taxpayers.

What's Next

Prisoner rights advocates and prison officials will recommend
candidates to take control of health care programs. The judge will
have the final say. The judge also may appoint a temporary receiver
until a permanent appointee is named.

The Numbers

164,000: Approximate number of inmates at 33 state prisons.

$1.1 billion: What state will spend this year on prison health care.

64: The number of inmates who may be dying unnecessarily in state
prisons each year because of poor medical care, according to
court-appointed physician Michael Puisis.