United for No Injustice, Oppression or Neglect

Medical Neglect - Prisoners Health Hazard

Reports show poor medical care in state's prisons 
Incompetent doctors called systemwide problem 
- Mark Martin, Chronicle Sacramento Bureau
Wednesday, August 11, 2004 

Sacramento -- Half of the doctors working at one California prison have a criminal record or mental health problems or have lost the right to practice in a hospital. 

At another lockup, a neurosurgeon with no expertise in internal medicine misdiagnosed an inmate suffering from pneumonia in both lungs, prescribing anti-depression medicine that nearly killed him. 

And an obstetrician who lost his medical license for seven years helps determine whether problem physicians at one prison should remain on the job. 

Adding more bad news for a scandal-plagued state prison system, two reports released Tuesday depict a corrections system rife with unqualified doctors working in poor conditions. The reports were made public by a Marin County law office that sued the state over prison health care. They add to mounting evidence that California's troubled prisons run a medical operation with out-of-control costs that often fails to provide basic health care for 162,000 inmates. 

The reports come on the heels of the mysterious death of an inmate at a Vacaville prison who apparently died after having a tooth pulled. The death has the inmate's Richmond family and some lawmakers questioning whether health care providers at the prison made mistakes with deadly consequences. 

On Tuesday, state Sen. Jackie Speier, D-Hillsborough, called the reports' findings "shameful.'' 

"It's Keystone Docs,'' said Speier, who has become a frequent corrections critic and who is looking into the June 28 death of Solano State Prison inmate Anthony Shumake. 

The reports were commissioned by the Marin-based Prison Law Office, which represents inmates and in 2001 sued the state Department of Corrections over shoddy medical practices. The lawsuit was settled in 2002 after the department agreed to dramatically reshape its health care program. 

As part of the oversight of the settlement, three independent prison health experts -- Dr. Michael Puisis of Illinois, Dr. Joe Goldenson of San Francisco and Madie LaMarre, a nurse from Georgia -- this year reviewed medical procedures at several prisons and at department headquarters. Among the findings compiled in two reports: 

-- At one prison, an obstetrician sees HIV patients. At another, "an incompetent retired cardiothoracic surgeon manages complex internal medicine patients and makes serious life-threatening mistakes on a continual basis,'' according to the report. 

-- Doctors in one unit at Salinas Valley State Prison in Soledad (Monterey County) must conduct exams while inmates remain in their cells, meaning the only way to touch an inmate is through a 4-inch by 12-inch food port. Health clinics at Salinas Valley and Sacramento State Prison have no examination tables. 

-- At Sacramento State Prison, forms inmates file to request a visit with a doctor were found piled up on a desk and had not been reviewed in months. At some facilities, according to the report, there is no chief physician, and therefore "physicians monitor themselves.'' 

The reports' authors were unavailable for comment Tuesday, and many of the allegations in the reports did not include names of doctors, prison locations or other details. 

But corrections officials did not dispute the reports' findings, instead saying they are working on a response plan that will be presented later this month to U.S. District Court Judge Thelton Henderson, who is overseeing the implementation of the settlement. 

Margot Bach, a spokeswoman for the Department of Corrections, said plans are already being developed to improve supervision of doctors from department headquarters and ensure that doctors are only working with inmate maladies that they are qualified to diagnose. 

This is not the first indictment of the prison system's medical system. 

Composing about 20 percent of the Corrections Department's $6 billion annual budget, health care services have been blasted for being too expensive and, at times, deadly. Prisons typically employ several primary care doctors and contract with specialists for services. 

The state auditor reported in April that three-fourths of medical contracts doled out by the department were not competitively bid, and many prisons fail to review whether providers aren't over-billing the state. 

A lengthy review of the entire prison system commissioned by Gov. Arnold Schwarzenegger called for dismantling and rebuilding corrections' health care administration. 

And a largely confidential report conducted by a state prison watchdog agency reviewed by The Chronicle earlier this year suggested that three deaths at a Corcoran (Kings County) prison during the last two years could be attributed in part to medical negligence. 

Both prison officials and a representative of a union that represents about 600 state corrections doctors say the state faces some of its health care problems because of its inability to hire enough good doctors, leading to many vacancies and forcing some spots to go to physicians with checkered pasts. 

Corrections physicians typically earn about $134,000 a year -- a salary that isn't enough to lure many doctors to work inside prison walls, said Gary Robinson, executive director of the Union of American Physicians and Dentists. 

"Who wants to work inside a prison, most if which are located in the middle of the desert?'' Richardson said. 

Speier, who heads a Senate government oversight committee, said she has begun communicating with some of the state's largest health maintenance organizations in hopes of persuading them to loan executives to help provide advice to change the system without having to raise costs dramatically. 

"There is plenty of expertise in this state,'' she said. "Right now, we have a system with extraordinary costs, extraordinary liability and very poor care.'' 

E-mail Mark Martin at  markmartin@sfchronicle.com. 

URL:  http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/08/11/BAG0G85QLF1.DTL  

April 20, 2004

I had a talk with my eye doctor today as  he  was examining me.  I don't know if you are aware that prisoners are used  to make eye glasses for people on medi-cal through the Prison Industry Authority.

"That's  slave labor doctor, isn't it"  I remarked.

"Pure and simple it's slave labor.  Bless you for this important  work Cayenne. I am extremely upset about cutbacks in medical services  to the poor" he said as he put in the  drops to dilate my eyes for a glaucoma test.

"Take this simple test I am giving you today to determine the pressure in your eyes. Prisoners never get this one.   They are allowed to simply go blind from a preventable condition that could easily be treated with medication.  Glaucoma. A test that takes less than five minutes to perform to save a  person's  eye sight. It's inhumane." he groused peering into  places that I've never allowed anyone to peer before with a bright light.

"Cayenne, your eyes show that you never abused drugs or alcohol but prisoners are often former addicts who have lost tissue  in their eyes.  Glaucoma and other diseases leads to total blindness and prisoners  are high risk due  to their addictions."

"Your eye pressure is slightly elevated even with your good healthy habits and low blood pressure.  I will be watching you every six months as a Glaucoma suspect. 80% of Glaucoma suspects  never lose their optical nerve and never get the disease. But 20% of them do and will become totally blind.  With your good sense to have this preventive test, we can check you  again in a  few months since eye pressure fluctuates  and see if  it is down or up.  You will not feel symptoms until 90% of your optical nerve is gone if  you ever develop it.  The point is that by not giving inmates preventive tests, they are sentenced to  blindness.  Isn't that a horrible way to treat our slaves?"   The good doctor was very upset at CDC's failure to diagnose and treat a very high risk group of people  for the sake of a profit to the state.

"This applies to all health care in prisons" I told him.  "The health care professionals  in the UNION are always upset over neglect, abuse, failure to treat both physical and mental illnesses. Do the labs  ever hire the  inmates from slave labor to real jobs?" I queried putting my chin and forehead up to his  big diagnostic machine.

"Once  I saw what looked to be a former inmate working at a lab in Auburn but I would say the answer is  NO.  Nobody will hire former inmates and the skills they are learning are simply yeoman's work, not really skills. Look at my  left ear"  he instructed.

"Well, you know why this is happening.   The law enforcement  unions are organized and putting their own  people into office.  We have Bermudez an active member of CCPOA sitting in elected office.  The majority of them are bought off and not listening to reason even in this  budget crisis.  They just fired all the prison teachers and the CSEA has filed a huge lawsuit over it."  I informed him.

At this point he back up his rolling stool and almost came unglued. 

Now he's yelling.

"What?   They have fired the prison teachers? What the hell are these people doing up there to allow this to happen.  Is that what they are doing?  Putting  their own people into office? That would explain this madness of three strikes and the whole industry!"  The examination has paused. 

I have hit a  nerve while he was examining mine.

"Yes,  and do you know what we are doing? Just putting up with it and failing to organize opposition and get out the vote.  My little raggle taggle efforts are struggling for money while the punishers raise millions and billions.  Where are all you medi cal doctors when we need your help?"  I asked.  "We can't do  lawsuits, initiative campaigns and elect candidates for free.  Maybe you guys need  to be helping us out here." I prodded.

"You look beautiful  on that soap box" he said.  "Please stay up there, people need you and let's keep your vision in good shape and not give that optical nerve a chance to deteriorate.  At  this time I am not going to give you medication but I am going to give you trifocals so that we preserve your vision for as long as possible.  Not many people were 50 years old before they needed any glasses at all, so you're fine. But regular check ups and let's try and get these for the inmates" he says.

"Ok, and will you recruit some medi-cal eye  doctors and dentists to our group, they are losing business and we need support for public information campaigns."

"Absolutely Cayenne and you  should all ask Medi Cal doctors and dentists to join the UNION.  We are all very busy people but it is clear the legislators have been hurting us because we are busy and not paying attention." he closed.

So I was blurry for a few hours today but  won us another ally who didn't need to be taught that  a voting lobby is the inmate's only hope for healing, for freedom, for an  end to medical neglect.

You can recruit workers to the UNION in the darnedest places.   The more intelligent the person is you're  addressing the easier it is to garner support.  The doctors and dentists know how horrible it has all become better than any other group.

Now our healers will be weakened and the knuckledraggers strengthened. A voting group of active writing, suing, picketing, hellraisers to outnumber the bullies is our only way to sanity.

Trifocals!  Damn I am getting old.  We simply must  hurry  up our efforts instead of dragging our feet and wasting money on lawyers who cannot win until the system is purged of corruption.  Work on your individual cases but don't neglect building the UNION because no lawyer, judge or legislator can rescue you without a large,  funded citizen's group.

Contact the eye doctors and dentists in your area and give them a vcr tape of our first six shows.  We speak a great deal about medical neglect and systemic problems. If you don't copy the bar codes and black spaces, three shows can fit on each 90 minute tape.  All doctors and dentists are upset about abuse of prisoners but those who accept Medi-Cal patients are OUTRAGED over the situation as the benefits  to the poor (and thus  their businesses are being cut).

If you make a vhs tape of  the  shows for a few Medi cal doctors  and dentists, ask them to share them with everyone in their  offices.  Health care workers know how to organize and are natural  born activists. 

God bless the health  care workers and teachers in the  UNION, the blue collar laborers who belong to other unions, and those who are bright enough to know there are no rescuers other than ourselves Trifocals! 

Time is awastin' we don't have years to get this done.  We need to do it now.  The tv shows are a tool to help you.  6500 or bust.  If you're not recruiting to the UNION, you're already whipped because there is  not other way out of this  prison mess except to organize.

Scathing report on prison health care still not out 
Agency suggests negligence in deaths at Corcoran facility 
Mark Martin, Chronicle Sacramento Bureau
Thursday, February 26, 2004 
©2004 San Francisco Chronicle

URL:  sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/02/26/MNG2P58ILF1.DTL

Sacramento -- The death last week of an 80-pound inmate at a prison in Corcoran who hadn't eaten in 40 days might not have surprised California corrections administrators. 

More than a year ago, a state prison watchdog agency issued a blistering confidential report on health services at the facility, suggesting three inmate deaths in the previous two years could be attributed in part to negligent medical treatment. 

Detailing conditions at the Substance Abuse Treatment Facility in Corcoran, the report chronicled a health department in disarray. The report, a copy of which was reviewed by The Chronicle, has not been publicly released by Gov. Arnold Schwarzenegger's administration. 

Problems ranged from lax oversight that has led to the wasting of millions of taxpayer dollars to full-time doctors who see only a handful of patients and continually sleep on the job, according to investigators with the Office of the Inspector General. 

Now an inmate is dead after apparently slowly starving himself to death, and prisoner advocates are wondering just what it will take to improve medical treatment at the Substance Abuse Treatment Facility in Corcoran. 

A Bay Area lawmaker who is leading the charge to reform California's troubled corrections system is demanding that Schwarzenegger publicly release the inspector general's report. 

"I'm becoming concerned that the administration is either dragging its feet or covering something up,'' said state Sen. Jackie Speier, D-Hillsborough, who has been asking for several inspector general reports for more than a month. "What are they hiding?'' 

A spokeswoman for Schwarzenegger said administration lawyers would likely release the reports to Speier -- and the public -- but were redacting names and other information that might be relevant to ongoing prison investigations. 

Meanwhile, corrections officials say they're still trying to determine exactly what happened to Khem Singh last week. Singh, 72, had been on and off hunger strikes since he was sent to prison in 2001. A Sikh priest who lived near Modesto, Singh was serving a lengthy sentence for lewd and lascivious conduct with a child under 14. 

Before dying, he had not eaten in 40 days, according to Patrick Hart, chief deputy district attorney for Kings County. Prison documents indicate he was removed from his cell Feb. 14 and taken to a local hospital, where he died two days later of heart and lung failure attributed to starvation. 

Corrections officials say Singh had been in and out of a medical clinic at the prison but was not there this month. 

"After 40 days, you would think he would have been in the hospital,'' said Kelly Santoro, public information director for the prison. 

Hart said his office has determined there was no criminal negligence by prison staff, but sources said Wednesday the inspector general's office had begun a probe this week. The office reports to the governor and conducts financial audits and investigations of prison issues. 

Prisoner advocates say death by starvation is something that shouldn't happen in modern prisons. 

"You don't just starve to death overnight,'' said Don Specter, executive director of the Prison Law Office. "This amount of inattention is inexcusable. '' 

State prisons do have policies to handle inmates on hunger strikes -- the policies were created after Specter's office won a 2002 class-action lawsuit alleging inhumane medical conditions in all state lock-ups. An internal review is determining whether prison medical staff correctly followed procedures, said Rosanne Campbell, deputy director of health care services for the Department of Corrections. 

It's not the first time health care at the facility has been investigated. 

Lesser known than its neighbor, Corcoran State Prison, the Substance Abuse Treatment Facility houses more than 6,200 inmates. 

Last January, investigators with the inspector general issued a report that concluded medical services there were inexcusably bad. A probe that lasted more than a year found full-time doctors paid more than $90,000 annually were only available to inmates 12 hours a week and full-time dentists spent most of their days outside the prison at private practices. Among the other findings: 

-- Three inmate deaths may have been caused in part by lax medical care. One inmate with a blood disorder was found lying prone in his cell in May 2001 and told a nurse "he couldn't go on,'' according to the report. The nurse told him to see a doctor the next day. He was later found vomiting blood and was pronounced dead soon after in the prison emergency room. 

-- One inmate in 2000 was diagnosed with tuberculosis, a highly contagious disease, but not isolated from the prison population for more than a year. Two guards and an inmate later tested positive for TB. 

-- Investigators witnessed pharmacy workers throwing away 30-pound garbage bags full of medication. They determined costly drugs were shipped to the prison for inmates who had been transferred or released in the same fiscal year that pharmacy spending at the prison exceeded the allotted budget by 211 percent, or more than $3 million. 

Corrections officials say they have a comprehensive plan to address each issue raised by the inspector general's report and review progress monthly. Included in the plan are establishing working hours for medical personnel and better tracking systems for medications. 

"A lot of it was oversight, and we're monitoring all of that,'' Campbell said. 

She said it would be "premature'' to say that the recent death at the facility shows that progress in improving medical care had been slow. 

"We're looking into it, and if we still see gaps (in care) we will address that,'' she said. 

But Speier said Singh's case may show yet another example of problems within corrections that never seem to be fixed. 

She and Sen. Gloria Romero, D-Los Angeles, held hearings in January highlighting a code of silence within prisons that prevents the system from policing rogue guards, a subject that came up in legislative hearings nearly a decade ago. And the state is in legal trouble for failing to change some procedures at Pelican Bay State Prison that were first described in a 1995 federal court decision. 

Speier and Romero are authoring legislation that would add funding to the inspector general's office and require that most of the office's reports be made public. She believes the public disclosure of reports would add pressure on corrections officials to make changes that benefit guards, inmates and taxpayers, who keep footing the bill for expensive litigation. 

Schwarzenegger, who first proposed eliminating the inspector general's office but has since changed his mind, has not offered an opinion yet on the legislation. 

Spokeswoman Terri Carbaugh said the governor generally does support beefing up the office and more public disclosure. The governor recently made public 20 previous inspector general reports, and Carbaugh said he planned to release more as soon as lawyers completed their review. 

Speier said she would place another call Wednesday to the governor's office to seek the other reports, including the study of medical care in Corcoran. 

"There are numerous examples of complete mismanagement in corrections, and this is precisely why we need more oversight, '' she said. 

E-mail Mark Martin at  markmartin@sfchronicle.com


Released Prisoners Major Health Hazard
United Press International

Monday, January 27, 2003 

WASHINGTON, Jan 27, 2003 (United Press International via COMTEX) -- The 11 million jail and prison inmates released each year bring AIDS, tuberculosis, hepatitis and mental disorders back into their communities, according to a report released Monday by a national healthcare coalition. 

In its 121-page report, the National Commission on Correctional Health Care said hundreds of thousands of inmates from jails and prison re-enter society each year with dangerous communicable diseases that were either acquired behind bars or untreated while the inmate was incarcerated. Prisons also send thousands of inmates back into society with untreated mental disorders who are a danger to themselves and others, the report said. 

"Growing numbers of incarcerated individuals suffer disproportionately from tuberculosis, HIV/AIDS, hepatitis, mental illness, substance addiction and many chronic diseases," NCCHC said in a statement. "Corrections departments are overwhelmed by the high cost of providing medical care and face serious challenges to providing treatment to patients. 

"Untreated patients jeopardize the health and safety of prison and jail staff, institution visitors, prisoners and the communities to which they return." 

The report called for a congressional investigation of the conditions it found and set out recommendations for action, ranging from setting national requirements for prison healthcare to funding a national vaccine program to protect prisoners against communicable diseases. NCCHC scheduled a news conference in San Antonio, Texas, for Monday to discuss its findings. 

The Justice Department funded the project, which used statistics on prevailing health conditions in the national prison inmate population on June 30, 1997, the most recent year available. 

"The approximate number of releases with these conditions was obtained by applying the same prevalence percentages to the total unduplicated number of persons released from prisons and jails during 1996," the report said. 

Although it used 1996 and 1997 figures, the report said that as of the most recent count in 1999, an estimated 2 million people were incarcerated in American jails and prisons and some 11.5 million prisoners are released from these institutions each year. 

It found startling trends: 

An estimated 34,800 to 46,000 inmates in 1997 were infected with HIV. An estimated 98,500 to 145,500 HIV-positive inmates were released in 1996. 

Included among these persons in 1997 were an estimated 8,900 inmates with AIDS. An estimated 38,500 inmates were released in 1996, using these figures. 

The report said there were an estimated 107,000 to 137,000 inmates with sexually transmitted diseases in 1997 and "at least 465,000" among the released prisoners. Vast numbers of prisoners were released with different forms of hepatitis, the report said. 

The report said there were about 12,000 persons with active TB who served time in a correctional facility during 1996 and 130,000 inmates tested positive for latent TB in 1997. This extrapolated to 566,000 inmates with latent TB coming back into the community in 1996. 

The report said that many jails and prisons fail to conform to accepted guidelines for clinical care of inmates and this makes the institutions breeding grounds for more disease. Half the nation's jails, for instance, had no screening procedure for TB and many institutions had no room for proper separation of ill prisons or the money to meet the high cost of proper care and medication. 

The report said that vast savings could be realized by correcting prison health conditions because it would cut the enormous medical costs these prisoners engender when they are freed. 

"Because they have a large and concentrated population of individuals at high risk for disease, prisons and jails offer a unique opportunity for improving disease control in the community by providing comprehensive health and disease prevention programs to inmates," the report said. 

In addition to medication and clinical care, it recommended offering instruction in safe sex, how to overcome drug dependency and hygiene methods as well as programs that would help the inmates deal with health and mental problems when they are released. 

Copyright 2003 by United Press International.

My name is Charles Wesley, and I was wondering if you would be interested in the torture of inmates in the form of Medical Negelect within the California Prison system. 

Below is a brief background of my situation, I do have all medical records, complaint forms, and detailed records of the past event. I have filed a Federal Civil Rights Suit against employees of the Californai Department of Corrections. 

My Attorney's name is Mark Ravis out of Beverly Hills, CA.  email MRAVIS@aol.com . I would like to add that I am remorseful for my non-violent crime, but this abuse was not part of my sentence. 

Background: Employees of the California Department of Corrections with deliberate indifference failed to provide medically necessary health care and pain management for a serious spinal injury, they delayed recommended surgery resulting in permanent nerve damage. Which now severely limits my daily activities and for the unnecessary and wanton infliction of pain. 

I had been in severe pain from April 2, 1999 to November 16, 1999 (day of surgery). The pain was caused by a severely extruded disk of my spine on the right L-5/S-1 causing posterior displacement and compressing on the right S-1 nerve root.   Employees of the C.D.C. had failed to provide reasonably necessary medical care and pain management, and insisted on continuing a 
course of treatment that doctors knew was painful, ineffective and entailed substantial risk and serious harm to the me. 

These negligent courses of action had caused me an inability to walk often or far distances, to sit for any appreciable length of time, to shower without extreme pain, or  when imprisoned, to proceed to the RCW culinary to eat on most occasions. 

My daily activities have been and are still severely limited. In have been to the California Institution for Men (C.I.M.) Reception Center West (R.C.W.) medical department over sixty-one (61) not a typo 61 documented times complaining of severe pain, and that the current medication prescribed 
provided no relief. 

Due to the RCW Medical's "POLICY" prescribing a stronger pain medication, to ease the excruciating pain was not allowed. Surgery was recommended. However, due to budgetary constraints within CDC, (I was told this confidentiality by CDC employees) the Chief Medical officer's (CMO) at C.I.M. delayed necessary surgery. (some seven months) 

Subsequently, the approval for the surgery was further delayed due to the CMO's vacation. Surgery was scheduled and then canceled, because I refused to rescind my administrative appeal (602). But was then rescheduled and completed on November 16, 1999. It was obvious that I was in severe pain, I walked with a abnormal gait, and had collapsed from the pain after being forced to walk back from medical, when I was escorted there via EMERGENCY in a wheelchair, only to be given two motrin, and two days of bed rest. 

CDC knew the injury was severe due to the fact a Magnetic Resonance Imaging (MRI) was performed by CDC on 5-26-99. Revealing a "Severe extruded disk on my spine". I was in severe pain every second my eyes were open. I have suffered from retaliation for complaing, about this medical abuse in the form of delayed surgery, threaten with transfer or higher custody, I was told that if my family members were to call the prison again complaining, that "it would cause me a lot of trouble". refusing to hospitalize me "unless you are dying, or bleeding". 

There is a licensed hospital her at Chino. And improper handling of my appeal. On November 02, 1999 I was sent on a bus ride to the M.S.F. hospital on the prison grounds only to sit "SHACKLED" for ten hours without receiving any medical treatment, I claim this was done because I refused to rescind my medical appeal complaining of medical neglect. I hope that you have read this far, this is not some bitterness being expled I have truly suffered. 

There was a story in the L.A.Time On September 29, 2000 in the Commentary section about my situation written by B. Bird director of the U.N.I.O.N.  Please respond with your thoughts. Thank you for your time and professional service. 

Charles Wesley 


Publication date: 05/19/2003

Jail health care cuts
Of The Examiner Staff

    San Francisco's county jail system is feeling the pain of budget cuts, in the form of a proposal that would privatize the jail's health-care services in order to slash Department of Public Health expenses by $40 million.

    Doctors and nurses are alarmed at the prospect of losing their jobs and warn that the effort to shave $15 million off a $25 million budget is a Band-Aid measure that would severely affect the health of The City's prison inmates, who they claim receive some of the best care in the United States.

    Increasingly across the country, counties and states are contracting out health-care services to private companies, with healthy and not-so-healthy results.

    The issue was in limbo last week. On Friday, the DPH and the Mayor's Office were negotiating with members of the Service Employees International Union Local 790, with the possibility that The City would retain responsibility for providing the health-care services but would ask workers to give something back in return.

    While critics of privatization say that companies chasing a buck have little incentive to provide quality health care, some 24 states across the country were providing completely privatized health-care systems to inmates in state prisons by 2000. 

    Others point out that in some states, the standard of care behind bars was so poor, governments were forced to contract it out, often under pain of lawsuits from civil liberties' groups.

    One full-time physician, eight full-time nurses, and one part-time nurse and physician would lose their jobs in San Francisco should the privatization plan become reality, said John Poh, a nurse and union representative.

    Poh cited scandals involving private contractors across the country, saying the system was fraught with problems. 

    These included contractors not providing sufficient malpractice-insurance coverage, resulting in sheriff's departments being left to pick up the bill, and apparent cases of neglect of inmates, leading to their death and subsequent court action, he said.

    Health-care workers inside the San Francisco County Jail, who stand to lose their jobs, were critical of the standard of care provided by private contractors.

    "The services we provide now -- if they're not the best, they're not equaled by many," Poh said. "We try to have a person leave (jail) in better health than when they came in."

    One nurse, who asked not to be named, claimed that private contractors had a lower nurse-patient ratio than what the DPH provided and would provide "very limited" jail psychiatric services to the severely psychiatrically ill population housed in the county jail's "Pod C."

    San Francisco is a leader in HIV and hepatitis-B and hepatitis-C testing and is thorough in immunization and care of chronic conditions such as hypertension, diabetes, and asthma, the nurse said.

    "Because of San Francisco's high homeless rate and high HIV rate, it makes the population more sick than the average (jail population)," she said.

    The jail conducts particularly thorough testing for sexually transmitted diseases on incoming inmates and conducts Pap smears -- services the nurse said could be lost if jail health care was bid out.

    "If we treat them in jail, that dilutes the amount of disease going back into the community," she said. "So far, it's been an amazing help for the community at large."

    "If I went to Sonoma, they wouldn't be providing these things. They would be putting Band-Aids on problems, hoping people would get out of jail before anything crops up," the nurse said.

    But over in Sonoma County, where the Sheriff's Department has contracted out the jail system's health-care services for the past 15 years, things couldn't be better, according to Assistant Sheriff Mike Costa.

    Sonoma County contracts with California Forensic Medical Group for everyday medical care, and patients needing surgery are transferred by CFMG to nearby privatized hospitals, Costa said.

    Costa said Sonoma County required its contractor to adhere to the California Medical Association's standard for prison care -- that it matches the standard of outpatient care in the community.

    Sonoma County retains control of prison psychiatric health care.

    Costa said that CFMG provided testing for sexually transmitted diseases and care for the chronically ill.

    Like many California counties, Sonoma County probably initially decided to privatize its health-care services because it was faced with a dwindling county hospital system and needed to save money, Costa said.

    "But we've been very happy with the arrangement," he said.


 Beverly Diaz Press Release

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