The federal receiver who runs California's prison health care system said Tuesday he will ask state lawmakers to approve four bills to control spiraling costs - including proposals to restrict prisons' use of prescription drugs and outside medical specialists and to parole the sickest and costliest inmates.
J. Clark Kelso is set to announce the plan Wednesday amid calls from Gov. Arnold Schwarzenegger and Democratic lawmakers for him to cut $811 million from his budget next year to bring California's spending on inmates closer to what it costs in other states.
Kelso told The Associated Press he needs all four bills to cut about $350 million. He is looking for other ways to make up the rest of the roughly 40 percent cut to his budget.
Soaring prison costs have been a target this year for state lawmakers and Schwarzenegger. Schwarzenegger this year proposed a constitutional amendment that would limit spending on prisons to no more than 7 percent of the general fund, while guaranteeing 10 percent of the general fund to the state's two public four-year university systems. Prisons now consume nearly 11 percent of the general fund, the main account that pays for the state's daily operations.
Attorney General Jerry Brown, who faces no serious opposition for the Democratic nomination to succeed the Republican governor, also has criticized Kelso for seeking to provide inmates with "Cadillac care." Kelso has since greatly scaled back his plans for new prison medical facilities in a bow to the state's looming $20 billion budget deficit.
Kelso was appointed by a federal judge to improve a prison health care system so poor it was blamed for killing an average of one inmate each week through neglect or malpractice.
He said about 600 inmates - the sickest 1 percent - cost taxpayers $135 million for outside medical care last fiscal year. That is nearly 30 percent of the total cost for outside specialists and hospitals because it is so expensive to treat the fraction who are on ventilators, in persistent vegetative states or have other conditions that require intense treatment.
Kelso's proposal would let the secretary of the Department of Corrections and Rehabilitation offer "medical parole" to inmates who are incapacitated and pose no public safety threat. It would exclude those facing the death penalty or life without parole.
Once paroled, about half of most inmates' medical costs could be paid by the federal government through Medicaid, though there would still likely be some public costs for their care, Kelso said. Older inmates could qualify for federal Medicare.
If their health improves, they would be returned to prison.
"This is a budget issue, not compassionate release. It's not, 'Oh, we feel sorry for these people,'" Kelso said. "This is simply the most cost-effective way to provide treatment."
Sen. Mark Leno, D-San Francisco, said 36 other states have similar medical parole programs. Leno, who chairs the Senate Public Safety Committee, is carrying the medical parole bill.
"When someone has been deemed to be medically incapacitated and not a threat to public safety, there's no reason we should be spending upward of a quarter million dollars a year on such individuals," he said.
California currently allows compassionate release for inmates who are permanently incapacitated or are terminally ill with less than six months to live. But the law is rarely used - just twice in 2009.
