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March 16, 2009

Will SCOTUS soon be considering California's corrections crisis?

This new AP article, headlined "California fight over inmate care may go to high court," provides the latest developments in the various legal battle over California's corrections mess.  Here are a few of the details:

When the quality of health care in California's sprawling prison system was first challenged in court, it seemed only a matter of time before major reforms would take hold. Nearly two decades later, the desires of the federal courts and inmate advocates have run into a wall of political inertia.

Legislative stonewalling, California's mounting financial problems and legal counterpunches by the state have conspired to stall the most ambitious of the overhaul plans. The result is a showdown over whether federal judges can take control of California's inmate population and order the state to make costly changes to its corrections system.

The dispute seems headed for the U.S. Supreme Court. If the state appeals to the high court, the justices will face a clash between two constitutional amendments: one that shields inmates from cruel and unusual punishment, and another protecting state sovereignty....

The legal challenges over California's inmate medical and mental health care systems date back to 1991 and initiated studies that found the system was indeed failing prisoners. Some doctors, for example, reused tongue depressors, passing them from patient to patient.

Ultimately, the courts ruled that negligence or malfeasance in the prison health care system was leading to the death of an inmate at the rate of roughly one a week. Finding the level of care unconstitutional, a federal judge in San Francisco in 2005 appointed a receiver to oversee the medical and mental health systems and implement reforms. Improvements have followed.

The receiver has gone on a hiring binge and ordered higher salaries to fill vacancies, with many prison doctors now making about $250,000 a year. A private company runs prison pharmacies, while hundreds of millions of dollars have been redirected from the state general fund to pay for new prison medical buildings and equipment....

The result was a pushback from the Schwarzenegger administration and Attorney General Jerry Brown. "This thing has escalated out of control. It's the most extravagant proposal for inmate health care we've ever seen in the United States," Brown, a Democrat, said in an interview.  Brown said the receiver's plan would create a system that coddles inmates with "Cadillac care" not afforded to many California taxpayers.

As noted in this recent post, UC Hastings College of the Law this week is going to have, as detailed here, a great conference on “The California Correctional Crisis.”   The full schedule for this timely conference is available at this link, and the full list of participants is available here. In addition, the conference organizers have this terrific blog, which is providing "News, Updates and Opinions on Sentencing and Corrections in California."

March 16, 2009 at 08:57 AM | Permalink


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Before joining the court, Justice Roberts said that the proper action is not to take over the prisons, but to hold the warden and other higher ups in contempt until the reforms ordered by the federal court are made. Considering this has gone on for almost two decades, I wonder why that hasn't been tired yet.

Posted by: . | Mar 16, 2009 10:32:50 AM

While he bemoans the fact that the Courts are requiring California to spend tens of millions of dollars on inmate health care that is beyond the reach of ordinary citizens, Gov. Jerry Brown fails to appreciate that pursuant to the U.S. Supreme Court's interpretation of the Eighth Amendment prohibition against cruel and unusual punishment, prison inmates are the only people in America that have a Constitutional right to require the Government to pay for their medical care. That is well-established law, but California wants to incarcerate more people than it can pay for health care for. Something has got to give in California, but I don't think it is going to be the 8th Amendment right to health care! Part of the problem is that prison inmates have frequently abused their bodies and health before they come to prison, to the extent that the average prisoner's health condition is about 10 years older than his chronological age; i.e., a 55 year old inmate with a 65 year old body. It's a fact of life in the prison system, at a time when the average inmate age continues to climb due to long drug sentences (2/3 of inmates are incarcerated due to drug or drug-related offenses).

Posted by: Jim Gormley | Mar 16, 2009 4:29:59 PM

The problem, of course, is that the courts have constitutionalized standard of care, which leads to bizarre results, like payment for hormone shots for women trapped in men's bodies with serious litigation over whether the state has to pay for sex-reassignment surgery for a prisoner. That is ridiculous.

At some point, I think, a state, consistent with the 8th Amendment can make medical decisions with respect to prisoners based on cost. Should a prisoner get a million dollar transplant? Should a prisoner with AIDS (particularly one who is a sex offender) get a Magic Johnson type regimen at taxpayer expense, or much more than palliative care? Resources are not umlimited, and very difficult choices need to be made.

Jim, your post has one very obnoxious statement: "but California wants to incarcerate more people than it can pay health care for". I'm sure California would love it if it didn't have to incarcerate a single person. California has rules, and there are consequences for those rules, and what you're saying is that inmates can overwhelm the system due to healthcare costs. But what about innocent people harmed if we let some of these criminals out? I guess that doesn't figure into your calculus.

I think most people agree that if a prisoner breaks his arm, he should get care and that if a prisoner needs a heart transplant (absent very special circumstances) he should not. Where do we draw the line? That's the issue, and I think that a lot of discretion has to be given to the corrections dept of a state. I also think that morality has to do with some of this. Let's say a prisoner assaults another prisoner, and the cost to help the other prisoner is $500K, in my view, the state can simply limit care to the assaulter to emergency, cheap and palliative care. So, the assaulter would get surgery for a burst appendix, but his hypertension, TFB.

This may sound harsh, but there are limited resources, and they need to be doled out, and morality is a great way to do it.

Posted by: federalist | Mar 16, 2009 5:14:13 PM

"but there are limited resources, and they need to be doled out"

That would require a great leap of activism as I read the 8th amendment over and over and couldn't find that exception.

Posted by: . | Mar 16, 2009 6:08:13 PM

First of all, 6:08, you can read the 8th Amendment over and over and not find a clue about how the provision of medical care is doled out or even whether the states have an obligation to provide any care that a doctor would require, so I don't think that you really can point the judicial activism finger at me.

Second, we have all sorts of extra-constitutional (and when I say that, I mean not in the plain language, e.g., Gideon). So why can't we come to some rough justice here? Let's take an example in the Gideon context. Let's say, during trial, a criminal defendant hauls off and punches his defense attorney in the mouth. Let's say that the defense attorney is unable or unwilling to continue and the judge excuses the lawyer and continues to hold the trial. Would the Sixth Amendment be violated? Same here.

Posted by: federalist | Mar 16, 2009 6:36:24 PM

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