The Real Cost of Prisons Weblog

Robert Sillen, the court-appointed prison health care receiver, said he's willing to back up the truck to raid the state treasury if need be, waive whatever civil service protections and state laws that get in his way and seek contempt-of-court citations against any state employee who tries to thwart his efforts to renovate California's $1.5 billion prison medical system.

"We're on our way," Sillen said, at the conclusion of his 1 1/2-hour testimony before the Little Hoover Commission. "We'll get medical care where medical care has to be, because I think we have the authority to do that over time. It's just a monstrous path to get there."

To illustrate the difficulties that Sillen said remain in his path, he recounted an inmate death that took place in August -- four months after he had been installed in his position by U.S. District Court Judge Thelton Henderson -- in which a quadriplegic inmate died of heat exhaustion after being transported in the middle of the summer from a Central Valley prison to another institution near the Mexican border.

The van had no medical personnel on board, and its air conditioning unit broke down during the course of an 11-hour trip -- made longer by six hours when the driver got lost, according to corrections spokeswoman Terry Thornton.

When the van arrived at the Centinela State Prison on Aug. 21 after driving from the Substance Abuse Treatment Facility in Kings County, the unidentified inmate had a body temperature of 109 degrees.

"That's the kind of thing I'm talking about," Sillen said. "There has to be a massive change of culture within the (California Department of Corrections and Rehabilitation) in general and with medical care. Inmate patients have to be viewed as patients in addition to being inmates.

"Not everybody in prison is a pedophile or murderer or a rapist."

Thornton said the inmate died Sept. 5 and that the case is under internal investigation.

Altogether, Sillen said, some 65 inmates die needlessly in the prison system every year.

"Those are inmates who perished because of either lack of access to care or, more horrifically, access to care," Sillen said.

Oscar Hidalgo, the prison system's communications director, echoed Sillen's testimony in saying that the problems in California's correctional health care are decades in the making and "will take time to correct."

"The department continues to work hand in hand with the receiver in order to remedy all the problems in the medical system," Hidalgo said.

Sillen told the state government watchdog commission during Thursday's hearing on prison management that he won't be shy in exercising his receiver's authority, especially when it comes to making sure he has enough money to get the job done.

"Something you must realize about money," he said, "is I do not need legislative appropriations to fund this. The power of the court includes calling the federal marshals, going to the controller or treasurer -- we've already worked out the arrangement -- and taking the money, seizing the money, through a writ of execution. And if we have to do that, we will."

Sillen has told the state that he and the special master overseeing mental health services need six new medical facilities. He told reporters Thursday he wants them located on prison property in San Luis Obispo, San Diego, Lancaster, Sacramento, Stockton and Whittier.

Hidalgo said the department will work with Sillen on the budget request during the next fiscal year. The Schwarzenegger administration proposed financing two prisons last year with lease revenue bonds, but later said it was willing to build medical facilities instead of big new lockups. Sillen said the bond funding sounded prudent to him.

"I'm going to do it in any case," he said of the six facilities. "If you want me to just reach into your general fund for a billion or a billion two, that's fine with me."

Sillen said he is prepared to seek court authority to circumvent civil service rules, the State Personnel Board and union contracts to get rid of incompetent doctors who administrators have failed to successfully fire.

"People are being reinstated who never should be practicing," Sillen told reporters after his testimony. "I won't have it."

Gary Robinson, executive director of the Union of American Physicians and Dentists, the union that represents prison doctors, said his members will appeal any attempt by Sillen to eliminate their employee rights.

"This is a kind of classic case that could end up before the U.S. Supreme Court," Robinson said.

Sillen said it is not just incompetent doctors he has in his sights.

"Anybody in state employ is under threat of contempt of court for thwarting my efforts, impeding my efforts, getting in the way, slowing it down," he told the commission.

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