Thursday, November 25, 2010





In the midst of election-season headlines, the single best California budget move of the last few years got almost no public attention last fall.

That move came when lame duck Gov. Arnold Schwarzenegger signed a bill called SB1399, which may be only a start in cutting out some of the wasteful rules and practices of the state’s prison system. In a day of budget deficits amounting to $25 billion or more, the $100 million a year or so in eventual savings here may not seem like much. But this measure can lead to much more.

Authored by Democratic state Sen. Mark Leno of San Francisco, the new law will allow medical paroles for convicts so disabled they cannot possibly pose any public danger – except to the public pocketbook. The law specifically excludes parole for criminals with death sentences or those serving life without possibility of parole.

Nor will this measure allow financially-pressed wardens to release prisoners willy-nilly. The chief physician of any prison where a disabled convict is confined would have to okay parole and that decision would then need to be verified by the state Parole Board.

So there’s plenty of concern for public safety in this cost-cutting measure, which should see as many as 32 prisoners turned out of prison hospitals or other nearby medical facilities by the middle of next year. More will follow.

“Taxpayers should not be forced to bear the high cost of caring for prisoners who no longer threaten public safety,” Leno said in one legislative hearing. “Rather than continue wasting millions incarcerating these individuals, we could use the funds to keep our schoolteachers employed.”

While California’s convicts cost taxpayers an average of about $47,000 a year, the seriously disabled can cost well over $1 million each. Much of that cost stems from the legal requirement to guard prisoners around the clock, even when there is not the slightest chance they might escape.

As positive a move toward fiscal sanity as SB1399 clearly represents, it should be only a start. Several times this year and last, this column has noted the large amounts wasted not only on paraplegic prisoners, but in many other areas.

At least as much is currently being thrown away by the prisons in excessive medical expenses as on caring for completely disabled convicts.

Those expenses come in the form of payments to community hospitals in rural areas near state prisons. Most such hospitals have resisted for years efforts by the state Department of Corrections and Rehabilitation to negotiate rate agreements similar to those virtually all hospitals make with commercial insurance companies.

These hospitals are where prisoners are sent when hospital medical facilities or staff can’t deal with a particular illness or injury. As it now stands, prisons pay far higher prices for hospital services than ordinary citizens with health insurance.

“We pay at least $100 million – maybe much more – than we should,” complained Clark Kelso, the court-appointed prison health czar, in an interview last year. “We’ve contracted with a major consulting firm that negotiates with hospitals, but they’ve had only modest success. There’s not a lot of competition in the rural areas where more prisons are. Plus, we as a department, tend to pay late. So the hospitals are reluctant to negotiate with us.”

It’s an uncertain legal question whether state government could pass a law compelling hospitals, both private and public, to make such deals. But the high costs prisons now pay are one reason Kelso keeps pushing for new prison hospitals even in bad economic times.

The prisons also use a 30-year-old information system with few electronic files and large stacks of paperwork that can look like the messy evidence lockers of a big-city police department. That means the information Kelso and other top officials get about things like double-billing by hospitals and doctors is often many months old.

Movement toward stopping the waste in the prison system is clearly not fast. But the new law allowing release of the most disabled prisoners represents progress when taken together with new standards aimed at preventing excessive hospitalizations, blood tests and electronic diagnostic scans.


Email Thomas Elias at His book, "The Burzynski Breakthrough," is now available in a soft cover fourth edition. For more Elias columns, visit

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