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Consultants recommend health chief for prison system

By Paige St. John

Consultants hired by the federal agent running California’s prison healthcare system say the state should put medical care for inmates under its own division to “safeguard” the gains made under court oversight.

The creation of an Undersecretary of Health Care is among more than 100 recommendations contained in the organizational draft as the California Department of Corrections and Rehabilitation moves to regain custody of inmate care. Preliminary recommendations were provided to the federal receiver’s office last October and the final report is now circulating.

The document suggests California maximize the amount of federal funding it receives for prisoner healthcare as federal Medicaid programs expand, and seek federal matches for inmate hospitalization. It suggests the state should also prepare for shortages of prison psychiatrists and other mental health workers as expansion of federal coverage increases the overall demand for those providers. The consultants recommend increased use of tele-medicine, in which doctors use video links to “see” patients in remote prisons, and rely more on medical assistants for routine care.

The consultants say the federal receiver’s office employs too many physicians in managerial roles, and the quality of nursing remains inconsistent, especially when it comes to coordinating care of patients with complex conditions as they move between prisons in the system.

The report recommends California’s Department of Corrections and Rehabilitation create an Undersecretary of Health Care overseeing a healthcare division, on par with the current two undersecretaries who oversee prison operations and custody.

“It provides protection from the return of pre-receivership conditions, under which health care matters often went unaddressed for long periods,” the consultants wrote.

Copyright © 2013, Los Angeles Times

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