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From humanity to health: Why can’t California get prison healthcare right?

Jonathan Simon, professor of law | February 10, 2014

To considerable embarrassment, no doubt, in the Brown-Beard administration, admissions to California’s newest prison near Stockton California were halted Feb. 5 by the court-appointed healthcare receiver, law professor Clark Kelso.

The prison, the first new facility in a decade, is the lynch-pin of the administration’s frequent claim to have gotten on top of California’s decades old prison health care crisis.  The prison is the first of its kind to be purposely built to house and care for many of the state’s seriously ill prisoners, whose suffering in the grip of the state’s chronic overcrowding led the Supreme Court to describe the state’s system as unfit for a civilized society (see Brown v. Plata, 2011).

Under pressure to show that it can make progress in reducing that overcrowding, the administration is no doubt frustrated to have to halt adding inmates to the facility intended to hold nearly ,1800 prisoners at full capacity.

But Receiver Kelso’s order, and the report that accompanied it, raises more basic questions as to whether the State has yet drawn any lessons, from its decades of human-rights abuse,  about what it takes to operate prisons that respect human dignity as required by the Constitution (as well international human rights conventions to which the state is answerable through the courts of the United States).

So what went wrong in this brand new prison designed from the ground up to deliver health care?  Problems with the radiation-treatment equipment for cancer patients? Problems staffing the dialysis center? Actually the problems were a bit more basic.  As reported in the Sacramento Bee):

A shortage of towels forced prisoners to dry off with dirty socks; a shortage of soap halted showers for some inmates, and incontinent men were put into diapers and received catheters that did not fit, causing them to soil their clothes and beds, according to the inspection report and a separate finding by Kelso.
The report also said there were so few guards that a single officer watched 48 cells at a time and could not step away to use the bathroom.
Kelso said the problems at the facility call into question California’s ability to take responsibility for prison health care statewide. He accused corrections officials of treating the mounting health care problems as a second-class priority, the newspaper said.

Spokes persons for the administration described the situation as a normal glitch associated with the rolling out of a new facility.  Perhaps. But it also looks like business as usual in a system where medical neglect of chronically ill prisoners went on for decades under the deliberate indifference of prison administrators and governors.

Rather than apologize to the citizens of this state and seek to make amends to the prisoners, former prisoners, and correctional workers forced to experience and participate in those degrading conditions, the administration has continued with smugness to defend the status quo, with an attitude that borders on contempt to the courts.

Is it surprising that actors never held to account for their human-rights violations cannot create conditions that respect human rights? Good healthcare takes medical professionals and modern infrastructure, which appear to be still lacking to a significant degree even in this brand new purpose built “Health Care Facility.”

But healthcare also takes humanity.

A prison system that can’t get that right, can ‘t run its healthcare system and shouldn’t be allowed to continue to operate prisons on which the good name of the people of California is stamped.

Cross-posted from Jonathan Simon’s blog Governing Through Crime.

Comments to “From humanity to health: Why can’t California get prison healthcare right?

  1. Please consider sharing this work with The American Prison Writing Archive (APWA), which is a digital archive recently established by the Digital Humanities Initiative at Hamilton College, Clinton, New York under Professor Doran Larson. It seeks contributors who write with the authority of first-hand experience. From their site:

    “All topics are of interest, including descriptions of sources of stress, ways of coping, health care, causes of violence and ways to reduce violence, material conditions, education, employment conditions and the challenges these conditions present, the environment for volunteers, the aging prison population, visions of a better way to operate (personally, politically, institutionally, etc.), reflections on the work of dealing with time inside (for workers as well as prisoners), the challenges of physical and psychological survival, public perception and popular depictions of prisoners and prison workers, the politics and economics of mass incarceration, what works and why it works, and what doesn’t work and why it doesn’t work (i.e. practical views on reform), etc. We are open to any testimony about the issues that matter to prison staff, administrators, corrections officers, teachers, volunteers, and prisoners.

    We value writing that takes thoughtful, constructive positions even on passionately felt ideas.

    The APWA is intended for researchers and for the general public, to help them understand American prison conditions and the prison’s practical effects and place in society. All the work in the APWA will be accessible to anyone, anywhere in the world with access to the Internet. The APWA will open the American prison to public observation, and showcase the thinking and writing being produced inside.

    Once included in the APWA, work will be retained indefinitely. Contributors can write under pseudonyms or anonymously. We reserve the right to edit or reject work that advocates violence, names names in ongoing legal cases, or libels named individuals. The APWA is not currently accepting poetry or fiction.

    We accept art (on a single 8.5×11 page) only if accompanied by an essay. A signed permission sheet must be included to post work on the APWA. By signing on the signature line below, you are granting us permission to include your work in the APWA. The questionnaire information will be used to offer researchers points of reference (for example, to study the specific concerns of staff who are veterans, or of Black and Latino men in maximum-security facilities).

    There is no deadline. We seek the widest possible gathering of American prison writing, and we will read, scan, and transcribe essays into the APWA on a continuing basis. Previously published work is acceptable if authors retain copyright. Please let us know where and when your essay appeared in print.

    Non-fiction essays, based on first-hand experience, should be limited to 5,000 words (15 double-spaced pages). Clearly hand-written pages are welcome. We charge no fees. We will read all writing submitted.

    There is a PDF form to submit with your essay. It includes the usual stuff — name, age, address, date, prison facility. It also includes an optional questionnaire to help the archivists digitally tag and organize essays.

    Please share the project, the link, and the address below far and wide.
    Mail essays to: APWA, 198 College Hill Road, Clinton, NY 13323.

  2. Torture of Minority Patients by California Department of Corrections.

    My name is Paul, I’ve been a Nurse since 1984, a paramedic firefighter and group home manager before that. My training is inner city ER Nursing, I also do floor, ICU, and disaster response. I’ve worked in Tampa Fl, Oakland, and San Francisco, am a Red Cross Volunteer and US Army Medical Officer during Desert Storm. I love dogs, search and rescue and biking. I am on a mission to stop Torture at CDCR.

    In 2006, I worked at Atascadero State Mental Hospital. I learned that mental illness can be treated. With compassionate, professional care, many returned to loved ones and society. No Torture was used, the concept counter to modern medicine.

    After transferring to the California Department of Corrections and Rehabilitation (CDCR)-run “California Men’s Colony State Prison” in 2007, I was given a month of training and told that abuse, be it physical, mental, or sexual, was not allowed.

    Assigned to the “Mental Health Crisis Bed (MHCB)” unit, I found 80+ Patients suffering Torture, sexual abuse and neglect. President Obama would recognize it as Torture. The vast majority of Victims Black or Hispanic, all the abusers White.

    Cold, dark cells hold captives in isolated sensory deprivation. Drugged, sick and in pain, nurses prevented death only to prolong torment, sometimes for years. Patients suffering preventable deaths during “medical treatment” in CDCR facilities may exceed all legal executions nationwide.

    Disguised as a Mental Health Ward, it’s a dungeon. Most naked, all privacy and possessions gone, I now suspect many are also innocent. Cut off from the world, they have no voice. Confined to a small cement box 24 hrs. a day with no exercise, yard privileges or sunlight, disease, psychological damage, and deaths are predictable. No effective medical care is possible in these conditions.

    I had never seen intentional harm done to patients in a medical facility. I’ve protected patients from attacks in the past — criminals, drunken husbands, rival gang members, etc, never Law Enforcement Officers. Having worked in Germany, I know the stigma created by medical professionals who helped run Hitler’s death camps, like Dr. Mengele. Conditions at CMC are strikingly similar.

    For years, I couldn’t understand how this could be happen in Californa, in the USA, after Martin Luther King’s Message, after electing President Obama…. The video of an Officer allowed to Strangle a Black Man to Death helped me understand, as did the report on CIA black Prisons and other events. It’s like the KKK with badges.

    Immune to legal or ethical restraints, a policy of abuse targets minorities. Videoing the attacks at least creates a record. At CDCR, videoing is a criminal offense, cameras searched for, abusers safe, victims isolated, vulnerable and alone.

    Autopsies by CDCR doctors never mention Torture. Victims can be attacked without concern that it will be reported, recorded or punished. Protected from discovery, abusers don’t need to hide under sheets.

    I know this first hand. I tried to report the abuse, from poisoning to attempted murder. Supervisors did nothing. My report to the Chief Medical Officer, Dr. Meyers, was removed from his mail box. Many tried to follow the Nurse Practice Act, requiring us to report abuse. Most lost their jobs immediately, even union reps.

    Abuses at CDCR are so similar to the CIA’s, I now wonder if they were being tested on prisoners. Being isolated in a cold cement room seems a standard, as does the infliction of pain, hopelessness, sexual degradation, threats and punishment for staff refusing to participate. Many CDCR Officers have experience in military prisons.

    Using Military-grade Pepper Gas, victims experience the pain of being burned alive. Massive poly-drug overdoses induce hallucinations and psychosis. I suspect these, too, will turn out to be CIA techniques. Approximately 20% of CIA victims were innocent. My patients have no secrets, but I suspect many are also innocent.

    I treated Torture victims from the Gulf States and Africa, now America. Techniques used are designed to break enemy forces, avoiding the Geneva Convention by leaving no marks. Here are a few, some are so degrading I can’t speak of them:

    Isolation – considered worse than beatings, rapes and starvation by sufferers like kidnap victim Amanda Knight. In 1829, Quakers used it to force salvation. Than as now, mass insanity and deaths result. The UN calls it Torture, medical research agrees.

    Mind Altering Drugs – causing terrifying hallucinations, psychosis and suicide are abused, thousands of doses kept in open, uncounted bins.

    Stripping victims – of all clothing, bedding and privacy is practiced in China, N. Korea, and CDCR. Females than verbally ridicule the men, an Abu Ghraib technique.

    Substandard Care – Baseline needs (Maslow’s Hierarchy) are not met. Patients respond to compassionate, professional care. Sadistic Ritual Abuse may have value to White Supremacists, Sociopaths and Sadists, but no medical, psychological or rehabilitative use. Without sunlight, hope, or human contact, suffering replaces modern medicine.

    Forced Feeding – Used in medically necessary situations, it’s bloody, painful, and dangerous. As punishment, I feel it’s a form of degrading rape. Attackers all powerful, victims left in pain, violated, penetrated and degraded. One brave US Navy Nurse is now on trial for refusing to participate in this Torture. He may be in Isolation.

    Pain – is constant. Besides cement beds, shackles, temperature extremes, etc, a Chemical Weapon, Military Capsicum replaces the rack. Attacking neural receptors, patients experience 10 out of 10 agony. It damages lungs, eyes and can be fatal. Naked patients genitals are targeted, cries of “I can’t breathe” and “I give up” ignored. Massive volumes turn cells opaque, the air poisonous, an execution method similar to Hitler’s, whose sick SS Leaders are still being hunted down worldwide.

    Coating the patient with oil, than a fine power irritant, a screaming horror jokingly called a “powered donut” is created. No cleaning of the unit is done, all patients are exposed and fans used for further mass punishment, the powder weapon airborne. Patients have only toilet water for decontamination, an ineffective, unsanitary, degrading policy.

    CIA Tortures, now too Un-American for terrorists, are used against Americans on a mass basis. The CIA calls Rectal Torture “rectal feeding”, pretending to be medical treatment. CDCR hides dark deeds behind this mask of “Medical Care”.

    Preventing abuse reports is vital and retaliation swift. Murderers are given addresses, data on children and SS#’s, of objecting staff, all present in State Records. Solicited to do violence, motives are provided, with one RN’s wife suffering permanent injuries. Hate letters circulate widely, some signed, spreading fear and job loss. This concentrates the number of unethical staff, especially supervisors. A “Code of Silence” is enforced, graduate nurses learn never to report abuse.

    Lindsay Hayes, of the National Center on Institutions and Alternatives, was commissioned by the State. He found CDCR’s practices increased deaths. Stripped, with no possessions, held in small cells and sleeping on cement floors CDCR’s treatment “punitive” and “anti-therapeutic.” Guards, not Medical Professionals, controlled the conditions within the cells. Worse, he noted that CDCR employees sometimes falsified watch logs.

    In my case, I saved a group of abandoned patients. The abuser falsified 90+ watch logs, claiming her absence couldn’t have been seen because I was “sleeping,” costing my job and pension despite the fact that she was not in the building. She continued work as usual, immune to the “zero tolerance policy”. She withheld Life Saving Equipment from a black man in respiratory arrest, was allowed computer use to look up data on ethical staff, etc. Supported by Supervisors, she did not work alone.

    When caregivers can’t report abuse, patients can be harmed with impunity, raciest and sexual abuse open-ended. My attempts to stop the abuse, include contacting State and Federal authorities, none acted. Both the UN and Amnesty International have reports of Torture at CDCR but can do nothing.

    After my continued reports, CDCR wasted approximately $30,000,000 on a new “treatment” facility at CMC, hiding the Dungeon, but run by the same folks, some promoted. Supported by Billions in tax dollars, reports from inmates and other professionals indicate CDCR is running many such facilities.

    Why put minority patients there? Diseases thrive, suicide is endemic. Many told of being framed by Law Enforcement. One Officer in particular, 30 years a State Records Expert, supported the abusers, refused to stop actions harming both patients and staff. She lied in court and may have impacted thousands of cases, isolation and brain damage hindering victims attempts to find justice.

    Like Hitler’s “treatment solutions”, nurses must not cooperate. As a nation, it tears us apart, as a State, it wastes Billions and will eventually be exposed. As Ferguson shows, raciest Law Enforcement is no longer a welcome standard in America.

    I noted events (often called footprints) common to sociopaths, like inflicting cruel and unusual physical and psychological Torture, “suicides” and clever deceptions. High functioning Sociopaths can leave a trail of injuries and deaths with no obvious perpetrator. Charles Manson would approve.

    Isolation removes the victims voice, screams unheard. Like Amanda Knight, chained to a wall, surrender is not an option. Sociopaths love tormenting helpless captives, often children, the retarded and mentally ill. A euphoric, sexual need escalating over time. Racists profess to torment only minorities. Both would feel at home in CDCR.

    Some victims are my fellow veterans and, innocent or not, Black or White, all need rescue now.

    Paul Spector RN, EMT-P, CPT. US ARMY Ret.

    Dedicated to Ousmane Zongo, Timothy Stansbury Jr., Sean Bell, Ramarley Graham, Eric Garner, Akai Gurley, Michael Brown…Tear Drops of death in an Ocean of Legalized Hate.

    “I believe it…to be cruel and wrong…I hold this slow and daily tampering with the mysteries of the brain, to be immeasurably worse than any torture of the body”. — Charles Dickens, after visiting Isolation prisoners at Eastern State Prison.


    Googling: Why Solitary Confinement Is The Worst Torture is a primer,
    “Torture Inc. Americas Brutal Prisons” from has video. The smells, screams and sadistic horror can only be appreciated first hand.

    On 01/22/2009 President Obama’s Executive Order 13491 banned Torture. It violates Core American Values and “under my administration the United States does not torture”. This agrees with UN and International Law that, so far, are ignored at CDCR.

    Many professionals report the abuse, like Dr. Everett Allen. In April 2014, fallowing weeks of graphic court testimony and chilling videos of inmates writhing in pain, a Federal Judge found use of force against mentally ill inmates in California prisons to be unconstitutionally harsh, confirming my our observations. Citing “horrific” videos and a wealth of other evidence (my letter perhaps?) U.S. District Judge Lawrence K. Karlton ordered state officials to continue revising the use-of-force procedures deployed against the state’s 33,000 mentally ill prisoners and limit the use of solitary confinement as a means of discipline.

    Mass insertion of feeding tubes is now used on prisoners protesting Isolation Torture. Emmeline Pankhurst wrote about its use on women seeking to vote: “Holloway (Prison) became a place of horror and torment. Sickening scenes of violence took place almost every hour of the day, as the doctors went from cell to cell performing their hideous office. I shall never while I live forget the suffering I experienced during the days when those cries were ringing in my ears.”

    Kemp Yarborough’s death by pepper spray, is a murder investigation. This rare glimmer of justice has not shown on CDCR. Death during Torture is never “suicide”. Evidence, like Joseph Duran’s body, can be destroyed, but the truth is clear. The murderer of 2 MYPD officers served in prison. If he suffered isolation or Torture, suicide and violence are predictable, fear of abuse a factor in cooperating with police.

    Mass Torture of minorities is a Hate Crime, a Crime Against Humanity that California taxpayers should not be financing. Those participating need prosecution. Despite the California Board of Nurses ignoring the Nurse Practice Act, and intensive retaliation, my attempt to report patient abuse continues, an RN’s duty.

    Racism is a cancer to the spiritual and economic fabric of society. To look the other way is to support policy that may well destroy America as a land of freedom, bringing suffering and violence to millions. The coverup of my Abuse Reports was poorly done, players identified in court papers and sworn testimony. Patients need medical care, families of the dead need to be told the truth. Only by exposing the dungeons and punishing the leaders will this practice stop, until than, like a puss pocket, it will only get worse. It will not only target minorities, but, as in N. Korea, anyone supporting freedom. This violation of the US Constitution requires action.

  3. Here is a story you may be interested in about a California prisoner who has become an artist in jail and is looking to help others do the same:

    We are trying to help spread the word by creating a documentary film. Here is a link to the Kickstarter Campaign. Please contact me with any questions and if you are interested help spread the word.

  4. The situation is even worse than described in professor Simon’s article. It’s not just lack of soap and towels. A recent report in the Los Angeles Times cites incidents of inmates forced to go without shoes, confined to broken wheelchairs, and left overnight in their own feces. In addition, it reports an incident of a bleeding inmate who died when his repeated requests for help were ignored.

    I’ve been to the Stockton Health Care Facility representing inmates there. I have to admit, it looks very impressive. But, after reading of the recent problems there, its apparent that looks are the only thing impressive about it. It’s also apparent that it is nothing but window dressing that won’t do a thing to stanch the gaping wound that is the State’s prison healthcare system.

  5. “smugness to defend the status quo”; those who are in management or within the union structure for years do honestly believe they know what is best even in the face of the obvious. Having worked in the prison healthcare for a few months, I can attest to the failure of administrators (including Kelso) to respond to staff concerns regarding the quality of healthcare.

    Administrators, we are talking high paid PhD’s and MD’s, are deeply rooted in not only their own delusions of grandeur, but in pleasing the security/prison staff to the degree of compromising the health and safety of inmates, as well as staff. This group of administrators do not function from best healthcare practices, nor quality oriented outcomes, but personal career politics, laziness and a significant lack of skill and knowledge about what to do.

    Mr. Kelso is not responsive internal to the corrections department staff; he, and the receivership staff, are engrained within the prison healthcare hierarchy; they seem to use these exercises to dispel community, staff and inmate restlessness (public relations) than to approach change with integrity and honesty.

    After 20 years of working in healthcare, the experience of being in CA prison healthcare was my first ride into oblivion, a place that words or stories cannot describe, a place of harsh realities; where the human potential for violence is met with silent appreciation.

  6. It’s much more than embarrassment – we can no longer say that CDCR is not corrupt. There is no humanity, no compassion and certainly no empathy.

    I am beyond disgusted and I hope the 3-judge panel slams Gov. Brown and CDCR by placing the entire system under federal oversight. More than 20 years and Plata-Coleman and CDCR still cannot get it right? Not even a slight improvement?

    What really gets me, is why aren’t the taxpayers up in arms? I know that answer; sadly it is because there is no feelings for people in prison.

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