So you think the $8 billion estimate bandied around as the cost for fixing medical care in California’s prisons might be just a tad high?
So does the court-appointed receiver who’s right now trying to get the first part of that money to start planning construction on high-security hospitals and mental wards for an estimated 10,000 prisoners.
“We may not need $8 billion,” concedes J. Clark Kelso, the Sacramento law professor who has taken charge of all state prison hospitals, doctors, and nurses. “The numbers we’re using could be wrong. Our projections of how prisoners’ health problems will develop might be wrong. There could be a prisoner release of some kind or a change in sentencing policies.”
That, of course, hasn’t stopped his lawyers from fighting for legal sanctions against Gov. Arnold Schwarzenegger and State Controller John Chiang if they don’t turn over $250 million by summer.
“I only want to go through the legislative procedure once, so we’re saying what we need if things keep developing as they are would be $8 billion,” Kelso said.
Whew. The actual cost might “only” be $4 billion or $6 billion or something like that. Most likely not anything less, because voters are not likely to change sentencing policies and allow murderers, rapists, burglars, car thieves, drug dealers, and the like to go free much sooner than they can now. Of course, the number could also be zero, if Schwarzenegger and Chiang win their current court effort and avoid using any more state money to give prisoners legally acceptable care.
In any case, Kelso is essentially telling voters and lawmakers to “trust me.” For when he says he wants $8 billion appropriated right away, but might not have to use all of it, he’s telling us to believe in his evaluations of need.
Meanwhile, Kelso also asserted in an interview that the cost of bringing prison health care up to constitutionally acceptable levels need not bust the troubled state budget. For one thing, the $250 million in startup money he wants was appropriated last year and shouldn’t be part of any budget now under consideration. For another, he says, new facilities can be built with lease-revenue bonds paid off over 30 years or so, just like the other $35 billion-plus in bonds California voters passed with alacrity over the last five years.
But this ignores the fact that paying back $4 billion or $6 billion or $8 billion in bonds would saddle future state budgets with anywhere from $260 million to $600 million in mandatory annual costs. That’s money which could be spent for other things-like avoiding furloughs and layoffs of state workers.
At the same time, there is some prospect that the review of prison health practices spurred by all the legal action might actually save some money in prison operations. Kelso says negligent, lazy contracting practices, plus the fact that more prisoners than necessary now go to outside hospitals for treatment, could be costing the state at least $100 million a year.
But Kelso insists there’s no chance the number of hospital beds needed to house chronically ill and mentally ill prisoners will be any less than half the 10,000 he’s now calling for. Not even with the early releases of convicts now being contemplated both by a three-judge federal panel and in Schwarzenegger’s latest budget plan. “We will get a new analysis of what we need between phases of the project,” he said, insisting there’s a proven need to proceed with building at least three of the seven hospitals in the current plan.
And just why should taxpayers provide mentally ill and aged criminals solid care and quarters when other elderly or mentally ill persons who have committed no crimes frequently go homeless, living on the streets and getting little or no care?
Kelso, who teaches at Sacramento’s McGeorge School of Law, offers a lawyerly explanation. “The moment someone is in custody and under control of legal authorities, the obligation to care for him or her kicks in,” he said. ”For people not in custody, the normal democratic processes determine whether government should provide care. It’s not the same thing.”
The bottom line: There’s a chance the prison hospital fix might cost billions of dollars less than anyone now says. Maybe.
But neither Kelso nor the judge who appointed him will soon lower their $8 billion demand, which means the dispute over prison hospital improvements will be around for months or years to come, with the U.S. Supreme Court most likely making the final decisions.
Elias is author of the current book “The Burzynski Breakthrough: The Most Promising Cancer Treatment and the Government’s Campaign to Squelch It,” now available in an updated third edition. His email address is email@example.com