Inmates' Medical Tab Nears $1 Billion

Paying millions to shuttle prisoners to hospitals hundreds of miles from where they are locked up also faced criticism.

With inmate healthcare spending nearly double what it was in 1999, lawmakers are demanding immediate changes to bring costs into line.

"Even if it weren't a tight budget year, this would be something that is absolutely unacceptable," said Assemblywoman Wilma Chan (D-Alameda).

The attacks on prison spending came at a joint legislative hearing and followed a state audit released in April. The audit revealed that prison officials seek competitive bids for less than a quarter of the contracts they enter into with hospitals, and may be routinely paying claims for services never provided.

The state prison system runs 32 facilities with 160,000 inmates, and healthcare accounts for a significant chunk of its $6-billion annual budget.

Prison officials challenged some of the accusations made by lawmakers, but acknowledged that reforms were needed. "We are using the recommendations contained in the Bureau of State Audit report as a blueprint for change," said Jeanne Woodford, director of the Department of Corrections.

Those recommendations include imposing rules to ensure that contracts are negotiated competitively and imposing uniform treatment standards spelling out what is appropriate and when.

But Woodford warned that the department must abide by a number of court judgments requiring it to provide medical care that may seem excessive.

"We are under court mandates affecting our services," she said.

In many cases, officials say, they are unable to attract trained doctors and nurses to work in the prisons and are left no choice but to enter into costly contracts with distant hospitals.

Prison officials also pointed out that the system must tend to thousands of patients requiring special care, including those with AIDS and other diseases, elderly inmates, prisoners in need of transplants, and paraplegics and quadriplegics.

Lawmakers, however, say the department can do better.