SAN FRANCISCO — The federal receiver hired to improve healthcare for state prisoners released an ambitious turnaround plan Thursday, prompting some critics to warn of exorbitant costs and others to lament the sluggish pace of reform.
The 50-page plan "will eliminate the unconscionable human suffering" in prison and protect California communities from diseases carried by inmates cycling in and out, receiver Robert Sillen said in filing the document with the federal court here.
Over time, he said, taxpayers will get more for their dollar from a system that experts said was so broken that it experienced an average of one inmate death per week as a result of medical incompetence or neglect.
"Good care is less costly than bad care," said Sillen, who has predicted it will take as long as 20 years before the sprawling medical operation is fixed and handed back to the state.
Sillen, 64, was appointed by U.S. District Judge Thelton Henderson after Henderson concluded the state was incapable of fixing prison medical care on its own. He has been on the job a year and earns an annual salary and compensation package totaling $650,000.
Lawyers for inmates initially hailed his appointment as a prescription for a $1-billion-plus medical care system that they said was understaffed, riddled with incompetent doctors and plagued by an absence of standards and a shortage of basic supplies, such as bandages and hand soap.
Now, however, they say their hope is tempered by frustration that Sillen has not moved faster on problems directly affecting inmate care.
Attorney Steve Fama of the nonprofit Prison Law Office, whose civil rights suit led to Sillen's appointment, said that a year ago he gave the receiver a list of seven prisons with the most severe medical crises. One was San Quentin, where Sillen established a pilot program for improving care. Another was Avenal, near Coalinga in the San Joaquin Valley, where three inmates died in December.
In response to the deaths, Sillen sent a team of doctors and created more than 50 new medical positions at the severely overcrowded prison.
"That action is terrific," Fama said. "I just wish it had been done months before that, given his authority and his mission as defined by the judge."
Sillen also has taken his lumps in the Legislature. Some lawmakers are chafing at his blunt style, while others are furious over the prospect of spending billions on inmate healthcare with no legislative control.
