BILL ANALYSIS
SENATE COMMITTEE ON Public Safety
Senator Bruce McPherson, Chair S
2003-2004 Regular Session B
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SB 549 (Vasconcellos)
As Amended April 21, 2003
Hearing date: April 29, 2003
Penal Code and Uncodified Law
SAH:br
INMATES - GERIATRIC FACILITIES
HISTORY
Source: Author
Prior Legislation: AB 456 (Longville) - 1999; failed passage
Assembly floor
Support: California Conference of Bishops; California Peace
Officers' Association; Friends Committee on
Legislation; Older Women's League of California
Opposition:None known
KEY ISSUES
SHOULD SPECIFIED LEGISLATIVE FINDINGS AND DECLARATIONS BE
ENACTED IN LAW ABOUT THE OLDER INMATES IN CALIFORNIA PRISONS,
INCLUDING:
OLDER PRISONERS OFTEN REQUIRE SPECIAL CARE AND ATTENTION
WITHIN THE PRISON SYSTEM. IN ADDITION TO DIFFICULTIES IN
MOBILITY AND INTERACTION, OLDER PRISONERS CAN BE TARGETS OF
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ABUSE BY YOUNGER PRISONERS. OLDER PRISONERS MAKE IDEAL
TARGETS FOR THEFT, EXTORTION, AND EVEN SEXUAL ASSAULT.
(CONTINUED)
THE NEEDS OF THIS GERIATRIC INMATE POPULATION WOULD BE BETTER
ADDRESSED IN SPECIFIED HOUSING FACILITIES THAT ARE SOLELY
DEDICATED TO ADDRESSING THE GERIATRIC INMATE NEEDS. OLDER
PRISONERS ARE AT LESS OF A RISK OF ATTACK AND HARASSMENT IN
GERIATRIC UNITS. WHILE OLDER PRISONERS WILL OFTEN REMAIN IN THEIR
CELLS OR HOSPITAL WARDS IN A GENERAL POPULATION FACILITY, THEY
TEND TO FEEL MORE COMFORTABLE MOVING AROUND WITHIN A GERIATRIC
UNIT, THEREBY REDUCING STRESS AND STRESS-RELATED ILLNESSES AS WELL
AS THE OBVIOUS COSTS OF PHYSICAL ASSAULTS.
SHOULD THE DEPARTMENT OF CORRECTIONS BE REQUIRED TO CONTRACT FOR THE
ESTABLISHMENT AND OPERATION OF ONE SKILLED NURSING CARE COMMUNITY
CORRECTIONAL FACILITY THAT IS SOLELY DEDICATED TO THE INCARCERATION
AND CARE OF INMATES WHO ARE LIMITED IN ABILITY TO PERFORM ACTIVITIES
OF DAILY LIVING AND WHO ARE IN NEED OF SKILLED NURSING SERVICES, AS
SPECIFIED?
SHOULD THE DEPARTMENT OF CORRECTIONS BE REQUIRED TO IDENTIFY ONE
FACILITY OF 500-BED DESIGN IN ONE PRISON IN NORTHERN CALIFORNIA AND
ONE FACILITY OF 500-BED DESIGN IN ONE PRISON IN SOUTHERN CALIFORNIA
TO BE DEDICATED FOR THE PURPOSE OF MANAGING GERIATRIC INMATES IN A
SETTING CONDUCIVE TO THE NEEDS OF THIS POPULATION AND TO MOVE
INMATES INTO THOSE FACILITIES BY JANUARY 1, 2005, AS SPECIFIED?
SHOULD RELATED CHANGES IN LAW BE MADE?
PURPOSE
The purpose of this bill is to enact specified legislative
findings and declarations about older inmates in California
prisons; to require that the Department of Corrections contract
for the establishment and operation of one skilled nursing care
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community correctional facility that is solely dedicated to the
incarceration and care of inmates who are limited in ability to
perform activities of daily living and who are in need of
skilled nursing services, as specified; to require that the
department identify one facility of 500-bed design in one prison
in Northern California and one facility of 500-bed design in one
prison in Southern California to be dedicated for the purpose of
managing geriatric inmates in a setting conducive to the needs
of this population and to move inmates into those facilities by
January 1, 2005, as specified; and to make related changes in
law.
Existing law generally regulates the conditions of
incarceration of prisoners. For example, the Director of the
Department of Corrections (CDC) is charged with the
supervision, management, and control of the state prisons, and
the responsibility for the care, custody, treatment, training,
discipline and employment of persons confined therein. The
director may prescribe and amend rules and regulations for the
administration of the prisons. (Penal Code 5054, 5058.)
Existing law authorizes the Director of the Department of
Corrections to contract with a city, county, or city and county,
to permit transfer of prisoners in the custody of the Director
of Corrections to a jail or other adult correctional facility of
the city, county, or city and county, if the sheriff or
corresponding official having jurisdiction over the facility has
consented. The agreement shall provide for contributions to the
city, county, or city and county toward payment of costs
incurred with reference to such transferred prisoners. Eligible
prisoners transferred to a local facility may participate in
programs of the facility, including work furlough rehabilitation
programs. No agreement may be entered into under this section
unless the cost per inmate in the facility is no greater than
the average costs of keeping an inmate in a comparable facility
of the Department, as determined by the director. (Penal Code
2910.)
Existing law grants additional authority for special facilities
to house parole violators. (Penal Code 2910.5.)
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Existing law authorizes the Director of Corrections to contract
with a city, county, or city and county to construct and operate
community corrections programs, restitution centers, halfway
houses, work furlough programs, or other correctional programs
authorized by state law. (Penal Code 2910.6.)
NOTE: Similar authority is granted the Director of the
Department of the Youth Authority in Welfare and Institutions
Code 1753.3 and 1753.4.
Existing law also authorizes the Director of Corrections to
establish community correctional centers to provide housing,
supervision, counseling, and other services for specified
inmates, who may be granted furloughs from the centers. The
Director is authorized to place the centers in counties or
cities under specified procedures and to contract with
appropriate public or private agencies, to provide housing,
sustenance, and supervision for such inmates as are eligible for
placement in community correctional centers. The Department of
Corrections shall reimburse such agencies for their services
from such funds as may be appropriated for the support of state
prisoners. (Penal Code 6250-6258.1.)
Existing law provides that if the California Department of
Corrections (CDC) Director, Board of Prison Terms (BPT) or both
determine both that the prisoner has six months or less to live
and the conditions under which the prisoner would be released do
not pose a threat to public safety, the CDC director or BPT may
recommend to the court that the prisoner's sentence be recalled.
(Penal Code 1170(e)(1).)
Existing law provides that the prisoner or his or her family
member or designee may request consideration for recall and
re-sentencing by contacting the chief medical officer at the
prison or the CDC director. The CDC director must submit a
recommendation within 30 days of making the aforementioned
determination for prisoners sentenced to determinate terms. For
prisoners sentenced to indeterminate terms, the CDC director may
make a recommendation to the BPT. The BPT shall consider this
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information, and make an independent judgment regarding
eligibility for release. (Penal Code 1170(e)(4).)
Existing law requires that any recommendation for recall
submitted to the court shall include one or more medical
evaluations, a post-release plan, and findings. If possible,
the matter shall be heard before the same judge of the court who
sentenced the prisoner. (Penal Code 1170 (e)(5) and (6).)
This bill makes the following Legislative findings and
declarations:
(a) By law, all prisoners have the right to adequate
and appropriate medical and psychiatric care.
(b) A number of prisoners remain on waiting lists for
appropriate medical and psychiatric care.
(c). It is estimated that the Department of
Corrections has over 5,000 geriatric inmates in
custody with special security and needs.
(d) California will soon confront a major demographic
shift in its correctional system due to the large body
of prisoners currently in or entering middle age.
This demographic shift will sharply change the
operational demands of the system's facilities and
staff as well as contribute to a sharp increase in per
capita prisoner costs.
(e) The Legislative Analyst's Office projects that
the over-55 population will approach 50,000 twenty
years from now, growing at a rate faster than the
prison population as a whole. As these prisoners
enter old age, the system will experience ballooning
hidden costs and systemic problems associated with the
aging process.
(f) California can reduce costs while improving care
for prisoners by making logical, risk-sensitive
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reforms. As the number of older prisoners increases,
a properly managed and centralized system can reduce
costs with the greater efficiency of buying and
dispensing services in bulk. This will bring down the
higher per capita costs of older prisoners and, thus,
the total expenditure for the state.
(g) Older prisoners often require special care and
attention within the prison system. In addition to
difficulties in mobility and interaction, older
prisoners can be targets of abuse by younger
prisoners. Older prisoners make ideal targets for
theft, extortion, and even sexual assault.
(h) The needs of this geriatric inmate population
would be better addressed in specified housing
facilities that are solely dedicated to addressing the
geriatric inmate needs. Older prisoners are at less
of a risk of attack and harassment in geriatric units.
While older prisoners will often remain in their
cells or hospital wards in a general population
facility, they tend to feel more comfortable moving
around within a geriatric unit, thereby reducing
stress and stress-related illnesses as well as the
obvious costs of physical assaults.
(i) Geriatric units can dramatically reduce the costs
of this category of older prisoners while
significantly improving the level of care. For older
prisoners, such units are in great demand, and
facilities like Virginia's Staunton prison and North
Carolina's McCain facility have long waiting lists of
requested transfers. Older prisoners in geriatric
units also live in an environment where staff members
are familiar with their medical, cognitive, and
mobility problems.
(j) Several class action lawsuits have been filed
against the state in cases involving prisoners who
were denied access to appropriate medical care and
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psychiatric services, based on long waiting lists.
(k) To address this problem, it is in the best
interest of the state to contract for skilled nursing
facilities for the care of inmates with long-term care
needs, thereby lessening the burden on the prison
medical care system. Skilled nursing facilities
provide long-term care services in a more specialized,
efficient manner, thereby saving medical care and
psychiatric care beds for other prisoners with acute
care or psychiatric care needs.
This bill :
Further finds and declares that "the purpose of the program
authorized under this subdivision [added by this bill] is to
address the special needs of inmates with regard to the
provision of long-term care in skilled nursing facilities."
Requires the Department of Corrections to contract for the
establishment and operation of one skilled nursing care
community correctional facility that is solely dedicated to
the incarceration and care of inmates who are limited in
ability to perform activities of daily living and who are in
need of skilled nursing services. The skilled nursing shall
address the long-term care of inmates as needed. In addition,
the facility shall be designed to maximize the personal
security of inmates, to maximize the security of the perimeter
of the facility, and to ensure the safety of the outside
community at large.
Requires the department to provide for the security of the
facility's perimeter of the facility in order to ensure the
safety of the outside community at large.
Requires the department to enter into an agreement for a
minimum of 60 months for transfer of prisoners to, or
placement of prisoners in, a private skilled nursing facility
under contract pursuant to this bill.
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Requires the Department of Corrections to develop a memorandum
of understanding with the State Department of Health Services,
outlining the terms and conditions of the contract for the
skilled nursing facility and provides that the State
Department of Health Services shall be responsible for
licensing the skilled nursing facility to ensure that it meets
health and safety standards.
Requires the Department of Corrections to provide for the
review of any agreement entered into under this section to
determine if the contractor is in compliance with the
requirements of this section, and allows the department to
evoke the agreement if the contractor is not in compliance.
Defines, for purposes of these requirements, "long-term care"
to means personal or supportive care services provided to
people of all ages with physical and mental disabilities who
need assistance with activities of daily living including
bathing, eating, dressing, toileting, transferring, and
ambulation.
This bill requires that the Department of Corrections identify
one facility of 500-bed design in one prison in Northern
California and one facility of 500-bed design in one prison in
Southern California to be dedicated for the purpose of managing
geriatric inmates in a setting conducive to the needs of this
population, as follows:
The department shall determine which of the facilities shall
be used for those purposes and shall identify the prisoners
eligible for relocation to the identified facilities.
On or before January 1, 2005, the department shall identify
and relocate the specified elderly prisoners into the two
facilities.
As used in this section of the bill, "geriatric inmate" means
an inmate 55 years of age or older.
COMMENTS
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1. Need for This Bill
The author indicates the following:
California faces significant problems associated with
its growing older prisoner population. The rising
population of older prisoners contributes to hidden
costs associated with rising medical, long term care,
and maintenance costs. The Legislative Analyst's
Office projects that by 2022, the elderly inmate
population will be approximately 30,200, or 16
percent of the total CDC population. If we proceed
on this current course, we could face a severe budget
crisis within the next two decades - based on
exponential increases in correctional costs.
Therefore, California cannot afford to continue
'business as usual' in our prisons. We must examine
effective ways to protect the public's safety while
also being mindful of taxpayer expense associated
with the full cost of care for the increasingly older
prison population.
SB 549 addresses the problem through a two-pronged
approach. First, it requires the Department of
Corrections to contract for the establishment of one
skilled nursing care community correctional facility
that is solely dedicated to the incarceration and
care of inmates who are limited in ability to perform
activities of daily living and who are in need of
skilled nursing services. Skilled nursing facilities
provide long term care services in a more
specialized, efficient manner, saving medical care
and psychiatric care beds for other prisoners with
acute care or psychiatric care needs. By creating
skilled nursing facilities for both elderly and
disabled prisoners, much of the burden will be taken
off of the prison medical system. Several class
action lawsuits have been filed against the state in
cases involving prisoners who were denied access to
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appropriate medical care and psychiatric services,
based on long waiting lists. This bill will allow
prisoners with acute care needs to be moved off
waiting lists and into medical system.
Second, SB 549 requires the Department of Corrections
to identify one facility of 500-bed design in one
prison in the North of California, and one facility
of 500-bed design in one prison in the South of
California to be dedicated for the purpose of
managing geriatric inmates in a setting conducive to
the needs of this population. This is for the
purposes of providing an adequate care system for a
population that needs a higher level of supervision
compared to the entire prison population, but does
not need skilled nursing care. To this end, the
needs of this population would be better addressed in
specialized housing facilities that are solely
dedicated to addressing the geriatric inmate needs.
Older prisoners in geriatric units live in an
environment where staff members are familiar with
their medical, cognitive, and mobility problems.
Geriatric units can dramatically reduce the costs of
this category of older prisoners while significantly
improving the level of care. For older prisoners,
such units are in great demand. Facilities like
Virginia's Staunton prison and North Carolina's
McCain facility have long waiting lists of requested
transfers. Finally, prisoners are at less of a risk
of attack and harassment in geriatric units. While
older prisoners will often remain in their cells or
hospital wards in a general population facility, they
tend to feel more comfortable moving around a
geriatric unit, thereby reducing stress and
stress-related illnesses as well as the obvious costs
of physical assaults.
2. CDC's Current Facts
The CDC runs a statewide system with 33 state prisons ranging
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from minimum to maximum custody - one, the Northern California
Facility for Women in Stockton no longer houses any inmates and
its future is not settled at this time; in addition the CDC
currently is constructing a maximum security prison at Delano
that is not now open. In addition, the CDC has 38 camps,
minimum custody facilities located in wilderness areas where
inmates are trained as wildland firefighters; 16 community
correctional facilities (CCF's); and 5 prisoner mother
facilities.
One of the 33 state prisons is the California Medical Facility
in Vacaville which provides a centrally-located medical and
psychiatric institution for the health care needs of the male
felon population in California's prisons. CMF includes a
general acute care hospital, in-patient and out-patient
psychiatric facilities, a hospice unit for terminally ill
inmates, housing and treatment for inmates identified with
AIDS/HIV, general population, and other specialized inmate
housing. Additionally, the Department of Mental Health operates
a licensed, acute care psychiatric hospital within CMF.
The CDC has developed an inmate classification system as a
method of prison management (new system being phased in
commencing early 2003); all inmates are assigned a
classification based on offense committed, prior history, and
other factors. The classification determines the degree of
custodial supervision which the inmate will require. Level I
inmates are today's "trustees" and are housed in dormitories and
may be allowed to work in prison offices, etc.; Level II inmates
require more custodial supervision but may be housed in
dormitories, etc.; Level III inmates are subject to greater
restrictions and generally are in newer facilities; Level IV
inmates require the highest level of supervision. (Level III
and Level IV are "celled" facilities.) In addition, there are
administrative segregation units within prisons where prisoners
are housed who have committed offenses in prison which require
removal from the general population and there are security
housing units (SHU) in the state prison system where inmates who
have committed offenses while in prison, e.g., serious
assaults/certain gang affiliations, are held in the most
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restrictive custody (23 hours per day in cell; limited access to
open space, movement in prison only while shackled, etc.). One
of the classification factors - and facility and "yard"
assignment factors is the vulnerability of the inmate to "abuse"
by other inmates, for example based on the crime committed or
"debriefing" status pertaining to prison gangs.
The CDC currently houses approximately 6,000 "geriatric" inmates
although age alone is not a final determinate of physical
condition or needs. For example, there are approximately 122
inmates of different ages, not only those over 55 years of age,
who are in a condition requiring essentially 24-hour care.
Thirty seven of those inmates are indeterminately sentence
"lifers" with 1 of those a condemned inmate and one serving a
life term without the possibility of parole.
It does appear that to some extent the CDC does make an
assumption that keeping older inmates mixed in populations
throughout the state has some benefits, such as allowing the
cost of housing those inmates to be included in settings where
there are enough inmates eligible and able to work in the
institutions so that the overall costs of housing older inmates
is not "isolated."
CDC currently does contract for the following facilities, both
with public and private entities:
Community Correctional Facility (PC 6250 et seq.) - 9 private
facilities
Community Correctional Facility (PC 2910 et seq.) - 7 public
facilities
Community Correctional Re-Entry Facilities (PC 6258) - 22
private facilities
Community Prisoner Mother Program (PC 3410 et seq.) - 3
private facilities
Family Foundations Program (PC 1174 et seq.) - 2 facilities
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3. Information Presented on February 25, 2003, at a Joint
Hearing in Sacramento
On February 25, 2003, a Joint Hearing on "California's Aging
Prison Population" was held by the Senate Subcommittee on Aging
and Long Term Care, the Senate Committee on Public Safety, and
the Senate Select Committee on the California Correctional
System. Professor Jonathan Turley (Shapiro Professor of Public
Interest Law and Executive Director of the Project for Older
Prisoners at George Washington University Law School in
Washington, D.C.) presented a statement that addressed a number
of issues and proposals for addressing issues involving an aging
prison population, including (pages 22-24; footnotes omitted):
High-Risk Prisoners: Geriatric Units
Even after low-risk and mid-risk prisoners are
removed from the prison population, there will remain
prisoners who were only recently incarcerated or
prisoners who continue to present a risk to society.
Geriatric units can dramatically reduce the costs of
this category of older prisoners while significantly
improving the level of care. For older prisoners,
such units are in great demand and facilities like
Virginia's Staunton prison and North Carolina's
McCain facility have long waiting lists of requested
transfers. Like most people, older prisoners prefer
to be around people of their generation. This is not
entirely due to a desire for reminiscence, but a
rational desire to improve personal safety and care.
Older prisoners are at less of a risk of attack and
harassment in geriatric units. While older prisoners
will often remain in their cells or hospital wards in
a general population facility, they tend to feel more
comfortable moving around a geriatric unit. Given
the "wolf-prey" syndrome discussed earlier, this
reduces the level of stress and stress-related
illnesses as well as the obvious costs of physical
assaults. Older prisoners in geriatric units also
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live in an environment where staff members are
familiar with their medical, cognitive, and mobility
problems. For example, in a general population
cellblock, there may be one or two old timers among a
couple of hundred inmates. This forces the older
prisoners to move at the pace of younger prisoners in
the hall or to the cafeteria.
There are a myriad of ways that geriatric units
reduce costs by consolidating the population of older
prisoners. As noted earlier, the consolidation of
inmates allows for savings in purchasing and
dispensing of special services in bulk. Dealing with
a small number of older prisoners in general
population units magnifies costs to the institution
in dealing with a small number of prisoners with
special needs. Likewise, some savings result from
the simple transfer to a compatible physical plant.
The very design of many correctional facilities can
cause injuries for older and geriatric inmates as
well as additional burdens for correctional staff.
Cells with accessibility for walkers or wheelchairs
can be a continual problem for both older prisoners
and correctional officers. Multi-tier prisons often
force older prisoners to use long stairways that
dramatically increase injuries. Furthermore, some
costs are reduced in the simple transfer to a minimum
security unit, which is the most common security
level of geriatric units. Since roughly fifty
percent of the operating costs of a facility are tied
to the salaries and benefits of correctional staff,
the increased use of minimum security facilities can
reduce costs through a reduction in the ratio of the
number of correctional officers to prisoners.
One of the greatest savings in the use of geriatric
units is achieved by creating a core of specially
trained correctional officers and medical staff. An
older prisoner on average has 24 medical incidents a
year. Proper training can reduce injuries and
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prevent chronic illnesses. Correctional doctors or
nurses are often ill-trained in early recognition of
geriatric illnesses. As a result, illnesses that
could be treated at a relatively low cost are allowed
to move into a more expensive chronic stage. The
aging process creates a problem called "masking" in
which classic aging characteristics like sullen
features and ashen color can mask illnesses with
similar characteristics. For example, the symptoms
of subclinical hypothyroidism include dry skin, cold
intolerance, poor memory, weight gain, slow thinking,
weak muscles, muscle cramps, puffy eyes,
constipation, fatigue, apathy, and cognitive
impairment. These are the same physical
characteristics of aging and can be easily missed in
a physical examination. By developing special
programs and facilities for geriatric inmates,
properly trained staff can develop greater expertise
and dispense care in a more cost-efficient manner. A
significant number of the clinical visits of older
prisoners are for common ailments such as
hypertension, chronic pulmonary disease, and insulin
dependent diabetes - treatments that can be reduced
in cost through consolidation of medical orders and
clinical visits.
Obviously, geriatric units run against the grain for
correctional experts who still believe in a uniform
policy of mainstreaming. However, the rising
population of older and geriatric prisoners should
demonstrate that there are logical economic and
administrative limits to mainstreaming.
Mainstreaming was designed to achieve certain goals,
it was not supposed to be a goal in itself. When
introduced, it offered great advantages for both
prisoners and prisons. However, the prison
population of the 21st Century is more heterogeneous
and diverse than at any other time in our history.
The failure to make efficient choices and the blind
adherence to mainstreaming principles will impose
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increasing heavy costs on both society and prisoners.
The only way to efficiently control costs and
improve care for older and geriatric prisoners is to
consolidate their sub-population in specialized
units.
4. Possible Questions Raised by This Bill
Contract facilities - should it be mandated or authorized
This bill adds a new Chapter 9.7 commencing with Section
6267 to the Penal Code pertaining to a skilled nursing
care community correctional facility (CCF). CCF's are
generally authorized in Sections 2910 et seq. (contracts
with cities, counties, or a city and county) and 6250 et
seq. (Section 6256 allows contracts with either public or
private agencies). Both CCF sections provide that the CDC
"may" contract for such facilities. This bill does state
that the CDC "shall contract" for the new skilled nursing
facility but does not state any required implementation
date, which is close to the same as "may" contract. It
might be appropriate to simply make this a "may" contract
bill since that is essentially what the bill currently
does as amended.
Either the public and private sector could become the
contracting provider
Presumably both public and private entities could
provide the kind of facility contemplated by this bill.
It is unclear to Committee staff whether or not only the
private sector would be likely to offer such a facility.
Regardless, the CDC would not be restricted to either
sector pursuant to this bill as currently amended.
Designated prisons
This bill does require the CDC to identify and transfer
geriatric inmates to two 500-bed facilities, as
specified, on or before January 1, 2005. Whether or not
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the CDC can respond to that mandate and make those
transfers by that date with appropriately identified
inmates may not be clear. The CDC would need to identify
the inmates, determine classification needs, and then
make those transfers to identified facilities. Other
considerations for the CDC may be the request of inmates
and families to be housed close to family or otherwise
meet other special needs of inmates.
Assumptions that combining geriatric inmates is appropriate
As noted in the testimony cited in Comment #3, above,
there are some who do not feel that housing all inmates
together based upon age is a cost-effective way to handle
an aging population. Given the variety of factors that
apply regarding inmates of any age, the CDC or others may
assert that such housing is not appropriate in many
circumstances.
Cost savings a factor or not
This bill as introduced - prior to the current amended
version - included only a skilled nursing facility
contracting provision that was both limited to "geriatric
inmates" and to housing that cost "less than the cost per
inmate of operating similar state facilities." Given the
mix of cost issues and the replacement savings of
maintaining medical beds for other inmate assignment, it
may be hard to easily quantify the cost savings for such
assignment while at that same time other benefits may
ensue. Therefore the current amended language deletes
both the "geriatric" limitation and the cost
requirements.
Existing court cases
The Court cases of Coleman; Madrid; Shumate (technically
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settled/closed); Gates (folding into Coleman); Clark; and
Armstrong - names of inmates/plaintiffs and now short
reference name - are some of the court cases involving the
operation of the state prisons where the courts have
ordered compliance with decisions, stipulations, or
appointed "special master" to monitor some issue or where
case is in progress (cases referenced deal with:
comprehensive mental health treatment program; health care
services at Pelican Bay State Prison; health care at
women's facilities; and treatment for inmates with serious
mental illness plus issue of separation of HIV infected
inmates); developmentally disabled inmate issues; ADA
issues in general (BPT is Valdivia case). The latest case
is Plata regarding health care.
This bill's language indicates that it will address and
help resolve issues of health care for the inmate
geriatric population.
Technical amendment
It may be that there is a duplication of language in this
bill as now amended and that therefore lines 6-8 on page 4
should be deleted and the subsequent subsections have the
letter "numbering" changed to reflect that deletion.
Those lines essentially repeat the requirement on lines 4
and 5 on page 4.
5. Increasing Numbers of Elderly Prisoners - 2002 Figures
As of June 30, 2002, the mean age of female prisoners was 36;
the mean age of male prisoners was 35.
Male Inmates :
Age Number Percentage
70+ 484 .3
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65-69 651 .4
60-64 1,463 1.0
55-59 3,139 2.1
50-54 6,901 4.7
45-49 13,477 9.1
Female Inmates :
Age Number Percentage
70+ 19 .2
65-69 21 .2
60-64 70 .7
55-59 163 1.7
50-54 434 4.4
45-49 977 9.9
Life Term Inmates
Female :
Lifers (not strikers) 942
Third Strike 69
Male :
Lifers (not strikers) 19,874
Third Strike 7,222
6. Legislative Analyst's Office Analysis of the 2003-04 Budget
Bill
The LAO Analysis of the 2003-04 Budget Bill does contain a
discussion of the "early release" of elderly inmates. While
this bill does not propose the "release" of any inmates, the
following is arguably relevant to consideration of this bill:
In addition to the special needs that generally come
with aging, there are some unique factors about
prison that make housing elderly inmates potentially
more costly. First, inmate demographics and prior
lifestyles probably result in a concentration of
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SB 549 (Vasconcellos)
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individuals more prone to certain health conditions
such as diabetes, heart disease, and hepatitis.
Second, the full cost of prison health care services
is borne by the state, rather than shared as in an
insurance program. Third, the cost of prison health
care services is accompanied by the cost of guarding
the inmate while services are delivered. This is
particularly an issue when the inmates need to be
transported to an outside facility for medical
treatment. Fourth, CDC is not equipped to
effectively manage the health care needs of elderly
inmates. For example, the department does not have a
chronic care management program for elderly inmates
that might allow it to prevent some inmates from
requiring expensive medical treatment.
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. . . By 2022, we estimate the elderly inmate
population will be approximately 30,200, or 16 percent
of the total CDC population. Preparing California's
prison system for this number of elderly inmates will
likely be extremely costly. This is because, it would
likely involve facility renovations, as well as a
change in the manner in which health care is
delivered, and potentially expensive treatments for
such age-related illnesses as cancer and heart
disease.
7. Support for This Bill
The California Catholic Conference of Bishops letter in support
of this bill includes:
It is estimated that the Department of Corrections
has over 5,000 geriatric inmates in custody with
special security and long-term heath needs. The
needs of these inmates would be better addressed in
smaller institutions that are solely dedicated to
addressing these needs. It would be significantly
less expensive to house older inmates with long-tem
care needs in specified freestanding facilities.
8. Related Legislation
SB 278 (Ducheny) - currently in the Senate Appropriations
Committee - requires that the Board of Prison Terms and
Department of Corrections, notwithstanding any other provision
of law, release on parole placement to a medical facility
prisoners for whom one or more of listed medical conditions are
met, and who are determined by the Board of Prison Terms or the
department, as applicable, not to pose a threat to public
safety, as specified. SB 278 is not limited by age but does
require that the inmate "is physically or medically
incapacitated by a medical condition that renders the prisoner
permanently unable to move without assistance, or permanently
unable to perform activities of daily living without assistance,
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including, but not limited to, dressing, feeding, ambulating, or
maintaining personal hygiene."
One of the arguments in support of SB 278 is that inmates on
"medical parole" outside of a state prison may qualify for other
private or public "assistance" such as Medi-Cal or veteran's
funding. However, those inmates would be limited not only by
physical needs for assistance but also by a determination of
either the Board of Prison Terms or the CDC that such inmates
are not a threat to public safety, so that SB 278 release might
not be an option for some number of inmates who might be placed
in a CCF skilled nursing facility as proposed by SB 549.
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