Transcript: Assemblyman Tom Ammiano’s Q&A with LAO analyst Drew Soderborg on the impacts of overcrowding on medical and mental health care in California prisons before the Assembly Select Committee on Justice Reinvestment on Oct. 21, 2013

Partial transcript of Assemblyman Tom Ammiano’s (D-San Francisco) Q&A with Drew Soderborg, Managing Principal Analyst, Corrections, Transportation, and Environment, at the Legislative Analyst’s Office, on the impacts of prison overcrowding on medical and mental health care in California’s prison system. The hearing before the Assembly Select Committee on Justice Reinvestment was held on Oct. 21, 2013:

Assemblyman Tom Ammiano (D-San Francisco):
Is there still a medical staff shortage?

Drew Soderborg, Managing Principal Analyst, Corrections, Transportation, and Environment, at the Legislative Analyst’s Office:
So the receiver continues to face staffing challenges, but the extent of the challenges have really been reduced in recent years. So, for example, in 2006, the vacancy rate for physicians was about 29% on a statewide level and now it’s down to 12%. The vacancy rate for nurses and pharmacy professionals was around 30%. The vacancy rate for nurses is now down to 16% and the vacancy rate for pharmacy specialists is around 23%.

But it is important to note that while improvement has occurred on a system-wide level, there is large amounts of regional variance. So a good example of this is that Chuckawalla Valley State Prison, Salinas Valley State Prison, and Pelican Bay State Prison still have vacancy rates in the physician classification that exceeds 30%.

Assemblyman Tom Ammiano (D-San Francisco):
What’s the status of the electronic medical records system?

Drew Soderborg, Managing Principal Analyst, Corrections, Transportation, and Environment, at the Legislative Analyst’s Office:
So within the last month, the receiver submitted a feasibility study report to the legislature to implement an electronic health records system and the receiver has also briefed the legislature on what it envisions the project to be. It estimates that it will begin rolling the system out to the prisons beginning around 2015.

Assemblyman Tom Ammiano (D-San Francisco):
Has the death rate of inmates decreased since the receiver has taken over? Not just because there’s been a reduction of population but in better care or not as good care?

Drew Soderborg, Managing Principal Analyst, Corrections, Transportation, and Environment, at the Legislative Analyst’s Office:
Yeah, the rate of preventable deaths per 100,000 inmates has generally declined under the receivership. So in 2006, it was about 40 per 100,000, and in 2011, it was at 27 per 100,000.

Now, if you don’t look just at preventable deaths but you look at the overall death rate, that has actually moved around a little bit. So it was 255 in 2006. It went down to 217 in 2008. And then it was back up again to 240 in 2011.

But really in some ways probably a more direct measure of the quality of health care is the preventable death rate.

Assemblyman Tom Ammiano (D-San Francisco):
…Maybe we could talk about mental health and what’s been happening with that.

Drew Soderborg, Managing Principal Analyst, Corrections, Transportation, and Environment, at the Legislative Analyst’s Office:
Yeah, so CDCR has made a series of changes to improve its mental health care. One of the most significant changes it’s made is standardizing its operations and procedures across the state. That was done in 2009. It’s also completed or initiated several major construction projects to try to increase the capacity of its mental health care system. The CDCR has indicated to us that waitlists for its inpatient mental health beds have been reduced significantly. So those give you a flavor of some of the improvements made to date.

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