A Costly Burden for State : Sick, Disabled Inmates Are Most Expensive to House; Some Say They Should Be Released if No Longer a Threat, but Judges Usually Free Only the Terminally Ill

In his wheelchair, he looks benign, almost pitiful--this man who was convicted of methodically shooting to death four people in a dispute over drugs five years ago in San Diego.

Carlos Fonseca was sentenced to life in prison without the possibility of parole, and was dispatched as a strapping 28-year-old to Pelican Bay State Prison, the place reserved for the worst of the worst.

His incarceration was supposed to be a custodial no-brainer: Keep him fed, clothed and locked up.

But two years ago his Pelican Bay cellmate gouged out Fonseca’s right eye and bashed his head against a concrete floor, causing severe brain damage.

Today Fonseca languishes in a hospital cell at the California Institution for Men. He is unable to stand up on his own and is incontinent. He is in therapy to learn how to manipulate his arms and legs after three surgeries released the contractures in his limbs.

Fonseca is one of about 200 state prisoners who receive acute hospital level care in California prisons or at nearby community hospitals. More than 1,000 others receive long-term nursing care behind bars. Another 3,000 inmates are being treated for acute mental illnesses.

The disabled inmates include amputees, paraplegics, the blind. Some are debilitated by strokes or by AIDS, heart disease or old age. They are the most expensive and burdensome of California’s 126,000 state prisoners, and under the “three strikes” sentencing law, their numbers are expected to increase as the prison population mushrooms and grows older.

Despite the deepening prison crisis, debilitated inmates such as Fonseca are kept behind bars at considerable taxpayer expense.

“It is neither humane nor productive for our society to keep people in prison when their physical condition has deteriorated to the point that they are no longer a threat,” said Alison Hardy, an attorney with the reform-oriented Prison Law Office.

Legislation to release such prisoners is under study by the Assembly Judiciary Committee staff, but it is doubtful that such a measure could survive the tough-on-crime political climate.

Prison officials say that judges, who must approve early releases, are not likely to let out debilitated inmates who are not terminally ill. The Department of Corrections recommended only four such releases during the past 3 1/2 years and, in three cases, the judges refused.

“I think the limited track record we have with these kinds of inmates shows that the courts are not inclined to grant these releases,” said corrections spokeswoman Christine May.

Inmates who are expected to die of their illnesses sometimes do get out of prison through a “compassionate release” procedure that excludes prisoners sentenced to death and those serving life without parole. But corrections officials are cautious about approving compassionate releases for fear that an inmate will unexpectedly recover and commit a new crime or that the public will protest.

The procedure requires that prison doctors determine that an inmate has less than six months to live. The director of corrections may then ask the sentencing judge to free the prisoner. Sometimes the procedure is so slow that the candidate for release never gets out alive.

During the last 3 1/2 years, prison physicians recommended compassionate releases for 208 inmates, most of them dying of AIDS or cancer. The director of corrections approved 113 of the recommendations and, of those, judges released 69.

But prisoners suffering from non-terminal illnesses almost never receive such releases, no matter how debilitating the disease.

In a first-floor locked medical wing at Vacaville prison, nurses and doctors tend to men who can barely get out of bed--let alone escape. One man suffers from dementia and another from a chronic heart problem. One is paralyzed from a gunshot wound, another from a stab wound. A stroke victim appears oblivious to the glowing television screen on the wall above him.

Sometimes sentencing judges are approached by attorneys or politicians seeking the release of such inmates.

Sen. Robert Presley (D-Riverside), the outgoing chairman of the Joint Committee on Prisons, has tried without success to persuade a judge to release a 28-year-old multiple sclerosis patient who is serving 25 years to life for robbery and murder. Since entering prison, Craig Lundy has gone virtually blind and his body is twisted into a fetal ball.

“The system is making sure he won’t hurt anybody,” said Susan Wallace, Presley’s chief counsel. “He won’t fall out of bed on you and hurt you.”

The only inmate suffering from a non-terminal affliction to be granted an early release from prison was Troy Christian Davey.

Now 26, Davey was involved in the stabbing death of a friend in Yolo County five years ago. An acquaintance of Davey’s wielded the knife and pleaded guilty to manslaughter; he was sentenced to seven years. But Davey refused to plea-bargain and was convicted of second-degree murder. He was sentenced to 15 years to life.

Davey later attempted to kill himself by drinking cleaning fluid in the Yolo County Jail. He was sent to the California Medical Facility at Vacaville where, in January, 1990, he again tried suicide with an overdose of medication. Shortly afterward, he was placed in a small cellblock where prisoners are evaluated for possible placement in the prison psychiatric hospital.

Some prisoners in these special units receive group therapy, others are considered too psychotic to interact with anyone. In one unit visited by a Times reporter, inmates were so mentally ill that they lay on the floor and one had crawled under his bunk. Outside, others paced in one-man, kennel-like exercise cages.

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Corrections officials are under court order to improve care for mentally disturbed inmates at Vacaville, but continually fail to meet the standards set. Earlier this month in Sacramento, U.S. District Judge Lawrence Karlton threatened to jail corrections officials if they do not make the improvements agreed to in a legal settlement with prison reform attorneys.

Charging that corrections officials apparently are “not serious” about improving mental health care, Karlton urged that they consider the volume of criticism and ask themselves, “Can everybody be wrong but us?”

Health care reformers say conditions will grow even worse as a result of “three strikes.”

“I expect it’s going to deteriorate even further,” said Meena V. Meenakshi, who quit her post as chief psychiatrist at Vacaville in protest of conditions. “They’re not geared to taking care of the people who are there already.”

Take the case of Davey, who was locked in a unit reserved for the most deranged inmates. In bare concrete cells behind a double set of steel doors, they are guarded by correctional officers who wear armored vests and goggles as protection against attacks and hurled feces and urine.

Four days after overdosing, Davey tried to hang himself with a sheet. The suicide attempt left him a quadriplegic with the mind of a child.

Davey’s mother, Alice Harris, said that during the next three years she wrote to prison officials and politicians attempting to get her son released as his limbs contracted from atrophy. State records indicate that prison medical personnel stopped giving him physical therapy.

Finally, Yolo County Superior Court Judge James Stevens, the jurist who sentenced Davey to prison, intervened. “Prison wasn’t having any effect on him,” the judge recalled, “because he didn’t know where he was.” Stevens also believed that releasing Davey was a “question of common decency.”

After an inquiry from the judge, a state investigator found Davey barely able to speak. In response to a question, he managed to say, “I’ve been a good, good boy.”

Sent home to Sacramento in March, 1993, Davey is now on probation for life and under the care of his mother.

A lawsuit filed by attorney Christopher T. Cody of Oakland accuses prison officials of failure to take steps to prevent Davey’s suicide attempt, failure to provide proper medical care, and operation of substandard medical facilities at Vacaville.

The Corrections Department denies the charges and says Davey was under close supervision before the hanging.

In Chino, 400 miles to the south, the once-ferocious killer Carlos Fonseca is kept in a locked prison hospital cell, where he is diapered like an infant.

His wife, Janice, clings to the hope that someday she will be able to take him home and care for him. She says he is no longer physically or mentally capable of crime and has no idea why he is in prison.

“He continually asks me why,” she said.