Prison Health Chief Set

Times Staff Writer

Ending a nationwide search, a federal judge has picked the top health official in Santa Clara County to take charge of California’s deeply troubled prison healthcare system, sources familiar with the selection process said Saturday.

Bob Sillen, 63, is expected to be formally appointed as a federal receiver on Tuesday by U.S. District Judge Thelton Henderson. The San Francisco judge decided to act after concluding last July that “extreme measures” were needed to fix a system that kills one inmate each week through medical incompetence or neglect.

The move effectively shifts power from state to federal authorities for all decisions related to inmate care -- including medical staffing, treatment standards and contracts with outside hospitals.


Legal scholars said the appointment marks the first time a government operation of this size has been placed under a federal receiver.

This week, the sources said, Henderson will issue an order detailing the extraordinary powers Sillen will have in managing the system, which provides healthcare for 168,000 inmates and employs 6,000 people in 33 prisons.

Details of Henderson’s order remain closely guarded. The sources spoke to The Times on condition of anonymity because they were not authorized to discuss it.

A spokesman for the state Department of Corrections and Rehabilitation, Todd Slosek, said officials “look forward to working with whomever the judge picks to help us manage healthcare in our prisons.”

Sillen was out of town and could not be reached Saturday. On Friday, he abruptly announced his resignation as director of the Santa Clara Valley Health and Hospital System, a multifaceted medical and mental-health care empire that has 6,200 employees and a $1.4-billion budget.

Although he declined to reveal his plans, Sillen told the San Jose Mercury News that his new job would be announced this week and would involve “a major turnaround effort” related to healthcare in the nonprofit sector.

Healthcare providers who have worked with Sillen described him in interviews as hard-nosed, blunt, extremely competent and a lifelong crusader for quality healthcare for the poor.

They said he arrived in 1979 to head a hospital -- Santa Clara Valley Medical Center -- that was beset by fiscal distress, low staff morale and other problems and turned it into one of the most respected healthcare institutions in the state.

“He is one of the most progressive, innovative and aggressive public health administrators I’ve known,” said Rhonda McClinton Brown, executive director of a coalition of community clinics in Santa Clara County. “He has really pushed the envelope of public hospital care with Valley Medical Center.”

McClinton Brown predicted that in his new job as czar of state prison healthcare, Sillen will “rip it apart and clean it up and put it back together again.”

Though McClinton Brown called him adept at dealing with public officials, others have described Sillen as controversial, and pushy in his determination to provide quality medical care to the poor and uninsured.

In a 1994 interview with the San Jose Business Journal, Sillen described himself as “a pragmatist with a heavy ideological overlay.”

“Some people think I’m absolutely a pain in the ass,” he said in another 1994 interview, with the Mercury News. “But that’s OK. God forbid one goes through life ... not doing anything meaningful enough for anyone to care about. That’d be terrible.”

Sillen was raised in New York and graduated from the University of Denver in 1965. He went to work for the U.S. Public Health Service and sought to stem the spread of sexually transmitted diseases while based in a Harlem clinic, according to Who’s Who Among Human Services Professionals and past profiles in the San Jose Business Journal.

He later obtained a master’s degree in public health at Yale University and became a hospital administrator. Through the 1970s, he held top positions at the University of California Medical Center in San Diego.

Since 1993, he has overseen a network in Santa Clara County that includes a hospital, a string of community clinics, the public health department, and also mental-health and drug-abuse programs.

Sillen also has joint responsibility, with corrections officials, for healthcare inside Santa Clara County jails and juvenile facilities. A grand jury report in April concluded that the county provided high-quality care for its adult inmates, but that the cost of care was high compared with what was spent on medical benefits for a comparable number of county employees.

In Santa Clara, Sillen earned an annual salary of $244,129, making him the county’s top-paid public official. As receiver, he is expected to be paid considerably more during a tenure that would last several years.

Henderson, the federal judge, announced his decision to name a receiver last summer, after a series of hearings during which court-appointed experts decried healthcare conditions in prison medical facilities. They testified as part of a lawsuit challenging the quality of inmate healthcare.

The case was settled in 2002, when the state agreed to overhaul inmate healthcare and phase in improvements by 2008. But the experts found few signs of progress, testifying that filthy conditions, ill-trained and neglectful doctors and a dearth of staff added up to a pattern of preventable deaths that one witness said was unlike anything he had ever seen.

To help him find a qualified receiver, Henderson hired an international search firm, Korn/Ferry International Inc., which developed a list of candidates. Henderson picked Sillen from four finalists with a range of experience in the public and private sectors.

The California receivership, experts say, is unprecedented in its scale. In 1995 the District of Columbia’s jails were assigned to a receiver for five years, but that system had only 1,700 inmates. The state prisons hold nearly 100 times that number.

In Texas, a lawsuit in the 1970s led a federal judge to appoint a special master as a monitor, but a receiver’s powers are far greater, involving the day-to-day management of the system, rather than oversight.

Adult prisons are not the only piece of California’s correctional system under court supervision. The state’s juvenile facilities, home to about 3,000 of its most troubled juvenile offenders, are under the supervision of a special master, who monitors compliance with court-ordered improvements in inmate medical care, mental-health care, education and other areas.