Healthcare for prisons: $7 billion

In a proposal that would nearly double the state’s prison construction program, Gov. Arnold Schwarzenegger’s administration asked lawmakers Friday to approve $7 billion in new spending to bring medical and mental healthcare in California prisons up to constitutional standards.

The plan, to be overseen by a court-appointed federal receiver, would result in the construction of seven facilities by the middle of 2013 to house 10,000 chronically sick or mentally ill inmates, many of them elderly, who are now in traditional cells or dormitories. It would also entail improvements to existing healthcare facilities at the prisons.

That spending, almost all of which would require borrowing to be authorized by state lawmakers -- although not voters -- nearly triples the $2.5 billion the governor proposed for new medical facilities in his budget submitted to lawmakers in January.

Since then, new receiver J. Clark Kelso has surveyed the system of care in the prisons and formulated a three- to five-year plan to fix the problems, including medical facilities that he wrote were “in an abysmal state of disrepair.” The system would then return to the control of state officials.

“In order to complete this in five years, I want to ask for all of what I think is the required money, upfront, once,” he said Friday.

Kelso, who is scheduled to testify about his plans before a state Senate committee Monday, could seek approval from a federal judge to go forward if legislators balk.

“I’ll deal with that issue if it arises,” he said.

U.S. District Judge Thelton Henderson, who created the receivership in 2005 and is on a three-judge panel that is weighing whether to cap the prison population, has called the system so broken that an inmate was dying every six or seven days from poor care.

The new proposal would bring the proposed cost of the state’s prison construction plans to $14.7 billion. Tens of thousands of beds would be added under one plan that the governor and lawmakers approved last year but that has been delayed.

H.D. Palmer, a spokesman for the state Department of Finance, said the spending is mandatory because the federal courts have demanded a remedy. “We have to accomplish this,” he said. “We are having to catch up for years in which this was not adequately financed.”

But Donald Specter of the Prison Law Office, a nonprofit advocacy organization for inmates, said the need for new spending is mainly a result of the state’s decision to keep thousands of ill inmates incarcerated when they could safely be released.

“It’s very expensive to provide even minimally adequate care in prisons,” said Specter, whose group launched a federal lawsuit that led to the creation of the receivership.

“This is essentially building new prisons,” he said, “but the care itself has to be improved in the existing prisons, and this is not the end of their requests for money to improve their care.”

Steven Maviglio, a spokesman for Assembly Speaker Fabian Nunez (D-Los Angeles), said lawmakers would probably take up the prison proposal quickly, given the court’s involvement. In a statement, he suggested that it could play into the battle between legislative Democrats, who want tax increases, and Republicans, who want budget cuts.

“This couldn’t have come at a worse time,” Maviglio said. “It makes a disastrous budget scenario even worse.”

The state faces a budget gap that was projected at $16.5 billion before legislators and the governor reduced it through borrowing, postponement of expenses and some cuts.

Kelso held out the possibility that his plans would cost less than projected. But if the state borrowed all the money the administration has requested for prison beds and medical facilities, it would cost taxpayers $1.2 billion a year to repay the debt.

As of Oct. 1, the state had $57.3 billion in debt outstanding, plus $78.2 billion that has been authorized but not yet borrowed. The prison borrowing would not be dependent on approval by voters because state officials want to use a type of bonds that requires only lawmakers’ permission.

Underlying the state’s quandary is the bloated nature of its prison system, which houses 170,000 inmates but was built for 100,000. Prisoners’ lawyers maintain that the dramatic overcrowding is the main cause of mental health care and medical care that don’t meet constitutional standards.

Henderson initially appointed Robert Sillen, an experienced healthcare official, as receiver in 2006. But, dissatisfied with the pace of reforms, the judge replaced him in January with Kelso, a law professor and veteran of reorganizing troubled state agencies.

The construction plan is one element of a four-pronged strategy Kelso outlined last month, which also included providing timely access to care, improving the care and hiring quality medical staff.

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michael.rothfeld@latimes.com

Times staff writer Evan Halper contributed to this report.