Improving prison medical care: Public health benefits of the California Prison Receivership

As a result of the State of California's prolonged failure to provide medical care to prison inmates at constitutionally acceptable levels, in 2006 Federal Judge Thelton E. Henderson appointed a Receiver to assume control of California's prison medical system. In its first two years, the Receivership has focused on both immediate interventions and infrastructure development. Progress to date has included dramatic increases in the number and caliber of clinical staff, increases in custody escort staff essential for access to care, facility and equipment improvements, information technology improvements, a new pharmacy system, development of a cadre of nursing and physician change agents, and removal of bureaucratic barriers to effective operations of the Receivership. While public health involvement in prisons has traditionally prioritized the threats posed by infectious diseases, the development of a functional medical care system in California prisons will open new possibilities of information sharing and collaboration across bureaucratic boundaries to focus on other determinants of health status and the roots of recidivism.