Oral

Abstract: Methods to improve daily conditions, human rights, and the quality of health care in U.S. jails and prisons have included legislation, administrative policy intervention, privatization, promulgation of standards accompanied by accreditation, and litigation. However, prisoner complaints and investigative reports testify to the continuation of harmful conditions and poor quality of care, both of which often fall below constitutionally permissible standards. This panel will examine one route to improving care: a court-ordered transfer of responsibility for health care services within a large state prison system from the system's administrators to a federal receiver, who has the power to hire and fire, change policies, and draw on the state's budget, including its general fund, to implement the changes. This process, currently taking place in California, is the most important consequence of the 2005 settlement of a lawsuit, Plata v. Schwarzenegger. While other prison class action lawsuits both in California and elsewhere have resulted in monitors to oversee changes, this receivership is the first of its kind, in which a federal judge has overridden state correctional authority in order to fix health care services directly. The receivership, which impacts a system with a daily census of over 300,000 prisoners, could last for 5-10 years.

Session Objectives: Distinguish among basic types of institutional intervention to change prison health care policy and practice. Analyze factors limiting long-term change after federal intervention in prison conditions. Understand 4 stakeholder positions on prison health care