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Health Care At The Heart Of Prison Release Ruling

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The U.S. Supreme Court upheld a ruling yesterday that could see thousands of California inmates released. At issue is whether prisons are so crowded that inmates don't have access to health care and mental health services.

— California has too many men and women in its prisons. The statistics say so, and so did a federal court back in 2002. Now, the U.S. Supreme Court has said so in its 5-4 ruling yesterday. There are 142,000 inmates in prisons that were built for 100,000.

Inmates like Terry Campbell, who is serving a life sentence at Donavan state prison in San Diego County.

"I've been in prison for 44 years," Campbell told KPBS last year during a KPBS special investigation into the state prison system.

Campbell is one of about 35,000 lifers in the system and one of many inmates who requires health care.

He’s had seven operations.

“My back. My shoulders because I broke bones in both my back and shoulders. My hand, twice,” Campbell said.

That access to health care and mental health services is at the heart of the legal challenge that eventually found its way to the U.S. Supreme Court.

The case began as a federal court class action lawsuit known as Plata vs. Schwarzenegger, challenging prisoners' access to care.

A federal panel of judges ruled inmates did not have access to health care and mental health services because California’s prisons were so overcrowded. The court ruled that a lack of health care was cruel and unusual punishment and violated inmates’ constitutional rights. The panel ordered California to come up with a plan to reduce its prison population.

The decision forced California to confront its overcrowding problem and challenged the public to contemplate the health care debate in a whole new way. If last year the country decided health care is not a right for all free citizens, why is it so easily determined as a right for convicted criminals?

It's a question Clark Kelso has been asked many times.

Kelso is the federal receiver in charge of the prison health care system.

"There's a huge difference between government's responsibility to you a citizen, a free citizen, and government's responsibility to someone that government is incarcerating. Once you have incarcerated someone, government has a constitutional obligation under the 8th Amendment to provide certain levels of care,” Kelso said last year in an interview with KPBS.

Since prison health care was turned over to a federal receiver in 2006, access to health care has improved, according to an inspector general report released this month. All 33 state prisons were inspected and given a score based on access. For example, Donavan prison in San Diego got a rating of 68 percent in 2008, but most recently improved to 73 percent. Donavan, however, still misses the overall target minimum of 75 percent, as do most prisons.

It's a target that keeps moving as a growing number of inmates age and demand more health services.

“The state of California and the people of California have made consistent judgments that certain types of crimes or certain patterns of criminal conduct need to be punished with life in prison and that's a judgment that has to be respected from my perspective is that needs to realize those decisions come with a cost,” Kelso said last year.

Campbell said he expects to die in the prison.

”I'm well adapted. Institutionalized, if you will. So I don't see a problem just existing. Eventually I won't be able to function anymore and eventually I'll end up in a hospital and eventually I'll die. But in the meantime, it's going to cost the state an awful lot of money to take care of me,” Campbell said.

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