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Health Care At The Heart Of Prison Release Ruling


Aired 5/24/11

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.

Inmate Terry Campbell is serving a life sentence for first degree murder at t...
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Above: Inmate Terry Campbell is serving a life sentence for first degree murder at the R.J. Donovan Correctional Facility. Campbell has been in prison for 44 years and he's 65 years old.

"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.

KPBS Reporter Joanne Faryon interviews Clark Kelso last year in Sacramento.
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Above: KPBS Reporter Joanne Faryon interviews Clark Kelso last year in Sacramento.

"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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Avatar for user 'davidz424'

davidz424 | May 24, 2011 at 9:18 a.m. ― 5 years, 10 months ago

I get extremely upset every time I hear about the enormous benefits prisoners receive at the hands for taxpayers. Yesterday I heard the interview with the lawyer who argued,free of charge, for their rights to the Supreme court.

I'm a law-abiding citizen. I've been unemployed for 2 1/2 years now. I am in serious need of dental care to the tune of $9000. I found a place with a sliding scale so I would be able to afford my own mental health care which I pay for from my own savings. I've been paying back my student loan since 2001 and still have $3000 left to pay. Tell me one reason why I shouldn't go out and commit a serious enough crime to get put away in prison, have all my dental work done, get free mental health care, education without having to take out a student loan, not to mention I wouldn't have to pay for cable tv, electricity, gym membership, rent.... have I missed anything here? Oh yeah, I made no money last year but I did have to pay taxes. What about us law-abiding citizens? What do we get?

I passed a kidney stone 3 years ago. I never had this experience and didn't know what it was so I went to a hospital. None of the "doctors" there guessed what it was so I was submitted to a CAT scan and finally given a Vicodin and sent home with an $8000 bill. When I applied to CMS I was told I would have to use the money in my IRA, my savings and anything else I had until I was down to less than $2000 before they would help me.

Prisoners should get ground beef, bread, salad and water daily, a newspaper to keep up with the outside world, be able to run around a yard for exercise and medical care only if it's life threatening. They should get no cell phones, have to pay student loans for education once they get out and get a job, do some sort of work while their in prison to pay for their stay, (perhaps farming for food for the law-abiding indigent outside), and maybe, just maybe, people would think twice before committing a crime. I've surely thought twice about committing one. Remind me why I shouldn't?

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Avatar for user 'Shaggymonster'

Shaggymonster | May 24, 2011 at 11:13 a.m. ― 5 years, 10 months ago

Heath care is very hard to get no matter who you are, my hub has been out of work for over 2 years now and he has very bad teeth we could not afford to get them fixed even when he was working but when he gets one that is to bad he can go to clinic and they will pull the tooth and give him meds for it, but when my son who is doing life got a bad tooth his whole face swelled up so bad he could not eat he could not even close his mouth and the pain was so bad all he did was lay in bed with a warm cloth on his face I had to raise hell to get him help you can die from an infected tooth it took me 5 weeks to get him help, and in that time he was going crazy with the pain, so no mater how hard it is out here there are places we can go get help, but the ones in prison can not, and its very wrong to let someone lay in bed in so much pain and no one will help them , we should not treat people like this its wrong to lock them up and then when they need help no ones comes to help.And I as his mom cried many nights over this knowing my son was in so much pain and nothing to help him.So many people talk about how easy it is in prison I wish they would spend a few weeks in prison and then they would have something to say they would no the truth of prison life,My son is 100% innocent but that does not matter to anyone but us his family and friends,but I am sick at heart the my county the great USA would treat people this way, we are no better then all the bad guys we chase after, when you mistreat a person, you are wrong and pray you wake up and have some compassion for others and stop believing all the things you read in the news and find out for your self what is going on in our prison and then maybe you would understand and have a little compassion for them JoAnn.

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Avatar for user 'randolphslinky'

randolphslinky | May 24, 2011 at 12:51 p.m. ― 5 years, 10 months ago

I agree with the comments of davidz424. Our country seems to have become a place in which if you're a law abiding person you always getting shafted by our government. The "victims" are always the other people.

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Avatar for user 'djiandunn'

djiandunn | May 24, 2011 at 1:02 p.m. ― 5 years, 10 months ago

@davidz - the difference between you and someone in prison is that you have the opportunity to get a job and healthcare, and someone in prison can't do that. not to slight your unemployment stint or your dental costs, but those two seperate problems are different than being sentenced for years. what do you mean by "enormous benefits"? are you just discussing the availability of medical care to prisoners? are you suggesting that prisoners not receive medical care? they're unemployed, just like you. except they're also in jail. are they supposed to come up with $9000 if they need it?

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Avatar for user 'HarryStreet'

HarryStreet | May 24, 2011 at 3:59 p.m. ― 5 years, 10 months ago

I don't recall hearing a dollar amount for the healthcare provided to inmates, so this sounds like we may be hemming-and-hawwing over spending taxpayers' money during tough times.

I do believe that as a society of laws we have a responsibility to care for the incarcerated. I also doubt they receive 'superior' healthcare. Let's not forget they are prisoners and the best doctors and nurses and care available is most likely not available for them. I seem to recall an article where the quality of care for inmates is below standards.

If this issue is raised as a way of looking where to cut spending. I'm sure we can find more important places. Bonuses for government employees at a time when we're laying off teachers, police, firefighters and the like come to mind.

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Avatar for user 'Number1dog'

Number1dog | May 24, 2011 at 5:26 p.m. ― 5 years, 10 months ago

Prison capacity is 100,000 but filled with 142,000, 35,000 are lifers. Seems obvious to me, get rid of the lifers via execution and we are nearly on par with the capacity of the prison system. May seem cruel and I'm sure there are those opposed to the death penalty, but we need to get real. Start executing and I do agree with the argument that it will deter murders etc... We made a law, time to enforce it.

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Avatar for user 'Dawna55'

Dawna55 | May 24, 2011 at 7:10 p.m. ― 5 years, 10 months ago

Prison dentistry is awful: tooth removal only
I served on a jury recently where prison dentistry and other prison conditions were important. I learned that the only dental care provided in CA prisons is tooth removal. No fillings, x-rays, root canals or other care are provided. If an inmate has a tooth ache they have to decide if they want to lose the tooth or not; those are the options. If they go to the dentist, they're in shackles, hands and feet. It isn't a party in there.
Three Strikes doesn't work well and needs Reform:
Our prisons have lots of people with 3 strikes, and the accompanying inflexible sentences. Three strikes in CA was supposed to be for serious crimes. The strikes in CA can be for ANY felony, including felony petty theft for stealing something worth less than $400. The third strike gets the person 25 years to life. They can get two of these sentences so they're serving 50 or 75 years. The people making decisions for early release end up letting out people like Phillip Craig Garrido, while the person in for cocaine possession or petty theft with a 3 strike sentence stays in.
Releasing the wrong people is expensive too.
In 2010, Phillip Craig Garrido's victims were awarded $20 million dollars from the state of CA. I think they deserve some money but it is too bad that it came from California taxpayers. We need to reform 3 strikes so sensible decisions can be made to release the least risky people.

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Avatar for user 'Joanne Faryon'

Joanne Faryon, KPBS Staff | May 25, 2011 at 10:03 a.m. ― 5 years, 10 months ago

Hello Everyone, thanks for commenting.
Shaggymonster, thanks for sharing your son's story. I would like to hear more. You can contact me directly at />And I have visited three state prisons and produced this documentary I hope it provides more context to our coverage.
And I wanted to throw something out into this debate - why do you think as a country, we decided that all citizens did not have the right to health care? In other words, we rejected universal health care in the US. It would be interesting to look at other countries' (with universal coverage) prison systems to see whether this is an issue.
And in terms of cost, last year the cost of prison health care was about $2 billion, this year its closer to $1.5 billion, according to the federal receiver in charge of prison health care.

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Avatar for user 'Shaggymonster'

Shaggymonster | May 28, 2011 at 1:17 p.m. ― 5 years, 10 months ago

I don't know what it happening in other country's but what it happening here in usa is very bad our prisoners are hurting from lack of medical care and have no way of getting help unless they have a family out here who can help it took me days to get help for my son,and it brakes my heart he had to go threw so much pain, he was in coalinga where they have valley fever he got sick with it and they told him it was the flue, his roommate tried to wake him up for 3 days and finely got someone to look at him he was in a coma they took him to hospital then moved him to high desert he is to take meds for it for life but as of today he has never been given the drug that stops the fever so he could get it again any time. I know people don't want to believer my boy is innocent but he is and he his slowing dieing in prison 11 years now I have tried to get his story out but found most people just don't care, but I just keep praying someone will here us and step up and help, he is my baby boy and I can stop fighting for him I am all he has.

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Avatar for user 'Linda217'

Linda217 | May 30, 2011 at 1:06 p.m. ― 5 years, 10 months ago

In response to davidz424 - you want to go to prison to have your teeth fixed? What makes you think prisoners get their teeth fixed? My father is in a federal prison for a minor infraction. He has been there for five years. He has never seen a dentist. He is 83 years of age. He fell in his bunk one day. He was left unconscious for eight hours before they called an ambulance for him. WHY? because it is less expensive for the Bureau of Prisons to have his die than to provide for his medical care. By the time they did call and send him to the local hospital he was in sepsis and only had a 10% chance of survival. He pulled through thank god. But no thanks to the 'wonderful' medical care he received in prison.
Where ever anyone gets an idea that inmates receive excellent care is beyond me. The care is reprehensible and inhumane. My father is a non-violent offender and should be permitted to come home with an ankle bracelet where I could provide for him the proper medical care that he needs.
A concerned and loving daughter.

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Avatar for user 'randolphslinky'

randolphslinky | May 31, 2011 at 8:30 a.m. ― 5 years, 10 months ago

Prison shouldn't be a place anyone would want to be, it should be a place of punishment, and in my opinion only the minimum of medical treatment should be available to prisoners. Having studied this subject a bit myself, and spoken to people who have worked in our prison systems it is also my belief that a good percentage of them should simply be put to death. They could never be released due to their violent behavior and criminal influence, and yet even in prison they remain a threat to other prisoners and the men and women who must guard them. The taxpayers should have no obligation to house, clothe, feed, and care for this kind of trash that there is no hope for. Just another thought, how many times have you seen a person on television arrested for a shocking crime and the family is in complete denial? How many times has someone told you a story and while they seemed completely dedicated to it, you knew that it was in fact a lie or a delusion? Prisoners are masters at lying and deceiving others.

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Avatar for user 'PRK'

PRK | June 1, 2011 at 9:30 a.m. ― 5 years, 10 months ago

kpbs staff this is for you .
What you fail to mention when you you talk about other countries and their universal health care is some simple facts about the life style's and how the people in those other countries behave and how big or actually how small in population those countries actually are in comparison to the United States.

A lot of people can afford health care in the U.S. but they decide to spend their money on cell phones or junk food or a night at the club. Most people waste a lot of money on things they do not need. They waste money on junk for their cars, new clothes every week or expensive make-up. That is where this country has gone wrong, it's with wasteful spending at the personal level and it continues up to the local gov. straight up to the federal level.
Anybody who has a car is paying insurance I hope. Well they could get rid of the car ( which needs a lot of maintenance costing $$$) and the insurance payment, take public transportation (saves the environment, less oil from the middle east) or walk (makes you healthier) and take that save money from not owning a car and pay for their health car. I bet somebody is says this : "well people will lose jobs if we don't own cars and waste money on cell phones and a night out on the club." Well none you see how messed up of a problem it really is.

continued in next post

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Avatar for user 'PRK'

PRK | June 1, 2011 at 9:31 a.m. ― 5 years, 10 months ago

So you you want socialism / communism telling you exactly how to live with little freedom to choose your own path in life or are we as a country going to go back to the hard work fundamental that made this country great and use our freedom more wisely like most of our grandparents and parents did. I'm 36 I live 1005 with in my means I used to do the race car thing, surf, and other wasteful thing but now their is no money for it and I do not let it drive me crazy because I cannot do those things anymore. I realize what is more important. Some my friends and people I "know of" that have kids are still living life like they were in high school. They are not saving anymore for their retirement. They are to busy being adult kids buying junk instead of working for their kids. Look back at what your parent(s) did. When you were old enough to know like 8 y/o, was your mom or dad going out to the club or playing video games all night? Were they buying junk for their cars or the biggest waste in our life time buying new cell phones and computer stuff every other month? There will always be somebody else who is a "good financial situation" that will be able to buy the crap or luxury items in life that will keep the economy moving. Think of it this way you have to first pay for these items: rent or mortgage, electricity & gas, water, food, basic clothing at times, trash, and healthcare before you do anything else period!!! You noticed I did not put down cable & internet or cell phone or car or car insurance? If you want those go bust your bust and use your freedom wisely so you can have those luxuries in life unless you want total socialism / communism telling you how to live. That is where this country has gone wrong. Time to go back to hard work people. The system does not need to be changed. People need to stick to the rules and stop lying and cheating just because no body is looking. Stop stealing from your workplace or asking your friends for a "hook up" at the companies expense. The lack of work ethic and morale's and honor in this country is sad. A majority of young people thinking they are owned something so they steal from the workplace. Like I said it's a messed up problem, how you going to fix it?

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Avatar for user 'Missionaccomplished'

Missionaccomplished | June 1, 2011 at 9:19 p.m. ― 5 years, 9 months ago

I would urge everyone here to read and digest "Inmate Count in U.S. Dwarfs other Nations" by Adam Liptak, NYT, Apr 23, 2008.

No one is taking the socio-political, let alone the moral responsibility for the this. America - land of the free.

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