Who’s to blame for the deplorable and abusive medical care in California prisons?

The medical service for California’s 165,000 prisoners is teetering on the brink of collapse into receivership. After three years of U.S. District Court supervision, the California Department of Corrections has not been able to bring a single one of its 32 prisons into compliance with the court settlement governing medical care.

After spending another $1.1 billion for medical services in the past year, each prison’s health care remains so substandard that it has been judged to be cruel and unusual punishment. CDoC’s leadership has publicly thrown up its hands and admitted that they can’t do the job. Prisoners are dying, becoming disabled and being neglected and returned to our communities worse off than when they entered prison.

California Prison Focus, a San Francisco based human rights organization, has been conducting investigative visits to our prisons for 15 years. Our scrutiny of prison medical care has produced a continuing stream of complaints that we have carried to every level of CDoC administration and government.

While we agree with what has appeared in the press during the last month, we believe that only part of the story is being told. There are forces that have not been mentioned at all that are key factors in CDoC’s hopeless incapability. The two most important of these impediments to change are the severe and unnecessary overcrowding of the prisons and the hostile atmosphere and work environment created by the custodial staff, particularly the leadership of the guards’ union.

There are just too many women and men in prison. In California, everyone who can be in prison is kept in prison, rather than everyone who needs to be in prison being kept behind bars. There are thousands of prisoners who have served much more time for their crimes than in any other state. These people are serving what are called life terms and are just denied parole year after year for no good reason.

There are thousands who are doing long terms for second and third strike offenses that were petty, often minor offenses committed 10 or 20 years after other more serious crimes they committed in their youth. There are thousands of nonviolent offenders who would be better served with drug treatment or job training.

Even more striking is the fact that the average person entering a California prison is a nonviolent person who has violated nothing more than a technical rule of parole or was caught using drugs while on parole. The governor just ended parole programs that would have diverted those folks from prison.

None of these men and women needs to be in prison to preserve public safety, but they do keep the prisons overfull and challenge all of the services of humanity and rehabilitation in prison.

An overcrowded prison system does serve one group well. It keeps lots of prison guards fully employed and collecting lots of overtime pay. It helps make prison guards among the most numerous six figured salaried employees in California.

That would be bad enough. But the custodial staff also creates a very hostile work environment. There is rampant disrespect of prisoners by guards. Verbal abuse is more common than courtesy. Physical abuse is all too common.

Gangs of guards run roughshod over the rules, the prisoners and other staff who try to do a decent job and act in a respectful and humane manner. Some of the most notorious gangs have been the Green Wall at Salinas Valley State Prison, the Sharks at Corcoran and White Lightening at Calipatria.

And the California Correctional Peace Officers Association (CCPOA) panders to and protects these abusers. The CCPOA calls prisoners enemies out of one side of its mouth and calls itself a professional organization out of the other side.

Staff who express a firm, fair and caring attitude toward prisoners are called prisoner lovers and shunned and criticized. As long as guards and the CCPOA act so antagonistically, it will be impossible for the medical service to attract and retain decent staff.

Also, CCPOA has refused to act responsibly and allow normalization of nursing services. In violation of all standards for prison medical care, the CDoC has guards called Medical Technical Assistants (MTAs) working as the first line nursing staff. The guards’ union viciously fights off medical decency by demanding that the MTAs remain guards and be paid as guards, rather than have them reassigned as full nurses.

The CCPOA fights all attempts to release prisoners, not out of a concern for public safety, but for their own narrow self interest, and fights normalization of nursing services for the same reason.

Corey Weinstein, MD, CCHP, is a board member of California Prison Focus and can be contacted at CPF, (415) 252-9211, or http://www.prisons.org

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