California prison medical receiver J. Clark Kelso's motion to ask the federal courts to order the state to give him $8 billion for inmate care raises questions about what he's doing and how he's doing it.

Does he have the authority? He can ask for it, thanks to a Feb. 14, 2006, federal court order that created his office. Whether U.S. District Court Judge Thelton Henderson grants the motion is another matter.

Here are some answers to more key questions:

Why $8 billion?

That's how much Kelso says it will cost to build seven, 1,500-bed long-term care facilities that he says are necessary to bring California prison medical care into constitutional compliance. He also wants to upgrade medical, dental and mental health units and improve disability access in all 33 state prisons.

How did this job come into existence?

The receivership was established by Henderson in the Plata case, in which the state stipulated it had failed to provide adequate medical care to its inmates.

What are the receiver's powers?

According to Henderson's order appointing the receiver, he can "control, oversee, supervise, and direct all administrative, personnel, financial, accounting, contractual, legal, and other operational functions" regarding prison medical care. And if state officials don't "fully" comply, he can ask the court to hold them in contempt.

Did the state appeal?

No.

How does he think the state can come up with $8 billion?

Kelso tried to get the Legislature this year to approve lease revenue bonds to fund his capital program. So far, it hasn't, but the legislative session isn't over until the end of the month. Kelso wants a hearing on his $8 billion motion on Sept. 22.

Last year, the state approved Assembly Bill 900, which contained $7.4 billion in bonds for prison construction and rehabilitation. Didn't it contain a billion or so for medical and mental health beds like the ones Kelso wants?

Yes, it did – $1.1 billion, in fact, for 8,000 medical and mental health beds.

Can that money be rolled into the $8 billion Kelso wants?

Not without new authorizing legislation, according to a spokesman for the receiver.

Is it true that legislative Republicans killed the deal to pay for the medical beds with lease revenue bonds?

Yes. They say they aren't willing to come up with that money until legislative Democrats join them in making some technical fixes in AB 900 that are needed to actually implement that bill. Democrats and Kelso say the two issues are unrelated.

What technical fixes?

Prison officials have changed their expansion plans since AB 900 was passed to include such things as more beds in cells instead of dorms, which are more expensive and will result in fewer beds than initially promised by the legislation. The attorney general's office has issued an opinion that the state needs cleanup legislation to enact those changes and that the AB 900 bonds can't be issued until then.

Why should taxpayers pay all this money for a bunch of criminals?

Kelso said the federal courts have ruled for nearly 40 years that states have a constitutional obligation to provide basic medical care to inmates under their custody.

What's "basic"?

For starters, inmates shouldn't be dying due to medical neglect, Kelso says. They also should have access to care, he says, for everything ranging from an aspirin for a headache to off-site oncology treatment if they have cancer. Judge Henderson said in late 2005 that a California inmate died every six or seven days due to medical neglect. A report by the receiver's office last year said the number remains pretty much unchanged.

Why is prison medical care so expensive?

Mostly because it's in prison. Custody costs account for 40 to 50 percent of the tab, according to Kelso. Correctional officers who transport inmates to medical appointments and protect health care workers don't come cheap in California. Their top-scale basic pay is $73,000 a year.

If Kelso succeeds in getting his $8 billion, how will it affect me?

It depends on whether you use state services, and whether the state ultimately funds his program with lease revenue bonds or the general fund. With the bonds, the rule of thumb is you double the total and divide by the 25 years it takes to pay off the bonds. In this case, it would be $640 million of your tax money out of the general fund every year to pay off the bonds. That means $640 million that otherwise could be going to services such as cops on the street, lifeguards, welfare, parks and schools. If the state opts, or the court orders, a direct "pay as you go" hit on the general fund, it would hurt more in the short term ($3.1 billion next year), but be over in five years.

How'd we get into this mess?

Prison growth exploded in the 1980s and 1990s, mostly as a result of tougher sentencing laws passed by Democratic and Republican lawmakers responding to the public's fear of crime. The rapid growth outstripped the state corrections agency's ability to provide medical, mental health, rehabilitative and other services to inmates, who in turn were mostly warehoused. Inmate-rights lawyers filed and won class-action lawsuits – sometimes with little opposition – covering medical, mental health and other issues, and the rest is history.

Call The Bee's Andy Furillo, (916) 321-1141.