New Folsom Prison health care deemed ‘inadequate,’ still under federal oversight

One of two state prisons in Folsom is still getting failing grades for the health care it provides to inmates, leaving it among the institutions that remains subject to oversight from a federal receiver.

The institution — known as California State Prison, Sacramento — recently received an “inadequate” rating from the California Office of the Inspector General on the overall quality of health care it provides.

Those ratings are among the factors that help determine when a prison can exit the federal receivership that has managed health care in state correctional facilities since 2006.

Fourteen of California’s 34 prisons remain in the receivership. Twenty of them, including Folsom State Prison, have left the receivership and are managed by the state.

California State Prison, Sacramento, sometimes referred to as New Folsom, is an all-male prison at 100 Folsom Prison Road. The inspector general monitored the prison’s health care delivery between May 2021 and October 2021 and issued the report in October.

The report said that the prison’s health care services scored adequately in three categories: health information management, preventative services and specialized medical housing.

The inspector general deemed inadequate the following: access to care, diagnostic services, emergency services, health care environment, transfers, medication management, nursing performance, provider performance, specialty services and administrative operations.

The report said it found one or more instances of expired medical supplies in nine clinics in addition to staff members’ personal items and food stored in the supply storage cabinet location, medical supplies stored directly on the floor and compromised sterile medical supply packaging.

In terms of sanitation at New Folsom, the inspector general found the staff appropriately disinfected, cleaned and sanitized only two of 11 clinics.

It also found a dead cockroach in a medication room, an unsanitary examination table, blood-like stains on the clinic floor, and during patient encounters in seven clinics, clinicians did not wash their hands before or after examining their patients, before applying gloves or after performing blood draws.

A receivership occurs when a court appoints a third party to exercise independent oversight and in the event of litigation where the parties cannot otherwise be fully protected, according to the American Bar Association.

A federal court appointed a receivership to oversee health care in California prisons in 2005 as part of a response to a lawsuit over prison conditions.

One-by-one, prisons have left the receivership since 2015. The first to return to state control was Folsom State Prison.

Federal receiver J. Clark Kelso looks at a number of factors when he determines if a prison is ready to return to state administration, said Liz Gransee, spokeswoman for the federal receiver.

“There are several factors taken into consideration when reviewing an institution’s readiness for delegation including a comprehensive Nursing Services review, the report of the (OIG) regarding the results of its medical inspection of the facility, as well as data from the Healthcare Services Dashboard and other internal monitoring tools, leadership, staffing and more,” Gransee said via email.

Hadar Aviram, a professor at University of California, Hastings college of law, said the receivership can complicate the management of a prison. Correctional officers report to a warden who is appointed by the state of California, whereas health staff at some facilities ultimately answer to the receivership.

Aviram said she recently studied, and will soon publish a book about, the COVID-19 crisis in California prisons, a situation in which the receivership played a large role.

“Partly because the receivership is in federal hands while the prison is in state hands, the custodial and the medical side of prison don’t really talk to each other very well,” Aviram said. “It’s kind of like one hand didn’t know what the other hand was doing.”

She said when decisions had to be made about quarantine, housing people or moving them between cells oftentimes custodial decisions trumped medical decisions to the detriment of the prisoners.

“It’s less about who is providing the services and more about finding somebody who will provide them humanely,” Aviram said.