Audit: Effect of CDCR Operations on the State Budget

California Department of Corrections and Rehabilitation:

Inmates Sentenced Under the Three Strikes Law and a Small Number of Inmates Receiving Specialty Health Care Represent Significant Costs

HIGHLIGHTS

Our review of California's increasing prison cost as a proportion of the state budget and California Department of Corrections and Rehabilitation's (Corrections) operations revealed the  following:

• Inmates incarcerated under the three strikes law (striker inmates):
  • Make up 25 percent of the inmate population as of April 2009.
  • Receive sentences that are, on average, nine years longer-resulting in about $19.2 billion in additional costs over the duration of their incarceration.
  • Include many individuals currently convicted for an offense that is not a strike, were convicted of committing multiple serious or violent offenses on the same day, and some that committed strikeable offenses as a juvenile.
• Inmate health care costs are significant to the cost of housing inmates. In fiscal year 2007-08, $529 million was incurred for contracted services by specialty health care providers. Additionally:
  • 30 percent of the inmates receiving such care cost more than $427 million.
  • The costs for the remaining 70 percent averaged just over $1,000 per inmate.
  • The costs for those inmates who died during the last quarter ranged from $150 for one inmate to more than $1 million for another
• A significant portion of the increased workload due to medical guarding and transportation is covered through overtime.
• The large leave balances of custody staff, to which the furlough program has contributed a significant amount, will eventually cost the State from $546 million to more than $1 billion.

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Special Review: California Prison Health Care Receivership 2007-2008

Special Review of California Prison Health Care Receivership Corporation Use of State Funds for Fiscal Year 2007-2008 as conducted by David R. Shaw, Inspector General of the California Office of the Inspector General (OIG): Our review found that the receivership spent $51.2 million during the year for its operating costs and long-term capital assets purchased on behalf of the California Department of Corrections and Rehabilitation (CDCR). This amount represents four percent of the $1.4 billion spent in fiscal year 2007-2008 to provide medical care to CDCR's adult inmate population. The largest expense category was capital assets, for which the receivership spent $28.7 million. In addition, the receivership spent $13.5 million on professional fees, $7.3 million on employee compensation and benefits, and $1.7 million on other expenses and travel...

Utilizing Managed Care Practices, CDC

From the Results section of the Auditor's report:
The department is required to provide medically necessary health care to inmates. In 1992, the department established a health care services division, whose mission is to manage and deliver health care statewide to the inmate population consistent with adopted standards for quality and scope of services within a custodial environment. The health care services division oversees the delivery of medical, dental, and psychiatric services at the institutions. To accomplish its mission, the division operates four licensed hospitals, a skilled nursing facility, 16 correctional treatment centers (CTCs), and 12 outpatient housing units. Each licensed hospital provides 24-hour acute care services to patients who require a high level of care. These hospitals offer medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services...