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Dispatches from the Inside: California's Chronic Care Program disappoints inmates

Credit California Department of Corrections & Rehabilitation

Richard Gilliam is incarcerated at the California Men's Colony (CMC).

September 6, 2012

Okay, so I just learned that a federal court in Massachusetts has ruled that a prisoner has the right to sex-reassignment surgery. The court ruled that it was cruel and unusual punishment to deny this individual what they termed "basic medical care."

Now, even I believe this is an extreme interpretation of what constitutes basic medical care – especially when prisoners in California prisons are still receiving less-than-adequate care, notwithstanding reports to the contrary. 

I can say this because I talk to prisoners everyday. I've listened to them recount the instances of misdiagnosis, unnecessary delay and official indifference perpetrated by an impersonal medical system.

Mark H. is a relatively healthy fifty-year-old inmate. He jogs and does calisthenics on a regular basis. A few months ago he began experiencing numbness in his upper chest and shoulder area. His first thought was that he might be developing heart problems. He was seen by the unit triage nurse, who gave him a cursory examination. She checked his heart-rate and blood pressure, finding everything within reasonable parameters, and she sent him on his way. A couple of days later he fell unconscious and had to be rushed to the hospital where it was discovered that he'd contracted Bell's palsy. Needless to say, that triage nurse is now known by the hypocoristic: Miss Diagnosis.

In response to a court mandate that the CDCR improve inmate healthcare the department has implemented what they call a "Chronic Care Program." This is for older inmates or those with some past medical issues, such as cancer, diabetes, past surgery or any ailment requiring follow-up care. These inmates are seen every three months or so to see how they are doing, but this only addresses the existing issue. If an inmate has a new ailment, this process isn't set up to assess that problem. They're referred to another doctor, which takes about two weeks, so that he or she can examine the inmate and say, "Yep, you have a hernia," or whatever new problem has arisen. That doctor then refers the inmate to a surgeon or specialist, which generally takes about a month more. Getting actual surgery, if it is required can take anywhere from two to six months. Meanwhile, what began as a minor treatment has turned into a long, painful wait and surgical necessity. 

So, when the general public hears stories about prisoners receiving the right to have expensive, esoteric procedures performed, I can understand their ire. The reality is that for the vast majority or prisoners healthcare is still a haphazard affair. Even with all the money spent to improve it.

Notwithstanding the federal court's curious ruling in regards to a prisoner's right to sexual reassignment surgery, we do not receive better care than the average citizen. By the same token, healthcare cannot be denied or delayed due to a person's circumstance.