Kelso: Sever Prison Health Care from CDCR

Yesterday's Sac Bee featured, in their Viewpoints section, a short piece by Clark Kelso, the federal receiver for the prison medical system. He begins by reporting their success--true to humonetarian principles, starting with savings:

We began the year anticipating our expenditures would be $2.146 billion. During the year, we implemented substantial changes to improve quality of care while simultaneously reducing unnecessary costs. The result? A reduction of $408 million in our expenditures. That is almost a 20 percent reduction and just over 80 percent of what I had forecast 18 months ago. My executive team and staff in the 33 institutions deserve the credit for this success.

However, Kelso also reports the improvement in quality of care:

The 2009 report of inmate deaths shows continued improvement. We have reduced the number of medical lapses by 16 percent, reduced the number of possibly preventable deaths by 26 percent and reduced the number of likely preventable deaths by 83 percent. There are other performance measures that I will be releasing soon. Those measures will reinforce that we are maintaining and improving the quality of care, although much work remains to be done.

Kelso plans a series of pieces on future improvements, the first of which, and most important in his view, is severing health care from CDCR:

The corrections department's mission is not health care. It is maintaining custody and control. The reason we have made so much progress on medical care in the past three years is because we have operated independently of CDCR and that independence let us focus on our health care mission. If responsibility for prison health care returns to the department of corrections after the conclusion of the receivership, the most likely result will be backsliding as the health care mission once again becomes subordinate to custody and control. This is not intended as a criticism of the department of corrections and its executive team or staff. It simply reflects the reality of organizational behavior and culture.

Whether or not one agrees with Kelso, or believes the improvements made to the health system were substantial (Julie Small's report on this matter showed mixed results), he comes off as thoughtful and genuinely passionate about improving prison health care. Moreover, the transparency of data from the receivership is astounding, especially in light of the difficulty of obtaining similar data from correctional sources. What do our readers think--should health services be completely independent of CDCR control?