The Trickle that will Become a Torrent

August 27, 2007

Using Muscle to Improve Health Care for Prisoners

SAN JOSE, Calif. — Last year, shortly after receiving extraordinary powers to overhaul the medical system in California’s prisons, Robert Sillen, armed with a stack of court papers, issued a blunt warning to cabinet officials at the governor’s office in Sacramento.
“Every one of you is subject to being in contempt of court if you thwart my efforts or impede my progress,” said Mr. Sillen, a silver-haired former hospital administrator chosen to carry out the overhaul of the prison medical system as the result of a class-action suit brought by a prison advocacy group.
Backing up his warning, Mr. Sillen handed out copies of a federal court order that named him the health care receiver for the California prison system.
In a subsequent warning, Mr. Sillen threatened to “back up the Brink’s truck” to the state’s treasury, if need be, to finance better medical services for the state’s 173,000 inmates.
State figures show that court-ordered changes to California’s prison system, including those in Mr. Sillen’s health care domain, have cost more than $1.3 billion, and the meter is still running.


This will send well deserved shivers up the spines of prison administrators across the nation. We are witnessing a period where simply throwing away the key is no longer sufficient. We are increasingly being required to properly care for and manage twice the number of prisoners most prisons were designed to hold.
It may be that the public will to throw the book at every offense will eventually (and maybe quickly) come up against the reality of costs associated with imprisonment. Anyone remotely associated with prison reform is anxious to see that happen.

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