Sunday, August 14, 2011
Lea Suzuki / The Chronicle
An inmate passes through a corridor of the medical center at the California Medical Facility in Vacaville, where a $33.6 million, 64-bed medical center addition to the existing hospital will open next month.
At a dusty construction site in Vacaville adjacent to a prison yard, workers are putting the finishing touches on a 45,000-square-foot structure that will soon house dozens of California's most severely mentally ill offenders.
When the $33.6 million project at the California Medical Facility is completed this fall, prison psychologists and psychiatrists will have private offices to treat their patients, and inmates requiring inpatient care will have individual cells near a nurse's station, as required by law.
The building, which will include 64 cells, is one of 13 prison construction projects being funded by a $7.4 billion bond approved by the Legislature in 2007. It is all part of an effort by the state to comply with a court order to reduce overcrowding and improve health care in its prisons.
Even as the construction continues, however - and as the state continues to face pressure to reduce its prison population - there is debate over whether Democratic Gov. Jerry Brown should move forward with the projects.
Thirteen other states have seen their inmate populations drop and are working to close prisons - including Texas, which began shutting down a century-old lockup last week.
Some people think California should follow suit.
"It's such a failed opportunity if we just build more beds instead of getting smart about policies," said Emily Harris of Californians United for a Responsible Budget, a coalition working to reduce the state's prison population and spending. "We know in California that if we build them, we will fill them."
The state, she said, should "use this as an opportunity to make smart reforms that advocates have been pushing for decades, and that we know from recent polls voters support."
Changing needs
The nonpartisan Legislative Analyst's Office bolstered that argument last week when it released a report recommending that the state reconsider its construction program.
The report's author, Paul Golaszewski, said approximately 1,500 low-security beds proposed at two of the 13 construction sites may not be needed once the state starts sending more inmates to local jails this fall under the governor's realignment plan, and that all future projects should be carefully evaluated.
"We don't know for sure whether they will need these projects," he said. "We don't think they should be delivering more dorm beds. Especially with realignment, it doesn't make sense."
After its completion next month, the Vacaville center will house maximum-security mentally ill inmates who need an inpatient setting. It will have an office area for mental health workers, a dining hall and an exercise yard. Rooms for group therapy will be furnished with heavy, rubber chairs that are impossible to pick up or use as a weapon. There will also be areas for occupational therapy and a handful of rooms with restraints or padded walls. All 64 cells will be within 90 feet of a nurse's station, as required by law.
Court order
Prison officials say this and the other 12 projects are medical and mental health sites that are crucial to getting the state out from under the court order, which arose when advocates sued, claiming that shoddy medical and mental health treatment was violating inmates' rights to decent care and leading to the preventable deaths of up to 50 inmates a year.
A federal court agreed, placed medical care under the control of a federal receiver and ordered the state to reduce its prison population by nearly 34,000 inmates over the next two years.
The conundrum for prison officials is that the population reduction order is directly linked to the court's finding of inadequate medical care and mental health treatment. Prison officials argue that the construction projects under way will help the state comply with the courts.
Improving services
The Vacaville center, for example, won't do much to ease crowding in the main prison, which is about 25 percent over capacity. But the new center will free up treatment space and help state officials better deliver mental health services, according to Stirling Price, who runs the Department of Mental Health's psychiatric program at the prison.
Currently, Vacaville inmates attend group therapy in makeshift rooms, including old cafeterias, and mental health workers must share tiny, crowded offices for individual therapy sessions. The new housing unit will give psychologists and psychiatrists their own office space away from inmates.
Another three-story, $24 million treatment space is also being built at the same prison for mentally ill patients who can be treated in an outpatient setting.
In all, mentally ill patients make up about one-third of the Vacaville institution's population.
"The construction will allow us to provide services based on a specific need. Right now it tends to be based on where the inmate lives," said David Silbaugh, chief psychologist at the prison. "The idea is to have (inmates) at the top of their game when they go back into the community."
State officials said the projects under AB900, the prison construction and rehabilitation law, have been constantly readjusted to match new policies, including Brown's plan to begin sending low-level offenders to county jails starting Oct. 1. Several projects for lower-security inmate housing were dropped after it became apparent they were not needed.
"We carefully thought through the things we needed, knowing the fiscal challenges of the state," said Deborah Hysen, deputy director of planning, construction and management at the prison agency. "We wanted to know that what we needed, we would need for a very long time, so if there is any concern about us going slow, it might have to do with the fact that we want to be careful."
Steep price tag
The price tag of these medical and mental health sites has nevertheless drawn scrutiny. On average, taxpayers will shell out $315,000 per bed for the projects that are under way.
Nancy Kincaid, a spokeswoman for the federal receiver in charge of health care in prisons, said the investment is worth it. The projects, she said, will allow California to treat far more inmates behind prison walls at a much cheaper cost than transporting them to outside centers.
"The people going back to the counties ... are not the people that use the medical facilities generally," she said. "Eighty to 90 percent are used by inmates with long-term sentences."
Kincaid said outside medical care contracts are the state's largest single expense, costing about $480 million a year.
The debate is likely to continue as the state considers moving forward with a handful of other projects authorized under AB900. Those include expansions of local jails, high-security additions to existing prisons and the creation of re-entry centers in cities and counties around California.
State Sen. Mark Leno, D-San Francisco, who earlier this year called on Brown to rethink the AB900 projects, said he agrees with the Legislative Analyst's Office report calling for reassessments of individual projects, but feels the prison department has done a good job so far focusing on things that are necessary.
"We need to match the beds we have to the needs we have, which is not currently the case," he said. "But we cannot and will not build our way out of our prison problem."
Prison construction
AB900 was signed into law in May 2007, authorizing $7.4 billion in lease revenue bonds for the construction or expansion of prisons, jails and re-entry centers. Nearly half of that money, $3.5 billion, will be used to add new beds and treatment and programming space at existing prisons. Among the ongoing projects are:
-- California Medical Facility
Location: Vacaville
Details: 64-bed mental health center at existing hospital
Cost: $33.6 million, or $526,000 a bed
Estimated date of completion: September
-- California Institution for Women
Location: Chino
Details: 45-bed acute- and intermediate-care mental health center for female inmates
Cost: $33.7 million or $750,000 a bed
Estimated date of completion: December
-- California Health Care Facility
Location: Stockton
Details: 1.2 million-square-foot medical center with 1,722 beds for patient-inmates
Cost: $906 million, or $52,000 a bed
Estimated date of completion: July 2013
-- California Men's Colony
Location: San Luis Obispo
Details: 50-bed mental health crisis unit
Cost: $35.7 million or $715,000 per bed
Estimated date of completion: September 2012
-- California Medical Facility
Location: Vacaville
Details: Additional treatment and office space for mental health patients
Cost: $24.2 million; no beds
Estimated date of completion: February 2013
-- DeWitt-Nelson YCF Conversion
Location: Stockton
Details: Renovation of former youth lockup into 1,133-bed adult mental health treatment center
Cost: $188 million, or $16,500 a bed
Estimated date of completion: August 2013
-- Estrella
Location: Paso Robles
Details: Conversion of former youth lockup to 1,000-bed adult center aimed at inmates with medical needs.
Cost: $110 million or $11,000 a bed
Estimated date of completion: unknown
-- California State Prison, Sacramento, Enhanced Outpatient program
Location: Sacramento
Details: Treatment and office space for 192 inmates
Cost: $12.7 million, no beds
Estimated date of completion: November
-- Lancaster State Prison
Location: Lancaster
Details: Treatment and office space for mental health services for 150 inmates
Cost: $11.49 million, no beds
Estimated date of completion: July 2012
-- Central California Women's Facility
Location: Chowchilla
Details: Treatment and office space for inmates with mental health treatment needs
Cost: $17.7 million, no beds
Estimated date of completion: October 2013
-- Corcoran State Prison
Location: Corcoran (Kings County)
Details: 14,932-square-foot building for mental health treatment space for existing inmates
Cost: $16.5 million, no beds
Estimated date of completion: February 2013
-- Salinas Valley State Prison
Location: Soledad
Details: Treatment and office space for mental health treatment for existing inmates
Cost: $25.3 million, no beds
Estimated date of completion: July 2013
-- Northern California Re-entry Facility
Location: Stockton
Details: 500-bed re-entry center for inmates at the end of their sentence
Cost: $116.8 million or $23,000 a bed
Estimated date of completion: 2013
-- Additional projects funded by AB900
$700 million to improve health sites at six existing prisons
$2.6 billion for up to 10,000 beds at secure re-entry centers in cities and counties around the state. The centers are located in local communities where inmates can serve the last part of their sentences and receive job training, mental heath and substance-abuse counseling, housing placement and other help.
At least two high-security additions to existing prisons at an unknown cost.
$1.2 billion for expansion of local jails. Counties may apply for the money if they agree to host a re-entry center. Five counties have already signed on.
E-mail Marisa Lagos at mlagos@sfchronicle.com.
This article appeared on page A - 1 of the San Francisco Chronicle
Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/08/13/MNHN1KJ12V.DTL&ao=all#ixzz1V0yQe8tR
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