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California's prison health care czar said in a report Tuesday that he has reached a "pivotal crossroad," with lawmakers failing to act and the state bureaucracy impeding his efforts to fix a system a federal judge found to be unconstitutionally bad. The third bimonthly report of Robert Sillen, director of the court-appointed California Prison Health Care Receivership, singled out the entire State Personnel Board as obstructing his reform plan. It also promised a construction program to create 10,000 hospital beds for physically and mentally ill inmate patients that will require billions in state funds to build and upward of 130 new employees to plan. Meanwhile, Sillen reported he is filling out his San Jose-based staff with professionals drawing substantial annual salaries. His $500,0000 -- more than twice Gov. Arnold Schwarzenegger's designated salary -- tops the list. The salaries do not include a benefit package that tacks on 30 percent. With progress running slower than expected -- Sillen's "plan of action" to fix the system is likely to run at least eight months late -- the receiver is threatening to seek court action to remove whatever obstacles he sees in his path. "The receiver will continue to work cooperatively and collaboratively with all stakeholders to the fullest degree possible," Sillen's report concluded. "However, maintaining the status quo is not an option. The mission ... will be accomplished, with or without cooperation. In this regard, the receiver anticipates seeking additional court orders whenever necessary to overcome the barriers imposed by those who attempt to obstruct the correction of unconstitutional conditions." U.S. District Court Judge Thelton Henderson placed the $1.5 billion prison health care system into receivership last year after finding it responsible for as many as 34 inmate deaths. Henderson appointed Sillen, the former director of the Santa Clara County medical system, to the receivership in February and gave him a virtual blank check on the state treasury and the power to suspend state laws and contracts to reshape the system. "At various levels of the organization, there have been those who have not been overly cooperative," Sillen said in an interview Tuesday. "And so we've dealt with that as we've gone along, and this is just to acknowledge that fact and to say we've had our boots on the ground for seven months now and we won't be thwarted and we won't be impeded. So people either have to cooperate or be held accountable for not cooperating." In characterizing his mission as having reached a crossroad, Sillen's report said the "overriding focus" of lawmakers over the past year -- seeking re-election -- resulted in "no progress" on the prison system's "gross overcrowding," where some 174,000 inmates are crammed into prisons designed for half that many. He singled out the State Personnel Board as the state's leading bureaucratic impediment, for requiring pre-employment drug testing for incoming licensed vocational nurses. Sillen wants to hire them to replace the custody-oriented medical technical assistants in frontline prison health care delivery jobs. The report called the drug-testing requirement "an apparent attempt to obstruct the MTA/LVN conversion." Sillen said "there are foreboding signs of resistance and obstinance from major agencies such as the State Personnel Board as well as individuals within various agencies of state government." He said "it may be necessary" for him to "move for sanctions" with the court against the personnel board "or to move to add the SPB as a party defendant in this case." State Personnel Board spokeswoman Sherry Evans said she can't comment on the report until the board reviews it. Sillen said the conversion to LVNs will save the state $39 million. California Correctional Peace Officers Association spokesman Lance Corcoran disputed the figure. "You will now need two people to do the job that one was accomplishing through the use of the MTAs," said Corcoran, whose union represents the prison system's 600 medical technical assistants. Sillen called for the construction of as many as seven medical facilities at existing prison properties around the state to add as many as 10,000 hospital beds for inmates in need of medical or mental health care. The Legislative Analyst's Office put the cost of the medical care beds alone at $3 billion over three to five years. Corrections Secretary Jim Tilton estimated in a report to the receiver that it will take a staff of 130 to plan, design and manage construction of the new facilities. Sillen said in an interview he expects the personnel to be requested in next year's state budget. As for the receiver's staff salaries, Sillen's is more than twice the $206,500 designated for Schwarzenegger (who only takes a dollar of it every year). Others drawing significant salaries include communications director Rachael Kagan ($180,000), chief medical officer Terry Hill ($350,000), chief medical information officer Justin Graham ($275,000), chief financial officer Rich Wood ($275,000), chief information officer John Hummel ($275,000) and acting health care project officer Jayne Russell ($187,678). |
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