LAO 2006-07 Budget Analysis: Judiciary & Criminal Justice

Analysis of the 2006-07 Budget Bill

Legislative Analyst's Office
February 2006

Adult Corrections

Who Is in Prison?

There were 164,179 inmates in the prison population as of June 30, 2005. About 93†percent of the population is male. Other demographics of the inmate population include the following:

Inmate and Parole Population Management Issues

Inmate Population Projected to Increase

The California Department of Corrections and Rehabilitation (CDCR) is projecting the inmate and parolee populations to increase in the current and budget years.

Inmate Population Increase. As of June 30, 2005, CDCR housed 164,179 inmates in prisons, fire and conservation camps, and community correctional facilities. The CDCR forecasts the inmate population will increase to 172,019 by June 30, 2007, a projected two year increase of 7,840 inmates, or about 5†percent, compared to the beginning of the current fiscal year. The state has not experienced a two-year increase in the prison population of this magnitude since the late 1990s. The projected increase in the inmate population is primarily the result of a recent trend of increasing admissions to prison from county courts. Figure†2 shows the year-end inmate and parole populations for the period 1996 through 2007.

Parole Population Increase. As of June 30, 2005, CDCR supervised 115,371 persons on parole. As shown in Figure†2, CDCR projects the parolee population to increase to 116,847 by the end of the budget year, an increase of 1,476, or 1†percent. This increase is primarily a result of the increase in the number of inmates released to parole after serving their prison sentence, as well as a decrease in the number of parolees discharged from state supervision.

Fiscal Implications of Population Changes. As a result of the projected increase in the adult inmate and parole populations, CDCR is requesting additional funds of about $89†million in the current year ($59†million in prison and parole costs and $30†million in payments to counties for jail beds), growing to $149†million in the budget year ($138†million for prisons and parole and $12†million for county jail beds).

Housing the Projected Growth in Inmate Population. The Governorís budget proposes an inmate housing plan to accommodate the additional 7,840 inmates that CDCR expects to receive by the end of the budget year. The plan has the following major elements:

Potential Risks to Accuracy of Projections. As we have indicated in past years, the accuracy of the departmentís latest projections remains dependent upon a number of factors, changes to any of which could result in significantly higher or lower populations. These factors include sentencing law, crime rates, and local criminal justice practices.

Caseload Will Likely Require Further Adjustment

We withhold recommendation on the 2006-07 budget request for caseload funding pending receipt of the May Revision because recent data indicate that the population is trending higher than the departmentís projections. We recommend that the administration provide, as part of its updated spring population projections, an estimate of the impact of the Governorís policy proposals on the inmate and parole populations. We will continue to monitor the caseload and recommend further changes, if necessary, following review of the May Revision.

Actual Inmate Population Increased Significantly in Recent Months. The fall 2005 projections anticipated that the inmate population would grow by about 2,200 inmates during the first half of 2005-06. Instead, it increased by about 3,900 inmates. According to the department, this population increase is attributable to a higher-than-anticipated number of inmates sentenced to state prison by the courts. The CDCR will issue updated population projections in spring 2006 that form the basis of its May Revision proposal. At that time, we will review whether adjustments to CDCRís funding for inmate and parole caseloads are warranted.

Budget Does Not Reflect Population Impact of Governorís Policy Proposals. The departmentís budget includes current- and budget-year expansions of various inmate and parole programs designed to reduce the likelihood that felons under CDCRís supervision will commit new crimes and return to prison. (See our discussion of Recidivism Reduction Strategies later in this chapter.) To the extent that these programs ultimately prove to be successful, one would expect a reduction in the prison population compared to what would occur in the absence of these expansions. The Governorís budget does not include any estimate of the likely population and associated fiscal effects of its proposed program expansions. We recommend that the department provide such an estimate as part of the May Revision process.

Analystís Recommendation. We withhold recommendation on the 2006-07 caseload funding request, though we recommend that the department adjust their request to reflect the likely impact of recidivism reduction programs proposed in the Governorís budget. We will continue to monitor CDCR population, and make recommendations as appropriate at the time of the May Revision.

Correctional Programs

Recidivism Reduction Proposal Requires Modification

The California Department of Corrections and Rehabilitation proposes to expand various inmate and parole programs designed to reduce reoffending and recommitment to state prison. While some aspects of the proposal have merit, the department has not provided sufficient justification for other parts of the proposal. We recommend approval of specific components of this proposal and rejection of other components pending further information. We also recommend additional steps the department should take to improve rehabilitative programs in prisons. (Reduce Item 5225-001-0001 by $28.4†million.)

Governor Proposes to Put the ďRĒ in CDCR

In creating the new CDCR, the administration emphasized a mission of rehabilitation (as well as incarceration) for offenders in state prisons as a means of improving public safety. The administration also emphasized the need to rely on research to develop evidence-based programs to reduce the likelihood that offenders will commit new crimes and return to prison.

To carry out this new mission, the department requested-as part of the 2005 May Revision-a total of $15†million in 2005-06 and $30†million in 2006-07 to expand adult inmate and parole recidivism reduction programs. However, because CDCR was unable to provide adequate detail on its proposal, the Legislature reduced the funding to $7.5†million for the current year and required the department to provide an implementation plan prior to expenditure of funds. This plan was received in January 2006.

Budget Request. The Governorís budget proposes a total of $52.8†million for new and expanded programs in the budget year. Under the Governorís proposal, this amount would grow to $79.3†million in 2007-08, and $95.3†million in 2008-09. This money would be used to develop and expand a wide range of programs designed to reduce recidivism, including education, rehabilitation, and treatment programs for inmates and parolees. The request also includes funds for a new local grant program administered by the Office of Community Partnerships, as well as funds for program research and evaluation, staff training, and support services in headquarters. Figure†3 shows the departmentís request by program area. We discuss each major component of the request in more detail below.

 

Figure 3

Recidivism Reduction Funding
Request by Program Area

(In Millions)

 

2005‑06

2006‑07

2007‑08

2008‑09

Prison Programs

 

 

 

 

Inmate education

$2.6

$21.1

$26.4

$26.1

Rehabilitative programs

0.1

6.0

6.9

4.3

Treatment

1.0

3.9

3.8

3.8

  Totals, Prison Programs

$3.7

$31.0

$37.1

$34.2

Parole Programs

$1.5

$7.8

$27.5

$48.1

Administrative Support

 

 

 

 

Community partnerships

$1.9

$7.7

$7.7

$7.7

Research and implementation

0.2

5.1

4.9

4.7

Training and development

0.5

1.5

Support services

0.2

0.6

0.6

0.6

  Totals, Administrative Support

$2.3

$13.9

$14.7

$13.0

    Totals

$7.5

$52.8

$79.3

$95.3

 

Inmate Education. In the current and budget years, the single largest component of the departmentís request is for expansion of inmate education programs. Among other things, the department would assess inmate education needs, increase the availability of academic and vocational programming in prisons, and provide new books and educational equipment. The department proposes to increase funding for inmate education by $2.6†million in the current year, growing to $26.1†million by 2008-09. The latter amount represents a 16†percent increase over estimated expenditures for inmate education in 2004-05. The departmentís inmate education funding request includes about 20 different components. We summarize the major components of this request below, which account for 40†percent of the new proposed educational funds in the budget year.

Rehabilitative Programs. Under the departmentís request, institutions would provide more rehabilitative programming through the development of services to increase inmate visiting, reduce serious inmate misconducts, as well as provide comprehensive correctional services specific to female inmates. The department proposes $100,000 in the current year, growing to $4.3†million in 2008-09 for six rehabilitative programs. We describe four of the components of this request below.

Treatment Programs. The departmentís proposal includes $1†million in the current year, growing to $3.8†million in 2008-09 for treatment programs. Most of this funding would be used to implement a new substance abuse program at Kern Valley State Prison. The remaining $100,000 in the current and budget years would be to contract with outside experts to research and develop in-prison treatment programs for mentally ill, dually diagnosed (with both mental health and substance abuse issues), and sex offender inmates.

Parole Services. By 2008-09, about half of the funding requested in this proposal will be for parole services. This funding would be used to develop new, and expand existing, community-based housing and services for parolees such as homeless parolees and sex offenders. The department is proposing $1.5†million in the current year, growing to $48.1†million in 2008-09. The three primary components of this proposal are described below.

Division of Community Partnerships. The departmentís budget includes $1.9†million in the current year, growing to $7.7†million in subsequent years to establish the CDCR Division of Community Partnerships. This proposal would establish nine positions to develop collaborations with counties and community groups, as well as administer a few million dollars in grants. According to the department, the focus of this office would be to promote reentry services for inmates as they reenter communities.

Research and Implementation. In order to accomplish its goal to develop evidence-based practices and programs, the department proposes $195,000 in the current year, growing to $4.7†million in 2008-09 for research and evaluation. This funding would increase CDCR research staff, fund research contracts with outside researchers, and update departmental information technology (IT) systems to incorporate program data.

Training and Development. The department requests $500,000 in the budget year and $1.5†million in 2007-08 for training. The departmentís request does not specify how these funds will be utilized.

Support Services. The department proposes $200,000 in the current year, growing to $600,000 in 2008-09 for seven positions. According to the department, these legal, IT, accounting, and management staff are the minimum necessary to provide sufficient support to ensure the success of the various program initiatives in this proposal.

Proposal Could Make Sense, but Is Incomplete and Too Ambitious

The departmentís request has merit in that it attempts to address major programmatic deficiencies that contribute to recidivism. For example, several of the proposals attempt to address common problems among offenders-low literacy and job skills, substance abuse, and housing instability upon return to the community. In addition, the needs assessment and evaluation components of this request are meant to address the departmentís limited ability to determine the programmatic needs of inmates and assess CDCRís ability to address those needs while incarcerated. Despite these positive aspects of the proposal, we have significant concerns with this request. We discuss these concerns below.

Limited Detail Provided. Many of the specific components of the departmentís proposal are accompanied by only limited detail. Many of the individual components of the proposal do not include sufficient detail to justify the request, including the lack of implementation plans, workload estimates, and clear evidence from the research that the proposed programs are likely to be successful at reducing recidivism. For example, the department has not yet identified what vocational programs will be activated at which prisons, despite the fact that the department will need to hire staff, purchase supplies and equipment, and perhaps make capital improvements before implementing the new programs. In addition, the department has not provided workload analyses to justify the number of positions requested for support services or project managers. The department also has not provided evidence from the research literature to support several of its proposals, including, for example, the alternative education programs and the Behavior Modification Unit.

Department Does Not Identify State Benefits. Should the strategies proposed by the administration be successful at reducing recidivism, there should be some future fiscal benefits to state and local governments through reduced criminal justice costs. However, the departmentís request does not estimate what those benefits are likely to be, nor does it suggest how it will identify those benefits in the future. These benefits are not likely to be significant in the current year, and it could take several years before the benefits are fully realized. However, it is important for the department to identify these potential benefits to weigh against the costs of developing and operating these programs. To the departmentĎs credit, the proposal does include research staff which would work to evaluate program effectiveness and outcomes, information which ultimately could be the foundation for more thorough cost-benefit analyses in the future.

Too Much, Too Quickly. We are also concerned that this proposal may contain too many components for the department to implement in the proposed timeframe. As we described in the 2005-06 Budget: Perspectives and Issues, CDCR is a large department with geographical dispersion of institutions but without an established infrastructure for implementing many rehabilitation programs. Moreover, the department has experienced program implementation failures in its recent history, including implementing legislatively mandated parole reforms such as electronic monitoring and substance abuse programs.

We are also concerned that several of the parole proposals would require contracts with community providers that may be difficult to secure on the scale envisioned in the departmentís request. For example, the department is requesting to expand the number of RMSC beds funded in the budget from 775 to 2,025, despite the fact that the department currently has only 376 beds under contract. We would also note that the department is currently in the process of implementing several other major statewide initiatives with which the various components of this request will compete for attention and resources, possibly delaying or preventing successful implementation. These other initiatives include completing the departmentís reorganization, managing the growth of the inmate population, and implementing lawsuit settlements related to inmate health care, parole revocations, and juvenile justice programs.

Finally, the departmentís request proposes to address a wide range of offender problems with a variety of programmatic efforts. However, it is possible that a more focused approach could also be more effective. Specifically, rather than spreading its resources across so many program areas, a potentially more effective approach to reducing recidivism would be for the department to focus its resources on improving and expanding a few programs that evidence shows are most effective at reducing recidivism. Our review of the literature suggests that such programs include classroom academic and vocational education, intensive substance abuse treatment, and cognitive behavioral therapy.

Operations Policies and Practices Limit Reach of Proposal

There are a few problems that have routinely limited the departmentís ability to provide programs. These problems are not addressed in this proposal. These include lockdowns, staff vacancies, the departmentís current funding structure, and the lack of incentives for inmate participation in rehabilitation programs. Unless the department addresses these issues, the proposed programs may not result in a significant increase in inmate rehabilitation. We address each of these issues below.

Lockdowns. During lockdowns, prison administrators confine large groups of inmates in their cells, typically in response to inmate violence or the threat of violence. When lockdowns occur, the prison keeps inmates-including those not involved in the incident that triggered the lockdown-from participating in programs. While the use of lockdowns is necessary to maintain the safety of a prison, there is evidence that the department overuses this strategy by not targeting the use of lockdowns to the most serious situations. According to department records, there were almost 600 lockdowns in state prisons in 2002-03 lasting an average of about two months each. (See our write-up on the departmentís use of disciplinary confinement in the Analysis of the 2005-06 Budget Bill, page D-34.) As a result, department records show that inmates are absent from education classes, for example, 24†percent of the time due to lockdowns.

Staff Vacancies. Inmates do not attend programs when there are staff vacancies, such as for teachers and vocational instructors. According to a staffing report from the State Controllerís Office, about 28†percent of the departmentís 1,300 teacher and instructor positions were vacant on December 31, 2005. These vacancies occur for a number of reasons, including difficulty hiring teachers in some locations and frequent lockdowns that reduce the need to fill teacher positions. In addition to permanent staff vacancies, teaching positions are often vacant when instructors take short-term leaves, such as for sick leave, vacation, and training. The CDCR reports that in 2004-05, teachers took an average of 23 days of leave during the year. Yet, despite frequent vacancies and leaves, the department does not utilize substitute teachers to fill vacancies, nor is it authorized to hire emergency credentialed teachers, steps which would help ensure that inmates continue their education program during staff absences. The department reports that inmates miss education classes 19†percent of the time due to instructor absences.

Current Funding Structure. The current process by which prison programs are funded contributes to inmates not getting to classes. This is because programs are not funded based on actual attendance, but rather based on expected attendance thereby limiting the incentive for prison administrators to ensure that programs are operating and inmates are in class. Under current practice, CDCR requests education funds, for example, based on the number and type of programs it plans on providing in the budget year, generally based on prior-year levels. The department then distributes these funds to each institution based on the number and types of programs expected to be operated at each prison.

However, the funding for these programs does not reflect the difference between projected enrollment and actual attendance levels that occur because of the frequent lockdowns and staffing vacancies described above. Because enrollment figures are usually higher than actual attendance, the department is budgeted to provide more educational services than it actually provides. Yet, there is no requirement that CDCR return education funding to the General Fund when prisons are unable to keep teacher positions filled or when prison administrators choose to keep inmates in lockdown much of the year.

In contrast, funding for public schools primarily reflects average daily attendance (ADA) rates which measure how often students are actually in class rather than the number of students enrolled in a school. In so doing, this provides incentive for schools to do as much as they can to ensure that students are in the classroom. Otherwise, the schools lose funding. No such incentive exists for prison administrators under the current funding structure. In other words, under the current funding structure, the department does not experience a fiscal consequence when enrolled inmates are not attending education programs because of lockdowns, vacancies, and leaves.

Fewer Incentives to Participate in Education Programs Than Other Programs. There is currently a disincentive for inmates to participate in education programs as compared to other prison programs. Most inmates who enroll in education programs earn work release credits equal to one day off from their sentence for each day in the program (commonly referred to as ďday-for-dayĒ). While these credits do provide some incentive to be in an education program, other programs provide greater benefits. For example, inmates who participate in conservation camps or drug treatment furlough programs can be released earlier than if they had participated in an education program. For example, inmates in conservation camps earn two days off of their prison sentence for each day in the program. Also, inmates assigned to a job in prison, such as working in the prison kitchen or laundry, not only receive day-for-day credits, but in addition, earn a small income, a benefit that participation in education programs does not provide. This structure, therefore, provides a relative disincentive for inmates to enroll in education programs as compared to other programs or prison jobs where they can earn income or greater work release credits.

Modify Proposal to Reflect More Realistic Implementation

We recommend approval of $24.4†million of the departmentís request for budget-year funding. We recommend rejection of the remaining components totaling $28.4†million pending the receipt of additional information. In addition, we recommend that proposed out-year program expansions be separately requested and considered based on the departmentís progress.

Approve Only Those Proposals With Sufficient Detail. We recommend that the Legislature only approve those components of this request where the department has provided sufficient detail to justify its request, including relevant implementation plans, workload analyses, and research evidence. We believe such components include the departmentís requests related to womenís programs, substance abuse, and research, for example.

We recommend rejection of many of the remaining components of the proposal. Further, we would ultimately recommend rejection of any department proposals where CDCR is unable to provide additional information during the course of the budget process to justify its request. The specific programs with which we have significant concerns are identified below, as well as the reduction in budget-year funding that would occur from rejecting these particular program components should the department not provide adequate justification for the proposals.

Figure†4 shows the fiscal savings associated with our recommendations.

 

Figure 4

California Department of Corrections and Rehabilitation Recidivism Reduction Proposal
LAO Recommendations—2006‑07

(In Millions)

Issues

Governorís
Request

LAO
Recommended
Funding Level

Savings

Inmate education

$21.1

$5.8

$15.4

Rehabilitative programs

6.0

3.9

2.2

Treatment

3.9

3.8

0.1

Parole programs

7.8

5.3

2.5

Community partnerships

7.7

2.6

5.1

Research and implementation

5.1

3.0

2.1

Training and development

0.5

0.5

Support services

0.6

0.6

  Totals

$52.8

$24.4

$28.4

 

 

We would note that some program proposals that currently lack detail are promising approaches. For example, though the department has not provided an implementation plan for additional vocational programs, the research literature on vocational programs suggests that they can be effective at reducing recidivism when the vocational training provided to inmates matches a viable job market in the community. Also, the department suggests that it would like to more often utilize half-day academic education programs. While no implementation plan has been provided here either, we would note that many other states utilize half-day programs, allowing inmates to regularly participate in multiple prison programs during a day, including vocational education, substance abuse, mental health services, and inmate jobs in addition to academic education.

Funding Should Only Be for Budget Year. Given our concerns regarding the ability of the department to implement so many program initiatives at one time, we recommend that the Legislature only approve the funding request for the budget year and not the additional increases assumed for 2007-08 and 2008-09. The detail for the next round of program expansions should be identified with the release of the Governorís 2007-08 budget plan. At that time, CDCR could present the status of program expansions initiated in the current and budget years, allowing the Legislature to determine which further program expansions are warranted.

Adopt Policies and Practices That Facilitate Program Delivery

We propose additional steps that could be taken to improve program delivery in prisons, as well as recommend a reporting requirement to ensure legislative oversight.

Additional Changes to Improve Rehabilitation. As described earlier in this write-up, there are several issues that limit the successful provision of inmate programs, in particular education programs. We identify steps the Legislature and administration could take to reduce these problems, several at little or no cost to the state.

Under our proposal, the amount of total funding for education would be set in the GovernorĎs budget proposal, and approved by the Legislature, just as it is now. However, this funding would be directly linked to projected attendance for academic and vocational programs. If actual attendance in academic programs falls short of these projections, a proportionate share of the education funding would revert to the General Fund.

Establishing an inmate education funding formula would provide a couple of benefits over the existing structure. First, an ADA formula would provide an incentive for the department to ensure that inmates go to programs regularly, knowing that if inmate attendance is low, the department will lose funding. This could have the benefit of CDCR being more strategic in identifying the best locations to operate academic and vocational programs-for example, at the prisons with lower vacancy rates and fewer lockdowns-and being more proactive in finding solutions to vacancy and lockdown problems that lead to low attendance.

Second, the proposed formula would improve accountability by more accurately aligning budget authority for education programs with actual expenditures on in-classroom instruction. In other words, the Legislature would know that CDCR funds spent on inmate education were actually used to educate inmates.

For example, one approach would be to link inmate pay scales with different levels of educational programming. Thus, an inmate who has advanced to high school level classes, for example, would earn more in his prison job than when he was in the middle school level class. The top paying prison jobs, provided by the Prison Industry Authority, would be reserved for inmates with a high school diploma or equivalent. This approach would not only provide an incentive for inmates to enroll in school, but importantly, to successfully advance in their studies. In addition, CDCR could similarly provide benefits such as extra visiting or recreation time, choices of better housing or work options, or special meals for those inmates who advance to higher academic levels. Providing an incentive for inmates to advance in programs is particularly important because research demonstrates that achievement of certain education levels, such as basic literacy and high school equivalency, are even more highly correlated with reduced recidivism than just participation in education programs.

It is also possible to use an inmateís release date as an incentive for program participation and success. One option for legislative consideration would be to enact a law providing ďeducation release creditsĒ for inmates who achieve certain levels of attainment while in prison. For example, an inmate who earned a vocational certification or high school diploma while in prison could receive specified credits towards his/her release date. As with all early release credits, they can be revoked if an inmate has serious disciplinary infractions while in prison. These bonus credits could be capped to ensure that no inmate earns an inordinate amount of time off of his/her sentence.

Department Should Report on Annual Basis. In order to ensure legislative oversight, we recommend the adoption of budget bill language requiring CDCR to report on the implementation status of any programs approved as part of this budget request. In subsequent years, the department should be required to begin providing annual reports on the estimated impacts of prison and parole programs. The following language is consistent with this recommendation:

5225-001-0001 Provision X. No later than January 10, 2007, the California Department of Corrections and Rehabilitation shall submit to the Chair and Vice Chair of the Joint Legislative Budget Committee, and the Committee on Budget in both the Assembly and Senate, a report providing the latest status of all programs approved as part of the Recidivism Reduction Strategies budget augmentation. This report shall, where applicable, include information on the number of actual inmate and parolee participants in each program, the timeline for full program implementation, and the reasons for any implementation delays.

Correctional Health Care

Expanding Telemedicine Program Could Reduce Costs and Improve Health Care

Our review finds that opportunities exist for the California Department of Corrections and Rehabilitation to significantly expand its use of telemedicine in prisons, thereby enhancing public safety, generating cost savings, and improving inmatesí access to care. We recommend the enactment of legislation to increase the use of telemedicine in prisons by requiring the department to (1) establish guidelines for the use of telemedicine, (2) provide more medical specialties via telemedicine, and (3) set annual performance targets.

The CDCR delivers health care services to inmates in several ways. Generally, primary care and psychiatric services are provided in prison by CDCR staff or contract staff. In addition, certain medical specialty care is provided in prisons by health care staff during regularly scheduled clinics. Inmates in need of other medical specialty care or hospital care are transported outside the prison to community health care facilities for treatment. In recent years, inmates also have received medical and mental health treatment through an alternative means known as telemedicine.

What Is Telemedicine? Telemedicine is the delivery of health care via interactive audio and video technology. Through the use of telecommunications systems, live images of the patient are transmitted over telephone lines to the doctorís office. Equipment such as exam cameras, monitors, and electronic stethoscopes allow physicians to treat patients without meeting them face-to-face. Telemedicine is often used by psychiatrists to evaluate and provide therapy to patients with mental health problems. Telemedicine is also used for initial and follow-up consultations in medical specialties such as dermatology and orthopedics. Orthopedists, for example, can use telemedicine to monitor patients with chronic back pain, or check a patientís progress following an operation. Medical consultations that require physical contact between a physician and patient, such as biopsies and surgeries, are not appropriate for telemedicine.

Telemedicine is used by public and private health care providers throughout the country to treat patients who otherwise would have to travel long distances to confer with a health care professional. In fact, the California Public Employeesí Retirement System recently began offering telemedicine services to health plan members living in rural areas of the state.

Telemedicine is also used in many states to treat incarcerated persons. Currently, 26 state correctional systems, including California, use telemedicine to provide care to inmates. With telemedicine, an inmate in need of care is directed to an in-prison examination room equipped with a monitor and camera. Prison health care staff introduces the inmate to the physician, who is off-site in an office (such as in a community hospital or clinic) also equipped for telemedicine. The interactive technology allows physicians to observe and speak with inmates about their medical or mental health condition without the need for an in-person consultation.

Benefits of Telemedicine in Correctional Settings. Correctional facilities have found that telemedicine is beneficial in multiple ways. First, telemedicine enhances public safety. This is because inmates who otherwise would have been transported into the community for medical treatment instead remain inside prison walls for their consultation. Second, telemedicine reduces costs associated with transporting ill or injured inmates to outside medical facilities. These costs include fuel and vehicle costs to transport inmates, as well as staffing costs for correctional officers to escort inmates to their medical appointment. Depending on the frequency with which prisons use telemedicine, the costs for telemedicine staffing, equipment, and maintenance can be more than offset by savings generated from avoiding medical trips. Contract costs with physicians may also be lower for correctional systems that deliver health care services using telemedicine as opposed to traditional in-person consultations. This is because telemedicine provides the opportunity to bid out contracts to a larger pool of physicians licensed to practice in a given state, rather than only to those contract physicians practicing in the region of a specific prison.

A third benefit of telemedicine is that it improves inmatesí access to health care by enabling correctional systems to expand their provider network to include physicians located outside the immediate vicinity of prisons. Improved access is one of the major goals of the Plata settlement agreement under which the courts have required that the state improve its delivery of health care to inmates. Telemedicine is particularly beneficial for inmates housed in remote areas of a state with shortages of health care professionals. Under federal law, all inmates are legally entitled to medical and mental health care. In fact, research suggests that inmates who receive their health care treatment via telemedicine are more likely to be seen on a timely basis, often by the same doctor, than if their only option was a face-to-face consultation.

Californiaís Correctional Telemedicine Program. The stateís prison telemedicine program began in 1997 as a pilot project for mental health inmates at Pelican Bay State Prison (Crescent City). The prisonís remote location made it difficult for the department to hire or contract with on-site psychiatrists. Consequently, inmates with mental health problems (including bipolar disorder and schizophrenia) were not seen regularly by clinical staff. The introduction of telemedicine allowed the department to use psychiatrists assigned to a Sacramento-area prison to prescribe medications and provide therapy to inmates at Pelican Bay. The pilot project was successful at improving inmatesí access to mental health care. Accordingly, the department decided later that year to expand the telemedicine program to provide mental health as well as medical specialty services at other prisons.

As Figure†5 shows, the program grew considerably within a few years, peaking at over 10,000 telemedicine consultations-about 5,200 of them medical specialty-related-in 2002-03. The department provided 9,100 telemedicine services in 2004-05, including 4,700 medical specialty consultations and 4,400 psychiatric consultations. Currently, 27 of the stateís 33 prisons are equipped to provide telemedicine services. While the telemedicine program has been expanded to most of the stateís prisons, the number of outside health specialists participating in the program is small. The department employs one infectious disease specialist, and contracts with a private medical group as well as four specialists from the University of California, Davis.

Until 2002-03, staffing and equipment for the telemedicine program were largely funded by the department using existing resources. Since a nurse must accompany the patient in the examining room to assist the off-site physician during consultations, prisons often pulled registered nurses from their regular duties in order to provide telemedicine services. As part of the Plata settlement agreement, however, the Legislature authorized one registered nurse position per prison dedicated to telemedicine, as well as one-time funding for additional telemedicine equipment and telecommunications lines at each prison. The purpose of these registered nurse positions is to increase inmatesí access to specialty medical care by performing duties such as scheduling inmates for their telemedicine appointment, operating telemedicine equipment, and ensuring that physiciansí orders are carried out. Under the settlement agreement, these resources are phased in at five to eight prisons per year beginning in 2002-03 and ending in 2007-08. As of January 2006, 22 prisons have participated in the rollout at a total annual ongoing cost of approximately $1.8†million for the telemedicine nurse positions and about $1.6†million in one-time costs for telemedicine equipment and lines. The 2006-07 Governorís Budget provides about $600,000 more for five additional prisons to receive telemedicine staff and equipment beginning January 1, 2007. By January 2008, all prisons will have received telemedicine staff and equipment.

The telemedicine program is administered by the Office of Telemedicine Services, a unit of CDCRís Division of Correctional Health Care Services. Currently, the telemedicine program is staffed by seven employees at headquarters. According to the department, the programís operating costs are more than offset by savings resulting from reduced transportation and medical guarding costs. The department estimates that it saves on average about $850 in transportation and medical guarding costs for each outside medical visit that is avoided due to telemedicine. In total, approximately $4†million in transportation and medical guarding costs were avoided in 2004-05 because of the program. The savings estimates appear to be reasonable based on our review of the departmentís methodology and the experience of other correctional telemedicine programs.

Department Is Underutilizing Telemedicine. Despite the growth of CDCRís telemedicine program since 1997, our review of the program finds that it is underutilized. We base this conclusion on a study done by the departmentís Office of Telemedicine Services. As a result, the benefits of telemedicine-including increased public safety, cost-effectiveness, and access to health care services-are not maximized.

In a 2003 study by the Office of Telemedicine Services, department staff reviewed a sample of records from actual medical specialty consultations provided by physicians to inmates in community medical facilities. The purpose of the study was to estimate the number of outside consultations that could have been provided via telemedicine. Based on its own assessment of the records, CDCR estimates that increased usage of telemedicine could further reduce the number of outside medical visits department-wide by as much as 20,000 per year. (The study also concluded that about 10,000 medical specialty consultations per year are not appropriate for telemedicine.) The department estimates that if the 20,000 consultations had been done via telemedicine, it could have saved up to $17†million annually in transportation and medical guarding costs. Savings could be even higher to the extent that increased usage of the program reduces contract rates with physicians. This is because the department can bid out contracts to specialists throughout the state, as opposed to only those practicing in the vicinity of a prison.

We have identified two factors that probably explain why telemedicine is underutilized by the department. First, CDCR encourages, but does not require, prison health care staff to use the program even when it could be effectively substituted for off-site medical appointments. Second, CDCR offers only a limited number of medical specialties through telemedicine. As a result, inmates that otherwise could be seen by a doctor using telemedicine are instead transported into the community for a face-to-face consultation. These findings are discussed in more detail below.

Prisons Not Required to Use Telemedicine; Policy Hinders Program Expansion. As noted above, 27 of CDCRís 33 prisons are equipped to receive telemedicine services. As Figure†6 displays, however, prisons with telemedicine equipment vary significantly in terms of their usage of the technology. In fact, of 9,090 telemedicine consultations in 2004-05, almost two-thirds (5,740) were conducted at just five prisons. The other 22 prisons accounted for just over one-third (3,350) of total consultations. Nine of the twenty-seven prisons with telemedicine equipment did not use the system at all, and thus did not generate any savings by avoiding outside trips to medical facilities.

Our review finds that the variation in usage among prisons is due in large part to longstanding department policy that makes their participation in the telemedicine program strictly voluntary. Prison health care staff are given the option to use telemedicine or to rely instead on traditional in-person consultations in order to deliver health care services. Accordingly, the extent to which a prison uses telemedicine can depend on the preference of an institutionís health care supervisors. This is true even for prisons that have received additional telemedicine resources as part of the Plata rollout. For example, it is our understanding based on discussions with department staff that health care managers who, under Plata, received a registered nurse position for telemedicine may opt to use the position exclusively to perform nontelemedicine-related duties at the prison. As a result, a number of institutions continue to send inmates with specialty care needs to outside medical facilities rather than use telemedicine, which increases department costs and potentially compromises public safety.

Department Offers Limited Number of Medical Specialties Via Telemedicine. The department offers telemedicine services in psychiatry and about a dozen medical specialties, including dermatology, orthopedics, infectious diseases, neurology, and pain management. Unlike other correctional and noncorrectional telemedicine programs in the country, however, the department does not provide additional specialties via telemedicine such as cardiology; hematology; gastroenterology; and ear, nose, and throat. Our review finds that CDCR could increase inmatesí access to health care services as well as generate additional savings by increasing the number of medical specialties it offers through telemedicine. For example, medical specialists performed roughly 4,500 cardiology and hematology/oncology consultations for inmates in 2004-05, including initial consultations and post-surgery follow-up appointments, both of which would be appropriate for telemedicine. Yet, none of these consultations were performed using telemedicine because the department does not currently contract with telemedicine physicians in these specialty areas. Consequently, the department is not taking full advantage of the cost savings that telemedicine could generate.

Establish Guidelines and Performance Targets for Telemedicine. In order to maximize cost savings potential, we recommend the enactment of trailer bill language that requires prisons to use the telemedicine program for all medical consultations that are appropriate for telemedicine consultations. Specifically, we recommend the trailer bill language require that, by January 2007, the department establish guidelines concerning the specific conditions under which telemedicine consultations be used in place of outside medical visits. Medical specialty appointments that meet these criteria would be provided via telemedicine. For example, a guideline could state that consultations with a dermatologist to evaluate rashes and other skin lesions take place via telemedicine unless physical contact between the doctor and inmate is required (such as for a biopsy). In order to promote the use of telemedicine whenever medically appropriate, the department also would be required to provide additional medical specialties to inmates (such as cardiology and hematology) via telemedicine.

We further recommend the trailer bill language require that, beginning in 2006-07, the department establish annual performance targets for prisons regarding the total number and percentage of medical specialty consultations that are conducted by telemedicine rather than at community medical facilities, and to report to the Legislature on its plans and performance. To establish reasonable targets, health care staff could review prisonsí records of recent medical specialty visits to determine how many consultations outside prison walls could have been performed via telemedicine. The departmentís preestablished performance targets can later be compared with actual outcomes-as well as results from previous years-to measure CDCRís level of improvement and overall success at reducing costs. The eventual goal would be to limit in-person consultations in the community to only those that, due to the nature of the medical problem, must be conducted in a face-to-face encounter between physician and inmate. By requiring the department to report regularly on its efforts and results, the Legislature would be in a better position to hold the department accountable for its performance.

Initially, the new requirements for telemedicine usage and performance targets should apply to prisons that have already received telemedicine resources as part of the Plata rollout. In addition, the performance measurement system would need to recognize that there may be mitigating factors that prevent the department from meeting its performance targets, such as the changing prison population. The performance targets also would need to take into account the extent to which contract specialists are available to provide telemedicine consultations. Adoption of this recommendation would require the department to augment its medical provider network. For example, the network would have to at least double in size if it were to provide an additional 5,000 medical consultations annually. We believe that this is feasible given the relatively small size of the telemedicine programís current provider network and the availability of other providers in the state that offer medical specialty services via telemedicine.

Costs to develop guidelines on telemedicine would be minimal, and could most likely be absorbed by the department using existing resources. The Office of Telemedicine Services could require a few additional staff (such as analytical and records staff) to support the programís expansion, though these costs likely would be fully offset by savings from the avoidance of outside medical visits. We recommend that the department report at budget hearings concerning any additional resources it would need to expand the telemedicine program.

Administration Agrees to Costly Inmate Dental Plan

The Governorís budget requests funds for the California Department of Corrections and Rehabilitation to comply with the Perez v. Hickman settlement agreement regarding inmate dental care, reached in December 2005. Overall, we find the departmentís budget request to be consistent with the requirements of the settlement agreement. However, we recommend adoption of budget bill language that restricts the departmentís funding and position authority to implement the agreement pending receipt and review of a court-required staffing study. We further recommend the adoption of supplemental report language to improve legislative oversight.

Perez v. Hickman Lawsuit and Settlement Agreement. In December 2005, Perez v. Hickman was filed in federal court contending that CDCR was in violation of the Eighth amendment of the United States Constitution by providing inadequate dental care to prison inmates. Some specific examples of key issues raised in the Perez class-action lawsuit include: (1) inadequate numbers of dentists and dental assistants, (2) lack of proper training and supervision of staff, (3) insufficient dental equipment such as examination chairs and x-ray machines, (4) poorly organized inmate dental records, and (5) unreasonably long delays for inmates to receive dental treatment, including prisoners with dental emergencies.

The lawsuit was filed concurrently with a settlement agreement reached between the state and the plaintiffs. The agreement committed the state to implement significant changes in the delivery of dental care services to inmates. The agreement requires the department to implement a number of newly developed policies and procedures at all 33 state prisons over a six-year period, beginning with 14 prisons in July 2006. The agreement focuses on improving inmate access to dental care, as well as the quality of dental care services provided in the prisons. For example, the policies and procedures require the department to treat inmates within specified time frames according to the severity of the dental problem, and set standards of care that prison dental staff must provide.

Generally, the policies and procedures modify or reiterate existing state regulations. For example, under the agreement the department is required to provide a dental examination to inmates within 90 days of arriving at an institution from a reception center, and provide subsequent examinations annually for inmates over 50 years of age and biennially for inmates under 50. Title 15 of the California Code of Regulations currently requires examinations within 14 days of an inmateís arrival; current requirements for subsequent inmate dental examinations are consistent with the settlement agreement. According to the department, none of the 33 prisons currently complies with the policies and procedures.

Staffing Study Required. The settlement agreement also directs CDCR to complete a study of the types and amount of additional staff it will require to implement the policies and procedures according to the schedule in the implementation plan. This study must be completed by June 1, 2006. The department is then required to hire personnel based on the results of the staffing study.

The Budget Proposal. The administration presents a three-year funding proposal in response to the lawsuit. (The administration indicates that it will request additional resources in 2009-10 to implement the policies and procedures at institutions for the final three years of the six-year rollout period.) The ongoing annual cost of the three-year funding proposal is estimated to be $42†million (an increase of 95†percent) with an additional commitment of 597 staff for this activity (an increase of 144†percent), as shown in Figure†7. The current inmate dental program consists of $44†million and about 415 positions.

 

Figure 7

Perez v. Hickman
Funding and Positions

2006‑07 Through 2008‑09
(Dollars in Millions)

 

Positions

Ongoing Cost

2006‑07

326

$21.2

2007‑08

84

9.4

2008‑09

187

11.4

  Totals

597

$42.0

 

In order to provide an increased level of dental care to inmates, the budget proposes an additional 326 positions and $21.5†million in 2006-07. (Of this amount, only $21.2†million will be an annually ongoing cost, as shown in Figure 7.) The request consists of 285 prison positions, mostly dentists and dental assistants, to be phased in throughout 2006-07 at a cost of $13.1†million. The budget also proposes $3.5†million for 41 headquarters positions to provide oversight of the dental rollout. In addition, the budget requests $1.2†million in one-time contract funding to determine which prison dental clinics will need to be expanded in order to comply with the settlement agreement, as well as $3.7†million in one-time funding to acquire dental equipment such as dental chairs and x-ray equipment.

Request is Reasonable, but Results of Staffing Study Still Pending. Our review of the request indicates that it is consistent with the settlement agreement. The proposal would add an average of four dentists and ten dental assistants to each of the rollout institutions over the course of the budget year. While we think this level of staff seems reasonable in light of the potential workload associated with the settlement agreement, this staffing level is not based on a staffing study as required by the court. According to the department, this is because there was not enough time to conduct the study prior to submittal of the budget request. The CDCR has indicated that a contractor has been hired to conduct the study, which is on track to be completed by June 2006.

Budget Bill Language Needed to Authorize Funding and Positions as Needed. Because the staffing study is not due to be completed until June 2006, it will probably be difficult for the Legislature to take its findings into consideration as part of the budget process. Consequently, we recommend the adoption of budget bill language that would allow the Legislature to adjust the funding and position authority as needed based on (1) the findings of the staffing study and (2) the departmentís progress in filling these positions. As regards the latter, we would note that the department currently has a 13†percent vacancy rate for dentists and a 15†percent vacancy rate for dental assistants. As such we question whether the department can fill the over 200 dentist and dental assistant positions requested in the budget year. To the extent the department is unable to fill positions in 2006-07, we believe that any unspent funds should revert to the General Fund.

In order to accomplish this, we recommend the Legislature appropriate $21.5†million in a separate item of the 2006-07 Budget Bill and adopt budget bill language that provides a total of $14.2†million to fund the establishment of 124 positions ($9.3†million) on July 1, 2006, as well as provide one-time equipment and contract funding ($4.9†million). The language would provide for authorization of the remaining funding and positions after the staffing study is completed and the Department of Finance certifies that the staffing and funding provided in the budget act are consistent with the results of the staffing study. The following budget bill language for Item 5225-xxx-0001 is consistent with these recommendations.

1. Of the funds appropriated in this item, $14,080,388 is to fund 124 dental staff positions, as well as equipment and contract costs, with a July 1, 2006 start date as part of the Perez settlement agreement.

2. The remaining $7,406,612 to fund 202 positions may not be expended by the California Department of Corrections and Rehabilitation until the Department of Finance provides to the Joint Legislative Budget Committee a copy of the staffing study and a letter certifying that staffing levels are consistent with the findings of the staffing study. The Joint Legislative Budget Committee shall have 60 days to review the staffing study and letter prior to authorizing funding and position authority.

3. Unspent funds in this item shall revert to the General Fund at the end of 2006-07.

The benefit of this approach is that it appropriates the funding required to comply with the lawsuit, while at the same time ensuring that CDCR does not receive more positions than it requires based on the staffing study. It would also ensure that any salary savings resulting from the departmentís inability to fill the positions, should that be the case, are not redirected for other unrelated purposes.

Require Annual Report. Given the potential magnitude of the stateís investment in the prison dental care system in the Perez court case, the Legislature should require CDCR to report periodically on a number of key indicators of its progress in implementing the policies and procedures. This would allow the Legislature to assess the extent to which the investment of public resources is moving the state toward full compliance with the court settlement agreement.

Accordingly, we recommend the Legislature adopt supplemental report language that directs CDCR to annually provide the Legislature information on the inmate dental care delivery system, including dental staff vacancy rates and compliance with the time frames required by the settlement, so that the Legislature may track the departmentís progress in improving the inmate dental program during the rollout period. The following supplemental report language is consistent with this recommendation.

The California Department of Corrections and Rehabilitation shall provide on December 1, 2006, December 1, 2007, and December 1, 2008 a report to the chairs of the fiscal committees in both houses and Joint Legislative Budget Committee on the status of the implementation of the Perez settlement agreement. The report to the Legislature shall identify specific outcomes relating to the settlement agreement and its goal of providing increased access and higher quality dental care services. The report shall include information on dental staff vacancy rates, as well as the number and percentage of applicable inmates at each rollout prison that were (1) provided with an initial dental examination within 90 days of arrival at an institution, (2) provided with subsequent examinations annually or biennially, and (3) seen within appropriate time frames according to their designated treatment priority level.

Health Care Vacancies Raise Concerns; Cost the State

The California Department of Corrections and Rehabilitation has a significant number of vacancies at headquarters in its Health Care Services Division which limits its ability to effectively oversee required changes in health care delivery, and results in higher state costs for inmate health care. Our review also finds that the department has made little progress to date addressing health care vacancies in the prisons. We recommend that the department report at budget hearings on this issue.

Health Care Vacancies at Headquarters. The CDCR currently has approximately 390 positions at headquarters in its Health Care Services Division (HCSD). These positions are responsible for a variety of activities relating to the administration and oversight of the prison health care services delivery system. Based on a December 2005 report prepared by the State Controllerís Office (SCO), about 135 of these HCSD positions (or 35†percent) were vacant. In fact, nearly 60†percent of all management positions in the division were vacant, including positions in such classifications as Chief Dentist, Chief Medical Officer, Physician and Surgeon, Pharmacy Services Manager, and Staff Services Manager.

Prison Health Care Vacancies. As we discussed in our 2005-06 Analysis, high vacancy rates in key health care provider positions have been a persistent problem in the prisons. (For more information, see page D-57 in our Analysis of the 2005-06 Budget Bill.) Our review of the December 2005 SCO report indicates that the department has made no progress during the last year in addressing the vacancy problem. For example, the report shows a vacancy rate of 30†percent for the physician and surgeon classification, 31†percent for registered nurses, and 42†percent for pharmacists. These vacancy rates are higher than those reported in 2004. This, in part, reflects the recent authorization of new positions. Nonetheless, the data illustrate that CDCR continues to struggle with hiring health care staff to work in the prisons. In December 2005, the federal judge in the Plata v. Schwarzenegger court case ordered the state to increase compensation for several classes of prison medical personnel (including physicians, nurse practitioners, and registered nurses) in an effort to reduce position vacancies and increase retention of staff.

We would note that many of the positions that remain vacant were provided by the Legislature in the current year to implement reforms required under the Plata settlement agreement. For example, all six facility captain positions provided in the current year to assist institutions with training officers in new protocols for escorting inmates to medical appointments pursuant to Plata are vacant.

Analystís Concern and Recommendations. This level of vacancies raises concerns about the departmentís ability to implement changes required by the court. In addition, we note that chronic vacancies in some positions result in higher inmate health care costs to the state. For example, our discussions with the department indicate that hundreds of its contracts with community hospitals and other health care providers have expired. According to the department, a shortage of staff has prevented CDCR from establishing new contracts in a timely fashion. As a result, the department sometimes transports inmates to more distant hospitals where there are contracts in place, which results in higher medical guarding and transportation costs. The unbudgeted costs associated with this practice are unknown, but could be significant.

In view of the above, we recommend that the department report at budget hearings on why it has failed to fill vacancies at headquarters in HCSD, as well as provide as part of the May Revision a detailed plan for recruiting and retaining sufficient staff to oversee the delivery of inmate health care services. The department should also be required to update the Legislature as part of the subcommittee process on its progress in implementing the pay raises required by the federal court order.

Correctional Administration

Custody Assistants Would Reduce State Costs and Improve Operations

The California Department of Corrections and Rehabilitation could improve prison operations and efficiency, as well as reduce state costs by utilizing a custody assistant classification similar to that used in some county jails. We recommend the adoption of budget bill language directing the department to develop a non-peace officer custody classification-custody assistants-for future use in state prisons.

Custody Operations in State Prisons. Correctional officers are the primary staff in state prisons responsible for the supervision and control of inmates. The day-to-day duties of correctional officers vary among specific assignments in correctional facilities, and include such tasks as conducting cell searches, escorting inmates, and supervising housing units. Many of these duties have inherent risks when, for example, officers respond to emergencies and control inmate altercations. Correctional officers are provided training to develop the skills necessary to handle these responsibilities, and the state compensates correctional officers accordingly for their training and the inherent risk of the job. There are approximately 23,000 correctional officer positions in state prisons supervising 168,000 inmates.

In addition to the potentially dangerous duties performed by correctional officers, there are also a number of custody-related activities they regularly perform that do not require control of or significant contact with inmates. For example, correctional officers staff employee entrances, control booths, and mail and property rooms. The use of trained peace officers in positions that do not require significant contact with inmates suggests a mismatch of staff skills and duties.

Non-Peace Officer Custody Classification Used Widely in Some County Jails. Similar to the state, both Los Angeles and San Bernardino Counties use peace officers-deputy sheriffs-as the primary custody staff to supervise and manage the inmate population. However, these counties also utilize non-peace officer staff to assist deputy sheriffs in the operation of the jails. Generally, these non-peace officer classifications-known as custody assistants in Los Angeles and sheriffís custody specialists in San Bernardino-have little direct contact with inmates, instead performing those custody-related duties that are not directly involved in the control of inmates. These duties include staffing employee entrances, reviewing videotape, working in control booths, and fingerprinting inmates. Figure†8 shows the use of peace officer and non-peace officer custody staff in Los Angeles and San Bernardino jails compared to state prisons.

Use of Custody Assistants Would Have Significant Benefits in State Prisons. Based on our visits to county jails and discussions with county personnel, we have identified several potential state benefits from converting some correctional officer posts to a non-peace officer custody classification similar to those used in Los Angeles and San Bernardino Counties. This conversion would involve creating a new custody assistant classification to be filled by new employees and moving current correctional officers to vacant posts that require more direct contact and control of inmates. The benefits from doing so would include the potential for improved prison operations and efficiency, as well as reduced state operating costs. We discuss each of these in more detail below.

Utilizing custody assistants in those institution assignments that do not require direct control of inmates would free up existing correctional officers to permanently fill vacancies. For example, by reclassifying 25 positions at each of the 33 prisons, the department would free up enough correctional officers to fill 825 (or 47†percent) of its vacant positions. Filling these vacancies could result in improved prison operations to the extent that officers are more alert because they are working less overtime. We would also note that addressing the vacancy problem is particularly important because correctional staff are due to receive an enhanced retirement benefit (3†percent at 50) under the Bargaining Unit 6 contract. The department projects this enhanced benefit will result in more than 1,500 additional vacancies by the end of the budget year. In fact, creation of a custody assistant classification might also help address future vacancy problems by serving as a potential recruiting pool within the department for correctional positions.

Second, to the extent that utilizing custody assistants would reduce correctional officer vacancies as described above, the department would experience a commensurate decline in overtime costs for correctional officers. Correctional officers earn overtime pay at 1.5 times their normal pay. In 2004-05, the department paid about $203†million in overtime costs for correctional officers. The reduction in correctional officer overtime might also contribute to fewer on-the-job injuries, sick leave, and workersí compensation costs. The department paid over $200†million for workersí compensation in 2004-05.

State Should Establish Custody Assistant Classification. In order to achieve the operational and fiscal benefits described above, we recommend that the Legislature instruct CDCR to immediately begin the process required to develop a custody assistant classification for use by 2007-08. In order to provide legislative oversight and ensure that the department meets this requirement, we further recommend that the Legislature adopt budget bill language requiring the department to provide a report on which posts will be reclassified to custody assistants. The following budget bill language is consistent with this recommendation:

5225-001-0001 Provision X. The Department of Corrections and Rehabilitation shall immediately begin the process of developing a non-peace officer, custody classification to be used in state prisons called custody assistants. No later than January 10, 2007, the department shall submit to the Chair and Vice Chair of the Joint Legislative Budget Committee, and the Committee on Budget in both the Assembly and Senate, a report identifying the number and type of posts in each of its correctional facilities that it plans to convert to custody assistant positions, as well as when the conversions will occur.

Various Proposals Need Modification

We recommend a reduction of $85†million requested in the Department of Corrections and Rehabilitationís budget for various costs that have not been justified. (Reduce Item 5225-001-0001 by $85†million.)

The proposed 2006-07 CDCR budget includes increased funding for parolee supervision, gang management, medical guarding, case records staffing, private correctional facility security, the correctional officer academy, and inmate health care services. Based on our review, we recommend reductions for these proposals that we have found are not justified as discussed below.

Global Positioning Systems (GPS). We recommend the deletion of the departmentís request for $5.1†million in the budget year-growing to $18.6†million by 2009-10-to expand its use of GPS for tracking sex offenders and other parolees. By 2009-10, this proposal would provide funding for an additional 2,000 GPS units and other equipment, as well as increased parole agent staffing. The department began implementing GPS supervision for the first time in the current year for 500 sex offender parolees. Because this is a new technology for the department and because there is little research evaluation on GPS nationwide, the department is having its current GPS program evaluated by University of California researchers to determine its effectiveness. We believe it is appropriate to wait until the pilot project and its evaluation have been completed before committing to significant program expansions. According to CDCR, the evaluation is expected to be completed in August 2007.

Gang Management Contract. We recommend rejection of CDCRís request for $200,000 to enter into a contract related to gang management. While we agree with the departmentís assessment that it could benefit from improved gang management strategies, we are concerned that the department has not provided sufficient detail regarding the nature of the proposed contract. Based on our conversations with the department, it is unclear whether the purpose of these funds would be to research best practices in other states, develop new punishments for gang members, implement rehabilitation programs, create staff training tools, or some combination of the above. Without a clear plan as to the intent of the contract, it remains unclear what specific benefit will be achieved with the requested funds.

Medical Guarding. We recommend rejection of CDCRís request for $818,000 and 9.5 PYs in the budget year for increased medical guarding of inmates. The department projects an increased need to transport and guard inmates at community hospitals based on the projected increase in the inmate population. We recommend rejection of this request for two reasons. First, the department already receives additional correctional positions because of the projected population increase, and a share of these positions could be used for medical guarding as needed. Second, CDCR could reduce its use of community hospitals and, hence, its reliance on medical guarding if it were to increase its use of telemedicine. (See our write-up on ďTelemedicineĒ in this chapter.)

Case Records and Automation. We recommend that the Legislature reject $10†million of the $14.6†million requested by the department to improve its management of inmate records. According to the department, the $10†million is required to increase pay for case records staff in order to reduce vacancies among these positions in prisons. In light of the existing vacancies and the importance of the work performed by case records staff, we believe that some level of increase may be justified to improve the departmentís ability to recruit and retain case records staff. However, this request is premature since the department lacks an implementation plan, and no analysis has been conducted to determine how much of a pay increase, if any, case records staff should get. Furthermore, it is our understanding that the Department of Personnel Administration has not yet approved CDCRís proposal. Accordingly, the Legislature has no way of knowing how much funding is required to implement the departmentís proposal. For this reason, we recommend the Legislature reduce the request by $10†million pending receipt and review of a more detailed proposal. We raise no concerns regarding the $4.6†million requested to develop and implement a new case records information system.

Private Community Correctional Facility (CCF) Security. We recommend deletion of the departmentís request for $453,000 in the budget year to provide additional custody staff at three CCFs. The department requests these funds because of concern that limited state correctional staffing at CCFs contributed to recent inmate disturbances. We recommend rejection of this request because inmate disturbances at CCFs are infrequent. In fact, there have only been a total of five inmate disturbances at the three facilities targeted for these funds in the last five years (though we would note that one of those facilities was closed for two years). Therefore, we do not believe the department has identified a sufficient need to justify this request of funds.

Basic Correctional Officer Academy (BCOA). We recommend approval of the departmentís request to expand the BCOA in the budget year in order to reduce vacancies. However, we recommend making the funding one-time based on our recommendations to develop a custody assistant classification by 2007-08. (See our write-up on ďCustody AssistantsĒ earlier in this chapter.) The use of custody assistants would reduce correctional officer vacancies, thereby reducing the demand to run an expanded academy in future years. Ultimately, the future capacity of the BCOA would depend on a number of factors, including changes in the number of authorized positions due to population and policy changes, staff attrition due to retirement and other factors, as well as the departmentís potential use of custody assistants. The CDCR should identify its projected correctional officer cadet need for 2007-08 based on these factors in the Governorís 2007-08 proposed budget.

Funding for Health Care Services. We recommend rejection of CDCRís request for a $68.1†million increase in the departmentís baseline budget to fund health care-related costs. The department states that expenditures on pharmaceuticals, contract medical services, and medical guarding are exceeding budgeted levels, thereby creating an ongoing base shortfall. As a result, CDCR claims that it has had to redirect funding from various non health care programs to offset the deficiency, thereby reducing the effectiveness of these programs. However, the department was unable to provide information concerning how and the extent to which the redirections have negatively impacted the non health care programs. In the absence of such information, we can only assume that the department is overbudgeted in the non-health care program and that those funds can continue to be used for health care purposes.

Budgeting for Lifer Parole Hearings Requires Modification

The Board of Parole Hearings holds hearings to determine which inmates sentenced to a life term with the possibility of parole can safely be released into California communities. In recent years, many of these hearings have not been held in a timely fashion, resulting in a backlog of cases. In addition, we have found that the departmentís budget for lifer hearings is overstated. We recommend several steps the Legislature and department can take to reduce the backlog and more accurately budget this program. (Reduce 5225-001-0001 by $503,000.)

Life With the Possibility of Parole. All offenders sent to state prison by the courts are sentenced to one of four types of terms: determinate, life with the possibility of parole, life without the possibility of parole, and death row. Most inmates are released from prison after serving a set, or determinate, sentence (less early release credits earned for good behavior). However, about 17†percent of all inmates are sentenced to life with the possibility of parole. These ďlifersĒ are sentenced to prison terms such as 25 years to life, meaning they must serve a minimum of 25 years in prison and are only eligible for release to parole based on a decision by the Board of Parole Hearings (BPH), a division of CDCR. If BPH never approves parole release, the inmate would serve the remainder of his/her life in prison. Figure†9 shows the number of inmates who are sentenced as lifers with the possibility of parole compared to other sentence types.

 

Figure 9

Prison Population by Sentence Type

As of June 30, 2005

Type of Prison Sentence

Number

Percent

Determinate

131,762

80.3%

Life with possibility of parolea

27,921

17.0

Life without possibility of parole

3,232

2.0

Death row

634

0.4

Other

485

0.3

  Totals

164,034

100%

 

a  Includes 7,718 third strikers.

 

Lifer Parole Hearings. There are two primary types of hearings BPH conducts related to lifers. (The BPH also conducts parole revocation hearings, but we focus only on lifer hearings in this piece.) First, BPH holds a documentation hearing within three years of an inmate coming to state prison. At this hearing, a deputy commissioner reviews the inmateís criminal history and other factors, such as education attainment and substance abuse problems, to develop a parole plan for the inmate. This plan identifies the steps the inmate would need to take in order to become a possible candidate for release from prison. The BPH held between 700 and 1,000 documentation hearings in 2004-05. At the time our analysis was prepared, BPH was not able to identify the exact number of documentation hearings held because it does not track that data.

Second, beginning one year before the earliest date at which an inmate is eligible for release based on his prison sentence-referred to as the Minimum Eligible Parole Date (MEPD)-the BPH begins holding parole hearings. At these hearings, the parole panel-made up of one BPH commissioner and one deputy commissioner-reviews the inmateís case file and conduct while incarcerated to determine whether that inmate should receive parole. According to department staff, the panelís assessment of the danger the inmate poses to public safety is the most important factor in determining whether an inmate is paroled. If the board denies parole for the inmate, the inmate will be eligible for another parole hearing within one to five years. If the inmate is a murderer, he may be eligible for a maximum five-year denial. All other lifers may receive no more than a two-year denial. The BPH conducted about 3,300 parole hearings in 2005, with about 5†percent resulting in approvals of parole.

Lifer Hearing Backlog. Beginning in the late 1990s, the number of lifer cases that were not being heard by the due dates was growing significantly. By the year 2000, the backlog of cases had reached approximately 2,000. According to the department, the main cause of the backlog was the statutory requirement that parole hearing panels have three members, two commissioners and one deputy commissioner. With only nine commissioner positions and frequent vacancies in those positions, the department was unable to keep up with the lifer hearing workload, resulting in delays in the scheduling and hearing of individual cases. In response to the growing backlog, the Legislature enacted Chapter†131 Statutes of 2001 (SB 778, Burton) which, among other things, authorized the department to hold two-person panels, as it continues to do now. In addition, three commissioner positions were added to BPH in 2005 as part of the reorganization of correctional departments into CDCR. This increased the total number of commissioners to 12 allowing BPH to hold more parole hearing panels than in prior years.

Budget Request. The BPH currently has about $3†million in funding dedicated for lifer hearings, including funds for 12 commissioners and seven deputy commissioners, as well as support staff. The Governorís budget requests an increase of $1.3†million and 13 positions, mostly deputy commissioners. The request is intended to address a projected growth of 4,500 lifer hearings, bringing the total hearings to 10,800 for 2006-07.

The department based its projected increase in hearings primarily on two factors. First, the request assumes a higher workload because the addition of three commissioner positions will allow BPH to operate more parole panels, thereby significantly increasing the number of parole hearings held in the budget year.

Second, as it has done historically, the department assumed an increase in lifer hearings commensurate to the projected increase in the total inmate population. The average daily inmate population is projected to increase by about 2†percent between the current year and the budget year.

Lifer Hearing Request Is Overbudgeted. Based on our review, the departmentís request is overbudgeted for both documentation and parole hearing workloads. Specifically, the budget assumes that BPH will conduct 3,200 documentation hearings in the 2006-07. However, we estimate that the annual number of documentation hearings is more likely to be about 1,300-less than one-half of the departmentís estimate. Our lower estimate is based on the rate of lifer admissions to prison in recent years. The BPH states that its higher projected caseload is to reduce a backlog of documentation hearings. However, at the time this analysis was prepared, the department was unable to identify the actual number of backlogged cases.

In addition, the departmentís budget proposal assumes that it will hold almost 7,600 parole hearings in the budget year. However, based on prior year data and the departmentís estimate of its parole hearing backlog, we estimate that the department is more likely to hold about 6,000 hearings in the budget year. The reason for BPHís higher estimate is that it reflects the number of hearings the department would be capable of holding with 12 commissioners, rather than reflecting the number of lifers who will actually need parole hearings in the budget year.

Reduce Funding Request. We recommend reducing the departmentís request for budget-year funding by $503,000 and 4.8 positions (3.6 deputy commissioners and 1.2†support staff) based on our finding that the department has overbudgeted its workload for documentation and lifer hearings. The revised funding level would provide sufficient staff for about 2,000 documentation hearings (consisting of an estimated 1,300 new cases and 700 backlogged) and 6,000 parole hearings. This level of funding would allow the department to roughly double its number of hearings compared to the prior year, thereby contributing to a significant reduction in the backlog of cases.

Operational Problems With Lifer Hearings. We are also concerned that three problems within the department contribute to operational inefficiencies and hearing backlogs. In particular, we find that the absence of a centralized database for lifers, commissioner vacancies, and delays in producing psychiatric evaluations result in parole hearing backlogs and limit the departmentís ability to project and manage its caseload. Moreover, unless steps are taken to address these problems, they are likely to grow worse in future years as the lifer population continues to increase steadily each year.

There is a considerable likelihood that the current inability to accurately identify workload will become a more substantial problem in the future because the lifer population has been increasing at a significant rate, thereby inevitably leading to increased lifer hearing workload in subsequent years. As Figure†10 shows, the lifer population has increased 110†percent (8†percent average annual growth) over the last decade. By comparison, the total inmate population has grown by 21†percent (2†percent annually) over the same period. In addition, the current parole hearing workload does not yet include third strikers who will first be eligible for parole in 2019. While this occurrence is more than a decade away, the additional workload for BPH will be substantial, potentially adding more than a thousand new parole hearings to the workload each year. A failure to adequately plan for the inevitable growth in the lifer hearing caseload could result in significant hearing backlogs.

The department usually schedules hearings a couple of months in advance because of the need to notify attorneys and victimsí families who may participate in the proceedings. Consequently, a long-term or unanticipated vacancy can cause as much as a couple months worth of cases to be postponed, contributing to the backlog of cases. Because the department pre-schedules all commissioners to hearing panels, there are none that can be used to fill in when vacancies occur. According to department records, about 28†percent of all cases postponed in the last three years were due to the scheduled panel being unavailable.

Require Department to Develop Plan to Improve Tracking System. We recommend that the Legislature require the department to develop a plan for implementing a scheduling and tracking system for lifer hearings. This would allow the department to manage its caseload better and improve its ability to project caseload growth for budget purposes. A centralized scheduling and tracking system could potentially be developed by modifying existing database systems used for other purposes, for example scheduling and tracking revocation hearings.

Administrative Changes to Reduce Backlog. There are also administrative changes the department can make to address the backlog of lifer cases. We would note, in fact, that the department has already formed an intradepartmental committee to explore ways to improve the lifer process.

One step the department should consider is using some commissioners as ďsubstitutesĒ to fill in when vacancies occur. This change could be accomplished relatively easily because of the expansion of commissioner positions under the reorganization from 9 to 12. For example, the three additional positions could be used as substitutes when vacancies occur. We estimate that this could allow the department to reduce the number of hearing postponements by about 28†percent. At those times when there are more substitute commissioners available than vacancies that need to be filled, the substitutes could be used to address on-going BPH workload, for example by working in place of deputy commissioners on lifer panels, documentation hearings, or even revocation hearings.

The department has informed us that one of the main issues that the lifer committee is working on is the timeliness of psychiatric evaluations. Some of the issues CDCR is attempting to address include whether updated psychiatric evaluations are necessary for all lifers (such as those who do not have a history of mental illness), the most appropriate evaluation tool to use, and the most appropriate staff to conduct these assessments. Each of these issues is important for the department to address. In addition, it is important that the department address its on-going vacancy problem among psychiatric staff.

In view of the above, we recommend that the Legislature adopt supplemental report language requiring the department to report by January 10, 2007, on the actions taken based on the recommendations of its lifer committee, as well as any progress made in reducing the lifer backlogs. The following supplemental report language is consistent with this recommendation:

Item 5225-001-0001. No later than January 10, 2007, the California Department of Corrections and Rehabilitation shall provide the Chair and Vice Chair of the Joint Legislative Budget Committee and the fiscal committees of each house a report about the departmentís efforts to reduce the backlog of lifer hearings. This report shall include an estimate of the backlog of documentation and parole hearings, as well as identify the specific recent actions taken by the department to reduce the backlogs of hearings.

Department Should Report on Progress of the Reorganization

The California Department of Corrections and Rehabilitation was created in July 2005 from the reorganization of state correctional departments. We recommend that the Legislature require the department to report at budget hearings on its progress to date in implementing the reorganization, including the reasons for any delays that have occurred, as well as identify fiscal efficiencies achieved.

Reorganization of State Corrections. In February 2004, the Corrections Independent Review Panel (CIRP) was established to conduct a broad examination of Californiaís correctional system and make recommendations to improve its operations. While CIRP made hundreds of recommendations regarding various aspects of the correctional system, it recommended that a reorganization of the youth and adult correctional agencies be given the highest priority.

The administration proposed an ďoverhaulĒ of the correctional system in two separate but related documents. These were the Governorís Reorganization Plan 2, Reforming Californiaís Youth and Adult Correctional System (GRP-2), and the Youth and Adult Correctional Agency Strategic Plan (the YACA Strategic Plan). The GRP-2 primarily focused on organizational changes, while the YACA Strategic Plan primarily focused on policy and operational changes within the reorganization that were intended to support the goals of increased accountability, efficiency, and effectiveness in the delivery of correctional services. In April 2005, the Legislature enacted Chapter†10, Statutes of 2005 (SB 737, Romero), thereby approving the reorganization of correctional departments into CDCR.

Efficiency. At the time that GRP-2 was proposed, the administration asserted that the reorganization would increase government efficiency by enabling the state to provide a higher level of services at a lower cost. The administration stated that one of the fiscal benefits of the plan was that merging the youth and adult correctional departments and boards would result in ďeconomies of scaleĒ and create an opportunity to ďleverageĒ its expanded population to obtain lower prices on the purchase of goods and services.

To date, there is little evidence available that CDCR has achieved its objective of improved efficiency. The Legislature adopted supplemental report language requiring the department to report quarterly beginning October 1, 2005 on the status of the reorganization, including identifying any fiscal or programmatic efficiencies achieved. At the time this analysis was prepared, the department had not submitted the first two quarterly reports due October 1, 2005 and January 1, 2006.

To the extent that any efficiencies and savings from consolidation occur, one would expect that they would be reflected, at least in part, in a reduction in total headquarters costs. The departmentís budget for headquarters is actually proposed to increase significantly compared to before the reorganization, growing from $177†million in 2004-05 to $244†million in 2006-07. At the time this analysis was prepared, the department was unable to identify the extent to which this increase in headquarters costs has been partially offset by any efficiencies from the reorganization.

Implementation of the Strategic Plan. The objective of CDCRís Strategic Plan was to improve department operations in various areas, including recidivism reduction, health care, information technology, and staff training and performance. In the 2005-06 Budget: Perspectives and Issues, we noted that the Strategic Planís proposed implementation timelines were optimistic. In particular, we raised the concern that the department was likely to experience delays due to staffing limitations, especially because a number of other significant projects were likely to compete for time and resources that might otherwise be used to implement the plan. Figure†11 identifies the planís strategies that are scheduled to be implemented by mid-2006-07.

 

Figure 11

Strategic Plan Components Identified for
Implementation by Mid-2006‑07

CDCR Strategies

Implementation Date

Workforce

 

Recruitment and hiring plan

October 2005

Employee performance appraisal process

December 2005

Human resources management plan

July 2006

Human resources Information Technology (IT)

December 2006

Multi-disciplinary academy

January 2007

Technology

 

Consolidate IT management

July 2005

Secure IT systems

July 2005

IT governance structure

July 2006

Organizational

 

Implement matrix organization

July 2005

Risk management program

July 2005

Program evaluations

January 2006

Organizational assessment of well being

July 2006

Legal Compliance

 

Identify problems and trends

October 2005

Lawful policy implementation

January 2006

Process for policy review

July 2006

Crime Prevention and Safety

 

Ensure safe and secure facilities

January 2006

Establish community collaborations

January 2007

Link inmate assessments and programs

January 2007

Outreach and Partnerships

 

Establish re-entry collaborations

January 2006

Collaborate with local advocacy agencies

July 2006

Collaborate with research communities

July 2006

Establish intergovernmental collaborations

July 2006

Enhance community-based collaborations

January 2007

Health Care Delivery

 

Health care re-entry programs

July 2006

Partnerships for delivery of services

July 2006

 

Currently, it is unclear just how much progress the administration has made in implementing the Strategic Plan in the timeframes it originally identified. Part of the difficulty is that several components are management changes that are not immediately apparent to outside observers because some elements do not require budget actions to implement. However, based on our conversations with the department, it does appear that at least a few of the planís components have been implemented. For example, the department has created a risk management office, as well as consolidated the management of its IT systems under one office. In addition, the departmentís proposal for the budget year includes funding to develop partnerships with local communities and academic researchers in order to improve prison and parole programs and services.

In other cases, however, it does not appear that CDCR has been able to meet its goals. For example, part of the departmentís plan to ensure safe and secure prisons includes implementation of a comprehensive and evidence-based gang management program by January 2006. However, based on our discussions with the department, such a program will not be implemented until 2007-08 at the earliest. The Strategic Plan also identifies the objective of providing health care programs for inmates upon re-entry into communities by July 2006. The department has implemented some such programs for inmates with mental illness and HIV. However, these programs existed prior to the reorganization, and the department has not proposed any expansions of these programs in the current or budget years.

Department Should Report to Legislature. We recommend that the Legislature direct the department to report at budget hearings on its progress implementing its Strategic Plan. Specifically, the department should identify any fiscal or programmatic efficiencies achieved by the reorganization as required by supplemental report language. In addition, the department should report on its progress in implementing specific components of the Strategic Plan, as well as identify any revised timelines for those components that have been or are likely to be delayed.

Department Has Not Provided Reports to Legislature

The California Department of Corrections and Rehabilitation has not completed all reports required in association with the 2005-06 Budget Act. The lack of information hinders legislative oversight of state programs. We recommend that the Legislature require the department to report at budget hearings on the status of these reports.

The 2005-06 Budget Act and the Supplemental Report of the 2005 Budget Act directed CDCR to report on a number of its programs and activities, including the reorganization of correctional departments, implementation of inmate programs, and development of juvenile justice policies and programs. The Legislatureís purpose in requiring these reports was to exercise legislative oversight by holding the department accountable for its use of funds and staff in achieving statutory objectives and goals. Many of these reports were required to be submitted by January 2006 in order to provide the Legislature with pertinent information as it reviews the departmentís 2006-07 budget request. For example, the Legislature required the department to provide a quarterly report that identified fiscal savings achieved from the reorganization of correctional departments in the current year. At the time this analysis was prepared, the department had not provided 9 of 16 required reports. Figure†12 lists these reports, and their due dates as well as the status of those reports.

 

Figure 12

California Department of Corrections and Rehabilitation Status of Legislatively Required Reports

Report Topic

Due Date

Status

California Department of Corrections and Rehabilitation Administration

Efficiencies from reorganization

10/1/05, 1/1/05

Not received

Oversight of high-risk Information Technology projects

7/31/05, 10/31/05, 1/31/05

Received one (11/16/05)

Adult Institutions and Parole

 

 

Foreign prisoner transfer program

1/10/06

Not received

Health care vacancies and contract registry

9/29/05, 12/29/05

Received one (12/20/05)

Inmate and parole programs

Before expenditure of funds

Received

Inmate violence and disciplinary confinement

1/1/06

Not received

Parole reforms

10/1/05, 1/1/06

Not received

Plata lawsuit

1/1/06

Not received

Juvenile Corrections

 

 

Farrell lawsuit

12/1/05

Not received

Long-term juvenile justice strategy

9/1/05, 12/1/05

Received

 

 

Analyst Recommendation. It is important that the Legislature have a means of obtaining information it deems necessary to make policy and budget decisions. Therefore, we recommend that the Legislature require CDCR to report at budget hearings on the status of any reports not yet provided, as well as the reasons for the delays.


Return to Judicial and Criminal Justice Table of Contents, 2006-07 Budget Analysis