Dear complaint unit,
I am a prisoner of the state and am housed in the Security Housing Unit (SHU) at Pelican Bay State Prison (PBSP) in Crescent City, California.
If these facts give you pause then you are confirming that which this letter hopes to convey. That is, our health care providers do not identify prisoners as patients.
Even though I can provide documentation of a specific complaint, involving specific medical providers, I'd rather, at this time, attempt to bring to light the mindset as mentioned above. This fixed way of thinking (read: us vs. them) I believe leads to misconduct and negligence here, by licensed health care providers.
And even though a federal district judge, in Plata v. Schwarzenegger (#C011351) is in the process of appointing an outside receiver, to take over the prisons "horrifying" medical system, I believe nothing will change unless the mindset is addressed. If not, the "extreme indifference" unearthed in Plata will continue.
I'll be brief as possible - the attached regulations are from the Califfornia Code of Regulations (CCR) Title 15. These examples of regulations are enlightening, and sadly so, insofar as being written, as the others, in the negative (no, not, never) tense. I believe the negativeness sets the stage and mind of providers, for "indifference to the point of callousness," as revealed in Plata.
Granted, prisoners and prison invoke little empathy, let alone sympathy, from the public at large. And, unfortunately, this is so even when it is widely known the prominence class and race plays in the system. Nevertheless, to the best of my knowledge, no prison sentence excludes medical care and no prison sentence includes medical care that only harms and never heals.
Furthermore, health, as your are more aware than I, involves both body and mind. However, the rigors of SHU and its unnatural environment, especially long term use, are not factored into our health care.
Example, our diet. We are on something called "a heartsmart diet." Which leaves us, me at least, hungry and not very smart.
When this and noticeable weight loss is brought to the attention of our health care providers, the first thing said is "that's because you exercise too much."
Luckily, pun intended, I suffer from neuropathy (nerve damage) in both legs. So excessive exercise can easily be ruled out in my case. However, I'm not everyone. But suppose someone does exercise a lot. Exercise is a part of one's health, especially in a stressful and unnatural environment such as the SHU. And if someone is exercising to excess, it is not a dietary problem. It could be a psychosis, a neurosis, or just someone's way of dealing with the SHU.
So again, this is another example of the negative tense. Instead of encouraging exercise or discussing an appropriate regimen, we are told no, not, never. Moreover, in a nutshell, it's believed our diet is being used as behavior control, designed to leave us weak and not very smart. Passivity, in a word. A medical issue becoming one of corrections. Turning health care providers to jailers, who mete out justice (read: punishment).
Believe it or not, I could easily continue, but I just hope I've made some sense of a very senseless situation. And as mentioned, I could provide documentation regarding my belief, of a specific case of negligence or write more on the overall picture.
I close with a final fact and thought: "At midyear 2003 the nation's prisons and jails incarcerated 8,078,570 persons" . . .and in "California" [at midyear 2003] its prisons and jails population stood at 163,361." And those that undervalue others will oppress them.
Title 15 citations
3350(a) The department shall only provide medical services for inmates, which are based on medical necessity and supported by outcome data as effective medical care. In the absence of available outcome data for a specific case, treatment will be based on the judgment of the physician that the treatment is considered effective for the purpose intended and is supported by diagnostic information and consultations with appropriate specialists. Treatments for conditions, which might otherwise be excluded, may be allowed pursuant to section 3350.1(d).
3350.1(3) Treatment for those conditions that are excluded within these regulations may be provided in cases where all of the following criteria are met:
1. The inmates attending physician prescribes the treatment.
2. The service is approved by the medical authorized review committee and the health care review committee. The decision of the review committees to approve otherwise excluded service shall be based on:
a. Available health care outcome data supporting the effectiveness of the services as medical treatment.
b. Other factors, such as: 1. Coexisting medical problems; 2. acuity; 3. length of the inmate's sentence.; 4. availability of service; 5. cost
- A California prisoner
Medical Board of California, Central Complaint Unit Response
December 21, 2005
Dear [X],
The medical board of California has completed its review of your recent correspondence.
The medical board of California is only authorized to take action against those individuals it finds in violation of the medical practices act. Your complaint does not fall within our jurisdiction because your complaint is not about medical care and treatment provided by a physician, but instead involves other staff and/or the prison's procedures. Therefore, as your complaint concerns a matter which would fall within the jurisdiction of the Department of Corrections. I am forwarding your complaint information to the address shown below for any action they may deem appropriate.
Thank you for contacting the board, and I regret we are unable to be of further assistance.
Sincerely,
Central Complaint Unit, Medical Board of California
Division of Correctional health Care Services Response
January 25, 2006
Dear [X]:
This is in response to your correspondence dated December 11, 2005, to the medical board of California. Regarding the medical care and treatment you are receiving while incarcerated at Pelican Bay State Prison (PBSP), California Department of Corrections and Rehabilitation (CDCR). Your correspondence was forwarded to the division of correctional health care services (DCHCS). I have been asked to respond to your concerns.
In your correspondence your expressed dissatisfaction with the "heart smart diet" you are provided at your institution, stating the portions leave you "hungry and not very smart." You state when you complained about insufficient portions, you were informed "you exercise too much;" however, you state that neuropathy in both legs prevents you from exercising excessively. Except for your complaint regarding the dietary program at your institution, you requested no assistance or intervention on your behalf to provide any additional health care services.
HCSD contacted the PBSP medical staff who reviewed your Unit Health Record (UHR). Your UHR indicated that you are expected to select appropriate dietary choices for yourself by using the "Heart Healthy Diet;" however, you are receiving an extra sack lunch to supplement your nutritional requirements. We were also informed you received a consultation with neurologist in October 2005 and are scheduled for periodic follow-up appointments.
The inmate appeal process described in the California Code of Regulations, Title 15, is an integral part of the administrative remedies available to resolve issues concerning any departmental decision, action, condition or policy that they can demonstrate has had an adverse effect upon their welfare. If you are not satisfied with the medical care you are receiving you are encouraged to continue to address your issues through the inmate appeals process. The issues are reviewed and responded to carefully and thoroughly. It is the CDCR's desire to resolve these issues at the local level if at all possible.
If you require further assistance, please use the "sick call" process by completing a request for health care services, CDC Form 7362, to request an appointment with a clinician to address your concerns.
I hope this information has been of assistance to you.
Sincerely,
Staff Services Manager I
Risk Management Clinical Programs Unit
Division of Correctional Health Care Services
Prisoner responds to responses
February 1, 2006
Dear Central Complaint Unit,
I'm writing in response to your December 21, 2005 correspondence which for the record was not personally received until January 11, 2006.
In your correspondence you acknowledged my 12-11-05 letter and explained to me that my complaint did not fall within your jurisdiction. But you did, however, forward it (my letter) to the Health Care Services Division of the Department of Corrections (Sacramento) which I very much appreciate, though, as of this writing, I have yet to hear from them.
In my 12-11-05 correspondence I did state I could provide documentation of a specific medical complaint, which I am doing now.
Enclosed are two sets of documents, both are inmate appeals, which as you may already know, is the administrative process of addressing (or not) prisoners' grievance with the CDCR. The first set of documents is 5 pages, and records my efforts, from 6/7/05 to approximately 12/27/05, in re-starting previously prescribed medication. This set has been reviewed, and denied at all its levels (of review) available to prisoners.
The 2nd set is 12 pages and records my efforts, from 10-25-05 to present, in re-starting previously prescribed medication after a second neurologist's examination, which also and again recommended previously prescribed medication.
I believe Dr----, at the very least, is negligent in his actions (Actually non-actions) and cruel in his indifference.
In closing, I thank you for your time…I realize only so much can be done but I feel that I have to at least go on record, which I'm sure you understand.
Sincerely,
A California prisoner