Results of the First 17 Medical Inspections Only two prisons’ overall scores exceeded the 75 percent minimum score for moderate adherence, and at 76 and 78 percent, those prisons barely crested the minimum score for moderate adherence. Prisons’ overall scores ranged from 78 percent down to 62 percent, averaging 70 percent. These scores reveal that the Receiver and the prisons can improve compliance with CDCR’s medical policies and procedures and selected medical community standards. While overall scores varied by only 16 percentage points, there were differences of as much as 89 percentage points in the scores among institutions on individual components. Clearly, some prison staff understood and carried out relevant policies and procedures while others did not. The highest average component scores were 94 percent in staffing levels and training, 91 percent in chemical agent contraindications, and 90 percent in clinic operations. The prisons achieved high adherence on 60 of the 166 questions in our medical inspection program. The 17 prisons’ lowest average component scores were 37 percent in preventive services, 46 percent in inmate hunger strikes, 59 percent in access to health care information, and 60 percent in specialty services. The prisons scored 60 percent or less on 42 of the 166 questions in our medical inspection program. The Receiver can improve the prisons’ compliance with medical policies and procedures by continuing to focus prisons’ performance on these 42 questions. Turning from the in-depth examination of individual health care components, we examined how those components function together to deliver health care. We sorted the data from 100 questions into five general medical categories that were recommended by our lead physician. From this broader perspective, we found significant problems in the categories of medication management and access to providers and services. The average score in medication management was only 58 percent, indicating that prisons were ineffective in getting medications to inmates in a timely manner or were failing to document their actions as required by policy. The average score for access to providers and services was only 60 percent. This low score indicates that the prisons were generally ineffective in ensuring that inmates are seen or provided services for routine, urgent, and emergency medical needs according to timelines set by CDCR policy. Access to providers and services scores ranged from 74 percent down to 45 percent. In the remaining three categories only nurse responsibilities, with an average score of 80 percent, exceeded the 75 percent minimum score for moderate adherence. However, continuity of care and primary care provider responsibilities were close, with average scores of 74 percent. The following sections of this report summarize and analyze the 17 prisons’ overall scores, their scores in each of the 20 components, and their scores in each of the five general medical categories.
Bureau of Audits and Investigations, Office of the Inspector General
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