However, even if some of the early actions are not as comprehensively planned or executed as would be desirable if we had the luxury of more time, these early steps will undoubtedly improve CDCR’s health care system. We have adopted six goals to focus our efforts. These goals, and their associated objectives and action items, summarize the steps necessary for CDCR’s health care program to rise to constitutionally acceptable and sustainable levels. The goals are as follows: 1. Ensure Timely Access to Health Care Services 2. Establish a Prison Medical Program Addressing the Full Continuum of Health Care Services 3. Recruit, Train and Retain a Professional Quality Medical Workforce 4. Implement a Quality Assurance and Continuous Improvement Program 5. Establish Medical Support Infrastructure 6. Provide for Necessary Clinical, Administrative and Housing Facilities There has already been significant progress on some of these goals (comprehensive status reports appear in the quarterly reports which the Receiver files with the Court, reports that are on the Receiver’s website at www.cprinc.org). For example, the recruitment of registered nurses has dramatically improved as a result of increasing compensation to market levels and vastly improved recruitment practices. Similar success is just now being seen in the recruitment of physicians. Substantial work has been completed at several prisons to improve conditions. Overall, however, we are at early stages in fully implementing our goals. The total costs for implementing this plan are substantial (see Appendix A). Bringing prison medical care up to constitutional standards will require a significant investment of resources, both one-time capital expenses and an increase in ongoing operational expenses. This is not a good time to be putting additional demands on the state’s budget. But there simply is no choice. The State of California has a constitutional obligation to improve its prison medical care system, and I am convinced the only way to satisfy that obligation is by making substantial investments today that will make up for 30 years of systematic under-investment in prison health care. The Court’s Order calls for periodic reports to the Court concerning our remedial progress (Order at 3:15-22). In addition to our Quarterly Reports, to keep the Court and public informed of our progress, and to hold ourselves accountable for our progress, we will add a “Progress Report” to the CPR website. The “Progress Report” will show how far along we are with each of our goals and objectives (a timeline and list of proposed metrics appears in Appendix A). It will be updated monthly.
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