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SIFC Healthcare Subcommittee – May 2019

Statewide Inmate Council Family Council Healthcare Subcommittee – May, 3 2019

Administrators from California Correctional Healthcare Services (CCHCS) will meet on a Quarterly basis with Statewide Inmate Family Council (SIFC) to provide information on healthcare practices and programs as well as address family healthcare concerns for our incarcerated loved ones.

  1. Update on Legionnaires’ Disease at the California Health Care Facility (CHCF)
  2. How is it transmitted, who gets it, how is it treated

Legionella is a bacteria found in complex water systems that are not well maintained. Cooling towers, showers, and hot tubs often house this organism. When susceptible individuals, most often those that are elderly or have chronic disease, are exposed, they can get symptoms ranging from the flu to serious pneumonia. It is not transmitted person to person, only through the water. Legionella is treated with antibiotics.

 

CHCF Experience

In early March a chronically ill patient from CHCF passed away at an outside medical facility. He had pneumonia. Multiple tests done during his hospitalization indicated he was positive for the Legionella bacteria. This result prompted testing of 30 patients at CHCF who also had pneumonia. One was positive for Legionella. He was effectively treated with antibiotics.

Two positive cases are an outbreak, and control measures were initiated. Water from all 60 buildings at CHCF was tested for Legionella. Since two Youth Correctional Facilities in the Stockton area share water supply with CHCF, their water was tested as well. There were some positive results. Therefore, self-filtering shower heads were installed, yard misters and power washers were discontinued, and bottled water supplied during treatment phase. Treatment consisted of chlorination of water supplies throughout the institution. Further environmental testing is ongoing. There have been no other cases at CHCF, and there were no cases as the Youth Facilities.

 

Influenza Vaccination

Influenza is a contagious disease that results in up to 700,000 hospitalizations in the U.S. yearly. The Center for Disease Control recommends yearly vaccination for adults 19 years and older. Close crowding is a significant risk factor for getting this illness; therefore, CCHCS is diligent in offering this vaccination to all eligible prisoners.  This flu season (October 2018 through May 2019), the vaccination was offered to 96% of California’s 120,000 state prisoners.  48% refused. This is a percentage a little better than that found nationally and up 8% from the previous year.

One factor in improved vaccination rate was institution of an Inmate Peer Education Program to promote vaccination. This program which offers Milestone Credits is currently available at two prisons but will be expanded.

  • Prescribed Narcotics for Pain Control

With focus on opioid crisis, there was family concern that narcotics legitimately prescribed for pain control were being withheld and non-narcotic substitutes given.

Currently there is less narcotic prescription in the California prison system than found in former years. This is a national medical trend.  However, narcotic use has not been eliminated. CCHCS has contracted a Pain Management and Palliative Care specialist, Dr. Donna Kalauokalani, to conduct case reviews when necessary and provide recommendations for appropriate pain control.

 

Treatment Plan Variations between Outside Hospitals and Prisons

There was family concern that when incarcerated patients are sent to outside hospitals and various treatments instituted, these treatments are not continued when the patient is transferred back to the prison. This variation in follow up care may result in negative health consequences for the patient.

CCHCS Administrators could not address this concern in a general way but invited families to provide specifics for further review. These specifics can be submitted to their Ombudsman,  to their institutions medical services, or to California Correctional Health Care Services at the following address:

 

Health Care Correspondence and Appeals Branch
P.O. Box 588500
Elk Grove, California 95758

E mail: CPHCSCCUweb@cdcr.ca.gov

Telephone: (916) 691-1404
Fax: (916) 691-2406 attn. Health Care Correspondence and Appeals

 

Medically Assisted Substance Use Disorder Treatment

Each year 38,000 prisoners are released from the California State Prison System. Opioid addiction is a significant health issue for this population, and there is a high rate of overdose in the weeks following release. Therefore CCHCS proposes a medically assisted treatment program to be initiated 15-18 months prior to release and continued at a county and state level after release. R. Corey Waller, M.D. is a nationally recognized addiction specialist who has been contracted by CCHCS to consult on this treatment plan.

  • Hepatitis C Treatment

22,000 prisoners are hepatitis C positive. This is a chronic disease that with new treatment plans can be effectively treated with a 12 week course of medications. CCHCS in the last year instituted treatment and to date 6,000 hepatitis C patients have been treated.

  • Dental Update

At one time dentures were a prisoner expense for all but the indigent. Now dentures are a covered service for all prisoners.