FRENCH CAMP, Calif. —California's $840-million medical prison — the largest in the nation — was built to provide care to more than 1,800 inmates.
When fully operational, it was supposed to help the state's prison system emerge from a decade of federal oversight brought on by the persistent neglect and poor medical treatment of inmates.
But since opening in July, the state-of-the-art California Health Care Facility has been beset by waste, mismanagement and miscommunication between the prison and medical staffs.
Prisoner-rights lawyer Rebecca Evenson, touring the facility in January to check on compliance with disabled access laws, said she was shocked by the extent of the problems.
"This place was supposed to fix a lot of what was wrong," she said. "But they not only were not providing care, but towels or soap or shoes."
Reports filed by prison staff and inmate-rights lawyers described prisoners left in broken wheelchairs and lying on soiled bedsheets. At one point, administrators had to drive into town to borrow catheters from a local hospital.
Prisoner advocates in January quoted nurses who complained they could not get latex gloves that fit or adult diapers that didn't leak. The shortages were documented in a report sent to corrections officials in Sacramento.
Even the laundry became a battleground.
Over several months, the warden ordered more than 38,000 towels and washcloths for a half-opened prison housing slightly more than 1,300 men — nearly 30 for each patient.
Even so, prisoner advocates reported, inmates were drying off with socks — or not allowed showers at all. Their towels had been thrown away.
Deborah Hoffman, a spokeswoman for the state Department of Corrections, said problems are unavoidable for any new lockup, and in this case were complicated by the medical prison's mission.
"It's not uncommon for new facilities to have stops and starts," Hoffman said, adding that "it is taking time to work out the bugs."
But J. Clark Kelso, the court-appointed federal overseer for California's prison medical system, said the facility's woes go beyond shortages and missteps.
Speaking outside a March legislative hearing on the prison's struggles, Kelso said a general apathy had set in with the staff.
"Because these really basic systems weren't working, everybody kind of went into an island survival pattern," he said. Adjusting to dysfunction, rather than fixing it, became "how we do things around here."
The troubles at the new prison outside Stockton reflect the decade-long battle for control of California's prisons, a system that also is the state's largest medical care provider.
In 2006, a federal judge declared that the prisons provided unconstitutionally poor healthcare. One inmate a week was dying of neglect or maltreatment, the judge found.
Since then, care has been split between two masters: the state Corrections Department, responsible for general custody, and Kelso, who is in charge of the $1.7 billion-a-year prison medical system.
The bifurcated lines of authority extend down to nursing aides and guards on the cellblock — each with separate channels of communication.
At the prison, there was disagreement from the start over who should manage the complex, a campus of 48 stand-alone medical and psychiatric wards with soaring ceilings and bright skylights.
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