Lawmaker Pushing for No Copays in Local Jails
By Crescenzo Vellucci
Vanguard Sacramento Bureau
SACRAMENTO – The California Department of Corrections and Rehabilitation (CDCR) and California Correctional Health Care Services (CCHCS) announced Thursday they will end the practice of charging inmates a $5 copayment for each medical or dental visit by March 1.
The surprise announcement followed the introduction of proposed legislation by Assembly Mark Stone (D-Scotts Valley) that would have made it illegal to charge for healthcare for state or local inmates.
It quickly became apparent from the news release disseminated by the CDCR that the reason for the change was not compassion, but costs.
“After recent internal analysis, it was determined that copayments have minimal fiscal benefit and are not aligned with patient care. Specifically, copayments may hinder patients from seeking care for health issues which, without early detection and intervention, may become exacerbated, resulting in decreased treatment efficacy and/or increased treatment cost.
“The Department’s health care delivery system, known as the Complete Care Model, is based on a preventative and comprehensive approach to patient care. Early detection and preventative health care aligns 
with most public and private health care organizations and can prove to be fiscally prudent,” the statement said.
Since most inmates have little or no money, and pay for work done in custody is in the 10 cents an hour range, the $5 fee proved uncollectible, according to prison critics.
Assemblymember Stone said he was pleased the change was made, but it won’t deter him from pressing forward with his legislation – to give inmates on a local level free healthcare as well.
“I am pleased that CDCR has taken this important step to ensure that all people incarcerated in California state prisons can access healthcare, regardless of their ability to pay. I look forward to continuing to fight for fair and just access to health care by eliminating this barrier to access in city and county jails,” he said in a statement to the Vanguard Thursday.
Stone’s AB 45 doesn’t just stop prisons from charging copays for medical and dental visits but also would prohibit county and city jails from charging copays, according to his staff.
Inmates at city and county jails throughout the state may welcome Stone’s measure.
The Sacramento County jails, for instance, face a massive lawsuit for poor or no provided healthcare that has apparently been a problem for decades. Inmates report waiting for healthcare for cancer and other ailments for months or even years.
The Yuba County Jail has been under court order for its mistreatment of prisoners – recently highlighted by a nearly weeklong hunger strike over conditions by ICE civil detainees.
“This is a large-scale initiative that will include emergency revision and repeal of some CDCR regulations, changes to medical and dental policies, and revisions to other internal documents. CDCR and CCHCS are working to ensure all necessary components are in place and notifications are made prior to this operational change,” said CDCR in the statement Thursday.
An internal report, according to CDCR, showed in Fiscal Year 2017/18, a total of 221,788 medical and dental visits occurred – $460,177.67 was collected from medical and dental copayments.
From both the medical and economic perspectives, it makes no sense to charge any fees which may deter an inmate from obtaining preventive or early intervention care.
There are two decades long lawsuits against the California prison system, Plata ( filed 20001) and Coleman ( filed in 2000), that have cost the state millions in legal wrangling over medical care conditions that should never have existed in the first place.
Granted these cases involve the state prison system, not county level incarceration. But the principles of adverse consequences, both medical and economic, of delayed or suboptimal medical care should be clear to all involved in incarceration at any level in California.