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A report from California State Auditor Elaine Howle on Tuesday found that specialty health care providers for prisoners cost the state $734 million in 2007-08, a fact advocates say bolsters the case for a medical parole system for incapacitated inmates.

The audit also found that just one-half of 1 percent of the prisoners during that fiscal year, or 1,175 inmates, incurred 39 percent of the specialty health care costs. Moreover, the audit found nearly 32 percent of health-related overtime costs, or $136 million, were related to guarding and transporting inmates for the purposes of care.

The audit says ideas to reduce prison health costs could include "a review of the program that allows for the early release of terminally ill or medically incapacitated inmates, and other possible means of altering the ways in which inmates are housed without unduly increasing the risk to the public."

On Monday, the state Senate Appropriations Committee approved a bill by Sen. Mark Leno, D-San Francisco, that would set up a medical parole system specifically for inmates who are in a vegetative or highly incapacitated condition. The measure is awaiting a vote on the Senate floor.

The prison health system has identified 21 inmates whose average annual health care and guard costs total more than $1.97 million apiece, which adds up to $41.4 million a year. Leno said the number of inmates who would qualify for medical parole under his bill may be even higher.

Leno's proposal, Senate Bill 1399, would allow the parole system to put certain inmates, many of them bedridden in outside long-term care facilities, on medical parole. That would shift half the cost from the state to the federal government for many of the patients because they would become eligible for Medi-Cal. The federal government would pay the full cost for those eligible for Medicare.

Additional savings could come from eliminating full-time, round-the-clock guard costs for these prisoners in outside facilities.

J. Clark Kelso, the federal court-appointed prison health receiver, said he's hopeful legislators will take the bill seriously at time of fiscal crisis.

"The budget implications are just extraordinary," Kelso said. "These are the most expensive inmates we have to treat."

"What you see in that audit (released Tuesday) is why 36 states ... have adopted some sort of medical parole," Kelso said.


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