The UC Board of Regents weighed the possibility of managing the state prison health care system in a public discussion Thursday in San Francisco, marking the first step in an ongoing University of California investigation into the topic.
“We are at the very, very beginning of exploring this situation,” said Regent Sherry Lansing.
A special committee was formed in March to further consider how to respond to a call from the governor and state officials to help fix a “broken” system, Lansing said.
One proposal recommends transferring a large part of the California prison population to the care of UC medical staff. The report, compiled by the health care company NuPhysicia, said that California could save $4.3 billion in five years and $12 billion in the course of 10 years.
Similar models of health care run by a state university system exist in Georgia, New Jersey and Texas, reportedly with success.
The California prison health care system has been in temporary federal control since 2005, when an inmate sued the state for unconstitutional care. In the interest of restoring the system to the state level, improving care and reducing costs, Gov. Arnold Schwarzenegger and state legislators called upon the UC to consider playing a role in the management of the system.
Lansing said the board is considering the NuPhysicia proposal because it fits the UC mission of serving the underserved and also providing the opportunity to raise external revenue in a time of fiscal crisis.
“If there is a potential to save the state money, and if the UC can get some of that money that would help us in this budget crisis, we have an obligation to look at it,” Lansing said.
However, she and John Stobo, the UC senior vice president for health sciences, said the NuPhysicia plan is one of a wide range of options under consideration.
“It was a wake-up call,” Stobo said. “The NuPhysicia report said, “˜Look, UC, you can play a role in addressing this issue.'”
The university already serves some members of the prison population. UC San Francisco and UC Davis are the most involved, the latter particularly making use of “telemedicine,” or virtual doctor visits.
The telemedicine aspect was the biggest issue raised at the public discussion. Under the NuPhysicia proposal, telemedicine may become more broadly used to reach a greater number of undeserved communities.
Scott Anderson, a physician in the department of mental health with the California Department of Corrections and a clinical professor at UC Davis, said telemedicine does not work in a prison setting.
The high rate of substance abuse and personality disorders within the prison community makes lawsuits against doctors common, Anderson said. The removal of direct interaction between the patient and the physician increases the chance of a lawsuit, a cost burden that would be transferred onto the UC.
Anderson recommended that the UC system create a fellowship to train its physicians in corrective medicine. Other meeting attendees echoed his sentiments.
“We should play a consultative and supportive role to the more robust prison system,” said Richard Pan, an associate professor of pediatrics at UC Davis.
In emphasizing the board’s ultimate mission to serve the underserved, Lansing pinpointed the board’s recent partnership with Los Angeles County to reopen Martin Luther King Jr. Hospital. Half of the hospital’s patients are expected to be on Medi-Cal and a third may be uninsured. The partnership produced a private, non-profit corporation to run the hospital, which will be opened in phases starting in 2012.
The UC system currently encompasses five academic medical centers, 16 health professional schools and 10 hospitals in a $5 billion operation.