Cal­i­for­nia prison record sys­tem cost dou­bles to $386 mil­lion

The Washington Times Daily - - NA­TION - BY DON THOMP­SON

FOL­SOM, CALIF. | A mas­sive project to mod­ern­ize med­i­cal record-keep­ing for Cal­i­for­nia prison in­mates has more than dou­bled in cost from orig­i­nal es­ti­mates to nearly $400 mil­lion in just three years, the lat­est in a long string of com­puter projects that have be­fud­dled state gov­ern­ment.

The fed­eral court-ap­pointed re­ceiver who con­trols Cal­i­for­nia’s in­mate health care sys­tem ap­proved the project in 2013 to re­place the state’s an­ti­quated pa­per­based records with an elec­tronic sys­tem that can track the med­i­cal and men­tal health care of nearly 130,000 in­mates.

But a year of de­lays means it now won’t be in­stalled at all 35 pris­ons un­til the end of 2017, and in­mate ad­vo­cates are so con­cerned that they may seek to push it back even longer at some trou­bled pris­ons.

The cost bal­looned from the orig­i­nal $182 mil­lion pro­jec­tion to $386.5 mil­lion now in part be­cause the first es­ti­mate left out ba­sics like the cost of main­tain­ing the sys­tem and re­plac­ing worn-out equip­ment, ac­cord­ing to doc­u­ments re­viewed by The As­so­ci­ated Press.

The re­ceiver, J. Clark Kelso, said his of­fice also failed to an­tic­i­pate need­ing $13 mil­lion worth of mo­bile de­vices — 16,800 lap­tops, dic­ta­tion ma­chines and other gear. Nor did it in­clude the ex­tra soft­ware re­quired for things as fun­da­men­tal as in­cor­po­rat­ing in­mates’ re­quests to see doc­tors.

Au­thor­i­ties last year added den­tal records to the sys­tem, and the lat­est es­ti­mate in­cludes three ad­di­tional years of op­er­a­tion.

“The more char­i­ta­ble de­scrip­tion is we learned as we went along,” Mr. Kelso said in an in­ter­view. “We started out with as cheap a sys­tem as we thought we could use, and then along the way there were some things that we de­cided, ‘You know, we ab­so­lutely need these, it turns out.’ ”

The big­gest prob­lem was a phar­ma­ceu­ti­cal records sys­tem so com­plex that it turned out to be “damn near un­us­able” when it was tested last win­ter at three pris­ons, Mr. Kelso said: “The thing wasn’t de­signed, im­ple­mented prop­erly.”

He brought in a new phar­macy chief in Fe­bru­ary and “told him his No. 1 job is to fix this.”

The drug-track­ing sys­tem is work­ing now, bring­ing ben­e­fits like au­to­mat­i­cally warn­ing doc­tors when cer­tain com­bi­na­tions of pre­scrip­tions could prove harm­ful, Mr. Kelso said.

Of­fi­cials have dis­cov­ered other is­sues along the way, in­clude a ma­jor hur­dle: Em­ploy­ees strug­gle to learn the new record-keep­ing sys­tem. Mr. Kelso had to slow down im­ple­ment­ing the com­puter sys­tem in other pris­ons and in­ten­sify the train­ing.

Physi­cians don’t like that the new sys­tem forces them to do more time­con­sum­ing data en­try that they used to del­e­gate to nurses, Mr. Kelso said, though he ex­pects them to even­tu­ally adapt.

The sys­tem has been in­stalled at eight ad­di­tional pris­ons since Au­gust.

“Every­thing’s go­ing swim­mingly,” said Mr. Kelso’s spokes­woman, Joyce Hay­hoe.

Yet doc­tors who tested the sys­tem still are see­ing about one-third fewer pa­tients a year later, po­ten­tially lead­ing to back­logs and poor treat­ment, said Steven Fama, an at­tor­ney with the non­profit Prison Law Of­fice that sued to force health care im­prove­ments.


Cal­i­for­nia Depart­ment of Cor­rec­tions and Re­ha­bil­i­ta­tion em­ployee Shellee Haun re­trieves in­mates med­i­cal records at a fa­cil­ity in Sacra­mento.

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