SACRAMENTO, Calif. -- Gov. Jerry Brown has likened it to the "Sword of Damocles," the sense of foreboding and uncertainty that has hung over California government since the federal courts assumed control over the state's massive prison medical operations.
Most of the prison system's core functions, from the care of mentally ill inmates to housing juvenile offenders, have been under the authority of federal and state courts for years. But the state appears to be emerging from more than a decade of lawsuits after a federal judge said Tuesday he is preparing to end court oversight of inmate medical care.
That has the potential to end a long-running battle between the state and federal courts that led to a U.S. Supreme Court challenge and a revamping of the nation's largest state prison system. Reforming that part of prison operations has cost California billions of dollars and led critics to say it created a system that provides convicts with better health care than many of the taxpayers who are paying to house them.
"California's prisons deteriorated to the point of an almost total federal court takeover," said Barry Krisberg, a senior fellow at the University of California, Berkeley, School of Law who testified as an expert witness in cases involving prison crowding and treatment of juvenile offenders. "Now the spirit has changed ... so we may be kind of digging our way out of this."
State spending on inmate health care and related costs doubled to a peak of $16,565 annually for each inmate in the first five years after U.S. District Judge Thelton Henderson of San Francisco seized control of the prison medical system.
He appointed a federal receiver to run it in 2006 after finding that an average of one inmate per week was dying of neglect or malpractice. The receiver boosted salaries for doctors and other prison health care providers while ordering billions of dollars' worth of renovations at prison medical facilities, culminating in a $906 million prison medical center being built south of the state capital.
Since then, the number of clearly avoidable inmate deaths has fallen and an independent inspector is giving better reviews to prison medical facilities, receiver J. Clark Kelso reported to Henderson last week.
"Significant progress has been made," Henderson wrote in ordering state officials and inmates' attorneys to begin preparing to end the receivership, with a report due by April 30. "While some critical work remains outstanding – most notably on construction issues – it is clear that many of the goals of the Receivership have been accomplished."
Brown acknowledged Wednesday that California's prisons have been "a big mess" but said the judge recognizes the vast improvement in health care there.
"In fact, I would say the health care is the best anywhere, any prison in the world, and better than many, many communities, even in California," Brown told reporters in Burbank. "So when we get out of the receivership we will save some money, because that's been a very, very expensive undertaking."
Don Specter, director of the nonprofit Prison Law Office, which brought the lawsuit, said conditions still are inadequate. He said questions remain about what standards the Department of Corrections and Rehabilitation must meet to be providing constitutionally adequate care.
Assemblyman Jim Nielsen, R-Gerber, a longtime critic of the receivership, said there will need to be long-term independent monitoring of the prison system even if the receiver turns control back to the state, "to make sure we don't get in this mess again."
Yet there are signs that judicial oversight may be easing. The same federal judge last March ended another legal case that had lasted more than two decades after he agreed the corrections department had made sufficient reforms to protect inmates from being abused by guards.
Brown has proposed phasing out the state's Division of Juvenile Justice, another longtime magnet for lawsuits. Corrections spokesman Bill Sessa said the department improved conditions by hiring teachers despite a statewide hiring freeze, adding portable classrooms and making sure young offenders receive adequate time out of their cells at the state's most troubled youth prison in Ventura.
That should be enough to avoid having a state judge issue a contempt citation against prison officials as requested by attorneys representing juvenile offenders, Sessa said.
The state also has spent hundreds of millions of dollars adding mental health treatment facilities and hiring treatment professionals as it tries to end another federal lawsuit, this one alleging years of poor treatment of mentally ill inmates.
"We are making great strides in assuring the court that we are meeting our constitutional obligations," said Elizabeth Ashford, a spokeswoman for the governor.
The state's poor treatment of mentally and physically ill inmates prompted federal judges to order the state to reduce inmate overcrowding as the only way to improve care.
In a ruling last May, the U.S. Supreme Court upheld the lower court's authority to order the state's 33 adult prisons to reduce their total population by 33,000 inmates over a two-year period. That led to a shift that is sending lower-level inmates from state prisons to county jails.
Lawsuits and the cost of caring for those inmates will inevitably shift to local governments, as well, Nielsen said.
Former state Sen. George Runner led Republican lawmakers' opposition to the judges' order that the state reduce prison crowding. On Wednesday, he lamented that the price for complying with the court order has been to send lower-level criminals to county jails, ending state supervision of many parolees and increasing early release credits for state prisoners.
"All of those things I think have added to making California less safe. But in the end, I guess that's what it's going to take to get the feds out of our system," said Runner, who now is a member of the state Board of Equalization.
Henderson's interest in ending the receivership has been many years in the making, said Assembly Speaker John Perez, D-Los Angeles. Ending federal oversight would promote more accountability for prison spending and allow lawmakers to "make smart choices" in managing inmates, he said.
California, with the nation's largest state prison system, spent $2.1 billion on inmate medical care in 2010, more than any other state, according to the American Correctional Association. By comparison, Texas spent $465 million and New York spent $437 million. The Federal Bureau of Prison's spent $153 million that year.
California currently averages more than $14,000 on each inmate's health care and related costs each year after efforts by the receiver to control costs, according to the state Department of Finance.
Using different figures, University of Texas researchers three years ago calculated that California averaged $6,935 annually on each inmate's direct care, while Ohio and Texas each spent less than $4,300. New York spent $5,813 and Florida averaged $4,330, about the same as the federal prison system.
Associated Press writers Michael R. Blood and Judy Lin contributed to this story.