By Claire Cooper, The Sacramento Bee
December 2, 2005

SAN FRANCISCO - Saying California authorities "still fail to grasp the gravity" of a crisis in prison health care, a federal judge on Thursday gave Gov. Arnold Schwarzenegger five days to put in charge someone with "authority and ability."

He ordered inspections to see that emergency fixes are made by early next year.

Senior U.S. District Judge Thelton Henderson also ordered pay hikes for prison doctors and nurses, starting immediately, as well as accelerated hiring procedures and other stopgap measures to reverse an exodus of medical personnel.

A Schwarzenegger spokeswoman said late Thursday that Peter Farber-Szekrenyi, appointed this week as chief of prison health care services, "will be held accountable and responsible by the governor for bringing needed reforms" and will work directly with the Governor's Office on the reform plans. She said he also will be the state official reporting to the judge.

Farber-Szekrenyi has a doctorate in health care institution administration and more than 30 years of experience in the field, according to an announcement from the Governor's Office.

Henderson earlier this year found medical care in California prisons to be in violation of constitutional standards for humane care, saying unnecessary inmate deaths averaged one a week. He ordered the system into receivership then and has been conducting a search for someone capable of running the billion-dollar-a-year prison clinic operation.

His latest ruling came two weeks after a temporary overseer reported further deterioration, approaching "meltdown," with about 600 clinical jobs vacant.

Henderson's order came just two days after an appearance in his San Francisco courtroom by state lawyers, who failed to dissuade him from following the overseer's recommendations.

"Instead of voicing an aggressive commitment to the recommended reforms, (the lawyers) were content to invoke bureaucratic red tape and 'business as usual' procedures as roadblocks," Henderson wrote Thursday.

He was particularly troubled by what he called "a remarkable symptom of this dysfunction" that came to light at the hearing - the lawyers' disclosure that neither Corrections and Rehabilitation Secretary Roderick Hickman nor Undersecretary Jeanne Woodford had been personally involved in directing the positions argued by the lawyers.

They "were not even aware of the objections" made in their behalf, the judge said.

Schwarzenegger, the lead defendant in the constitutional case, has assured Henderson since taking office that he will fix the prison health care system. Spokeswoman Julie Soderlund reiterated the promise Thursday.

But Donald Specter, director of the nonprofit Prison Law Office, which represents inmates in the constitutional case, said Thursday that time has run out.

"The governor is risking contempt if there isn't compliance now with the court's order," said Specter, noting that Henderson "has told the governor exactly what he has to do in the next month to get doctors and murses into the prisons and stanch the bleeding of clinical personnel."

Henderson, saying Thursday that he still believes in Schwarzenegger's commitment, focused the blame on "those in his service."

Henderson demanded a highly specific status report on the emergency changes by Dec. 15 from Schwarzenegger's designated agent.

The judge also ordered on-site inspections by medical experts in January and February at prisons with the greatest clinical staff shortages.

Henderson cited the high vacancy rate in staff positions in rejecting defense arguments that money isn't available for hefty pay increases.

He set the floor for doctors' starting salaries at $12,519.10 a month and ordered retention differentials of at least 10 percent for doctors currently on staff. For nurses he ordered recruitment and retention differentials of at least 18 percent.

The pay hikes were to become effective Thursday and would show up on paychecks no later than February.

Henderson also ordered corrections officials to act on applications for clinic jobs within 10 days of receiving them, rejecting objections filed by the state lawyers, who had asked for 30 days.