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22 J A N U A R Y / F E B R U A R Y 2 0 0 6 C A L I F O R N I A N U R S E tremendous pressure on these political forces demanding a complete overhaul within corrections in the state. THE LEGISLATIVE BRANCH The Legislature is charged with various oversight responsibilities concerning the CDCR. The Senate Rules Committee must approve all prison wardens and Board of Parole hearing members following their appointment by the governor. The Legisla- ture must approve the corrections budget as well, while prison oversight committees review various internal functions and pro- grams in corrections. In recent years, highly publicized leg- islative hearings and frequent press reports have begun to reveal the depth of conflict within the CDCR. Various unethical prac- tices have also come to light, such as the "code of silence" maintained by staff about what happens inside prison walls. There is much more that may or may not be revealed through lawsuits and investiga- tive reports. CDCR has a long history of expertise at shielding its practices. As stat- ed in a press report, "they now have a code of silence regarding the code of silence," reflecting the depth of these problems. Despite these hearings, the Legislature has failed to pass legislation to effectively resolve the problems within CDCR. Mem- bers of the Legislature must run for elec- tion and they are vulnerable to the political power of the CDCR and CCPOA. The correctional officers association has made large financial contributions and conducted active lobbying of the Califor- nia Legislature to achieve its goals. During the 2003-04 legislative sessions, CCPOA donated $155,463 to various legislators. The Legislature has failed to pass sub- stantial legislation that would create true reform and accountability within the state corrections system, and the various agen- cies are governed by a complicated patch- work of laws. Laws regulating the CDCR and other facilities are scattered through- out the various state codes. THE JUDICIAL BRANCH The two major class action lawsuits that currently impact CDCR mental health- care and medical care for inmates are known as "Coleman" (1995) and "Plata" (2001). The rulings in both these cases have held that the CDCR has engaged in constitutional violations of prisoners' civil rights. Federal judges have found CDCR to be completely recalcitrant to efforts to imple- ment minimally-humane healthcare. Fed- eral courts have been presented with massive amounts of evidence concerning incompetence, neglect, abuse, delays, and failure to provide even minimal health- care to prisoners. In "Coleman," the fed- eral magistrate found "deficiencies of a constitutional magnitude in most neces- sary areas." CDCR is being forced to change its unconstitutional and brutal ways but remains highly recalcitrant and resistant even under federal court-required moni- toring. There is overwhelming evidence presented to the federal courts in these class action suits that have specifically named screening at the time of reception, staffing, competence of healthcare providers, access to care, medical records, implementation of basic protocols, delays in care, and pharmacy and medication management as major areas of deficiency. Plata v. Davis is a federal civil rights class action lawsuit regarding medical care for CDCR prisoners. It was settled in an agreement to avoid trial as CDCR was found unconstitutional in its medical and mental healthcare in Coleman. In the Plata settlement, CDCR was ordered to make major medical improvements and the case will end when court experts decide that CDCR has substantially com- plied with the settlement at each prison. Despite the number of lawsuits that have been litigated about medical care in the past 20 years, it seems that real and lasting improvements have yet to be achieved. THE EXECUTIVE BRANCH Every juvenile, county, and state prison is governed by many various laws and regu- lations in California. The common politi- cal problem with all correctional systems in California is a complete lack of politi- cal will to enforce laws and regulations governing their functions. There is no overall organized structure in government that governs state, county, or juvenile cor- rectional healthcare facilities. Each juris- diction operates within its own autonomous legal authority. This complicated infrastructure of var- ious governmental agencies allows for long-standing and increasing corruption and political influence. This leads to lack of enforcement of healthcare standards and regulations in the correctional indus- try and leaves nursing out on a limb. There are numerous oversight executive agencies and commissions in California all having in common a lack of enforce- ment power. There is currently no collec- tive voice of correctional RNs in any branch of government. California has one of the largest num- bers of prisoners in the world and is known nationally for being resistant to change. Proposed governmental solutions to its problems will venture into unchar- tered territory. Solving these problems will reach far beyond the changes imple- mented nationwide and in the correc- tional industry over the past thirty years in other U.S. prisons and jails. Gov. Arnold Schwarzenegger attempt- ed to tackle this problem by creating the California Performance Review and, after reviewing the report, issued a reorganiza- tion plan for corrections resulting in the newly-named Department of Corrections and Rehabilitation. This new plan cen- tralizes power in the Secretary of Correc- tions and Rehabilitation who reports directly to the governor. Unfortunately, exactly one paragraph is devoted to healthcare and offers no new ideas or pro- grams. The entire report is vague, overly broad, and generalized. LABOR UNIONS The California Correctional Peace Officers Association (CCPOA) represents over 33,000 prison guards and MTAs, com- bined, in California and has successfully defeated legislative attempts to specifical- ly outlaw MTAs within the CDCR. An example of CCPOA's political power can be seen in their 2004 defeat of Propo- sition 66, which would have amended Cal- CE Home Study Course The field of correctional nursing needs to identify its experts, leaders, and educators from within and establish curriculums, content, and core functions specific to the practice environment.