Left to right: Gary Forest, executive director of clinical operations for custodial health for the New South Wales government, is shown the Patient Management Unit by Rebecca Anderson-Potts, chief nurse executive for CHCF, and Bob Edwards, Chief Executive Officer. Anderson-Potts and Edwards explained how nursing staff completes a medical review when new inmate-patients arrive to the facility.

By Terry Thornton, CDCR Deputy Press Secretary

Sydney, Australia, is nearly 7,500 miles from Stockton, but despite the distance, correctional administrators in both places have much in common.

This was apparent when Gary Forest visited California Health Care Facility (CHCF) on July 25.

New South Wales Photo 3

Brittany Brizendine, Chief of Mental Health at CHCF, Chief Executive Officer Bob Edwards and Gary Forest of New South Wales discuss the challenges of providing care to both chronically- and mentally-ill inmate-patients while touring the dialysis clinic at CHCF.

Forest is the executive director of clinical operations for custodial health for the New South Wales government. His visits to CHCF and to San Quentin State Prison the day before were to gain an understanding of international prison health service models. The two California prisons were the only correctional health care facilities in the United States that Forest wanted to see.

The visit to CHCF began with a meeting with CHCF officials who manage nursing, mental health and custody functions.

Forest began by describing the statewide health services in New South Wales (NSW). Approximately 1,400 staff members handle clinical operations for inmates.

NSW is also experiencing a growing inmate population and Forest projects his system will have 5,000 more inmates over the next three years. Forest said that 67 percent of inmates in NSW have substance abuse issues.

He also cited a lack of mental health treatment in the community as a contributor to his correctional system’s increasing mentally ill population.

Forest said they are seeing higher numbers of chronic complex illnesses, something CHCF is designed to address.

CHCF has the largest number of mental health crisis beds in the state and specialized facilities to provide inpatient acute care and enhanced outpatient facilities for mentally ill inmates as well as low- and high-acuity beds for chronically ill inmates.

Eugenia Giguere, who heads up diagnostic and procedures, shows one of the procedure rooms at CHCF used to treat inmate-patients.

Before an inmate is transferred from another CDCR prison, nursing, mental health and custody staff members from CHCF and the sending institution discuss the inmate-patient’s medical needs, ADA issues, dietary needs, mental health status, assistive devices, custody level and other needs.

An aging inmate population is something NSW prison officials are also trying to address and Forest described how his system is dealing with more end-of-life issues and are seeing more deaths due to natural causes.

Like California, his country does have compassionate release laws, but Forest said that they are also seeing more admissions of older inmates due to the solving of cold cases using DNA technology, old sex abuse cases and pension fraud.

Forest said that officials in his country are considering buying a nursing home.

Before the tour, Forest was provided an overview of CHCF, activated just one year ago. Within a fence line just 200 feet short of three miles is 1.2 million square feet in 54 buildings that provide acute care and housing space for the state’s most seriously ill inmates. Construction of the $839 million medical facility was completed in 2013.

Sgt. B. Pinneo, a health care sergeant in the Patient Management Unit, explains to Forest how custody staff performs a housing review for newly arriving inmate-patients to CHCF. The unit serves as the receiving and release area of CHCF.