ABSTRACT
The California Prison Industry Authority (CALPIA), a semiautonomous prison labor agency under the California Department of Corrections and Rehabilitation, runs two optical laboratories operated by people incarcerated at Valley State Prison and California State Prison, Solano,1 and these laboratories supply ophthalmic lenses to eligible Medicaid recipients, such as this young patient. Documents we obtained through a public records request revealed that our state's public health agency, the California Department of Health Care Services (DHCS), agreed to pay CALPIA up to $37.9 million for the 2021/22 fiscal year for optical services alone. CALPIA wages in prison-based optical shops range between $0.35 and $1.00 per hour,6 up to 55% of which can be deducted by law for restitution and administrative costs, resulting in an effective pay rate as low as $0.16 per hour.7 Courts have routinely rejected legal challenges to these meager wages by concluding that, because the Thirteen Amendment permits the involuntary servitude of incarcerated people, the federal minimum wage law does not apply to prison labor.8 The result is a strange supply chain that is not always transparent or top of mind: medical devices produced by poorly paid imprisoned people are provided to the poorest members of free society, such as the infant who needed sight-saving glasses. Others have called for public health officials, researchers, and physicians to address the sprawling reach of the prison industrial complex.14 Medical providers could use their position of authority to advocate better pay and conditions for incarcerated workers who produce the very devices that providers prescribe.