The medical system is by definition cruel and unusual. It is the largest mental health system in the world since the state closed many hospitals.
The department has done a piss poor job of providing medical care and many medical staff have taken other jobs. Recruitment is extremely difficult. All while inmate population doubled more than 3 times in the last 30 years.
The unions have bribed previous governors and the legislature so that you can't sneeze without permission. Can't bring in a private prison system and lower costs. Inmate gangs determine housing assignments. And on and on. If someone has a solution, it would be refreshing.