In 2006, the California Department of Corrections and Rehabilitation was found to be lacking in its ability to provide a constitutional level of medical care to its inmates. At this time, a Federal court appointed a Receiver to oversee the direct management and operation of the State's inmate medical care program. In January 2012, it was found that enough progress had been made in the provision of inmate medical care to allow the transition for responsibility for managing the program back to the State to occur. This report provides information on four key points: a status update on the Receiver's actions; a description of how these actions have impacted inmate medical care spending and outcomes; a discussion of the experiences of other States that have faced problems similar to California's in delivering inmate medical care; and a set of recommendations for delivering a constitutional level of inmate medical care in the most cost-effective manner possible. The keys to delivering inmate medical care over the long-term includes independent oversight and evaluation, and delivering care cost-effectively. The report also presents information on recent proposals to improve inmate medical care which include establishing a prison health care authority, and partnering with the University of California to provide inmate health care.