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CDCR Facing Daily Fines in 33-Year-Old Suit Over Deficient Mental Health Care

For its entire three decades of publication, PLN has been reporting developments in a class-action suit brought by California state prisoners challenging grossly deficient mental health care provided by the state Department of Corrections and Rehabilitation (CDCR). Filed in 1990, the suit eventually resulted in appointment of a Special Master to oversee the CDCR’s compliance with corrective measures, including a 2009 mental health staffing plan.

On February 28, 2023, the federal court for the Eastern District of California issued three additional orders in the case. The first criticized state prison officials for failing to comply with the staffing plan, finding that “staffing levels remain inadequate, many years later than they should have been cured.” Some of that delay was due to the COVID-19 pandemic, and some was due to a whistleblower report that sent the plan back to the drawing board, as PLN has reported. [See: PLN, Feb. 2020, p.40.] Yet 14 years after the staffing plan was first adopted, the Court found that the state had “not achieved a systemwide vacancy rate of ten percent or less in any of the mental health classifications they are required to report.”

In fact CDCR had a vacancy rate of 33% for psychologists, 18% for psychiatrists, 31% for social workers, 14% for recreation therapists and 27% for medical assistants. In total, there were over 400 unfilled mental health staff positions in California’s prison system.

Class members, represented by attorneys from Rosen, Bien, Galvan and Grunfeld in San Francisco, noted that the number of mentally ill prisoners in CDCR lockups has grown to include 34% of the state’s prison population. Defendants argued that they were trying to boost staffing but cited difficulties hiring new mental health workers. The district court rejected that argument, as “tight labor markets do not relieve defendants of their constitutional obligations.”

Therefore, the Court imposed fines on CDCR, effective March 31, 2023, based on the average monthly salary for each vacant mental health staff position above the 10% allowed. The fines ranged from $4,553 per month for a medical assistant to $27,905.50 per month for a chief psychiatrist; those penalties were then doubled as an incentive for CDCR to fill the vacant positions quickly.

In its second order, the Court addressed CDCR’s deficient performance in adopting suicide prevention measures that had been ordered eight years earlier. The state had agreed to implement specific suicide prevention recommendations made by mental health expert Lindsay Hayes but did not do so. “It is undisputed that defendants failed to implement 15 of a total 29 recommendations,” the Court wrote.

Defendants’ counsel noted that the suicide rate in CDCR prisons had fallen to 15.2 per 100,000 prisoners in 2021 and 17.2 per 100,000 prisoners in 2022. But while that was a “hopeful sign,” the Court held it did not excuse prison officials’ noncompliance with implementing all recommended suicide prevention protocols. Defendants were ordered to fully implement those measures by April 1, 2023, or face civil contempt proceedings and monetary sanctions. After that time, the court said it would impose fines of “$1,000 per outstanding recommendation per institution per day” for the 34 adult state prisons in California.

In its third order, the Court addressed $1,787,156.56 in fines that CDCR had accrued since May 2017 for the failure of prison officials to “comply fully and permanently with … timelines for transfer of inmate patients to acute and intermediate care [mental health] facility programs.” Defendants had appealed the order imposing the fines to the U.S. Court of Appeals for the Ninth Circuit, but their appeal was dismissed for lack of jurisdiction in 2018. A hearing was scheduled by the district court for August 25, 2023, “for consideration of findings of contempt and requirement of payment of fines that have accumulated.” See: Coleman v. Newsom, 2023 U.S. Dist. LEXIS 33598 (E.D. Cal.).

That hearing was later postponed and didn’t conclude until early October 2023, with no order to be issued until a hearing now set for November 2, 2023. “The court is at a critical crossroads,” wrote U.S. District Court Judge Kimberly Mueller, who is overseeing the case, observing that the state’s 96,000 prisoners had “waited far too long for constitutionally adequate mental health care.” So long that children born the year this case was filed have now had their 15th high school class reunion. The case remains pending, with no end in sight, and PLN will continue reporting updates as they are available. See: Coleman v. Newsom, USDC(E.D. Cal.), Case No. 2:90-cv-00520.  

Additional source: Kaiser Health News

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Related legal case

Coleman v. Newsom