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Williams v. Kernan

September 4, 2009

JOHN WESLEY WILLIAMS, PLAINTIFF,
v.
S. KERNAN, ET AL., DEFENDANTS.



FINDINGS AND RECOMMENDATIONS

Plaintiff is a state prisoner proceeding without counsel in an action brought under 42 U.S.C. § 1983. Currently before the court is defendants' December 2, 2008, amended motion for summary judgment.*fn1

Plaintiff's January 31, 2007, complaint claims that defendants Bailey, Vance and Vasquez removed him from the Enhanced Outpatient Program, a mental health service program at California State Prison, Sacramento, in retaliation for having filed numerous inmate appeals and for assisting other inmates in doing the same. Plaintiff also claims that defendant Hernandez filed a false disciplinary report against plaintiff in retaliation for having filed an inmate appeal against Hernandez. As explained below, plaintiff has failed to present evidence sufficient to show a genuine issue of material fact and defendants' motion must be granted.

I. Facts

The following facts are undisputed, except as noted below.

A. Mental Health Classifications

Inmates housed within the California Department of Corrections and Rehabilitation ("CDCR") who are diagnosed as suffering from a mental illness are evaluated and classified according to their mental health needs. Defs.' Am. Mot. for Summ. J., Stmt. of Undisp. Facts in Supp. Thereof ("SUF") SUF 1. CDCR has four levels of mental health treatment, which include, from the lowest level of mental health treatment to the highest, the Correctional Clinical Case Management System ("Case Management System"), the Enhanced Outpatient Program, the Mental Health Crisis Bed ("Crisis Bed"), and the California Department of Mental Health. SUF 2, 9, 14, 19, 24. The appropriate level of care for an inmate is based upon his level of functioning. SUF 4. An inmate's level of functioning is determined by the severity of his symptoms, his ability to conduct self-care, his ability to participate in activities of daily living, and his general adaptation to the prison environment. SUF 5. Furthermore, an inmate's level of functioning is measured by his Global Assessment of Functioning ("GAF) score. SUF 6. The GAF is a numeric scale (0 through 100) that rates a person's social, occupational and psychological functioning. SUF 7. An inmate's GAF score is estimated by the inmate's clinical case manager, who is typically a psychologist or psychiatric social worker. SUF 12. The score is a subjective determination representing "the clinician's judgment of the individual's overall level of functioning." SUF 8.

The first, least severe level of mental health care, is the Case Management System. SUF 9. Inmates who receive active treatment for a mental illness, and are able to live within the general prison population, fall within this category. SUF 10. Inmates in the Case Management System will have a GAF score of 50 and above. SUF 13. The next level of care is the Enhanced Outpatient Program, which is designed to be a short-term program for inmates that need a structured clinical program with separate housing. SUF 14, 15. The goal of the Enhanced Outpatient Program is to provide focused evaluation and treatment, and return the inmate-patient to a mental state where he is able to function in the general prison population. SUF 17. Inmates in this category will have a GAF score of 30 to 49. SUF 18. The third level of care is the Crisis Bed, where patients in crisis can stay for a ten day maximum. SUF 19, 20, 21. A Crisis Bed inmate will have a GAF score of 30 or below. SUF 23. Inmates at the fourth level, the California Department of Mental Health, will also have a GAF score of 30 or below, and receive 24 hour nursing and psychiatric care in a hospital setting. SUF 25, 26.

B. Changing an Inmate's Classification

From the Case Management System, an inmate may move up a level to the Enhanced Outpatient Program or to the Crisis Bed, with only a recommendation from his clinical case manager and his treating psychiatrist. SUF 27. To move down from the Enhanced Outpatient Program to the Case Management System, however, that inmate's clinical case manager and the treating psychiatrist must recommend that he be considered for a transition, and that recommendation must then be approved by the Interdisciplinary Treatment Team ("Treatment Team"), which is a group of clinicians that decides an inmate's treatment needs. SUF 28, 30. Custody staff will participate in a Treatment Team meeting only for the purpose of informing clinical personnel of the inmate's program compliance, and other custody related observations. SUF 29. All decisions regarding mental health placement are clinical decisions and must be made by a mental health professional. SUF 32. Custody staff may not change an inmate's level of mental health treatment. SUF 31.

C. The Enhanced Outpatient Program

Plaintiff arrived at California State Prison, Sacramento in December, 2004, and was assigned to the Case Management System level of care. SUF 37. From December 2004 until June 2005, Dr. Dina Botello, a psychologist, was plaintiff's clinical case manager. SUF 38. Following a "suicide gesture" in which plaintiff used his fingernails to cut his wrists, breaking the skin, Botello sent him to the Crisis Bed level of care. Defs.' Am. Mot. for Summ. J., Ex. B, Decl. of D. Botello in Supp. Thereof, ¶ 5. Plaintiff was discharged from the Crisis Bed to the Case Management System and then back to the general population, where his GAF score was 55. Botello Decl., at ¶ 6. Although Botello thought plaintiff was a high-functioning inmate, meaning that his GAF score was consistently at 50 and above, he was having temporary difficulty in the general population, so she recommended that he be placed in the Enhanced Outpatient Program, expecting that it would be for a short period of time. Id. at ¶ 8. Defendant Vasquez was the supervisor and senior psychologist of the Enhanced Outpatient Program. Defs.' Am. Mot. for Summ. J., Ex. D, Decl. of M. Vasquez in Supp. Thereof ¶ 1.

Once plaintiff was placed in the Enhanced Outpatient Program, Dr. K. Morgan, a senior psychologist, became plaintiff's clinical case manager. SUF 40; Defs.' Am. Mot. for Summ. J., Ex. C, Decl. of K. Morgan in Supp. Thereof ("Morgan Decl.") ¶ 1. On June 10, 2005, Morgan interviewed plaintiff, and spoke to him about his suicide gesture. SUF 41. Plaintiff told her that two weeks earlier he "tried to take [his] vein out of [his] arm" because he believed that the custody staff did not like him in C facility because he filed legal actions while housed there. Morgan Decl. ¶ 5. Morgan assessed plaintiff's GAF score at 40 based upon his self-report, and Morgan's clinical observations that indicated major impairment in functioning in the areas of judgment, thinking and mood. Id. at ¶ 6. Specifically, plaintiff exhibited stuttering speech, poor eye-contact,"downcast affect," and paranoia. SUF 42; Morgan Decl. ¶¶ 6, 7. Plaintiff also reported several symptoms of serious depression, namely inability to concentrate, which was negatively impacting his ability to do legal work, insomnia, and continued suicidal ideation, but without a plan or intent to follow through with any suicide attempt. Morgan Decl. ¶ 6. Morgan believed plaintiff's suicide gesture was his method of coping with plaintiff's perception that custody staff on C-yard would harm him due to their dislike of his frequent legal actions. Id.

D. Plaintiff's Inmate Appeals

Upon entering the Enhanced Outpatient Program, plaintiff began assisting other inmates in preparing inmate appeals. Pl.'s Opp'n to Defs.' Am. Mot. for Summ. J., Stmt of Disp. Facts in Supp. Thereof ("Pl.'s Opp'n, SDF") at II, ¶ 1. Plaintiff also filed his own inmate appeals. Id. at ¶ 5. The inmate appeals were forwarded to defendant Vance, a correctional captain in the Enhanced Outpatient Program, for disposition.Id. at ¶2; Defs.' Am. Mot. for Summ. J., Ex. E, Decl. of Vance in Supp. Thereof, ¶ 1. Plaintiff claims that on October 7, 2005, Morgan advised him that defendants Bailey, Vance and Vasquez wanted plaintiff removed from the Enhanced Outpatient Program because plaintiff's "processing of a lot of paperwork" meant that he was highly functional. Pl.'s Opp'n, SDFat II, ¶6. According to plaintiff, Morgan also informed him that the decision to remove him from the Enhanced Outpatient Program was coming from "higher up" than herself. Compl. ¶ 24. In response, plaintiff wrote to each defendant regarding their alleged plan to bar him from the program. Pl.'s Opp'n, SDFat II, ¶7. Thereafter, Vance purportedly advised plaintiff that his "paperwork" is creating "controversy" and that Vance did not want him in the program. Id. at ¶9.

E. Plaintiff's GAF Score Improves

By July 29, 2005, plaintiff's GAF score had risen to 48, based upon his improvements in speech quality, concentration, sleep, and cessation of suicidal ideation. SUF 49. Nearly one month later, on August 26, 2005, plaintiff's GAF score remained at 48, as he was maintaining his improved level of functioning. SUF 53, 54. Several days later, on August 29, 2005, Morgan assessed plaintiff's GAF score as 49, because plaintiff appeared to be improving and stabilizing, his thinking was future-oriented, and not dominated by concerns about custody staff, he was getting along well with his cellmate, and his vegetative signs (i.e., sleep, appetite, concentration, etc.) remained within normal limits. SUF 59; Morgan Decl. ΒΆ 10. By September 16, 2005, Morgan determined plaintiff's GAF score had improved to 50 because plaintiff's behavioral indicators (i.e., attitude, general appearance, speech and physical mannerisms) were within normal limits, cognition (including attention, concentration, insight and judgment) were within normal limits, vegetative signs were within normal limits, and plaintiff denied any suicidal ideation. SUF 61. As of September 23, 2005, plaintiff's GAF score remained at 50. SUF 66. On September 29, 2005, Morgan met with plaintiff and based on this meeting, his appearance, his communications, and his ability to put his frustrations into writing, Morgan determined that his GAF score was 55. SUF 71. Plaintiff and Morgan met again on October 7, 2005 and Morgan determined that his GAF score remained at 55. SUF 75. Morgan's clinical notes reflect that as ...


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