On July 2, 2012, the Special Master filed his Twenty-Fourth Round Monitoring Report. The report contains one recommendation, as follows:
[T]he special master recommends that the Coleman court enter an order requiring defendants to review and assess their existing quality assurance process, and to develop an improved quality improvement process by which it can address issues with the quality of the care that is delivered, as described above. The quality improvement process should be developed from the standpoint of it being the beginning of a transition by CDCR into self-monitoring by its own DCHCS. It should include, but not be limited to, the development of a process for improved document production for institutional paper reviews, so that the provided information is clear, consistent, responsive to the special master's document request, and useful for the assessment of institutional levels of compliance. The defendants' review and assessment of their existing quality assurance process, and the development of an improved quality improvement process, should be carried out under the guidance of the special master and his staff, with participation and input of the Coleman plaintiffs, during the six-month period following the entry of such order.
Twenty-Fourth Round Monitoring Report, filed July 2, 2012, at 66-67. On July 12, 2012, defendants filed objections to the recommendation. Plaintiffs filed a response to defendants' objections on July 20, 2012, and on August 3, 2012, defendants filed a reply to plaintiffs' response.
Defendants raise three objections to the Special Master's recommendation. First, they contend their "current quality assurance process is constitutionally adequate, and an order directing Defendants to revise a presumptively constitutional process is not needed." Defendants' Objections, filed July 12, 2012, at 1. Second, they contend that the order "is unnecessary and could be counterproductive" because of steps the Receiver in Plata v. Brown, No. 01-1351 TEH (N.D.Cal.) is taking to implement a "comprehensive remodeling and revision of CDCR's health care quality assurance process, of which mental health's quality assurance process is a subset." Id. at 2. Third, defendants state their willingness to work with the special master to "improve the quality assurance process without a court order." Id.
Pursuant to paragraph C of this court's December 11, 1995 order of reference, which outlines the duties and powers of the Special Master in this action, this court will not entertain any objection to the Special Master's report "unless an identical objection was previously submitted to the special master in the form of a specific written objection . . . ." Order of Reference, filed December 11, 1995, at 8. With their response to defendants' objections, plaintiffs have filed a copy of the written "comments and objections" submitted by defendants to the Special Master after the parties received his draft Twenty-Fourth Round Monitoring Report. Ex. A to Declaration of Laura Boysen-Aragon, filed July 20, 2012, at 1. The "comments and objections" contain no objection to issuance of the recommended order. Instead, defendants offered comments, as follows:
I. Recommendation Concerning the Division of Correctional Health Care Services' Quality Assurance Process.
The Report recommends that the Court issue an order instructing Defendants to "review and assess their existing quality assurance process, and to develop an improved quality improvement process by which it can develop and address issue within the quality of care that is delivered. . ." and that this process should be implemented under the guidance of the Special Master and with the participation of the Coleman plaintiffs over a period of six months. (Report pp. 62-63.) While Defendants believe that their current quality assurance process is constitutional, they are willing to evaluate and improve their system for providing care in cooperation with the Special Master.
Currently, the Receiver in Plata v. Brown is implementing a comprehensive remodeling and revision of CDCR's health care quality assurance process, of which mental health's quality assurance process is a subset. These revisions reflect the Receiver's and the State's goal of integrating all three health care disciplines--medical, mental health, and dental--under one administrative system. In his Nineteenth Tri-Annual Report, the Receiver states that his process is in the "final" stage of development. (Nineteenth Triannual Report, Dkt. 4145-1 p.16.) Defendants therefore invite the Special Master to review the revised quality assurance process in coordination with the CDCR and the Receiver. This coordination will allow the quality assurance process to be evaluated without duplicating planned revisions or creating conflicted systems.
Id. at 1-2. In a footnote, defendants added that they "do not waive any legal rights or limitations under the Prison Litigation Reform Act by inviting the Special Master to review and assess their quality assurance process in coordination with the Plata Receiver." Id. at 2 n.1.
Nothing in the foregoing constitutes an objection to issuance of the order recommended by the Special Master.*fn1 Indeed, the comments suggest acquiescence in the recommended order. The principal purpose of the requirement that the parties tender an identical objection to the special master prior to raising it with the court is to give the Special Master an opportunity to address all objections before a final report is filed. Considerations of both judicial economy and fairness inform this requirement. The court is aided immeasurably by the Special Master's monitoring reports and by his consideration of all objections tendered to his draft reports and recommendations. Defendants did not raise with the Special Master their objection that the recommended order should not be issued. For that reason, their objections to its issuance will not be entertained by this court.*fn2
The Special Master's Twenty-Fourth Round Monitoring Report and the findings and recommendation contained therein will be adopted in full. At this late stage in this case, the court wants to emphasize in particular its complete concurrence with the Special Master's finding that "[a]n important goal of the remedial phase of this case is, . . ., for CDCR itself to assume the mantle of ultimate responsibility for diagnosing of its own problems, i.e. conduct its own 'qualitative analysis,' and create a quality improvement process that it can use to achieve and maintain compliance, and move on to eventual removal from federal court oversight." Twenty-Fourth Round Monitoring Report at 65 (emphasis added).
The Special Master's role in guiding the remedial process has been invaluable. Most recently, that guidance, together with the cooperation of the parties and diligent efforts by defendants, has led to significant breakthroughs in what previously seemed intractable problems with access to inpatient mental health care. The court expects and anticipates the same level of focus and diligence to be brought to the tasks that remain in the remedial phase of this litigation.*fn3
In accordance with the above, IT IS HEREBY ORDERED that:
1. The Special Master's Twenty-Fourth Round Monitoring Report and the findings and recommendation contained ...