United States District Court, E.D. California
order filed March 24, 2017, this court directed defendants to
show cause in writing why they should not be required to come
into full and permanent compliance with Program
Guide timelines for transfer to acute and
intermediate care facility (ICF) mental health care by May
15, 2017. ECF No. 5583 at 2, 25. The court also directed the
parties to brief why defendants should not be required to
comply with the Program Guide twenty-four hour timeline for
transfer to mental health crisis beds (MHCBs) by the same
date and, if so, whether full or 90 percent compliance across
all California Department of Corrections and Rehabilitation
(CDCR) institutions should be required. Id. at 2.
Finally, the court directed the parties to brief how such
orders, if made, should be enforced as well as whether
monetary sanctions are an appropriate remedy for
non-compliance with such orders. Id. The parties
have timely filed the briefs required by the March 24, 2017
order. See ECF Nos. 5593, 5595.
background and history contained in the March 24, 2017 order
is incorporated by reference in this order. See ECF
No. 5583 at 2-8. The issue currently before the court is
enforcement of provisions of defendants' plan to remedy
Eighth Amendment violations in the delivery of mental health
care to class members. In relevant part, the Program Guide
1. Any inmate referred to an MHCB be transferred within 24
hours of referral;
2. Any inmate referred to any acute inpatient mental health
placement be transferred within ten days of referral, if
accepted by Department of State Hospitals (DSH); and
3. Any inmate referred to any intermediate care mental health
placement be transferred within 30 days of referral, if
accepted by DSH.
Guide at 12-1-16. It is well-established that defendants have
a constitutional obligation to provide class members with
“access to adequate mental health care.”
Coleman v. Wilson, 912 F.Supp. 1282, 1301 (E.D. Cal.
1995); see also Coleman v. Brown, 938 F.Supp.2d at
981. The time frames for transfer to inpatient care contained
in the Program Guide “represent defendants'
considered assessment of what is sufficiently ‘ready
access' to each level of care.” Coleman v.
Brown, 938 F.Supp.2d at 981. The court turns first to
compliance with the timelines for transfer to acute and ICF
ARGUMENTS OF THE PARTIES
their brief, ECF No. 5593, plaintiffs contend (1) the court
should order defendants to come into full and permanent
compliance with Program Guide timelines for transfer to
inpatient care by May 15, 2017; (2) the court's order can
and should be enforced through civil contempt proceedings;
(3) the court has authority to impose monetary sanctions if
necessary to coerce compliance but that defendants must be
given an opportunity to reduce or avoid such sanctions
through compliance; (4) there is a risk imposition of fines
would discourage defendants from referring inmate-patients,
or encourage rescission of necessary referrals and therefore
“careful reporting and monitoring will be
required” if this remedy is chosen; (5) the existing
data templates are insufficient to allow enforcement of the
court's order; (6) the court should order defendants to
come into compliance with Program Guide timelines for MHCBs
by May 15, 2017 and should require 100 percent compliance;
and (7) before enforcing an order requiring compliance with
MHCB Program Guide timelines, the court should take
additional evidence to determine the obstacles to full
compliance and ascertain whether targeted remedial orders are
required prior to imposition of monetary sanctions.
oppose issuance of an enforcement order and consideration of
monetary sanctions for non-compliance. Defendants contend
requiring full compliance with Program Guide timelines
“is not consistent with the constitutional standard or
the Prison Litigation Reform Act.” ECF No. 5595 at 3.
Defendants argue that “whether system-wide
constitutional deficiencies exist, does not depend on whether
the Court's remedial plan has been fully accomplished.
Rather, the question is whether State officials are
deliberately indifferent to serious mental-health
needs.” Id. at 12. In a similar vein, they
contend requiring full compliance with the Program Guide
timelines “is at odds with the constitutional
deliberate indifference standard” and therefore should
not be the benchmark for imposition of monetary sanctions.
Id. at 15.
further contend imposition of monetary sanctions would
violate the Prison Litigation Reform Act “because such
relief extends further than necessary to remedy
constitutional violations.” Id. at 13. For the
reasons set forth in this order, the court finds that full
and permanent compliance with Program Guide timelines for
transfer to inpatient care is necessary to remedy
constitutional violations identified in this action. The
court has found, and defendants have acknowledged, that full
and permanent compliance with these timelines is feasible.
For that reason, the court finds that continued
non-compliance would only be remediable through an order of
contempt and imposition of coercive monetary sanctions and,
therefore, that such relief, if required, would be necessary
to remedy the constitutional violation.
contentions call for a review of two issues: (1) the role of
the deliberate indifference standard at this stage of these
proceedings; and (2) the role of the Program Guide in
assessing constitutional compliance.
argument concerning the role of the deliberate indifference
standard misses the mark and fails to recognize that the
court already has repeatedly addressed and rejected this
argument, albeit in different contexts. In denying
defendants' 2013 motion to terminate these proceedings,
the court considered and rejected an argument made by
defendants that they are no longer “deliberately
indifferent” to the need to provide constitutionally
adequate mental health care and therefore should no longer be
subject to court supervision. See Coleman v. Brown,
938 F.Supp.2d at 988-89. Subsequently, in a 2014 order on
plaintiffs' motion for enforcement of court orders and
additional relief related to use of excessive force,
disciplinary measures, and housing and treatment of class
members in administrative segregation units (ASUs) and
segregated housing units (SHUs), the court again rejected
this argument, holding that
once an Eighth Amendment violation is found and injunctive
relief ordered, the focus shifts to remediation of the
serious deprivations that formed the objective component of
the identified Eighth Amendment violation. See Coleman v.
Brown, 938 F.Supp.2d at 988. Remediation can be
accomplished by compliance with targeted orders for relief or
by establishing that the “violation has been remedied
in another way.” Id. To the extent the
subjective component of an Eighth Amendment ...