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Attorneys clash over fines in decadeslong fight for mental health care in California prisons

The state faces around $6.7 million in fines every month from failing to meet a court mandate regarding mental health professionals working in prisons.

SACRAMENTO, Calif. (CN) — Attorneys in a decadeslong federal class action argued Friday over whether California should pay millions of dollars in fines for failing to meet a court mandate over the number of mental health professionals for prisons.

Federal judges for years have ordered the state to reduce its job vacancies and take the necessary steps to ensure compliance with a staffing plan. Attorneys for the state on Friday said that, at times, prisons have complied with parts of that plan. While they conceded the state isn’t in compliance, they argued it shouldn’t be held in contempt and fined.

The hearing that began Friday, and which could span into mid-October, focuses on whether the state should be held in contempt and pay fines that have accumulated since late March. Close to $6.7 million in fines are levied each month.

The court proceeding stems from the 1990 class action now called Coleman v. Newsom, a legal action about mental health care in state prisons.

Representing the state, attorney Paul Mello said U.S. District Court Chief Judge Kimberly Mueller would have to decide if the state’s failure to provide enough mental health workers in five different classifications — psychiatrist, psychologist, clinical social worker, recreation therapist and medical assistant — warranted a contempt citation. He argued that despite the state’s efforts to recruit and retain those employees, the labor market and other factors hampered its efforts.

Erica Greulich, an economist who worked on a report about the issue, testified about the factors that have stymied the state.

There are shortages of psychiatrists and psychologists in California and the nation. Additionally, those who are here trend older and are nearing retirement.

“I think it indicates that there’s a shortage in California,” Greulich said.

Additionally, the Covid-19 pandemic increased the difficulty for people to get mental health care and exacerbated recruitment and retention problems, she added.

Despite this, the California Department of Corrections and Rehabilitation has had some success. Its vacancy rates for mental health professionals dropped between 2018 and 2022. It’s also increased its use of telepsychiatry.

Greulich opined that, considering the labor market and compensation, the state’s prison system has taken reasonable steps to employ the mental health professionals it needs and meet its court mandate.

Mello said California’s prisons have changed since 2009, when a judge ordered the state to take all necessary steps on staffing. Almost 15 years ago, there were over 148,000 people in state prisons. That number is now under 92,000.

That’s helped, though state prisons continue to struggle with staff shortages, fallout from the pandemic and labor market conditions. However, the state hasn’t remained still, Mello said. Instead, it’s taken reasonable steps toward solving complex issues of recruitment and retention. State officials have committed to raising salaries.

“They have increased registry rates, providing recruitment and retention bonuses,” Mello said.

The state also continues to evaluate its actions, seeing what works and what needs work — all acts that show the state shouldn’t be held in contempt.

Attorney Ernest Galvan, representing the class, listed Mello’s arguments as he argued against them.

Mello said the state has been in compliance at times. Galvan said that should be used to determine how much in sanctions it should face.

Prisons aren’t as crowded as they were in 2009, Mello said. Galvan argued that staffing requirements are adjusted twice a year.

“The crowding element is not a defense, either,” Galvan said.

Mello offered an argument about a difficult labor market. Galvan said filling vacancies isn’t impossible. The state has made efforts and not achieved complete success, which brought attorneys to court Friday.

“Fixing the problem is not impossible,” Galvan said.

The state has failed to take all the actions it could have, Galvan argued. Its raises have been small salary hikes, and its recruitment process filled with bureaucratic delays. It hasn’t addressed poor working conditions or listened to managers about what’s needed to fill a job.

Private sector salaries are higher than the state’s, and state pensions don’t have the attraction they once did, Galvan said.

The state has failed to take all reasonable steps to meet its court mandate. Fines of almost $7 million a month — over $40 million from April through September — would mean about $1,300 if divided between everyone in the class action, Galvan said.

“Clinicians don’t want to work in an understaffed system,” he added. “Staffing has to be brought into compliance or it will keep spilling down.”

Categories / Courts, Health, Regional

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