SAN JOSE, Calif. (CN) – A jail medical-services provider, Monterey County and a plaintiff who settled claims of deliberate indifference after a spate of suicides at the county jail returned to federal court Wednesday to determine if the terms of the deal were being upheld.
California Forensics Medical Group, which provides medical services in several county jails including Monterey County, and attorneys representing a class of prisoners who received inadequate medical care at the jail squared off in front of U.S. District Judge Beth Labson Freeman.
The central question before the judge was whether the medical group is adhering to the terms of a settlement the parties agreed to in May 2016.
Five plaintiffs filed the original complaint in May 2013, claiming they received inadequate medical attention. Lead plaintiff Jesse Hernandez said he was denied a colostomy for months and suffered intense pain and discomfort before finally receiving the procedure – only to receive inadequate post-operative care, which caused further physical and mental distress.
The parties settled the case for $4.8 million, stipulating to a raft of improvements for a jail beset by inmate suicides, accusations of poor conditions for inmates and lawsuits.
Van Swearingen, attorney for the plaintiffs, filed an enforcement of settlement after learning that despite stipulations that required California Forensics to employ a full-time psychiatrist at the jail and an on-call psychiatrist available 24 hours per day, the group had not been doing so.
“CFMG had not had an on-site psychiatrist until recently, but I believe that has now been remedied,” Freeman said during the lengthy hearing.
The medical group’s attorney Peter Bertling explained the delay.
“The problem quite simply is that we could not find anybody to fill this position,” Bertling said. He said many psychiatrists do not want to work in correctional settings and that the cost of living in Monterey and the surrounding area makes it tough to attract quality candidates.
Freeman appeared unsympathetic.
“Maybe you need to offer a better salary,” she said at one point, and repeatedly told the medical group it had to do whatever is necessary to ensure that it meets the terms of a settlement.
“What you are arguing is overbroad,” she said. “There needs to be parameters.”
The real root of the disagreement between the parties involves the practice of telepsychiatry, using Skype or other video-conferencing equipment to assess the mental health of a patient.
Bertling said telepsychiatry is perfectly acceptable and widely used in jails across the state and the nation, with some jails such as the one in Mendocino County using it as the sole means of providing psychiatric services.
Swearingen said it is woefully inadequate when compared to on-site services and pointed to language in the settlement that expressly called for in-jail services.
Freeman seemed to favor the plaintiffs’ argument.
“To just allow telepsychiatry anytime, I am not in favor of that,” she said toward the beginning of the hearing.
Bertling repeatedly asked the judge to define the practice’s inherent problems, and she said she was not there to judge the validity and viability of telepsychiatry but to enforce the terms of the settlement.
However, doing so proved more complicated to the point where Freeman eventually agreed to hold an evidentiary hearing where both sides can bring their experts to testify about the quality of telepsychiatry versus on-site services.
The details weren’t quite hashed out by the end, but the parties tentatively agreed to meet early this winter.
Monterey County Jail and California Forensics have been the subject of several related lawsuits. They settled a $1.1 million suit involving Joshua Claypole, who hanged himself with his bedsheets in 2015 after his mother was barred from entering the jail to provide him with medication.
The suit was separate from the one in front of Freeman on Wednesday.
Other suicides and jail deaths have raised questions about the sufficiency of California Forensics’ medical services as well as how the jails are managed.
There were six inmate deaths between 2009 and 2015, with three in 2015 alone.
As recently as last month, the Monterey County civil grand jury released a report that said the county jail still operates as a de facto mental health facility. Approximately 45 percent of the men and women housed in incarceration facilities throughout California suffer from mental health issues, according to the report.
Swearingen works for Rosen Bien Galvan & Grunfeld in San Francisco. Bertling is with Bertling and Clausen in Santa Barbara, California.