SAN FRANCISCO (CN) — The Ninth Circuit held two hearings Monday in a decades-old case focused on mental health care for California inmates, digging through both legal procedures and a baseline of psychiatric care patients need.
The state appealed two separate issues in the class action of Coleman v. Newsom. It pushed back against offering patients a minimum of 20 hours of treatment per week. The state also wants the issue of telepsychiatry, and restrictions placed on it, remanded to a lower court.
Attorneys argued the two issues — a small portion of the sprawling case — before a three-judge panel. Deputy Attorney General George Morris argued that an August 2023 ruling by U.S. District Court Chief Judge Kimberly Mueller, which called on the 20-hour minimum, had no findings of fact to justify it.
According to Morris, patients in the next lowest category, when they’re deemed unable to handle 10 hours of treatment, are placed into the category that currently requires offering a patient 20 hours a week.
“There is nothing that shows more hours is going to solve their problem,” Morris said.
Saying Mueller made no finding that the 20-hour requirement was the least intrusive, Morris argued the appeals panel should reverse her 2023 order.
U.S. Circuit Judge Consuelo Callahan, a George W. Bush appointee, said it appeared Morris was arguing he should have 100% deference in determining the minimum requirement. Morris said it shouldn’t be him, but instead people like experts and adherence to a program guide.
Attorney Lisa Ells, representing the Coleman class, said Mueller tried multiple times to defer to the state’s wishes.
“But deference failed,” she added.
Having no minimum number of hours would maintain an unconstitutional status quo, Ells said. Affirming Mueller’s order would mean the appellate panel found 20 hours is an appropriate minimum requirement, not necessarily that 20 hours was constitutionally required.
The issue of a constitutional requirement became a sticking point for some jurists.
“There’s no way to tell if 15 [hours] would be enough,” said U.S. Circuit Judge Susan Graber, a Bill Clinton appointee. “Picking this number seems to be rather out of thin air.”
Attorney Gary Watt argued for the state in the second issue, which focused on the proper legal pathway through which a specific order from a lower court could be appealed — here, a 2017 ruling that put restrictions on telepsychiatry. Watt told the panel that if an order makes a command or prohibition, it’s an injunction. That order required the inclusion of a telepsychiatry policy in a program guide and prohibited telepsychiatry in some cases. That made it an appealable injunction.
The state had presented a telepsychiatry policy, which wasn’t accepted by the lower court and instead funneled to a special master to work with officials on the policy. However, disputes arose.
“It’s been going on for 20 years,” Callahan noted of the decadeslong case. She said the state has in that time failed to meet certain goals, adding that the lower court judge has grown frustrated with the state over time.
Mueller in June found the state in civil contempt and fined it over $110 million. State officials have appealed that sanction, which wasn’t heard on Monday.
Watt asked the panel to send the issue back to the lower court for a hearing. The hearing shouldn’t focus on the special master’s policy, but instead on the state’s original telepsychiatry policy and the evidence supporting it.
Ells called Watt’s recitation of the timeline faulty. She said the state has the authority to use telepsychiatry in over 75% of its patients but wants all restrictions removed, which would mean no patient would ever see a therapist in person.
Ells argued that the state opted to appeal this issue to the Ninth Circuit because another method of challenging the lower court’s decision, called a Rule 60(b) motion, requires a higher burden.
“This has been going on for a very long time,” Callahan said. “I feel it might be going on for the rest of my natural life.”
U.S. Circuit Judge Lucy Koh, a Joe Biden appointee, rounded out the panel. They did not say how or when they would rule.
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