By Maggie Angst
The Sacramento Bee
SACRAMENTO, Calif. — A judge has levied more than $50 million in fines against California for failing to correct a chronic shortage of mental health providers in its state prisons.
The fines, imposed by Chief U.S. District Judge Kimberly Mueller, are part of a decades-long, federal class action lawsuit regarding the treatment of mentally ill California inmates. Mueller, who recently wrapped up a trial on the matter, will decide in the coming weeks whether to hold the state in contempt and order the full payment of fines.
Gov. Gavin Newsom has made overhauling the state’s mental health system a major focus of his second term, but his office declined to comment on the staffing deficits, citing ongoing litigation. Newsom is pushing for voter support to pass a $6.4 billion bond measure in March to add thousands of new behavioral health beds across the state.
Ernest Galvan, an attorney representing the inmate plaintiffs in the lawsuit, said expanding treatment options in the community is key for long-term success but that the state needs to meet people where they are now.
California, under court order, reduced its prison population from about 136,000 to 92,000 over the past decade, but the percentage of people behind bars with mental illness continues to grow.
“None of us should be happy with the idea that we need to staff up these prisons with mental health clinicians because these prisons are the worst kind of places to deliver mental health treatment,” said Ernest Galvan, an attorney representing the inmates in the lawsuit. “But that’s the unfortunate result of the last generation of mental health policymakers.”
“Many people get sicker in prison and then they don’t adjust well to being out, so we need to channel the care there,” he added.
Fines accumulate amid ongoing legal battle over inmate care
Under the case, known as Coleman, a federal court ruled in 1995 that the California Department of Corrections and Rehabilitation was not providing adequate mental health care to prisoners. The court concluded that the department’s mental health staff were “stretched dangerously thin,” resulting in a decline in the quality of treatment and the number of inmates who were treated, as well as an alarming number of in-custody suicides.
The state’s corrections department in 2009 submitted a detailed plan to the court to guide an overhaul of its mental health care system, and the court appointed a special master to monitor compliance.
But nearly 15 years later, Mueller has found that the state has been unable to meet its targets and the maximum 10% job vacancy rate required by a court order. The state has only met the court-imposed staffing mandates for certain classifications at various points in time.
Terri Hardy, a state corrections spokesperson, said her department could not comment on pending litigation but added that “the health and well-being of the people in our care is of the utmost importance.”
Hardy said the department’s shortage of providers is compounded by the location of state prisons are often in rural communities and historically difficult to staff.
Mueller began imposing fines in April based on how much money the corrections department had saved by not filling vacant but budgeted mental health positions. She calculates the fines monthly using the average maximum salary for each open position. The largest vacancy rates, incurring the highest total amount of fines, are for clinical psychologists and social workers.
Under the ongoing lawsuit, the state has also faced fines for delays in transferring inmates to state mental hospitals and for failing to complete court-ordered suicide prevention measures.
California struggles to fill vacant mental health roles in prisons
This month’s trial centered on one key question: Had the California Department of Corrections and Rehabilitation taken all reasonable steps to fill its mental health staffing shortages and come into compliance with the court’s 90% staffing mandate?
Through testimonies and written briefs, attorneys representing the state and the inmates offered their own economists and mental health experts who provided conflicting opinions to the judge.
The state argued the corrections department made “extraordinary efforts” to fill and maintain staffing levels, citing higher-than-average salaries, expanded telework options and new labor agreements with salary increases and other financial incentives.
Despite those measures, the state asserted in a court brief that compliance was “impossible under the current context.” That context, they wrote, was a national shortage of mental health providers due to burnout and an aging workforce.
The inmates’ attorneys refuted those claims. Instead, they maintained that the state had “not acted with enough urgency to fill positions” and “simply continued with business as usual.”
A closing brief, written by the inmates’ attorneys, argued that the salaries offered to psychologists and social workers in California prisons did not “come close to compensating them for the abysmal working conditions they must endure.”
The state has asked Judge Mueller for more time to come into compliance. The inmates’ attorneys have asked her to issue a contempt ruling and order the state to pay the full amount of fines.
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