On April 14, 2015, the Honorable Paul S. Grewal, United States Magistrate Judge of the Northern District of California, issued a 44-page opinion granting the motion of a certified class of prisoners in the Monterey County Jail for a preliminary injunction.  Full text of order is here: Monterey County Jail Order Granting Mot for PI, 4-14-15

The order requires sweeping improvements to the Jail’s tuberculosis screening program, process for ensuring prisoners are continued on medications prescribed for them prior to their arrest, and program for treating prisoners who are suffering from potentially fatal alcohol and drug detoxification. Prisoners with disabilities will no longer be categorically excluded from a host of programs and services at the Jail. And, the County will have to remove hanging points from the Jail’s segregation units—suicide hazards that the court found had been used by four prisoners to commit suicide in the past 5 years, including one suicide earlier this year.

“We are very pleased that after almost two years of litigation, our clients and the public will benefit from increased safety and health at the Monterey County Jail,” said attorney Gay Grunfeld of Rosen Bien Galvan & Grunfeld LLP who, along with the the Monterey County Public Defender and the ACLU, represents the class of all present and future prisoners at the jail. “If the County promptly implements the reforms in this order, the benefits will go not only to our clients, but to all of the staff at the jail who will be able to work in a safer and healthier environment.”

The order discusses at length the factual and legal background for the decision, and gives the defendants, the County of Monterey and California Forensic Medical Group, 60 days to come up with a detailed plan addressing the following serious constitutional and statutory violations at the Jail:

  • Defendants’ tuberculosis identification, control and treatment program at the jail shall comply with the standards laid out in Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC (June 2006);
  • All inmates newly booked into the jail shall receive a timely tuberculosis symptom screening administered by adequately trained health care staff (nurse or higher level staff);
  • Defendants shall have a reliable system to track whether all newly booked inmates have received tuberculosis screening and appropriate follow-up testing and treatment;
  • Medical staff shall timely conduct the initial evaluation to determine if an inmate is intoxicated and/or suffering from withdrawal or at high risk for withdrawal;
  • Medical staff shall make the decision on who should be placed in a sobering cell and who should be transferred to the hospital to be treated for possible or actual withdrawal;
  • Medical providers (physicians, physicians assistants, and/or nurse practitioners) shall be timely involved in assessing and treating inmates potentially undergoing withdrawal, and non-provider medical staff shall timely refer to providers those inmates undergoing withdrawals when clinically indicated;
  • Detoxifying inmates shall be adequately monitored using the CIWA protocol or equivalent validated monitoring protocol, shall receive pharmacological treatment as indicated and be appropriately housed based on their clinical conditions;
  • Defendants shall develop separate treatment protocols for opiate, alcohol and benzodiazepine withdrawal;
  • All inmates newly booked into the jail, who at the time of booking are prescribed medications in the community, shall be timely continued on those medications, or prescribed comparable appropriate medication, unless a medical provider makes an appropriate clinical determination that medications are not necessary for treatment;
  • Inmates who, at the time of booking, report to Defendants that they are taking community-prescribed medications, but whose medications cannot be verified by Defendants, shall be timely assessed by a medical provider and timely prescribed medications necessary to treat their health needs;
  • Defendants shall remove all hanging points and other hazards in the jail’s administrative segregation units that pose a risk of being used by inmates to harm themselves or attempt suicide;
  • Defendants shall conduct health and safety checks of all inmates housed in segregation at least once every 30 minutes at irregular and unpredictable intervals;
  • Defendants shall design and implement a system for identifying and tracking all inmates who are qualified individuals with disabilities, as that term is defined by the ADA and its implementing regulations, including but not limited to inmates with mobility impairments or who are deaf, hard of hearing or unable to speak .
  • Defendants shall also design and implement a system for identifying and tracking the reasonable accommodations necessary for qualified inmates with disabilities to participate in programs, services and activities offered by Defendants at the jail, including but not limited to inmates who must be provided access to programs, services and activities in spaces that do not require climbing stairs and who require sign language interpreters in order to have an equal opportunity to participate in, and enjoy the benefits of, programs, services and activities offered by Defendants;
  • The County Defendants shall offer all programs, services and activities, including but not limited to outdoor exercise, religious services, Choices and Pride classes and Narcotics and Alcoholics Anonymous meetings, in locations that do not require inmates to climb stairs in order to access the programs, services and activities;
  • Defendants shall furnish qualified sign language interpreters to any inmates for whom sign language is their only or primary method of communication, in all circumstances where a qualified sign language interpreter is necessary to ensure an inmate has an equal opportunity to participate in, and enjoy the benefits of, programs, services and activities offered by Defendants. The interactions for which Defendants must furnish qualified sign language interpreters include but are not limited to the intake process, classification hearings, disciplinary hearings, all medical, mental health and dental treatment, religious services, educational classes, Choices and Pride classes, Narcotics and Alcoholics Anonymous meetings and any other interactions with staff that implicate an inmates’ due process rights and
  • Defendants shall implement a system to document that Defendants have provided qualified sign language interpreters to inmates who need them and that the inmates have understood the information conveyed by the qualified sign language interpreter.

The case is Hernandez v. County of Monterey, No. CV 13 2354 PSG, in the United States District Court for the Northern District of California.

Michael Bien
Gay Crosthwait Grunfeld
Rosen Bien Galvan & Grunfeld llp
(415) 433-6830

James Egar
Public Defender, County of Monterey
(831) 755-5806

Alan Schlosser
ACLU Foundation of Northern California
(415) 621-2493

Eric Balaban
National Prison Project of the ACLU
(202) 393-4930