Pauli Halstead: On contracted medical services at Wayne Brown Correctional Facility in Nevada County
March 14, 2019
As part of the Stepping Up Initiative to reduce mental illness in jail, Nevada County was to create a process to track progress using data and information systems, and to report on successes.
In Nevada County we still have no data on the medical and mental health treatment individuals receive at Wayne Brown Correctional Facility. Most are released back into our community without receiving proper treatment and a post release treatment plan.
Nevada County has contracted with California Forensic Medical Group to provide medical services to Wayne Brown and Juvenile inmates. The contract amount is $8,936,282, for the period of Jan. 1, 2016 to June 30, 2019. CFMG is the state's largest for-profit correctional health-care company. Unfortunately CFMG has been sued numerous times in California for not providing adequate mental health and drug treatment care for inmates.
The U.S. Department of Justice has estimated that at least one-third of all prisoners have serious mental health issues. According to an August 2017 Monterey County civil grand jury report, 45 percent of the county's prisoners have mental health issues, leading the jury members to say the jail served as a "de facto mental health facility."
Grand juries in Sonoma, Ventura and Santa Cruz counties have criticized CFMG for how it handles inmate detoxification. In a 2008 report titled "Death by Incarceration," a Sonoma County grand jury found indications that "drug and alcohol withdrawal played key roles in three deaths and the company's procedures failed to detect people at risk for alcohol withdrawal.
"There have been needless deaths under the watch, care and authority of this organization," said Monterey County Public Defender James Egar. A common thread in the reports and court complaints: CFMG allegedly provides insufficient mental health and detoxification services, two of the most persistent needs in jails.
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In a 10-year period ending in May 2014, 92 people died of suicide or a drug overdose while in the custody of a jail served by CFMG, according to a Sacramento Bee analysis of a state Department of Justice database. In May 2016, Joshua Hightower died of a heroin overdose at Wayne Brown after an inmate smuggled the drug into the jail. Initially charged with manslaughter, the smuggler cut a plea deal and was placed on probation.
In 2015 Lake County settled a $2 million federal lawsuit filed by the son of a woman who died by suicide in the Lake County Jail. CFMG was also named in the lawsuit and had to pay an undisclosed settlement. The suicide occurred on Aug. 2, 2015, a day after the female inmate was taken into custody.
The Lake County suit cited seven causes of action, the first three of which referenced the U.S. Constitution's 14th Amendment, which speaks to due process and equal protection under the law: deliberate indifference to serious medical/mental health needs and failure to protect "inmate" against harm; inadequate policies, customs and/or practices resulting in deprivation of medical/mental health care and failure to protect against harm; and failure to train/supervise.
The other four claims included wrongful death arising from negligence; violation of California Government Code 845.6, which is the failure to furnish or obtain medical care for a prisoner; violation of the Americans with Disabilities Act for failing to accommodate inmate's mental disability and discrimination based on that disability; and violation of the Unruh Act, which also alleged failure to accommodate for a disability and discrimination against the inmate for it.
In Monterey County a 2015 settlement included a payment of $4.8 million in attorney's fees and a requirement that the county employ a full time on-site psychiatrist in an effort to reduce the increasing number of prisoner suicides at the jail. In a subsequent court hearing CFMG admitted that it had only recently hired an on-site mental health professional due to difficultly in filling the position.
U.S. District Court Judge Beth L. Freeman was unsympathetic. "Maybe you need to offer a better salary," she said, and indicated she was less than enthusiastic about the use of telepsychiatry – conducting mental health screenings by video rather than in-person. Telepsychiatry in no way replaces having a psychiatrist see an inmate in person to assess critical mental health issues.
This year, before renewing the contract with California Forensic Medical Group, it is imperative that the BOS demand a thorough data-driven analysis of the quality of care they are providing and the outcomes of that care. CFMG is paid out of the County General Fund and the community needs to know if progress is being made.
Pauli Halstead lives in Nevada City.
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