Court to monitor jail mental health care

Sep. 27—Bookending a longstanding legal case regarding conditions at the Yuba County Jail, a federal judge approved a second amended consent decree on Sept. 13 which will continue to monitor the jail's conditions as it pertains to mental health provisions and suicide prevention.

The case was originally filed by a group of inmates at the Yuba County Jail in 1976, who alleged that the jail's conditions violated the U.S. and state constitutions as well as California law.

According to the U.S. District Court for the Eastern District of California, after several months of litigation, the court concluded that county officials were "violating prisoners' constitutional rights with regard to inmate opportunities for exercise and recreation, the adequacy of the law library, and the lack of a trusty program for female inmates."

In 1979, the court entered a comprehensive consent decree binding on Yuba County officials and their predecessors. According to Gay Grunfeld, lead counsel for the plaintiffs, this consent decree allows the courts to oversee the jail's operations as it makes improvements to its conditions over time.

"The original consent decree covered all manner of issues at the jail from food to discipline to environmental hazards. ... After a period of time, the original lawyers who represented the plaintiff class — basically everybody in the jail — the lawyers were precluded from continuing to work on the case by federal legislation. For a while, the consent decree just sat there," Grunfeld said.

In 2015, the University of California, Davis School of Law Civil Rights Clinic started investigating the conditions of the Yuba County Jail and requested the Rosen Bien Galvan & Grunfeld law firm to serve as co-counsel, Grunfeld said. In October 2016, plaintiffs filed a motion to enforce the consent decree, arguing that mental health care at the jail was inadequate.

According to court documents, plaintiffs alleged that they were denied necessary outside medical and mental health care, psychosocial treatment, out-of-cell time for segregated inmates, confidentiality and language interpretation.

"We filed a motion for further relief and to enforce the old consent decree. Our motion argued that mental health care at the jail was abysmal and the conditions there were very serious and there were a number of problems," Grunfeld said.

After a year-long settlement process, all parties agreed on an amended consent decree, which was approved on Jan. 30, 2019, to last for four years.

Since then, counsel representing the plaintiffs have monitored the jail's conditions and the defendants' compliance with the amended order. According to court documents, this consisted of reviewing quarterly document productions, conducting several tours of the Yuba County Jail, interviewing hundreds of inmates, reviewing inmates' medical and mental health records and retaining an expert mental health consultant to assess the jail's mental health and suicide prevention systems.

Counsel documented their findings over seven reports, which asserted that the Yuba County Jail did not comply with the amended decree's staffing requirements, especially with regard to mental health provisions.

Counsel reported that defendants had a practice of cycling certain severely mentally ill inmates in and out of the jail's safety and step-down cells for weeks or months at a time. Counsel also asserted that inmates who needed more intensive mental health treatment were being placed in restrictive housing instead of being transferred to a facility capable of treating them.

They began focusing their efforts on the jail's mental health provisions after two inmates were suspected to have died from suicide and one died from fentanyl overdose within a year in 2021.

"In less than two years, we've had one person definitely committ suicide. The other two are suspected suicides. Obviously, that's a very high suicide rate for such a small jail. There's a serious need for improved mental health care at the jail," Grunfeld said.

Through their findings, counsel reported that while the jail's conditions have improved significantly, its mental health program remained out of compliance with the amended consent decree, which was set to terminate on Jan. 30 this year.

In order to extend this monitoring process and ensure that mental health provisions at the jail improved, a second amended consent decree was approved by Magistrate Judge Edmund Brennan on Sept. 13. Grunfeld said that the second amended consent decree effectively extends the court order for an additional two years or longer if counsel finds that the jail is not in compliance by 2025.

"This is two more years, and then it will end unless the plaintiffs can show that it has not been complied with. There is an option for an extension if it's not being complied with. We have every hope and wish that the county will comply," Grunfeld said.

Yuba County Undersheriff Nicholas Morawcznski said that mental health provisions at the jail remain a high priority for the Yuba County Sheriff's Office, which will continue to maintain improved jail conditions as laid out by previous consent decrees.

"The Sheriff's Office was found to be in substantial compliance with the amended consent decree. The Second Amended Consent Decree continues provisions for mental health care and suicide prevention. Regardless of these provisions, it will remain a high priority to deliver the best care available to those in our custody," Morawcznski said in a statement. "As an example of this dedication to provide the highest of services to those in our care, Yuba County is currently constructing a new medical and mental health facility adjacent to the current jail. This facility will include medical and mental health treatment, and designated spaces for group treatment and vocational learning in an effort to reduce recidivism and promote rehabilitation."

Court orders

The second amended consent decree allows for a neutral, third-party monitor to assess the jail's conditions. According to Grunfeld, Jackie Clark, a health official who works closely with the California Department of Corrections, will monitor the Yuba County Jail for the duration of this consent decree.

As a third-party monitor, Clark will tour the jail every six months and investigate any complaints regarding the jail's compliance with the consent decree.

This court order mandates that a physician, nurse practitioner, physician assistant and/or registered nurse be physically present at the Yuba County Jail at all times. The jail must also employ a psychiatrist to provide mental health services.

According to the second amended consent decree, psychiatry services will be available three days per week for eight hours per day. In addition, a licensed clinical social worker, marriage and family therapist or counselor must be employed at the jail for at least eight hours per day.

Individuals in these positions must be able to provide mental health screenings for those in need of mental health services, conduct psychosocial assessments to include a mental status examination and diagnosis, conduct suicide risk assessments, develop treatment plans, provide psychosocial therapy, create referals and coordinate care with custody and medical staff.

This decree also establishes new intake procedures for fresh arrestees. The jail must include standards and timelines to ensure that arriving inmates are promptly screened for mental health needs. Translators and interpreters will be used whenever necessary to ensure effective communication.

As part of the intake process, a medical official must assess whether an arriving inmate should be excluded from the jail and sent for mental health evaluation and treatment to Adventist Health/Rideout Hospital, Sutter-Yuba Behavioral Health Services or to comparable facilities.

Qualified mental health professionals must be available on-site seven days a week and on-call as necessary to determine whether an inmate at risk of suicide requires outside treatment and intervention, up to and including psychiatric hospitalization where warranted. Custody and health staff must be trained and alerted to suicidal behavior during incarceration. Suicide awareness, prevention and emergency response training should be given to new employees during orientation and annually thereafter, the court order said.

"I have every faith that these individuals are doing everything they can to comply, and it is my hope that the second amended consent decree will be complied with in two years, and the jail will continue to follow these best practices and monitor themselves. No one wants to see poor mental health care or, even more tragically, suicide deaths and overdoses occuring at their local, community jail," Grunfeld said. "We are committed to being good partners to those individuals in government and Wellpath care to continue to work together to avoid tragic outcomes. ... The vast majority of people in the jail will be returning to the community. The second amended consent decree has provisions for continuity of care. It's very important that when people are released from jail, they have their medications and a way to continue their medication, find work in the community and resume their lives after incarceration."