Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_90-cv-00520/USCOURTS-caed-2_90-cv-00520-48/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

RALPH COLEMAN, et al.,

Plaintiffs, No. CIV S-90-0520 LKK JFM P

vs.

ARNOLD SCHWARZENEGGER, 

et al.,

Defendants. ORDER

 /

On March 3, 2006, this court ordered defendants to file, by April 17, 2006, a plan

for the provision of acute and intermediate inpatient beds for all seriously mentally ill male and

female inmates in the California Department of Corrections and Rehabilitation (CDCR)

clinically determined to be in need of those levels of inpatient care, and for the provision of

mental health crisis beds for all seriously mentally ill male and female inmates in CDCR within

24 hours of a clinical determination that they require that level of care. (Order filed March 3,

2005, at ¶¶ 3, 5.) The court also set a hearing for April 26, 2006 on the adequacy of the plan.

On April 17, 2006, defendants filed a Statewide Mental Health Bed Plan. On

April 21, 2006, plaintiffs filed a series of objections to the plan. The matter came on for hearing

on April 26 and 27, 2006, before the undersigned. Michael Bien, Esq., appeared as counsel for

plaintiffs. Lisa Tillman, Deputy Attorney General, appeared as counsel for defendants.

Case 2:90-cv-00520-KJM-SCR Document 1800 Filed 05/02/06 Page 1 of 6
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 In addition, defendants do not dispute that the methodology used to project future need

for mental health care services, developed in 2002, also needs to be updated. Douglas

McKeever, Project Director for the Mental Health Care Services Division of CDCR, testified that

defendants have entered into a contract to update the methodology.

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At the start of the hearing, the court provided the parties with a series of questions

to be addressed. Thereafter, the court heard sworn testimony from a number of state officials in

response to the questions. The court has carefully considered that testimony, the plan and its

supporting documents, and plaintiffs’ objections thereto and their supporting evidence.

At issue is the access to necessary and constitutionally adequate levels of care for

the most seriously mentally ill inmates in the CDCR, including the availability of sufficient

numbers of acute inpatient beds, intermediate inpatient beds, and mental health crisis beds. In

their objections, plaintiffs note that the bed plan submitted to the court in April 2006 was based

on population projections that were outdated by the time the plan was filed. There is no dispute

that the population figures on which the April 2006 plan is based are already out of date.1 Thus,

while the long range plan appears sound in principle, it may require adjustments based on the

new population data now available to defendants. The long range plan will be approved subject

to modification based on the new population data.

The special master reports, the record reflects, and defendants admit, that the plan

presented to the court in no way adequately responds to the severe shortage of intermediate care

facility beds and mental health crisis beds that currently exists in the CDCR. It is undisputed that

the shortage is leaving critically mentally ill inmates languishing in horrific conditions without

access to immediately necessary mental health care. In his testimony, Dr. Peter FarberSzekrenyi, who was appointed to the position of CDCR’s Director of Health Care Services on

December 1, 2005, repeatedly referred to the shortage as a “crisis,” a description entirely

supported by the record before this court. Dr. Farber-Szekrenyi testified that at present there is a

shortage of 75 mental health crisis beds and 125 intermediate inpatient beds. In the latter 

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2

 Budd, et al. v. Cambra, et al., Case No. 319578, Order Granting Plaintiffs’ Motion for

Summary Judgment and Permanent Injunction, filed August 14, 2002 in the San Francisco

County Superior Court.

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category, the most serious shortfall is in beds for inmates who have a Level IV security

classification.

Over the course of the hearing, and in consultation with the special master, several

options emerged that are immediately available to help address both aspects of the crisis. One

requires a short discussion; all will be made an order of this court.

At present, there is a unit at California Men’s Colony (CMC) presently being used

as an outpatient housing unit. Until approximately one year ago, this unit was a locked

observation unit (LOU) and provided 36 beds to inmates in need of a mental health crisis bed

level of care. Following a state court decision requiring the CDCR to bring its medical treatment

centers into compliance with state law licensing requirements,2 the locked observation unit was

closed and reopened as an outpatient housing unit. The closure of the locked observation unit,

and defendants’ failure to replace the beds lost thereby, accounts for a significant portion of the

current shortfall in mental health crisis beds. 

State licensing requirements serve an important function, and the judgments of

state courts are ordinarily, based on important concerns of comity and federalism, deferred to by

federal courts. However, “the Supreme Court has stated that otherwise valid state laws or court

orders cannot stand in the way of a federal court’s remedial scheme if the action is essential to

enforce the scheme.” Stone v. City and County of San Francisco, 968 F.2d 850, 862 (9th Cir.

1992) (quoting, inter alia, North Carolina State Bd. of Educ. v. Swann, 402 U.S. 43, 45, 91 S.Ct.

1284, 1286, 28 L.Ed.2d 586 (1971).) It is essential to provide immediately mental health crisis

beds to critically ill inmates in the CDCR. Reopening of the locked observation unit will remedy

expeditiously a substantial amount of the shortage of such beds. Under present circumstances,

state licensing requirements must temporarily give way to measures necessary to remedy the

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Eighth Amendment violations that remain unresolved in this action. Defendants will therefore be

directed to reopen forthwith the locked observation unit at CMC and to use it to provide 36

mental health crisis beds to class members until further order of this court.

In accordance with the foregoing, and good cause appearing, IT IS HEREBY

ORDERED that:

1. The defendants’ long term plan for provision of acute and intermediate

inpatient care and mental health crisis beds is approved, subject to modification based on current

population projections. Within sixty days from the date of this order defendants shall file an

amended long term plan that is based on current population projections and incorporates an

updated version of the methodology first adopted in the 2002 Tucker-Alan bed needs 

projections.

2. The defendants’ long term plan for enhanced outpatient beds describes a

shortfall of over 1000 such beds in the year 2011 and therefore is not approved.

3. Defendants shall include with the amended long term plan a list of those

projects that can be accelerated as well as a list of any statutory, licensing, or staffing barriers to

such acceleration and/or to timely opening of the projects described in the amended long term

plan.

4. Within forty-five days from the date of this order defendants shall file a plan

for interim provision of intermediate inpatient beds and mental health crisis beds. Defendants

shall include with said interim plan, as appropriate, a list of any statutory, licensing, or staffing

barriers to implementation of any aspect of said plan.

5. Plaintiffs are granted a period of ten days in which to file and serve a response

to the interim plan required by paragraph 3 of this order. 

6. Defendants shall maintain thirty-six (36) intermediate inpatient beds at the

California Medical Facility (CMF) P-2 unit until further order of court. In connection therewith,

defendants are reminded of their obligations under the heat plan developed pursuant to prior

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orders of this court, and defendants are directed to take every mechanical step presently feasible

to maintain appropriate temperatures within said unit.

7. Not later than May 30, 2006, defendants shall open thirty-six (36) intermediate

inpatient beds at Salinas Valley State Prison (SVSP) that were slated to receive inmates from

CMF. Said beds shall be used for Level IV inmates. 

8. Defendants shall create an additional thirty-six (36) intermediate inpatient beds

at SVSP on the same time schedule and with the same waivers used to create the thirty-six (36)

beds referred to in paragraph 7 of this order. Said beds shall also be used for Level IV inmates. 

9. Defendants shall forthwith review the list of 123 inmates presently awaiting

placement in the intermediate inpatient bed program at SVSP and shall identify all inmates on

said list appropriate for placement in the DMH program at Atascadero State Hospital or Coalinga

State Hospital. The provisions of the current memorandum of understanding between the CDCR

and the California Department of Mental Health (DMH) notwithstanding, said review and

identification shall be made by appropriate officials of the CDCR. Thereafter, appropriate

officials of both CDCR and DMH shall take all steps necessary to facilitate promptly said

placement decisions. Any dispute between CDCR and DMH over the appropriateness of a

placement shall be promptly submitted to the special master for decision. 

10. Twenty-five (25) intermediate inpatient beds shall be made immediately

available at Coalinga State Hospital for appropriate CDCR inmates. Within thirty days

thereafter, an additional 25 intermediate inpatient beds shall be made available at Coalinga State

Hospital for appropriate CDCR inmates.

 11. Within six months from the date of this order, defendants shall file a report on

the feasibility and cost of creating thirty (30) intermediate inpatient beds at Coalinga State

Hospital beds for Level IV high-custody CDCR inmates. Said report shall be prepared by the

CDCR in collaboration with DMH and the California Department of General Services.

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 12. Defendants shall activate the mental health crisis beds in the correctional

treatment centers at Kern Valley State Prison and California State Prison-Sacramento not later

than July 1, 2006, or inform the court in writing by that date why said centers are not fully

operational.

 13. Defendants shall forthwith reopen the locked observation unit at the California

Men’s Colony (CMC) as a thirty-six (36) bed mental health crisis bed unit on a temporary

emergency basis. Said mental health crisis beds shall remain in use until further order of this

court. 

 14. Until further order of this court, defendants shall not close any intermediate

inpatient bed or mental health crisis bed on the basis of state licensing requirements without

approval of the special master.

DATED: May 1, 2006.

/s/Lawrence K. Karlton 

LAWRENCE K. KARLTON

 SENIOR JUDGE

 UNITED STATES DISTRICT COURT

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