Health & Medicine

March 28, 2013

Fury at hearing on California prison mental health case

The Brown administration's high-stakes motion to wrest control of California's prisoner mental health care away from federal court oversight ran into a buzz saw Wednesday.

Editor's Note: This story originally reported that U.S. District Court Judge Lawrence K. Karlton's anger stemmed from the way experts hired by the state gathered information for the filing of 50 declarations in a lawsuit challenging the quality of mental health care in California prisons. The experts filed just two reports. The declarations came from various prison officials and medical personnel.

The Brown administration's high-stakes motion to wrest control of California's prisoner mental health care away from federal court oversight ran into a buzz saw Wednesday.

An angry U.S. District Court judge said state corrections officials engaged in a "profound ethical violation" when their experts quizzed inmates without the knowledge of the prisoners' lawyers.

The merits of the state's motion to terminate Judge Lawrence K. Karlton's hold over the treatment of 33,000 inmates who suffer from serious mental health disorders were shoved into the background when Karlton took the bench. He immediately lashed out at state corrections officials and their attorneys over what he said were the unethical methods employed by their experts.

Karlton made no ruling on the state's motion, and the ethical issue now hangs like a dark cloud over the long-running class-action lawsuit that Gov. Jerry Brown says needs to end.

In a hearing that lasted about 90 minutes, Karlton continually pondered and mused aloud about how to proceed in light of this development. Compounding his quandary, he said, is the statutory mandate that he must rule by April 7.

The attorneys for the inmates, who insist that conditions in the sprawling prison system are still woefully inadequate and contribute to high suicide rates, contend the state's actions were so egregious that the judge should throw out the evidence in support of its motion.

At issue are a series of tours, interviews and records inspections that experts hired by the state conducted at numerous prisons. The inmates' lawyers say these actions were carried out secretly, despite the legal requirement that the lawyers be present for every interaction between people working for the state and seriously mentally ill patients who have counsel.

"They interviewed our mentally ill clients without our knowledge about the case and then they used the evidence (to buttress their claims that conditions in the prisons have improved)," Don Specter, head of the Prison Law Office, said after the hearing.

"They didn't really explain to the mentally ill clients what the purpose of the interviews were, so the inmates had no idea who they were speaking to."

Those interviews, tours and clinical records inspections formed the basis for 50 expert declarations filed with the court by the state. They now are central to the dispute over whether California has made enough progress improving mental health care in its prisons so that the treatment has finally been elevated to a constitutional level.

The inmates' attorneys want the declarations thrown out, a move that would cripple the state's efforts to rid itself of the 23-year-old class action.

Jeffrey Beard, the newly appointed secretary of the California Department of Corrections and Rehabilitation, told reporters that "there was no intention to hide anything."

"In fact, when you go into a prison, there are no secrets in jail," Beard said. "The very first prison that someone goes in, everyone knows they're there."

Beard added that he remains optimistic that Karlton will let the expert testimony remain in the case.

The experts' declarations describe improvements the state has made in mental health care, and are the underpinning for the argument that the state can now handle it without court supervision.

But Karlton made it clear during the hearing that he is deeply troubled by the dilemma he finds himself in over a case that was first filed in 1990.

"I think this is a serious matter, a very serious matter," Karlton told Deputy Attorney General Patrick McKinney, who was arguing for the state.

Karlton acknowledged that the state has made tremendous progress in reforming the horrific overcrowded conditions that compromised its ability to provide basic mental health and medical care to the inmates. Those conditions led to a U.S. Supreme Court endorsement of a 2009 court order to reduce inmate population to 137.5 percent of design capacity by the end of this year.

The Brown administration contends it has done enough to improve conditions, and McKinney noted that the state now spends $400 million annually on mental health care for inmates.

"What we've seen year to year is the system just getting better," McKinney said.

He told Karlton that what the inmates' lawyers and a court-appointed special master want is "a perfect system," which is not attainable anywhere and is a goal that does not equate to a system in compliance with the Eighth Amendment's ban of "cruel and unusual"punishment.

But Michael Bien, the lead attorney for the inmates, said there is still evidence of "deliberate indifference" to the lack of adequate treatment on the part of prison officials. Clinical and custodial staffing problems still exist at some institutions, depriving inmates of acceptable treatment by psychiatrists or other mental health care providers, he said.

He added that he, his fellow attorneys and the court's special master have no way of knowing which inmates were interviewed by the state's experts, when the interviews took place, or what their clients told the experts.

"Here we have a mess," Bien said. "I don't know what records they saw. They haven't shared what they saw."

Calling the situation "unique" in the history of the Prison Litigation Reform Act of 1996, upon which the state's motion turns, Karlton discussed his options and asked for suggestions from McKinney and Bien.

The act mandates that such a motion must be decided within 90 days of its filing – in this instance that is 10 days from now. Absent a ruling by then, all the orders Karlton has issued over the years are automatically stayed, which would in essence do what the state wants – throw control of mental health care back to California's corrections officials.

Under normal circumstances, the judge noted, he would hold an evidentiary hearing – essentially a mini-trial – and then make his decision, but the time constraints do not allow for that. Among Karlton's options, discussed by the judge with opposing counsel, are:

Strike the court declarations from the state's experts and reject the motion for lack of evidence.

Fail to rule by the deadline, let the stay of his orders go into effect, and hold an evidentiary hearing. If he subsequently ruled in favor of the patients, the lawsuit would have to start again from square one – an expensive and time-consuming process, the judge noted.

Find that imposition of the act's deadline in this complex, class-action suit is unconstitutional because it would deny due process to the parties, and then proceed with an evidentiary hearing. That precise issue has been before the U.S. Supreme Court only once, and it remains an open question because the high court deferred ruling. The case law created by various federal appellate opinions cuts in favor of the state.

Rule on the state's termination motion based on the entire body of evidence submitted by the two sides. Karlton said he doesn't want to do that because he has no idea how much weight to give the declarations of the state's experts given the unethical way they gathered information.

Call The Bee's Sam Stanton, (916) 321-1091 or The Bee's Denny Walsh, (916) 321-1189.

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