Coleman, et al v. Schwarzenegger, et al

Filing 6296

STIPULATION and ORDER signed by District Judge Kimberly J. Mueller on 9/26/19 APPROVING Desert Institutions Transfer Policy Addendum. (Mena-Sanchez, L)

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XAVIER BECERRA
Attorney General of California
MONICA N. ANDERSON
Senior Assistant Attorney General
ADRIANO HRVATIN
Supervising Deputy Attorney General
ELISE OWENS THORN, State Bar No. 145931
TYLER V. HEATH, State Bar No. 271478
ROBERT W. HENKELS, State Bar No. 255410
Deputy Attorneys General
1300 I Street, Suite 125
P.O. Box 944255
Sacramento, CA 94244-2550
Telephone: [phone]
Fax: [phone]
E-mail: [e-mail]
Attorneys for Defendants

ROMAN M. SILBERFELD, State Bar No. 62783
GLENN A. DANAS, State Bar No. 270317
ROBINS KAPLAN LLP
2049 Century Park East, Suite 3400
Los Angeles, CA 90067-3208
Telephone: [phone]
Fax: [phone]
E-mail: [e-mail]
Special Counsel for Defendants

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IN THE UNITED STATES DISTRICT COURT
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FOR THE EASTERN DISTRICT OF CALIFORNIA
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SACRAMENTO DIVISION
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Case No. 2:90-cv-00520 KJM-DB (PC)

RALPH COLEMAN, et al.,

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v.

Plaintiffs, STIPULATION AND ORDER
APPROVING DESERT INSTITUTIONS
TRANSFER POLICY ADDENDUM

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GAVIN NEWSOM, et al.,

Judge: The Hon. Kimberly J. Mueller

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Defendants.
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In March 2019, Defendants proposed a policy to expedite the transfer of inmates housed in

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desert institutions who have a level-of-care change and need to be included in the Mental Health

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Services Delivery System (MHSDS), and of Coleman class members who are inadvertently

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transferred to a desert institution.1 The policy shortens the transfer timeframes set forth in the

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MHSDS Program Guide. The parties met and conferred nearly every month for six months and

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negotiated the terms of a policy under the direction of the Special Master through the workgroup

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The desert institutions are Calipatria State Prison, California City Correctional Facility,
the California Correctional Center, Centinela State Prison, Chuckawalla Valley State Prison, and
Ironwood State Prison.
[3419376.1]
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Stip. and Order re: Desert Institutions Transfer Policy Addendum (2:90-cv-00520 KJM-DB (PC))

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process. The final agreed-upon policy, entitled Desert Institutions Expedited Transfer for Mental

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Health Services Delivery System Inmates, was submitted as Exhibit A to the parties’ stipulation and

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proposed order filed on September 12, 2019. (ECF No. 6279.)

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On September 19, 2019, the Special Master’s deputy informed the parties that the Court

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required the parties to provide an addendum to the policy submitted on September 12, 2019, defining

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the terms “calendar day,” “working day,” and “business day.” The final agreed-upon definitions are

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attached as Exhibit A. The definitions will apply to the Desert Institutions Expedited Transfer for

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Mental Health Services Delivery System Inmates submitted to the Court on September 12, 2019, once

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the Court approves the policy and definitions.

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The Special Master has reviewed and concurs with this stipulation.

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IT IS SO STIPULATED

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Dated: September 20, 2019

XAVIER BECERRA
Attorney General of California
ADRIANO HRVATIN
Supervising Deputy Attorney General

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Elise Owens Thorn_________
ELISE OWENS THORN
Deputy Attorney General
Attorneys for Defendants

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ROSEN BIEN GALVAN & GRUNFELD LLP

Dated: September 20, 2019

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Lisa Ells_____________________
LISA ELLS
Attorneys for Plaintiffs

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* * *

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ORDER

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The court has reviewed the Desert Institutions Expedited Transfer for Mental Health

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Services Delivery System policy and the addendum of definitions, both of which are appended as

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[3419376.1]

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Stip. and Order re: Desert Institutions Transfer Policy Addendum (2:90-cv-00520 KJM-DB (PC))

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Exhibit A to this order, as well as both the stipulation of the parties filed September 12, 2019,

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ECF No. 6279, and the stipulation above. The stipulation filed September 12, 2019 includes the

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agreement of the parties, with the concurrence of the Special Master, for defendants to file

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monthly reports on the transfers of Coleman class members out of the California Department of

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Corrections and Rehabilitation (CDCR) desert institutions, and to end on-site monitoring by the

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Special Master at those institutions. The stipulation does not remove these institutions or class

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members who may be housed there from the jurisdiction of this court. With these observations,

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the stipulations filed September 12, 2019, ECF No. 6279, and September 20, 2019, ECF No.

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6290, and the policy and addendum attached to this order as Exhibit A are APPROVED.

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IT IS SO ORDERED.
DATED: September 26, 2019.

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UNITED STATES DISTRICT JUDGE

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[3419376.1]

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Stip. and Order re: Desert Institutions Transfer Policy Addendum (2:90-cv-00520 KJM-DB (PC))

Exhibit A

State of California

Department of Corrections and Rehabilitation

Memorandum
Date:
To:

Associate Directors, Division of Adult Institutions
Wardens
Chief Executive Officers
Chiefs of Mental Health
Chief Medical Executives
Classification and Parole Representatives

Subject:

DESERT INSTITUTIONS EXPEDITED TRANSFER FOR MENTAL HEALTH SERVICES DELIVERY
SYSTEM INMATES
The California Department of Corrections and Rehabilitation (CDCR) remains committed to
ensure timely mental health access for all inmates who are included in the Mental Health
Services Delivery System (MHSDS).
It is CDCR policy to not transfer inmates in the MHSDS to the following desert institutions: CAL,
CAC, CCC, CEN, CVSP and ISP. The purpose of this memorandum is to announce the new
transfer policy timelines for those inmates housed in desert institutions who have a level of care
change and are then identified as requiring inclusion in the MHSDS.
Effective
December 1, 2019, inmates housed at desert institutions whose mental health level of care
(LOC) changes to Correctional Clinical Case Management System (CCCMS) or Enhanced
Outpatient Program (EOP) shall be transferred to a MHSDS designated institution consistent
with their case factors within 14 calendar days of the LOC change being reflected in the
Electronic Health Record System (EHRS). This memorandum makes no changes to existing
Mental Health Crisis Bed transfer timelines.
14-Day Transfer Process for Desert MHSDS Inmates
1)

2)

Within one business day of notification, the C&PR shall coordinate with the Population
Management Unit (PMU) for appropriate transfer placement.

3)

[3416311.1]

The mental health clinician determines the inmate is appropriate for CCCMS or EOP LOC
and updates the LOC in the EHRS. On the same day, the clinician notifies the Classification
and Parole Representative (C&PR) or designee of the LOC change.

PMU, in coordination with the institution, will review the case no later than the next
working day. All efforts will be made to facilitate transfer to an institution likely to meet
the inmate’s case factors which would be appropriate for permanent endorsement. Upon
determination of approved placement location, institutional staff shall notify the inmate
and facilitate the classification committee.

Associate Directors, Division of Adult Institutions
Wardens
Chief Executive Officers
Chiefs of Mental Health
Classification and Parole Representatives
Page 2

4)

PMU will review the Desert MHSDS LOC Change Report daily to identify inmates with a
mental health LOC change pending the transfer process in order to ensure all inmates
requiring transfer are identified in Step #2.

5)

Following committee the C&PR will notify PMU the case is ready for review by a
Classification Staff Representative (CSR). If there is casework that needs to be completed
the CSR is to endorse the case and the receiving institution will be responsible to complete
the casework.

6)

Upon determination of an appropriate placement, PMU will notify the Statewide
Transportation Unit (STU) and add the inmates to an existing bus schedule. It is the
expectation that inmates involved in this process shall normally move via the statewide bus
schedule. If the inmate cannot be added to an existing bus schedule, STU will notify the
sending institution of the need to facilitate a special transport and ensure transfer within
the 14-day transfer timeframe requirement.

7)

Ongoing coordination will occur between the C&PR and PMU to ensure the timely transfers.

8)

Medical Holds will be addressed in accordance with California Correctional Health Care
Services Health Care Department Operations Manual, Chapter 1, Article 2, Section 14,
Appendix 1: The Medical Classification Factors, subsection (b)(1). A Temporary Medical
Hold is used when a patient requires medically necessary health care services, and it is
medically prudent to provide these services at the institutions where the patient is
currently housed.
If a patient is out to hospital or on a medical hold the transfer timeframe shall be suspended.
As soon as possible, but not to exceed 24 hours after a patient on medical hold or who has
identified medical issues that raise concern regarding safety for transport is placed in the
mental health program, a joint team of medical and mental health clinicians shall discuss
which clinical needs, mental health treatment or medical care, take precedence. If the
medical condition is deemed more urgent than the mental health treatment need, a
medical hold shall be ordered in accordance with current policy if one is not already in
place. Mental health staff shall document the discussion in the electronic healthcare record,
including the names and positions of those who participated in the discussion, the date and
time the discussion occurred, the determination reached, and the specific rationale for the
determination. The relative urgency of the medical and mental health needs, as dictated by
the patient’s condition, shall be continually monitored by the joint team, and mental health
staff shall document in the electronic healthcare record the reasons that the medical need
continues to outweigh the mental health need. If resolution of the medical issue delays
CDCR’s ability to transfer the patient to the mental health program within the transfer
timelines, the patient shall be transferred as expeditiously as possible, and no later than 14

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Associate Directors, Division of Adult Institutions
Wardens
Chief Executive Officers
Chiefs of Mental Health
Classification and Parole Representatives
Page 3

calendar days after the medical hold is lifted. If a medical hold is removed, the provider
removing the hold shall contact the referring mental health clinician and document the
communication of removal of the medical hold in a progress note.
The responsible provider for lifting the medical hold will notify the C&PR to ensure
expedited transfer.
9) The goal is to have the patient be expeditiously housed at an institution that can meet both
the medical needs as well as the mental health needs of the patient. The primary care
provider (PCP) shall work towards addressing the reason for medical hold to allow for the
patient to be transferred to a more appropriate institution that can address both the
patient’s medical needs and mental health level of care. The Regional Deputy Medical
Executive (DME) and Regional Mental Health Administrator may need to work with their
counterparts in another region in an effort to help transfer the care to the institution that
can meet both the medical and mental health needs of the patients.
If there is disagreement between the PCP and the mental health clinician regarding the
patient’s most urgent treatment needs, the parties shall immediately elevate their concerns
and recommendations to the Chief Medical Executive (CME) and the Chief of Mental Health
(CMH), or their designee's. The CME and CMH shall review the totality of the case and
make a determination on the priority treatment needs with the final decision being
transmitted to the PCP and mental health clinician no later than 24 hours after escalation of
concerns. The primary MH Clinician shall ensure this decision is documented in the EHRS
and communicated to necessary stakeholders.
Should the CME and CMH be unable to come to resolution on the primary treatment needs
of the patient, they shall elevate the recommendations for final decision to the appropriate
Regional DME and Regional Mental Health Administrator (s), or their designees. The
Regional DME and Regional Mental Health Administrator, or designee, shall make a
determination within 24 hours and ensure the decision is documented in the EHRS and that
the CME and CMH are notified. The CME and CMH will make all necessary notifications to
ensure the appropriate treatment needs of the patient are being met.
10) Transfers will be consistent with California Code of Regulations, Title 15, Section 3379(d)(1)
The sending institution shall, prior to any medical or psychiatric transfer, determine
whether the inmate has enemies or might be in danger at the receiving facility, and shall:
(A) Inform staff of the receiving facility by telephone prior to the transfer regarding any
precautions needed to protect the inmate. (B) Make an alternate institutional transfer
arrangement which will not jeopardize the inmate. This requirement shall not delay a
transfer past the timeframes in this memorandum.
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Associate Directors, Division of Adult Institutions
Wardens
Chief Executive Officers
Chiefs of Mental Health
Classification and Parole Representatives
Page 4

11) Any inmate-patient within the MHSDS inadvertently transferred to a desert institution shall
be transferred out to an appropriate placement within 72 hours.
In-Service Training Managers shall ensure all Licensed Clinical Social Workers, Psychologists,
Correctional Counselors, C&PRs/Assistant C&PRs, Captains, and Associate Wardens receive
On-the-Job Training on this expectation, using BET Code 11059945 (“Desert Institutions Expedited
Transfer for MHSDS Inmates – OJT”), within 30 days from the date of this memorandum.
Wardens shall ensure staff training is completed and submit a proof of practice memorandum,
along with a copy of their updated local operating procedure, to their respective mission’s
Associate Director.
If you have any questions, please contact Dawn Lorey, Associate Warden, Mental Health
Compliance Team, at [phone], or Dennis Halverson, Chief, Population Management Unit, at
[phone].

CONNIE GIPSON
Director
Division of Adult Institutions
cc:

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R. STEVEN THARRATT, MD, MPVM, FACP
Director, Health Care Operations
Statewide Chief Medical Executive
Eureka Daye
Brittany Brizendine
Laura Ceballos
Angela Ponciano
Michael Golding
Regional Deputy Medical Executives
Regional Healthcare Executives
Regional Mental Health Administrators
Chief Physicians & Surgeons

Jennifer Barretto
Kelly Mitchell
Dawn Lorey
Dennis Halverson
John Herrera
Brian Moak

Addendum to Desert Institutions Expedited Transfer for Mental Health Services Delivery System
Inmates
For purposes of this policy, the following definitions apply:
Calendar Day – a consecutive 24-hour day running from midnight to midnight; all days in a month,
including weekends and holidays. When not otherwise modified, the word “day” as used in this policy
means calendar day.
Business Day – any day Monday through Friday, excluding state holidays, between the hours of 8:00
a.m. and 5:00 p.m. Business day and working day are used interchangeably.