Hernandez v. County of Monterey

Background

This class action was filed in 2013 by inmates seeking relief from constitutionally deficient conditions at the Monterey County Jail. The County operates the Jail and contracts with Wellpath, LLC, to provide medical, mental-health, and dental services. In 2015, the court approved a Settlement Agreement, and in 2016 it approved implementation plans describing how the defendants would meet their obligations. The Settlement Agreement and implementation plans were incorporated into the court’s approval order and became enforceable court orders.

The Settlement Agreement required the parties to follow a notice, investigation, negotiation, and mediation process before seeking judicial enforcement. Plaintiffs gave notice of alleged noncompliance in February 2020, January 2022, and December 2022. Earlier efforts led to corrective-action plans and enhanced monitoring. After the parties could not resolve the issues raised in the December 2022 notice, plaintiffs filed the present enforcement motion against Wellpath on May 11, 2023.

The parties’ positions

Plaintiffs argued that Wellpath was not substantially complying with 44 specific requirements involving medical, mental-health, and dental care. They relied primarily on reports from neutral monitors who had evaluated Wellpath’s performance over several years. Plaintiffs asked the court to require compliance and impose conditional civil-contempt fines if Wellpath did not comply within six months.

Wellpath opposed the motion and asked the court to deny it as premature. It argued that the monitor reports were outdated and that its recent hiring of supervisory staff and increase in staffing showed that it was moving toward substantial compliance. The court stated that Wellpath did not substantively challenge plaintiffs’ evidence or provide evidence showing that substantial compliance had been achieved after the monitor reports.

Court’s analysis

For civil contempt, the court required plaintiffs to prove by clear and convincing evidence that Wellpath violated a specific and definite court order. Once plaintiffs met that burden, Wellpath had to show why it could not comply and that it had taken every reasonable step to do so.

The court found clear and convincing evidence of current noncompliance with 43 requirements—requirements 1–13 and 15–44. These requirements covered staffing; medical intake, sick calls, chronic care, health maintenance, continuity of care, outside referrals, intoxicated-patient treatment, communicable diseases, pharmaceuticals, and medical quality assurance; mental-health screening, treatment, segregation practices, suicide-risk assessments, records, and quality assurance; and dental screening, treatment, referrals, procedures, facilities, records, and quality assurance.

For requirement 14, concerning hospital transfers, the court found clear and convincing evidence of historical noncompliance but not current noncompliance. The most recent mental-health monitoring report stated that more information was needed before making a current compliance finding. The court therefore did not include that requirement among the 43 violations supporting the contempt order.

The court rejected Wellpath’s argument that the evidence was too old. It found that the reports from 2017 through 2022, particularly the most recent reports from each monitor, showed continuing noncompliance and that Wellpath had offered no evidence of later substantial compliance. The court concluded that Wellpath failed to meet its burden to explain why it could not comply.

Sanctions and order

The court concluded that coercive civil-contempt sanctions were appropriate because Wellpath’s continued noncompliance posed a serious risk to the health and well-being of the Jail’s inmate population, and earlier corrective measures had not produced compliance. Coercive sanctions are designed to pressure a party to comply and must allow the party an opportunity to end the violation.

The court granted plaintiffs’ motion to enforce the Settlement Agreement and Wellpath Implementation Plan. It found Wellpath in civil contempt for each of the 43 requirements, ordered immediate and sustained compliance, and imposed a conditional coercive fine of $25,000 for each requirement. Wellpath was given six months—until March 25, 2024—to comply before the fines could attach. The neutral monitors were directed to report on compliance at the end of that period, and Wellpath would have to show cause in writing if the reports found continued noncompliance.

The court also allowed plaintiffs to seek further orders requiring additional $25,000 fines after later monitoring reports if Wellpath remained out of substantial compliance. It reinstated neutral monitoring for two mental-health medication provisions from which Wellpath had previously been released. The court set a status hearing for March 28, 2024, and found that the order was necessary, narrowly tailored, and the least intrusive means of ensuring compliance.