18 MONTEREY COUNTY WEEKLY september 14-20, 2023 www.montereycountyweekly.com afflicting its incarcerated people, such as drug addiction and mental illness. “When you are bringing in a population that is the most ignored, unfortunately we have had jail deaths.” The ongoing fight over conditions at Monterey County Jail dates back to 2013, when the class-action lawsuit was filed in federal U.S. District Court for Northern California. Hernandez v. County of Monterey takes its name from Jesse Hernandez, an inmate who, after undergoing colostomy reversal surgery during his imprisonment, claimed he did not receive proper care—resulting in symptoms such as fevers, bleeding and intestinal swelling. Hernandez eventually collapsed from the symptoms; after other prisoners in his pod shouted “Man down,” it took half-an-hour for medical assistance to arrive. The lawsuit alleged that the constitutional rights of Hernandez and others at the jail were being violated by its inadequate health care services. Under the 2015 settlement reached in the case (commonly known as the “Hernandez settlement”), the County and Wellpath were ordered to comply with a wide array of medical, mental and dental health care standards—practices touching everything from initial intake screenings and chronic care services, to suicide risk assessments and dental emergencies. The jail’s disability accommodations and safety measures were also subject to monitoring. To ensure that compliance, the jail was ordered to allow court-appointed neutral monitors—professionals in the medical, psychiatric and dental fields— to conduct site visits at least twice annually, during which they would be allowed to interview inmates and staff and review records. The monitors began their site visits in 2017. Since then, their now-unsealed reports have indicated little-to-no progress at the jail, with the facility continuing to be in noncompliance with the vast majority of standards. In his first audit in March 2017, Dr. Bruce Barnett, the designated medical monitor, determined an overall compliance score of 48.1 percent—well below the 80-percent mark generally accepted as compliance. By Barnett’s October 2022 visit more than five years later, the overall compliance score had fallen to 42.6 percent. “The neutral monitors have given [Wellpath and the County] the recipe book for success, but that has been ignored,” Swearingen says. “In every single neutral monitor report, there are recommendations the defendants should take in order to come into compliance. Those are routinely ignored and not adopted.” The October 2022 report noted that “few, if any of my recommendations” from Barnett’s previous visit to the jail six months prior had been followed, and cited “persistent departures” from the court-ordered implementation plan meant to bring the jail into compliance with the settlement. Intake screenings saw patients with serious clinical conditions “not consistently referred for appropriate follow-up examinations,” Barnett wrote. Inmates were “not timely seen following their written request for [a] sick call.” Those with substance abuse issues were “often not entered into appropriate monitoring protocols,” while patients with infectious diseases like HIV, hepatitis C and tuberculosis were not screened properly. Annual exams “were at times incomplete and lacked full physicals,” sometimes resulting in “inaccurately reported diagnoses.” Staffing continued to be “insufficient.” The reports also shed light on numerous case studies involving inmate medical incidents and emergencies—including the November 2022 death of 29-year-old David John Sand of Carmel Valley, who had a documented history of schizophrenia. Sand’s mental illness had seen him cycle in and out of psychiatric treatment centers while battling drug abuse and spending time homeless on the streets of Salinas. He was booked at Monterey County Jail in April 2022 due to probation violations including a felony charge for throwing a rock at a fire engine, his father says. Yet Sand’s medical records at the jail showed he received no psychiatric evaluation or treatment during his time at the facility—or even an initial health history assessment and physical exam— among multiple other “departures from care required by the implementation plan,” Barnett wrote. On Nov. 12, 2022, he was found unresponsive and pulseless in his cell, lying in a pool of blood and water, according to postmortem reports by the Sheriff-Coroner’s Office. He had been writing on the walls of his cell in his own blood; an autopsy report determined the cause of Sand’s death as acute water intoxication likely caused by the excessive and compulsive drinking of water, a known symptom of schizophrenia. “I can’t begin to explain how appallingly I feel about the way the County treated my son,” says his father, Eric Sand, who plans to pursue legal action against the County and Wellpath for David’s death. “The County knew he had been in jail many times from the effects of schizophrenia…They had access to his health history.” Other deaths in which the jail was 2021 A Covid-19 outbreak at the jail infects at least 130 inmates—a situation complicated by Sheriff Steve Bernal’s refusal to comply with a county vaccine mandate within his department. The outbreak results in the death of Covid-positive inmate Sergio Gonzalez. Inmates subsequently launch a hunger strike to protest the jail’s handling of the Covid outbreak. 2022 The court issues another order which requires Wellpath to confer with plaintiffs’ attorneys about staffing deficiencies at the jail and empowers the neutral monitors to provide training and supervision to Wellpath staff through “enhanced monitoring.” Staffing issues result in Wellpath ceasing initial health assessments for inmates from June to September, and all dental care from October to January 2023, according to the inmates’ attorneys. Deaths at the jail include 29-year-old David John Sand— who, despite suffering from schizophrenia that likely led to his death, received no psychiatric evaluation or treatment at the facility, monitors later find. 2022 The Monterey County Board of Supervisors renews Wellpath’s contract at the jail through 2025, at a total cost of $44 million. 2023 Lawyers representing the people incarcerated at the jail seek a court order finding Wellpath noncompliant with the Hernandez settlement. A federal judge orders the public release of 30-plus previously sealed reports by the neutral monitors detailing conditions inside the facility. Inmates’ attorneys claim that 26 people have died at Monterey County Jail since the 2015 settlement—making its annual death rate more than twice the national average for local jails—while five deaths in 2023 put the facility on track for its deadliest year since the settlement was reached. “I feel angry and also helpless.” Isabel Gonzalez A health care monitor found that Sergio Gonzalez was deprived of a blood-thinner prescription that could have prevented his death at Monterey County Jail in 2021. timeline continued from previous page
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