California: Private Medical Provider can be Liable for ADA Violations; Class-action Suit Settles

by David M. Reutter

A California federal district court held in September 2014 that a jail’s private medical provider may be held liable under Title III of the Americans with Disabilities Act (ADA); the class-action lawsuit later settled, with the jail agreeing to make a number of policy changes.

At issue was a complaint that alleged the Monterey County Jail (MCJ) had substandard conditions that included “violence due to understaffing, overcrowding, inadequate training, policies, procedures, facilities, and prisoner classification; inadequate medical and mental health care screening, attention, distribution, and resources; and lack of policies and practices for identifying, tracking, responding, communicating, and providing accessibility for accommodations for prisoners with disabilities.” [See: PLN, June 2014, p.1].

The defendants, including the County of Monterey, Monterey County Sheriff’s Office and California Forensic Medical Group (CFMG), filed motions to dismiss. MCJ frequently houses more than 1,100 prisoners; the majority are pretrial detainees who stay an average 30-40 days.

Health care at the facility is provided under a contract with CFMG, which is responsible for determining “the method, details, and means of performing services.” The complaint in the class-action suit listed eight causes of action and named 21 prisoners and former prisoners as plaintiffs.

The defendants argued that the plaintiffs “who are no longer incarcerated do not have standing for mootness and for lack of redressability because they are no longer subject to the conditions they challenge.” The plaintiffs countered that “they qualify for the transitory exception, under which a named plaintiff need only have standing at the time they enter the dispute.”

The district court agreed with the latter argument. “On balance, the court is persuaded that the short average length of stay of prisoners in the putative class and the plodding speed of legal action qualify plaintiffs for the inherently transitory exception.” It noted that the average stay at the jail of 34 days was too short to resolve the litigation, which was already two years old. Further, the plaintiffs may be subject to the same jail conditions if re-incarcerated.

CFMG moved to dismiss the plaintiffs’ ADA claim because the company “does not own, lease, or operate a place of public accommodation.” It argued that it is merely an independent contractor and neither the jail nor its medical services are open to the public.

The plaintiffs countered that CFMG is a provider of a public accommodation in that it “operates a professional office of health care provider, hospital, or other service establishment” within MCJ, which fits in the “services establishment” category of the ADA. Moreover, they argued CFMG is not insulated from liability under the ADA because its health care facilitates at MCJ are not open to the general public, as it is the “sole provider” of medical services at the jail.

The district court held that CFMG operates a place of public accommodation for purposes of the ADA. The “expansive purpose” of the ADA, the court wrote, is to reach all “critical areas” of society that persons with disabilities face, and two of those were involved in this case. Additionally, the same district court had recently ruled that a private provider of jail health care services could face claims for disability discrimination. See: Wilkens-Jones v. County of Alameda, 859 F.Supp.2d 1039 (N.D. Cal 2012). As such, the court denied the defendants’ motions to dismiss.

Previously, the district court had certified a class defined as “all adult men and women who are now, or will be in the future, incarcerated in the Monterey County Jail.” The court also certified a sub-class of “all qualified individuals with a disability, as that term is defined in 42 U.S.C. § 12102, 29 U.S.C. § 705(9)(B), and California Government Code § 12926(j) and (m), and who are now, or will be in the future, incarcerated in the Monterey County Jail.”

The district court entered a preliminary injunction in April 2015, and the following month granted the parties’ stipulated motion for preliminary approval of a settlement in the class-action suit. The proposed settlement provides that the parties shall “develop Implementation Plans ... for improvement of care, services, programs, and activities at the Jail.” Those include intake screenings, such as screenings for TB and MRSA; infection control; detoxification; safety cells for prisoners with medical and mental health care needs; medication continuity for when prisoners enter the jail; staffing levels for both security and clinical staff; medical, mental health and dental treatment; violence reduction (which may include the installation of video cameras); and services for prisoners with disabilities.

Further, “expert monitors will be retained to monitor Defendants’ compliance” with the terms of the settlement agreement with respect to medical, mental health and dental care, as well as ADA compliance and general conditions of confinement and security. The cost of the monitors will be paid by the defendants, who will also pay the plaintiffs’ attorney fees and costs in an amount not to exceed $4.8 million – and the defendants agreed “not to object to plaintiffs’ petition for fees and expenses up [to] that amount.” In addition, the plaintiffs may petition the court for up to $250,000 per year in additional fees and expenses for “monitoring work, inspections, negotiations, meet and confer processes, mediation, review of documents, and correspondence with class members.”

The settlement consists of a consent decree that will be enforceable by the district court for five years. A final approval hearing pursuant to F.R.C.P. Rule 23(e) was held on August 18, 2015, and the district court approved the settlement that day. The plaintiffs were represented by the law firm of Rosen Bien Galvan & Grunfeld LLP, and by the Office of the Public Defender for Monterey County, the ACLU National Prison Project and the ACLU of Northern California. See: Hernandez v. County of Monterey, U.S.D.C. (N.D. Cal.), Case No. 5:13-cv-02354-PSG; 2014 U.S. Dist. LEXIS 138247.

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