Appeals Court decision allows release of thousands of pages of documents about conditions in Monterey County Jail.

The public now has its clearest picture yet of medical and mental health care conditions at Monterey County Jail after the release of previously sealed reports by neutral monitors charged with inspecting the state of the jail.

On Thursday, Aug. 10, attorneys representing Monterey County Jail inmates in a 2015 class-action settlement over inadequate conditions at the facility publicly filed thousands of pages of documents providing unprecedented insight into the jail’s treatment of the people housed there. Those documents include the monitors’ reports, depositions by inmates, and correspondences relating to the jail’s management by the County of Monterey, the Monterey County Sheriff’s Office and Wellpath, the jail’s contracted health care provider.

As defendants in the 2015 class-action settlement, the County, the Sheriff’s Office and Wellpath have been ordered to comply with an array of standards meant to improve the state of medical, dental and mental health care at the facility. Yet attorneys representing the inmates claim that they are falling far short of those standards, and had sought the public release of the sealed documents—as well as a court order finding the County and Wellpath noncompliant with the settlement agreement, potentially resulting in millions of dollars in fines. 

The attorneys representing incarcerated people in the jail believe that the documents prove that noncompliance, and claim a court order is needed to force jail management to provide safe conditions for inmates. 

“For more than seven-and-a-half years, Wellpath has defied its Court-ordered obligations and provided systemically inadequate care to people incarcerated at the Monterey County Jail,” according to the plaintiffs’ motion. 

The latest chapter in the years-long legal battle was an effort to unseal those previously confidential documents. (The Weekly—along with the First Amendment Coalition and family members of two people who died in the jail—are also engaged in the narrower issue of whether these documents should be publicly disclosed. This group filed seeking to become intervenors in this case, a matter which is still pending before the court.) 

Wellpath and the County of Monterey opposed the unsealing of the records, but were denied by a federal district court judge. Wellpath appealed that decision, and was again denied by the Ninth Circuit Court of Appeals on Wednesday, Aug. 9. Those denials meant that 60 documents, labeled as exhibits 1-60, were filed in publicly court on Thursday and are now viewable to the public. (The newly filed court records are attached as PDFs in this post on the Weekly’s website). 

Many of the documents are lightly redacted, protecting people’s identities and personal information. Some exhibits are still filed entirely under seal. But they begin to paint a picture of an institution struggling to comply with court-ordered plans to ensure adequate health and safety requirements for the people incarcerated there. 

The reports and other materials detail the state of a facility where no fewer than 25 inmates have died since the 2015 settlement, including four in 2023 alone. According to attorneys for the inmates, Monterey County Jail had a fatality rate of 361 deaths per 100,000 people as of May 31—more than twice the national average of 167 deaths per 100,000 incarcerated people.

The documents reveal that Monterey County Jail has consistently been found “noncompliant” with the settlement’s standards of care in recent years, according to the monitors, with performance regressing in some cases. Those shortcomings have contributed to several inmate deaths in recent years, per the monitor reports, as well as other incidents in which physically and mentally ailing inmates did not receive the aid they needed in a prompt manner, if at all.

The reports detail cases where inmates requested medical attention that was slow or failed to arrive, in some cases leading to further complications. There are instances where inmates were found to have active or latent tuberculosis, yet were not isolated and did not receive prompt followup care. Some inmates with chronic medical ailments, including HIV, were not seen by qualified physicians until their conditions worsened, according to the reports.

The specter of untreated mental illness looms large in the reports, which recount numerous cases where inmates suffering from mental conditions did not receive the attention required, leading to suicide or other causes of death. One 59-year-old inmate with documented schizophrenia and dementia, as well as physical ailments like diabetes and hypertension, who died in November 2017 was documented as having “markedly abnormal vital signs” just a month prior to his death that should have been further monitored, according to one report. 

Inadequate women’s health care also arises repeatedly, such as several cases of misdiagnosed and untreated vaginitis. Earlier this year, one female inmate was repeatedly admitted to the hospital after what a monitor described as consistently “deficient care” by Wellpath that could have potentially led to her death. 

Another female inmate, who requested help terminating her pregnancy in February 2023, was not able to do so until nearly two months later due to Wellpath’s slow response—eventually doing so just shy of the 23-week gestation mark that would bar pregnancy termination in California in non-health-threatening cases.

One neutral monitor report about dental care, based on a tour of the jail in December 2017 and a follow-up visit in May 2018, describes “continuing and ongoing issues with noncompliance.” Specifically, it found challenges with scheduling: “On many days, in excess of 50 patients were scheduled for triage and treatment for one dentist, one dental chair and one dental assistant.” (The report notes “on a positive note” that after contract negotiations with the County were completed in December 2017 for Wellpath to continue providing dental service in the jail, they added a dental day to the schedule—up to three days per week, from two days previously.) 

The monitor returned in May 2018 to see whether the enhanced schedule was sufficient to meet the dental needs of jail inmates, and what had changed. The report documents some improvements in the months in between: “Dental was painted! The dental clinic space has improved tremendously. It is a joy to see the improvements.” But there were also many ongoing issues, including no hand-washing or use of hand sanitizer prior to gloving up or after a patient’s treatment; an unregistered X-ray unit; and an absence of floss loops.

Many of the reports included date back several years, to 2017. (In 2022, a $90 million expansion project at the jail was completed after a decade of planning and construction. Many of the reports filed in the court record pre-date the expansion of the facility.) But some records included as exhibits are more recent.

In an email to the attorneys responsible for monitoring the settlement agreement that was responding to a suicide on Jan. 5, 2023, Dr. Bruce Barnett wrote: “I know everyone is saddened by this death. I believe the demise fits a pattern of circumstances which might merit attention and action to reduce the risks to other similarly situated incarcerated persons.”

Specifically in this case, Barnett raised concerns about how to handle people who are booked in the jail and have been using methamphetamine. “Bizarre behaviors including suicidal ideation is not unusual in patients using and/or withdrawing from methamphetamine,” Barnett wrote. 

Emails are just one of the types of documents included in these newly public records. There are also coroner’s reports, including autopsy reports, describing in detail deaths that have occurred in the jail, in addition to the third-party monitors' reports.

Barnett is one such monitor, responsible for reviewing the provision of medical care. 

In his introduction to a Dec. 26, 2022 health care audit of the jail, Barnett wrote: “Based upon my review of medical records and site visit on Oct. 13, 2022, I find that medical care provided at Monterey County Jail is not substantially compliant with the Implementation Plan.”

It is not clear whether all third-party monitor reports are included in the court exhibits, and whether some reports are among the exhibits filed under seal. The Weekly has filed a California Public Records Act request with the County of Monterey seeking all of the 30-plus reports produced since the settlement agreement was approved in 2015. 

“The court has rendered its decision, and we respect and will comply with the ruling,” says County spokesperson Nick Pasculli. “As responsible stewards of both legal mandates and ethical considerations, we will work diligently to ensure that any public disclosures strictly adhere to the court's guidance.

“The County of Monterey remains dedicated to enhancing transparency, accountability, and justice within the confines of the law. We will continue to collaborate with all relevant parties to strike a balance between public awareness and the protection of sensitive inmate information.”

“We are pleased that the courts reached the right result and ordered that the neutral monitor reports be publicly accessible,” says Jackie Osorno, an attorney with nonprofit legal advocacy group Public Justice, which is representing the Weekly and other proposed intervenors in this case. “The information contained in those documents likely contains evidence of ongoing constitutional violations. The Monterey County community has a right to examine that evidence and demand change where it is warranted.”

Most immediately, the documents will be considered by a federal judge on Aug. 24. That’s when both sides are set to argue in court about whether or not the jail is in compliance with the settlement agreement.

“Year after year, the court-appointed neutral monitors responsible for evaluating medical, mental health, and dental care find Wellpath noncompliant with the vast majority of the requirements of the settlement agreement and Implementation Plan,” according to the plaintiffs’ motion. “Year after year, the neutral monitors make recommendations about how Wellpath can come into compliance. Nevertheless, Wellpath refuses to implement the neutral monitors’ recommendations and continues to deliver substandard care.

“This Court must intervene and order Wellpath to finally meet its remedial obligations.”

Wellpath representatives did not respond to the Weekly’s requests for comment. 

Last year, the County Board of Supervisors renewed the company’s contract, at a cost of over $44.3 million through Dec. 31, 2025—the duration of the Hernandez settlement agreement.