Judge finds Monterey County Jail’s health care contractor in violation of inmate conditions settlement.

A federal judge ruled that Monterey County Jail’s for-profit health care provider is in violation of a class-action settlement over inadequate inmate conditions at the Salinas facility—and has given the company six months to improve its services or risk paying over $1 million in penalties.

U.S. District Court Judge Beth Labson Freeman ruled on Tuesday, Sept. 26 that Wellpath, the largest prison health care contractor in the U.S., “is not in substantial compliance” with 43 of 44 requirements laid out in the 2015 settlement agreement that are meant to improve medical, mental and dental health care conditions at Monterey County Jail.

Freeman has given Wellpath until March 25, 2024 to address those deficiencies, or else face fines of $25,000 for each of the 43 requirements in question—penalties that could potentially amount to nearly $1.1 million if all of the issues are still unaddressed.

Court-appointed neutral monitors—who have inspected the facility since 2017 as part of the settlement—will continue to provide reports evaluating Wellpath’s compliance with the agreement, and their findings will determine whether the health care contractor remains in violation.

Should those monitors’ reports beyond March 2024 find that Wellpath is still noncompliant with the settlement’s terms, attorneys representing the plaintiffs—the jail’s incarcerated people—may request a court order resulting in additional fines of $25,000 per requirement, according to the judge’s ruling.

The court order comes after the inmates’ attorneys filed an enforcement motion this past May alleging Wellpath’s noncompliance with the settlement agreement and seeking the civil contempt fines now being levied against the company. Freeman ruled that those attorneys “submitted clear and convincing evidence” of Wellpath’s continued violation of the vast majority of the settlement’s mandates on health care services at the jail; in only one of the 44 requirements—mandating hospital transfers for inmates under prolonged suicide watch—did the judge not find “a current lack of substantial compliance.”

“Wellpath’s continued failure to comply with its obligations…creates a serious risk of harm to the health and well-being of the entire inmate population of the Jail,” Freeman wrote in the ruling. “The Court agrees that Wellpath has left it no viable option but to impose coercive sanctions in the form of a conditional fine in the hope that a threat to its bottom line may galvanize Wellpath’s compliance where other measures have failed.”

The judge set a status hearing on the order for March 28, 2024.

After filing the class-action lawsuit in 2013, the plaintiffs reached the settlement agreement with defendants Wellpath, the County of Monterey and the Monterey County Sheriff’s Office (which manages the jail) in 2015. Court-appointed neutral monitors—experts in the medical, mental and dental health fields—began inspecting the facility in 2017, and since then their reports detailing conditions there have found little-to-no improvement in Wellpath’s health care services. Freeman’s ruling cited how medical monitor reports found that Wellpath’s compliance had actually declined between March 2017 and October 2022.

In August, attorneys for the inmates succeeded in unsealing more than 30 reports from the neutral monitors, which revealed Wellpath’s continued noncompliance with the settlement and how inadequate health care had contributed to inmate deaths, illnesses and injuries. Twenty-six people have died at the jail since the 2015 settlement, including five in 2023 alone, according to plaintiffs’ attorneys—who noted that the jail’s annual death rate since the settlement was more than twice the national average for local jails. (The Weekly joined the First Amendment Coalition and the families of two people who died in the jail as intervenors in the case, in an effort to unseal the monitor reports.)

“Judge Freeman’s order confirms what Wellpath has long known—that it is providing inadequate medical, mental health and dental care to the thousands of individuals who are incarcerated in the Monterey County Jail each year,” attorney Van Swearingen, whose San Francisco-based law firm Rosen Bien Galvan & Grunfeld is representing the inmates, said in a statement. “As a for-profit company, Wellpath is incentivized to skimp on its provision of health care. We are hopeful that the threat of significant fines will spur Wellpath to do better, and to come into compliance with its court-ordered obligations.”

Although Wellpath, the County and the Sheriff’s Office are all defendants in the settlement, the plaintiffs’ motion and resulting court order specifically targeted Wellpath and its implementation plan for medical, mental and dental health care at the jail. The company—which operates at roughly 500 correctional facilities in 37 states, including at more than half of California’s county jails—has faced widespread criticism for its substandard care of inmates, and has reportedly faced thousands of lawsuits across the country in recent years.

Wellpath was formed through a 2018 merger between two prison health care contractors, Nashville-based Correct Care Solutions and California Forensic Medical Group. The latter company had been contracted at Monterey County Jail since the mid-1980s when it was founded by Monterey-based physician Taylor Fithian, who now sits on Wellpath’s board of directors.

Representatives for Wellpath did not return requests for comment.

When reached for comment, Monterey County Sheriff Tina Nieto says her office is “doing everything we can” to meet the settlement’s terms, including working with Wellpath to create a “compliance team” tasked with addressing the issues at the jail. Nieto adds that she intends to again ask the Monterey County Board of Supervisors for more budget funds in order to increase staffing at the jail and better meet the needs of inmates, after securing an additional $1 million in the 2023-24 fiscal year budget to fund seven new positions mostly tied to jail operations.

“I think we are making headways,” Nieto says of conditions inside the facility. “I think you’ll see that in future [monitor] reports.”

A spokesperson for the County declined to comment.