Newly released documents detail Monterey County Jail’s failure to improve health care.

The release of previously sealed court reports documenting the state of medical and mental health care at Monterey County Jail has revealed an institution failing to meet the standards of a 2015 class-action settlement over inmate conditions, according to neutral monitors tasked with inspecting the facility.

The reports emerged after attorneys representing the jail’s inmates won a court battle over their release against the County of Monterey and Wellpath, the jail’s contracted health care provider. As a result, thousands of pages of documents were publicly filed on the case docket on Thursday, Aug. 10, providing unprecedented insight into the jail’s treatment of the people housed there.

The detailed inspection reports by the court-appointed neutral monitors – who have regularly visited the Salinas facility since 2017 per the terms of the settlement – specify how the jail has consistently fallen short of the settlement’s standards on medical, mental and dental health care for inmates.

The most recent released report, written by medical monitor Dr. Bruce Barnett in December 2022, found Monterey County Jail “not compliant” with 11 out of 12 quality indicators cited in the settlement’s court-approved implementation plan – including intake screening, access to care, continuity of care, outside care referrals, intoxication/detoxification care and infection control.

Barnett noted that the jail’s compliance “seems to have deteriorated since the last audit” written in July 2022, citing persistent issues including “long delays in attending to patient requests for medical services.” Barnett noted that “few, if any of my recommendations issued [during the previous audit] have been implemented.”

In a court filing released with the documents, attorneys representing the inmates alleged “egregious and largely unchanged levels of noncompliance by Wellpath since monitoring began in 2017.” In addition to medical care standards at the facility, they cited how monitors “have never found Wellpath substantially compliant” in all but two of the 17 mental health care quality indicators outlined by the implementation plan, and pointed to understaffing at the jail – another issue meant to be addressed by the settlement – as a factor in its “consistent noncompliance.”

Lawyers representing the inmates claim this state of affairs has led to the excessive death rate at a jail where 25 incarcerated people have died since the 2015 settlement. Monterey County Jail’s annual rate of 361 deaths per 100,000 people, as of May 31, is more than twice the national average of 167 deaths per 100,000 incarcerated people, according to the attorneys. They note how neutral monitors found that 18 of the 19 jail deaths they fully reviewed “could have been prevented with adequate treatment.”

Attorneys for the inmates are seeking a court ruling at an Aug. 24 hearing to find the County and Wellpath noncompliant with the settlement, which could potentially see millions of dollars in penalties imposed on the defendants for continuing to fail to meet the terms in the future.

Van Swearingen, a partner at San Francisco-based law firm Rosen Bien Galvan & Grunfeld, which is representing the people who are incarcerated, describes the release of the monitor reports as “monumental” in bringing more transparency around conditions at Monterey County Jail.

“The people who have been incarcerated have been subject to horrible conditions,” Swearingen says. “They know this is happening to them, but they didn’t know the extent to which Wellpath and the County have utterly failed to meet their court-ordered obligations.”

County spokesperson Nick Pasculli says the government “respect[s] and will comply with the ruling” prompting the release of the documents.

Representatives for Wellpath did not respond to 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.

In addition to documenting deaths at the jail, case studies in the neutral monitor reports include multiple 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.

The reports also recount cases where inmates suffering from mental illness did not receive the attention required, leading to suicide or other causes of death.

Inadequate women’s health care arises repeatedly in the case studies, such as several instances of misdiagnosed and untreated vaginitis. Earlier this year, one female inmate was repeatedly admitted to the hospital for bleeding 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. She eventually terminated the pregnancy just shy of the 23-week gestation mark that would bar abortion in California in non-health-threatening cases.