Attachment_1_Mays_Proposed_Consent_Decree.pdf
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- Solicitation number
- OFCA/028
- Issued by
- Sacramento County, San Francisco City, California
About this file
This document is a Proposed Consent Decree related to Sacramento County's Adult Correctional Health (ACH) system operations. The decree establishes comprehensive requirements and oversight mechanisms for the County's correctional healthcare delivery across both the Sacramento Main Jail and Rio Cosumnes Correctional Center. The document outlines detailed standards for medical care, operational procedures, staffing requirements, training protocols, and quality assurance measures that the ACH system must implement and maintain. Key provisions address healthcare delivery standards, inmate access to medical services, medication management, mental health services, infectious disease protocols, and documentation requirements. The consent decree establishes monitoring mechanisms, reporting obligations, and compliance timelines that Sacramento County must adhere to throughout the agreement period, with specified milestones for implementing policy revisions, conducting staff training, and achieving operational improvements in correctional healthcare standards of care.
The decree includes provisions for independent oversight through court-appointed subject matter experts and establishes ongoing technical assistance and monitoring protocols to ensure sustained compliance with medical standards of care. The document addresses governance structures, chain of command clarifications, resource allocation requirements, and performance metrics for evaluating the effectiveness of implemented reforms. Financial obligations and resource commitments necessary to support the mandated improvements are referenced throughout the decree, though specific monetary amounts are not clearly delineated in the provided excerpt. The agreement establishes a framework for collaborative oversight involving County legal counsel, class counsel, correctional healthcare and custody staff, and County leadership to ensure comprehensive implementation of all required operational, medical, and policy-based improvements across Sacramento County's ACH system.
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Case 2:18-cv-02081-TLN-KJN Document 85-1 Filed 06/20/19 Page 15 of 119
EXHIBIT A
Consent Decree Mays v. County of Sacramento
Case 2:18-cv-02081-TLN-KJN Document 85-1 Filed 06/20/19 Page 16 of 119
MAYS V. COUNTY OF SACRAMENTO
REMEDIAL PLAN
Definitions “Chief Disciplinary Officer” is the individual who is responsible for overseeing the disciplinary system and ensuring consistency in disciplinary practices and procedures.
“County” refers to Sacramento County.
“Designated Mental Health Units” refers to any specialized units specifically operated to house and serve prisoners requiring mental health treatment, including the inpatient unit (2P), the Intensive Outpatient Program (IOP), the Outpatient Psychiatric Pods.
“Disciplinary Hearing Officer” includes any sergeant, officer, or other individual who has responsibility for adjudicating a disciplinary report and/or imposing disciplinary measures.
“Discipline” is the imposition of penalties for prisoner misconduct that violates Jail facility rules.
“Disability” means any physical or mental impairment that substantially limits one or more major life activities. These include, but are not limited to, any disability that would substantially limit the mobility of an individual or an impairment of vision and/or hearing, speaking or performing manual tasks that require some level of dexterity.
Additionally, disability includes a physical or mental impairment that would inhibit a person's ability to meet the rules and regulations of the facility.
“Effective Communication” means that any written or spoken communication must be as clear and understandable to people with disabilities as it is for people who do not have disabilities.
“Intellectual Disability” is a disability characterized by significant limitations in intellectual functioning (such as learning, reasoning, and problem-solving) and in adaptive behavior (conceptual skills such as language, literacy, money, time, and self-direction; social and interpersonal skills; and practical skills such as personal care and schedules/routines). This includes people for whom the onset of the disability occurred before age 18 (developmental disabilities) and people for whom events later in life resulted in similar limitations (for example, head injury, stroke, or dementia).
“Medical Staff” means medical personnel including physicians, dentist, pharmacist, nurse practitioners, supervising registered nurses, registered nurses, registered dental hygienists, licensed vocational nurses, pharmacy technicians, medical assistants, registered dental assistants, certified nursing aids and other medical personnel.
Case 2:18-cv-02081-TLN-KJN Document 85-1 Filed 06/20/19 Page 17 of 119
“Medical services,” “medical treatment” and “medical staff” includes dental services, dental treatment and dental staff, as well as medical pharmacy services and pharmacy staff.
“Mental health caseload” means all prisoners in the jail with a current need for any mental health services.
“Out-of-cell activities” are activities which occur out of the inmates’ cell. Examples of such activities include but are not limited to games, the use of tablets and other socialization among inmates.
“Provider” means physician, dentist, pharmacist, physician’s assistant, or nurse practitioner.
“Qualified Mental Health Professional” means psychiatrists, psychologists, master’s level social workers, licensed professional counselors, licensed nurses, or others who by virtue of their education, credentials, and experience are permitted by law to evaluate and provide mental health care to patients.
“Qualified Health Care Professional” means physicians, physician assistants, nurses, nurse practitioners, dentists, qualified mental health professionals, and others who by virtue of their education, credentials, and experience are permitted by law to evaluate and provide health care to patients.
“Qualified Sign Language Interpreter” (“SLI”) is an individual, available on-site or through a VRI service, who is adept at American Sign Language and has passed a test and qualified in one of the categories established by the National Association for the Deaf
(NAD) or one of the categories established by the Registry of Interpreters for the Deaf
(RID).
“Segregation” means the confinement in a locked room or cell, with or without a cellmate, with limited social contact as compared with the general population, in conditions characterized by substantial isolation, whether pursuant to disciplinary, administrative, or classification action. If a housing unit or location does not meet the above definition, the unit will not be considered a segregation unit, regardless of name.
“Serious Mental Illness” (“SMI”) means a mental, behavioral, or emotional disorder of mood, thought, or anxiety that significantly impairs judgment, behavior, capacity to recognize reality, or substantially interferes with primary activities of daily living.
“Temporary Suicide Precautions Housing” refers to any non-inpatient unit where the
Jail houses prisoners requiring suicide precautions and/or inpatient level of psychiatric care, including but not limited to safety cells, holding cells, North Holding Cell No. 2 at
RCCC, Main Jail booking segregation cells, and the classrooms/multipurpose rooms adjacent to the Main Jail housing units.
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“TTYs” or “TDDs” means devices that are used with a telephone to communicate with persons who are Deaf by typing and reading communications.
“Videophone” means a device with a video camera that can perform bi-directional video and audio transmissions between people in real-time.
“Video-Relay Services” or “VRS” is a video telecommunications relay service that enables persons with hearing-related disabilities who use Sign Language to communicate with voice telephone users through video equipment, such as a Videophone, rather than through typed text.
“Video Remote Interpreting service” or “VRI service” means an interpreting service that uses video conference technology over dedicated lines or wireless technology offering clear, delay-free, full-motion video and audio over high-speed connection that delivers high-quality video images as provided in 28 § 35.160(d).
GENERAL PROVISIONS
The County shall maintain sufficient medical, mental health, and custody staff to meet the requirements of this Remedial Plan.
The parties agree that the custodial and health care staff must be increased to meet minimal constitutional and statutory standards. Presently, there are insufficient deputies to supervise out-of-cell activities for people in the general population and administrative segregation, and to provide security for health-related tasks. The parties agree that reduction in jail population is a cost-effective means to achieve constitutional and statutory standards.
1. The County intends to hire additional custodial and health care staff. The parties agree that population reduction of the jails will facilitate compliance with this Remedial Plan. All population reduction measures should be designed to promote public safety through evidence-based programs.
2. If through the monitoring process it is determined that the County is not fulfilling the provisions of this Remedial Plan due to staffing deficiencies, the parties will meet and confer regarding what steps to take to reduce the population of the jail, including available resources to facilitate population reduction.
The parties agree to meet and confer regarding the gathering and posting of data related to the Jail population. The parties agree that the categories of information to be gathered and publicly posted on a quarterly basis are the following:
a) the number of people with mental illness booked into jail;
b) their average length of stay;
c) the percentage of people connected to treatment;
d) their recidivism rates;
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e) the total number of people in jail with a mental health need;
f) the number of people who were receiving mental health services at the time of booking; and
g) the number of sentenced and unsentenced inmates in custody.
h) For sentenced people in the jail, the nature of the commitment convictions, length of sentence(s), and level of mental health care (e.g., Acute, IOP, OPP).
i) For unsentenced people in the jail, the nature of the charges, length of pre-trial detention, and level of mental health care (e.g., Acute, IOP, OPP).
AMERICANS WITH DISABILITIES ACT (ADA) COMPLIANCE
Policies and Procedures
1. It is the County’s policy to provide access to its programs and services to prisoners with disabilities, with or without reasonable accommodation, consistent with legitimate penological interests. No prisoner with a disability, as defined in 42 U.S.C. § 12102 shall, because of that disability, be excluded from participation in or denied the benefits of services, programs, or activities or be subjected to discrimination. The County’s policy is to provide reasonable accommodations or modifications where necessary, consistent with 28 C.F.R.
§§ 35.150 & 35.152, and other applicable federal and state disability law.
2. The County shall, in consultation with Plaintiffs’ counsel, revise its Operations Order to establish standard and consistent procedures for the Jail to ensure compliance with the ADA and the remedial provisions outlined herein.
3. The County shall, within 12 months from court approval of the Settlement and in consultation with Plaintiffs’ counsel, revise policies, procedures, and inmate orientation materials (e.g. Inmate Handbook), in accordance with the revised Operations Order and the remedial provisions outlined herein. A list of policies which the County will revise consistent with the provisions outlined herein, as appropriate and in consultation with Plaintiffs’ counsel, is attached as Exhibit A-1.
4. All staff will receive training appropriate to their position on policies and procedures related to compliance with the Americans with Disabilities Act (ADA) and related disability laws.
ADA Tracking System
1. The County shall develop and implement a comprehensive system (an “ADA
Tracking System”) to identify and track screened prisoners with disabilities as well as accommodation and Effective Communication needs.
2. The ADA Tracking System shall identify:
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a) All types of disabilities, including but not limited to psychiatric, intellectual, developmental, learning, sensory, mobility, or other physical disabilities, and special health care needs;
b) Prisoners with disabilities that may pose a barrier to communication, including but not limited to learning, intellectual, or developmental disabilities, and hearing, speech, or vision impairments;
c) Accommodation needs, including as to housing, classification, Effective Communication, adaptive supports, and assistive devices;
d) Prisoners who require specific health care appliances, assistive devices, and/or durable medical equipment (HCA/AD/DME);
e) Prisoners who are class members in Armstrong v. Newsom (N.D. Cal.
No. 94-cv-02307), with their applicable disability classification(s) and accommodation need(s).
3. The ADA Tracking System’s prisoner disability information will be readily accessible to custody, medical, mental health, and other staff at the Jail who need such information to ensure appropriate accommodations and adequate program access for prisoners with disabilities.
ADA Coordinator
1. The County shall have a dedicated ADA Coordinator at each facility.
2. The ADA Coordinator position shall be dedicated to coordinating efforts to comply with and carry out ADA-related requirements and policies, shall have sufficient command authority to carry out such duties, and shall work with the executive management team regarding ADA-related compliance, training, and program needs.
3. The County shall clearly enumerate, in consultation with Plaintiffs’ counsel, the job duties and training requirements for the ADA Coordinator position and for ADA Deputies assigned to support the ADA Coordinator position.
4. The County shall ensure that ADA Coordinators and ADA Deputies possess requisite training to implement and ensure compliance with the Jail’s disability program and services, including operation of the ADA Tracking System.
Screening for Disability and Disability-Related Needs.
1. The County shall conduct adequate screening of prisoners to be housed in the
Jail in order to identify disabilities and disability-related accommodation, housing, classification, and other needs. All individuals detained at the Jail for any period of time will be assessed for Effective Communication needs, consistent with the provisions herein.
2. The County shall take steps to identify and verify each prisoner’s disability and disability-related needs during medical intake screening, including based on:
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a) The individual’s self-identification or claim to have a disability;
b) Documentation of a disability in the individual’s health record;
c) Staff observation that the individual may have a disability that affects placement, program access, or Effective Communication; or
d) The request of a third party (such as a family member) for an evaluation of the individual for an alleged disability.
Orientation
1. The County shall ensure that, for the population to be housed in the Jails, prisoners with disabilities are adequately informed of their rights under the ADA, including but not limited to:
a) Accommodations available to prisoners;
b) The process for requesting a reasonable accommodation;
c) The role of the ADA coordinator(s) and method to contact them;
d) The grievance process, location of the forms, and process for getting assistance in completing grievance process;
e) Instructions on how prisoners with disabilities can access health care services, including the provision of Effective Communication and other accommodations available in accessing those services.
2. Upon processing and classification, prisoners with disabilities shall receive, in an accessible format, the jail rulebook; orientation handbook; and a verbal orientation or orientation video regarding rules or expectations.
3. The County shall accommodate individuals with disabilities in the orientation process through the use of alternative formats (e.g. verbal communication, large print, audio/video presentation), when necessary for Effective Communication of the information.
4. The County shall develop an Americans with Disabilities Act Inmate Notice.
The Notice shall be prominently posted in all prisoner housing units, in the booking/intake areas, in medical/mental health/dental treatment areas, and at the public entrances of all Jail facilities.
Health Care Appliances, Assistive Devices, Durable Medical Equipment
1. The County shall establish a written policy to ensure provision of safe and operational HCA/AD/DME, with a process for repair and replacement.
2. The County shall timely provide HCA/AD/DME to prisoners with disabilities who require such assistance. The County shall ensure an individualized assessment by medical staff to determine whether HCA/AD/DME is warranted to ensure equal and meaningful access to programs, services, and activities in the Jail.
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3. The County shall allow prisoners to retain personal HCAs/ADs/DME (which will include reading glasses), unless there is an individualized determination that doing so would create an articulated safety or security risk.
a) Where Jail staff determine it is necessary to remove a prisoner’s personal HCA/AD/DME for security reasons, the County shall provide an equivalent Jail-issued device unless custody staff, with supervisory review, determine and document, based on an individualized assessment, that the device constitutes a risk of bodily harm or threatens the security of the facility.
b) If such a determination is made, the ADA coordinator or supervisory-level designee shall document the decision and reasons for it, in writing, and shall consult with medical staff to determine an appropriate alternative accommodation.
4. The County shall, in consultation with Plaintiffs’ counsel, implement a written policy governing the release of prisoners who need assistive devices upon release.
a) The County will ensure that any personal mobility device belonging to a prisoner is returned to the prisoner prior to release from custody.
b) If a prisoner does not have a personal mobility device, but is ambulatory with the assistance of a cane, crutch, or walker, the prisoner will be permitted to retain such device that was used while in custody upon release, or will be provided a comparable device, upon release.
c) If a prisoner who is due for release requires a wheelchair, but does not have a personal wheelchair, Jail staff shall coordinate with the prisoner, the prisoner’s family or friends, and other County agencies as needed to secure a wheelchair or take other steps to address the individual’s needs upon release. The County shall document this process in the ADA Tracking System for purposes of individual tracking and quality assurance.
Housing Placements
1. The County shall house prisoners with disabilities in facilities that accommodate their disabilities.
2. The County shall implement a housing assignment system that includes an individualized assessment of each individual’s functioning limitations and restrictions, including but not limited to:
a) The need for ground floor housing;
b) The need for a lower bunk;
c) The need for grab bars in the cell and/or shower;
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d) The need for accessible toilets;
e) The need for no stairs in the path of travel; and
f) The need for level terrain.
3. Prisoners with disabilities shall be housed in the Jail consistent with their individual security classification. Prisoners prescribed or possessing HCAs/ADs/DME will not automatically be housed in a medical housing unit.
Placement in a medical housing unit will be based on individualized clinical determination of need for treatment.
4. Classification staff shall not place prisoners with disabilities in:
a) Inappropriate security classifications simply because no ADA-accessible cells or beds are available;
b) Designated medical areas unless the prisoner is currently receiving medical care or treatment that necessitates placement in a medical setting; or
c) Any location that does not offer the same or equivalent programs, services, or activities as the facilities where they would be housed absent a disability.
Access to Programs, Services, and Activities
1. The County shall ensure prisoners with disabilities, including those housed in specialized medical units or mental health units (e.g., OPP, IOP, Acute) have equal access to programs, services, and activities available to similarly situated prisoners without disabilities, consistent with their health and security needs.
Such programs, services, and activities include, but are not limited to:
a) Educational, vocational, reentry and substance abuse programs
b) Work Assignments
c) Dayroom and other out-of-cell time
d) Outdoor recreation and fitted exercise equipment
e) Showers
f) Telephones
g) Reading materials
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