1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 MICHAEL LAROY DIGGS, Case No. 19-cv-06517-EMC
8 Plaintiff, ORDER GRANTING MOTION FOR 9 v. PARTIAL SUMMARY JUDGMENT
10 AMY DAVIS, et al., Docket No. 92 11 Defendants.
12 13 I. INTRODUCTION 14 Defendants Cindy Black and Amy Davis move for partial summary judgment on Plaintiff 15 Michael Diggs’s remaining Fourteenth Amendment equal protection claim. Defendants argue that 16 no reasonable juror could find that either Defendant personally participated in, directed, or 17 knowingly acquiesced in the alleged sex-based discrimination arising from Mr. Diggs’s placement 18 in the Intensive Substance Recovery Unit (“ISRU”) — an all-male housing and treatment program 19 at the Napa State Hospital (“DSH-Napa”). Defendants also contend that they are entitled to 20 qualified immunity. 21 For the reasons set forth below, Defendants’ motion is GRANTED. 22 II. BACKGROUND 23 A. Factual Background 24 Mr. Diggs was charged in Alameda County Superior Court with murder, with a prior 25 conviction for carjacking. Dkt. 23-1 at 11. He was found not guilty by reason of insanity and 26 referred to DSH-Napa for treatment. Id. Mr. Diggs was housed at DSH-Napa from 2015 until his 27 transfer to Patton State Hospital in 2019. The relevant events at issue occurred between 2017 and 1 Motion”) at 2–3 (stating that Mr. Diggs was transferred to the ISRU in early-2017); DiBaise 2 Declaration (Dkt. 119), Ex. 20 (Patient Complaints) at 65, 71, 84 109, 112 (correspondence 3 indicating Mr. Diggs’s continued placement in the ISRU throughout 2019). 4 In addition to suffering from psychiatric disorders including schizophrenia, antisocial 5 personality disorder and PTSD, Mr. Diggs was diagnosed with several substance abuse disorders. 6 SJ Motion at 2. As a result of his substance abuse history, psychiatric disorders, and an incident in 7 which two packets of methamphetamine were mailed to Mr. Diggs, he was placed in the ISRU, 8 which “promotes comprehensive treatment for patients . . . who have co-occurring mental illness 9 and substance dependence or a drug induced psychotic disorder.” Dkt. 23 at 34. 10 The ISRU was created before Mr. Diggs’s admission to DSH-Napa, after a clinical staff 11 member was killed in 2010. See Opposition to Motion for Partial Summary Judgment (“Opp. to 12 SJ Motion”) at 6; DiBaise Decl., Ex. 3 (Dr. Patricia Tyler Deposition) at 55:2–8. During the 13 implementation of a pilot program, it was described as “part of our on-going violence reduction 14 efforts . . . for patients with severe, active problems of substance abuse/dependency.” DiBaise 15 Decl., Ex. 18 at 2 (Email re ISRU Pilot). Dr. Patricia Tyler, the former Medical Director at DSH- 16 Napa, confirmed that the ISRU was created in part to address the correlation between aggression 17 and substance use. DiBaise Decl., Ex. 3 (Dr. Tyler Deposition) at 63:2–15. A presentation about 18 substance recovery programs also notes this connection between aggression and substance use. 19 None of these records report a gender-based aspect to substance-induced aggression. 20 According to Mr. Diggs, the ISRU was markedly more restrictive than other substance 21 recovery units. The record indicates that patients housed in the ISRU were: 22 - Required or strongly encouraged to attend self-help support groups such as NA and AA 23 meetings. Dkt. 119, DiBaise Decl., Ex. 10 (ISRU Protocol) at 6–7 (listing “[a]ttendance at 24 NA/AA on a regular basis” as part of the “Exit Criteria” for ISRU patients); Ex. 9 (ISRU 25 Advancement Criteria) at 2 (requiring attendance at treatment and recovery group meetings 26 to advance to less restrictive treatment “levels”1 within ISRU). 27 1 - Compelled to undergo more frequent urine drug screenings, including biweekly screenings 2 for “Level 1” (intensive) patients. Id. Ex. 10 (ISRU Protocol) at 5; Ex. 24 (Administrative 3 Directive) at 2–3. 4 - Subjected to coercive measures to punish any patients who refused to complete urine drug 5 screens. See id. Ex. 10 (ISRU Protocol) at 6. 6 - Prohibited from possessing a more inclusive list of “contraband,” including certain foods 7 and medications, including Xanax, Wellbutrin, and Ambien. See id. Ex. 3 (Dr. Tyler 8 Depo) at 102:3–20; Ex. 12 (Banned Medications List). 9 - Restricted in their movement through DSH-Napa, with the most intensive “Level 1” 10 patients fully confined to the ISRU unit and prohibited from other units “except for unit 11 sponsored walk groups or visiting center.” Id. Ex. 10 (ISRU Protocol) at 1–4. Even less 12 restricted “Level 2” patients were required to sign a contract and submit to “an increase in 13 random urine drug screens” and more frequent body searches to attend off-unit 14 programming with mixed groups, though “socializing with other patients away from the 15 group or using the restroom repeatedly” could lead to removal from the mixed group. Id. 16 Ex. 13 (ISRU Off-Unit Protocol) at 1–2. 17 - Prohibited or limited in their ability to work or attend employment training programs 18 outside the ISRU. Id. Ex. 20 (Patient Complaints) at 19, 30, 34. 19 These restrictive conditions on ISRU patients were not strictly temporary. Dr. Steward, a 20 psychologist who treated ISRU patients, testified that he could only recall two of his patients 21 “graduating” from the ISRU over the course of his five years treating patients in the program. See 22 id. Ex. 6 (Dr. John Steward Deposition) at 20:7–15; see also id. Ex. 13 (ISRU Off-Unit Protocol) 23 at 1 (stating that ISRU patients “progress through 3 months in Level 1 prior to becoming eligible 24 for Level 2. . . . Patients must complete 3 months of successful programming on Level 2 . . . in 25
26 are those actively using substances and who “have not accepted their need for substance recovery despite evidence that this is necessary.” Id. at 3–4. “Level One is a 4-month service at 27 minimum.” Id. “Level 2” is also a four-month minimum program for patients actively engaged 1 order to become eligible for Level 3”). 2 The ISRU houses only male patients admitted by their respective treatment team based on 3 “their individual behavioral needs.” Dkt. 92 (SJ Motion) at 3. The ISRU provides services to 4 male patients undergoing substance recovery and psychiatric stabilization. See id. Defendants 5 concede that “[o]nly those male patients whose treatment team has determined their psychiatric 6 stabilization levels and maladaptive behaviors require a higher level of care for their own safety 7 and the safety of others, are admitted to the ISRU.” Id. (emphasis added). 8 DSH-Napa did not evaluate female patients for eligibility in the ISRU. See DiBaise Decl., 9 Ex. 1 (Amy Davis Deposition) at 19:20–24. Although the ISRU is all-male, DSH-Napa houses 10 male and female patients, with roughly 20% of its 1,330 total patients identified as female during 11 the relevant period. DiBaise Decl., Ex. 19 (DSH-Napa Demographics) at 1–2. Units at DSH- 12 Napa are divided into “general” and “specialty” units, with units often being co-ed. See DiBaise 13 Decl., Ex. 5 (Jennie Leigh Gilmore Clay Deposition) at 24:4–20. There are a few all-male units 14 but they are seemingly limited to housing sex offenders or individuals with acute medical 15 sensitivities. See id. 16 The all-male ISRU is just one residential unit administering the Substance Recovery 17 Program (“SRP”) within the hospital. All genders may participate in the SRP, but “any female 18 patient whose psychiatric stabilization levels and maladaptive behaviors required a higher level of 19 care such as is required by those housed on ISRU would receive that level of care, but in their 20 home residential unit” rather than in the ISRU or a similarly restrictive equivalent. SJ Motion at 4 21 (emphasis added); see also SJ Motion, Ex. 4 (Supplemental Declaration of Amy Davis) at 2.
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1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 MICHAEL LAROY DIGGS, Case No. 19-cv-06517-EMC
8 Plaintiff, ORDER GRANTING MOTION FOR 9 v. PARTIAL SUMMARY JUDGMENT
10 AMY DAVIS, et al., Docket No. 92 11 Defendants.
12 13 I. INTRODUCTION 14 Defendants Cindy Black and Amy Davis move for partial summary judgment on Plaintiff 15 Michael Diggs’s remaining Fourteenth Amendment equal protection claim. Defendants argue that 16 no reasonable juror could find that either Defendant personally participated in, directed, or 17 knowingly acquiesced in the alleged sex-based discrimination arising from Mr. Diggs’s placement 18 in the Intensive Substance Recovery Unit (“ISRU”) — an all-male housing and treatment program 19 at the Napa State Hospital (“DSH-Napa”). Defendants also contend that they are entitled to 20 qualified immunity. 21 For the reasons set forth below, Defendants’ motion is GRANTED. 22 II. BACKGROUND 23 A. Factual Background 24 Mr. Diggs was charged in Alameda County Superior Court with murder, with a prior 25 conviction for carjacking. Dkt. 23-1 at 11. He was found not guilty by reason of insanity and 26 referred to DSH-Napa for treatment. Id. Mr. Diggs was housed at DSH-Napa from 2015 until his 27 transfer to Patton State Hospital in 2019. The relevant events at issue occurred between 2017 and 1 Motion”) at 2–3 (stating that Mr. Diggs was transferred to the ISRU in early-2017); DiBaise 2 Declaration (Dkt. 119), Ex. 20 (Patient Complaints) at 65, 71, 84 109, 112 (correspondence 3 indicating Mr. Diggs’s continued placement in the ISRU throughout 2019). 4 In addition to suffering from psychiatric disorders including schizophrenia, antisocial 5 personality disorder and PTSD, Mr. Diggs was diagnosed with several substance abuse disorders. 6 SJ Motion at 2. As a result of his substance abuse history, psychiatric disorders, and an incident in 7 which two packets of methamphetamine were mailed to Mr. Diggs, he was placed in the ISRU, 8 which “promotes comprehensive treatment for patients . . . who have co-occurring mental illness 9 and substance dependence or a drug induced psychotic disorder.” Dkt. 23 at 34. 10 The ISRU was created before Mr. Diggs’s admission to DSH-Napa, after a clinical staff 11 member was killed in 2010. See Opposition to Motion for Partial Summary Judgment (“Opp. to 12 SJ Motion”) at 6; DiBaise Decl., Ex. 3 (Dr. Patricia Tyler Deposition) at 55:2–8. During the 13 implementation of a pilot program, it was described as “part of our on-going violence reduction 14 efforts . . . for patients with severe, active problems of substance abuse/dependency.” DiBaise 15 Decl., Ex. 18 at 2 (Email re ISRU Pilot). Dr. Patricia Tyler, the former Medical Director at DSH- 16 Napa, confirmed that the ISRU was created in part to address the correlation between aggression 17 and substance use. DiBaise Decl., Ex. 3 (Dr. Tyler Deposition) at 63:2–15. A presentation about 18 substance recovery programs also notes this connection between aggression and substance use. 19 None of these records report a gender-based aspect to substance-induced aggression. 20 According to Mr. Diggs, the ISRU was markedly more restrictive than other substance 21 recovery units. The record indicates that patients housed in the ISRU were: 22 - Required or strongly encouraged to attend self-help support groups such as NA and AA 23 meetings. Dkt. 119, DiBaise Decl., Ex. 10 (ISRU Protocol) at 6–7 (listing “[a]ttendance at 24 NA/AA on a regular basis” as part of the “Exit Criteria” for ISRU patients); Ex. 9 (ISRU 25 Advancement Criteria) at 2 (requiring attendance at treatment and recovery group meetings 26 to advance to less restrictive treatment “levels”1 within ISRU). 27 1 - Compelled to undergo more frequent urine drug screenings, including biweekly screenings 2 for “Level 1” (intensive) patients. Id. Ex. 10 (ISRU Protocol) at 5; Ex. 24 (Administrative 3 Directive) at 2–3. 4 - Subjected to coercive measures to punish any patients who refused to complete urine drug 5 screens. See id. Ex. 10 (ISRU Protocol) at 6. 6 - Prohibited from possessing a more inclusive list of “contraband,” including certain foods 7 and medications, including Xanax, Wellbutrin, and Ambien. See id. Ex. 3 (Dr. Tyler 8 Depo) at 102:3–20; Ex. 12 (Banned Medications List). 9 - Restricted in their movement through DSH-Napa, with the most intensive “Level 1” 10 patients fully confined to the ISRU unit and prohibited from other units “except for unit 11 sponsored walk groups or visiting center.” Id. Ex. 10 (ISRU Protocol) at 1–4. Even less 12 restricted “Level 2” patients were required to sign a contract and submit to “an increase in 13 random urine drug screens” and more frequent body searches to attend off-unit 14 programming with mixed groups, though “socializing with other patients away from the 15 group or using the restroom repeatedly” could lead to removal from the mixed group. Id. 16 Ex. 13 (ISRU Off-Unit Protocol) at 1–2. 17 - Prohibited or limited in their ability to work or attend employment training programs 18 outside the ISRU. Id. Ex. 20 (Patient Complaints) at 19, 30, 34. 19 These restrictive conditions on ISRU patients were not strictly temporary. Dr. Steward, a 20 psychologist who treated ISRU patients, testified that he could only recall two of his patients 21 “graduating” from the ISRU over the course of his five years treating patients in the program. See 22 id. Ex. 6 (Dr. John Steward Deposition) at 20:7–15; see also id. Ex. 13 (ISRU Off-Unit Protocol) 23 at 1 (stating that ISRU patients “progress through 3 months in Level 1 prior to becoming eligible 24 for Level 2. . . . Patients must complete 3 months of successful programming on Level 2 . . . in 25
26 are those actively using substances and who “have not accepted their need for substance recovery despite evidence that this is necessary.” Id. at 3–4. “Level One is a 4-month service at 27 minimum.” Id. “Level 2” is also a four-month minimum program for patients actively engaged 1 order to become eligible for Level 3”). 2 The ISRU houses only male patients admitted by their respective treatment team based on 3 “their individual behavioral needs.” Dkt. 92 (SJ Motion) at 3. The ISRU provides services to 4 male patients undergoing substance recovery and psychiatric stabilization. See id. Defendants 5 concede that “[o]nly those male patients whose treatment team has determined their psychiatric 6 stabilization levels and maladaptive behaviors require a higher level of care for their own safety 7 and the safety of others, are admitted to the ISRU.” Id. (emphasis added). 8 DSH-Napa did not evaluate female patients for eligibility in the ISRU. See DiBaise Decl., 9 Ex. 1 (Amy Davis Deposition) at 19:20–24. Although the ISRU is all-male, DSH-Napa houses 10 male and female patients, with roughly 20% of its 1,330 total patients identified as female during 11 the relevant period. DiBaise Decl., Ex. 19 (DSH-Napa Demographics) at 1–2. Units at DSH- 12 Napa are divided into “general” and “specialty” units, with units often being co-ed. See DiBaise 13 Decl., Ex. 5 (Jennie Leigh Gilmore Clay Deposition) at 24:4–20. There are a few all-male units 14 but they are seemingly limited to housing sex offenders or individuals with acute medical 15 sensitivities. See id. 16 The all-male ISRU is just one residential unit administering the Substance Recovery 17 Program (“SRP”) within the hospital. All genders may participate in the SRP, but “any female 18 patient whose psychiatric stabilization levels and maladaptive behaviors required a higher level of 19 care such as is required by those housed on ISRU would receive that level of care, but in their 20 home residential unit” rather than in the ISRU or a similarly restrictive equivalent. SJ Motion at 4 21 (emphasis added); see also SJ Motion, Ex. 4 (Supplemental Declaration of Amy Davis) at 2. Put 22 simply, women are not placed into, or even considered for, the ISRU under any circumstances, 23 even if they suffer from substance abuse and psychiatric ailments. See SJ Motion, Ex. 4 at 2 24 (describing the ISRU as “an all male unit” and stating that “[o]nly male patients . . . are admitted 25 to the ISRU unit”). And DSH-Napa does not have an all-female equivalent to the ISRU. See SJ 26 Motion at 4; DiBaise Decl., Ex. 5 (Clay Deposition) at 33:15–18. 27 Defendants contend that the ISRU was not created or operated in a discriminatory manner 1 through DSH-Napa’s SRP. See SJ Motion at 4. Mr. Diggs contends that non-ISRU treatment 2 programs were not as restrictive as the ISRU, and that Defendants thus “imposed discriminatory 3 barriers on Mr. Diggs and other men . . . without imposing comparable barriers on women.” Opp. 4 to SJ Motion at 9. 5 Defendants in this action are two DSH-Napa officials: Cindy Black and Amy Davis. Both 6 defendants held supervisory and program-level responsibilities. 7 Cindy Black served as the Clinical Administrator for DSH-Napa from 2012–2018, and the 8 Executive Director of DSH-Napa from 2018–2022. SJ Motion at 2. Mr. Diggs alleges that, 9 through her roles, Ms. Black was “responsible for approving unit conversions and policies 10 governing substance recovery programs, including the [ISRU].” Opp. to SJ Motion at 10. She 11 also allegedly worked with others to ensure that DSH-Napa programs and services complied with 12 applicable federal and state laws, including federal gender discrimination laws. Id. at 10–11 13 (citing DiBaise Decl., Ex. 2 (Cindy Black Deposition) at 60:9–12; Ex. 7 (Clinical Administrator 14 Position Duties) at 1). Defendants assert Ms. Black “did not create the ISRU unit” and that she 15 “did not make the clinical decision that Plaintiff be placed in the unit. Additionally, she did not 16 decide whether Plaintiff could continue or transition from the unit. This determination was made 17 by his treatment team and program level.” SJ Motion at 9. 18 Amy Davis served as DSH-Napa’s sole Substance Abuse Recovery Coordinator during the 19 relevant period. DiBaise Decl., Ex. 1 (Amy Davis Deposition) at 13:7–21. Mr. Diggs alleges that 20 Ms. Davis was involved in “developing and overseeing the ISRU from its inception.” Opp. to SJ 21 Motion at 9. Mr. Diggs identifies several indications of Ms. Davis’s involvement with the ISRU 22 program: a member of the ISRU treatment team testified at their deposition that Ms. Davis as the 23 “overall director” for the ISRU program, Ms. Davis is described in an internal memo as holding 24 “revision responsibility” for administrative directives governing substance recovery services, and 25 she was listed as the primary, and only, contact for patients on the ISRU’s brochure. Id. (citing 26 DiBaise Decl., Ex. 6 (Steward Deposition) at 30:22–31:1; Ex. 23 (Administrative Statement) at 1; 27 Ex. 11 (ISRU Pamphlet) at 1). According to Ms. Davis’s own deposition testimony, she was 1 involved in Mr. Diggs’s referral to the ISRU.2 DiBaise Decl., Ex. 1 (Davis Deposition) at 28:23– 2 25. Defendants’ motion disputes whether Ms. Davis made the decision to place Mr. Diggs in the 3 ISRU, but Defendants do not object to or even acknowledge Ms. Davis’s deposition testimony 4 conceding her involvement in referring Mr. Diggs to the ISRU. See SJ Motion; Dkt. 120 (Reply 5 in Support of SJ Motion). 6 B. Procedural History 7 Mr. Diggs filed this action in 2019, asserting constitutional claims against the California 8 Department of State Hospitals and various DSH-Napa officials arising out of his confinement and 9 treatment. In September 2021, the Court issued an order denying Mr. Diggs’s motion for 10 summary judgment, and in November 2022, the Court denied Defendants’ motion for summary 11 judgment. The parties then entered settlement discussions, and the Court appointed counsel in 12 2024. Dkt. 75 (Order Appointing Counsel). 13 At a March 4, 2025 status conference, the Court clarified the scope of remaining issues in 14 this case. Dkt. 86 (March 4, 2025 Minute Entry). The Court ruled that Mr. Diggs’s First 15 Amendment claim regarding forced participation in substance recovery meetings was live, as was 16 his gender discrimination claim. Id. At that status conference, the Court authorized the parties to 17 brief this discrete gender discrimination issue through a motion for partial summary judgment. Id. 18 Defendants subsequently filed the present motion for partial summary judgment. 19 III. DISCUSSION 20 Mr. Diggs brings this gender discrimination claim under 42 U.S.C. § 1983, alleging that 21 Defendants Amy Davis and Cindy Black, acting under color of state law, violated his right to 22 equal protection under the Fourteenth Amendment by creating and maintaining the male-only 23 ISRU, placing him in the highly restrictive unit, and not subjecting similarly situated female 24 patients to comparable conditions. 25 To establish an equal protection violation, Mr. Diggs must show that each individual 26 defendant “acted in a discriminatory manner,” that “the discrimination was intentional,” and that 27 1 Mr. Diggs’s gender was at least a motivating factor in the discrimination. Serrano v. Francis, 345 2 F.3d 1071, 1082 (9th Cir. 2003); Reese v. Jefferson Sch. Dist. No. 14J, 208 F.3d 736, 740 (9th Cir. 3 2000). 4 The Court must also determine whether Defendants are entitled to qualified immunity as a 5 matter of law. 6 A. Gender Discrimination Claim 7 In evaluating an equal protection claim, the Court first assesses whether the groups being 8 compared are similarly situated, and if so, the Court determines the appropriate level of scrutiny 9 and then applies it. Gallinger v. Becerra, 898 F.3d 1012, 1016 (9th Cir. 2018). 10 First, with respect to the similarly situated analysis, the Fourteenth Amendment’s Equal 11 Protection Clause requires states to treat similarly situated persons alike. City of Cleburne v. 12 Cleburne Living Ctr., Inc., 473 U.S. 432, 439 (1985). Consistent with the parties’ submissions, 13 the relevant comparison is between male ISRU-eligible SRP patients and female SRP patients 14 who, based on substance abuse and psychiatric needs, would be candidates for an intensive 15 substance recovery setting but for the ISRU’s male-only design. See FAC at 9; SJ Motion at 4. 16 Second, sex-based classifications are subject to intermediate scrutiny. Prison and 17 institutional regulations that facially discriminate on the basis of sex are constitutional only if the 18 government demonstrates that they serve important governmental objectives and that the 19 discriminatory means employed are substantially related to the achievement of those objectives. 20 Harrison v. Kernan, 971 F.3d 1069, 1076 (9th Cir. 2020) (applying intermediate scrutiny in 21 custodial setting); see also U.S. v. Virginia, 518 U.S. 515, 516 (1996). The state must offer an 22 “exceedingly persuasive justification” for sex-based distinctions, and may not rely on “overbroad 23 generalizations” or stereotypes about different talents, capacities, or tendencies. Id. 24 Binding Ninth Circuit case law also instructs that custodial officials are afforded deference 25 in managing institutional operations, but that sex-based policies remain subject to heightened 26 scrutiny. See Harrison, 971 F.3d at 1077–78; Ambat v. City & Cnty. of S.F., 757 F.3d 1017, 1026 27 (9th Cir. 2014). Determining the degree of deference owed is a fact-intensive and case-specific 1 Mr. Diggs alleges, and the record supports, that male SRP participants meeting certain 2 criteria were screened for placement in the ISRU, while female patients with comparable 3 substance-use histories were neither housed in the unit nor evaluated for placement in it. Opp. to 4 SJ Motion at 1; see also SJ Motion, Ex. 4 (Supplemental Declaration of Amy Davis) at 2 (“Any 5 female or transgender patient whose psychiatric stabilization levels and maladaptive behaviors 6 required a higher level of care would receive that level of care, but in their home residential 7 unit.”). Defendants’ own motion describes the ISRU as an “all-male unit” that provides 8 “specialized substance treatment for dually-diagnosed individuals” and imposes additional control 9 and restrictions beyond those in standard program units. See SJ Motion at 4, 6. 10 In view of Ninth Circuit precedent, the Court must afford DSH-Napa administrators a 11 measure of deference. In doing so, the Court finds it relevant that female patients comprised 12 approximately only 20% of the total DSH-Napa population. DiBaise Decl., Ex. 5 at 33:9–19. The 13 Court also considers evidence that DSH-Napa typically establishes a specialized unit only after 14 determining that a sufficiently large cohort — generally around 40 patients — requires the same 15 level of specialized care, and that specialty units are most effective when fully populated. SJ 16 Motion, Ex. 4 at 2 (Supplemental Declaration of Amy Davis); DiBaise Decl., Ex. 4 (Kleinhenz 17 Deposition) at 55:1–25. The Court also recognizes DHS-Napa’s representations that it housed, 18 and continues to house, a “sufficiently large amount of dually diagnosed male patients who require 19 psychiatric stabilization and an emphasis on maladaptive behavior while enrolled in the” SRP, and 20 that “there was not a sufficiently large number of [female patients] to also require the additional 21 level of care provided in an ISRU to warrant an all-female ISRU.” SJ Motion, Ex. 4 at 2; see also 22 DiBaise Decl., Ex. 1 (Davis Declaration) at 61:9–62:5. 23 On the other hand, there is significant countervailing evidence in the record. Defendants 24 do not contest that only men were considered for placement in the ISRU. See SJ Motion; Reply in 25 Support of SJ Motion. With respect to relative population sizes, several specialized units at DSH- 26 Napa operate with populations smaller than the typical 40-patient threshold identified by 27 Defendants, including units housing fewer than 30 patients. DiBaise Decl., Ex. 2 (Cindy Black 1 wings, indicating flexibility in unit design beyond the blunt exclusion of entire genders from 2 programs. DiBaise Decl., Ex. 5 (Clay Deposition) at 24:1–14, 33:20–34:6; see also DiBaise Decl. 3 Ex. 2 (Black Deposition) at 5:5–9. Most critically, the record reflects no contemporaneous study, 4 survey, or other concrete information-gathering process undertaken to assess the size or needs of a 5 potentially qualifying female patient population before the ISRU was created or during its 6 continued existence. Ms. Davis testified that she did not review any documents or data to support 7 her assertion that the female population was too small to warrant creation of an equivalent unit, 8 and that her declaration on this point was based solely on her memory of patient numbers. See 9 DiBaise Decl., Ex. 1 (Amy Davis Deposition) at 61:24–62:8. Ms. Davis further testified that she 10 could not recall any discussion within the Substance Recovery Committee concerning whether 11 there were sufficient numbers of female patients to justify inclusion in the ISRU or creation of a 12 separate unit. Id. at 59:3–7. Defendants likewise do not point to any survey, study, or formal 13 assessment conducted prior to or during the ISRU’s operation to bolster their population-based 14 justifications. 15 When faced with decisions that differentiate along gender lines in a prison, prison officials 16 responsible for custodial institutions must be able to justify sex-based distinctions through at least 17 some form of reasoned decisionmaking and not rely on inaccurate assumptions. See Harrison, 18 971 F.3d at 1081 (holding that prison administrators must show that correlative relationships 19 “adequately justify the salient features of a challenged regulation” and may not rely on 20 “traditional, often inaccurate assumptions about gender”); Ambat, 757 F.3d at 1026 (requiring 21 evidence that the administrator’s judgment was “the product of a reasoned decision-making 22 process, based on available information and experience”); Robino v. Iranon, 145 F.3d 1109, 1110 23 (9th Cir. 1998) (upholding gender-based policy where prison officials conducted a study and 24 grounded their decision in evidence). On the relatively narrow record presented, an argument 25 could be made that DSH-Napa unlawfully filtered male patients into the restrictive ISRU based on 26 general assumptions rather than through a data-informed process or individualized assessments 27 applied across genders. Nonetheless, the Court need not decide the constitutional question here, 1 judgment must therefore be GRANTED in their favor. 2 B. Defendants’ Liability and Qualified Immunity 3 Mr. Diggs contends that Defendants Amy Davis and Cindy Black, acting under color of 4 state law, subjected him to a sex-based classification in violation of the Equal Protection Clause 5 by implementing and maintaining a male-only ISRU that imposed substantially more restrictive 6 conditions on male patients than on similarly situated female patients. Opp. to SJ Motion at 9. 7 Section 1983 imposes liability on any individual who “subjects, or causes to be subjected” another 8 person to a constitutional deprivation. 42 U.S.C. § 1983; Johnson v. Duffy, 588 F.2d 740, 743 (9th 9 Cir. 1978). Liability may be established through direct participation or through setting in motion a 10 series of acts that the defendant knew or reasonably should have known would cause a 11 constitutional violation. See Duffy, 588 F.2d at 743–44. 12 These principles apply to supervisory officials too. A supervisor may be held liable if they 13 personally participate in the unconstitutional violation or if there is a sufficient causal connection 14 between the supervisor’s conduct and the violation, including where the supervisor knowingly 15 approves or fails to correct a constitutionally deficient policy. Keates, 883 F.3d at 1242–43; Starr 16 v. Baca, 652 F.3d 1202, 1207–12 (9th Cir. 2011); Rodriguez v. Cnty. of L.A., 891 F.3d 776, 798– 17 802 (9th Cir. 2018). There is no respondeat superior liability under § 1983, Ashcroft v. Iqbal, 556 18 U.S. 662, 676 (2009); Keates v. Koile, 883 F.3d 1228, 1242–43 (9th Cir. 2018). 19 The record includes evidence that Ms. Davis was involved in Mr. Diggs’s referral to the 20 ISRU, served as the program’s overall director, and held administrative responsibility for 21 substance-recovery services, including revision responsibility for directives governing the ISRU. 22 See DiBaise Decl., Ex. 1 at 28:23–25 (Ms. Davis’s deposition testimony stating that she was 23 involved in referring Mr. Diggs to the ISRU); DiBaise Decl., Ex. 6 at 30:22–31:1; Ex. 23 at 1; Ex. 24 25 at 2–3. She was also identified as the sole contact for ISRU patients. DiBaise Decl., Ex. 11. 25 Mr. Diggs has also produced evidence that Ms. Black approved or oversaw policies 26 governing the ISRU while it operated as a male-only unit, and that she possessed authority over 27 unit conversions, administrative directives, and compliance with applicable state and federal law. 1 7 at 1–2; Ex. 20 at 9–14, 21, 32–34, 39, 46–49. 2 Accordingly, the individual defendants may be held responsible for the alleged 3 constitutional violation. Despite Defendants’ involvement in creating or maintaining the ISRU, 4 however, Defendants are entitled to qualified immunity. 5 Qualified immunity shields officials from civil damages liability unless (1) the facts show 6 the official violated a constitutional right, and (2) the right was clearly established at the time of 7 the alleged misconduct. Pearson v. Callahan, 555 U.S. 223, 232 (2009); Hernandez v. City of San 8 Jose, 897 F.3d 1125, 1132 (9th Cir. 2018). “[F]or a right to be clearly established, ‘existing 9 precedent must have placed the statutory or constitutional question beyond debate.’” White v. 10 Pauly, 580 U.S. 73, 79 (2017). Where, as here, qualified immunity is raised at summary 11 judgment, the Court must draw all reasonable inferences in the non-movant’s favor. See Brosseau 12 v. Haugen, 543 U.S. 194, 195 n.2 (2004). 13 As discussed above, Mr. Diggs has presented a fair argument that Defendants subjected 14 him to a sex-based classification that imposed materially more restrictive custodial conditions on 15 male patients relative to similarly situated female patients. But the Court rules that the 16 constitutional right at issue under the circumstances of this case was not clearly established at the 17 time of the challenged conduct such that any reasonable official would be aware of the 18 unlawfulness of Defendants’ acts. Ashcroft v. al-Kidd, 563 U.S. 731, 741 (2011); White, 580 U.S. 19 at 79; Hernandez, 897 F.3d at 1132. 20 Although it had been established by binding precedent that government programs in 21 prisons may not allocate benefits or burdens based on archaic or overbroad generalizations about 22 the relative capacities or tendences of the genders or mere administrative convenience alone, it is 23 not clear from the record that the ISRU’s male-only composition would be manifestly unlawful to 24 a reasonable DSH-Napa administrator. See Califano v. Goldfarb, 430 U.S. 199, 206–07 (1977); 25 Nev. Dep’t of Hum. Res. v. Hibbs, 538 U.S. 721, 730 (2003); Blake v. City of L.A., 595 F.2d 1367, 26 1376 (9th Cir. 1979). In so holding the Court assumes that circuit precedent may clearly establish 27 a legal principle under the doctrine of qualified immunity even where the Supreme Court has 1 right may be clearly established “by decisional authority of the Supreme Court or this Circuit” or 2 “decisions of state courts, other circuits, and district courts”); Meyers v. Pope, 303 F. App’x 513, 3 516 (9th Cir. 2008) (holding that the obligation to detain individuals in non-punitive conditions 4 was clearly established based on a prior Ninth Circuit decision). 5 As noted above, by at least 2014, some Ninth Circuit authority suggested that custodial 6 officials, while afforded deference in institutional management, could not rely solely on 7 generalized assumptions when adopting sex-based policies. Instead, such officials were required 8 to ground sex-based policies in some form of reasoned decisionmaking rather than generalized 9 assumptions or archaic stereotypes, or post hoc rationalizations. See, e.g., Ambat v. City & Cnty. 10 of S.F., 757 F.3d 1017, 1026–27 (9th Cir. 2014) (upholding policy prohibiting male deputies from 11 supervising female inmates, but also holding that deference to custodial officials “is not 12 automatic” and that officials must be able to demonstrate that the policy was “the product of a 13 reasoned decision-making process, based on available information and experience”) (quoting 14 Torres v. Wisc. Dep’t of Health & Soc. Servs., 859 F.2d 1523, 1532 (7th Cir. 1988)); Robino v. 15 Iranon, 145 F.3d 1109, 1110–11 (9th Cir. 1998) (upholding similar policy after a prison task force 16 conducted a study and determined the policy was the “best policy to protect female inmates”); see 17 also Califano, 430 U.S. at 206–07; U.S. v. Virginia, 518 U.S. at 516. 18 However, pre-2020 authorities did not clearly define what showing custodial officials were 19 required to make in order to justify a gender-based program under the Fourteenth Amendment. 20 See id.; Goldyn v. Angelone, 1999 WL 728561, at *2 (9th Cir. Sept. 16, 1999) (stating that 21 prison’s sex-based policy required an “exceedingly persuasive justification” without establishing 22 guidelines or standards for prison administrators to follow); Laing v. Gusto, 92 F. App’x 422, 23 423–44 (9th Cir. 2004) (hinting at the application of intermediate scrutiny in the correctional 24 context but ruling in jail’s favor and not explaining the specific requirements for custodial officials 25 to follow); Byrd v. Maricopa, 629 F.3d 1135 (9th Cir. 2011) (same). 26 In particular, no binding authority mandated that officials conduct a formal study, collect 27 or analyze particular categories of demographic or clinical data, or evaluate cross-gender 1 established that it was unconstitutional to rely not on archaic stereotypes and assumptions, but on 2 a perception as to the practicality of implementing a coed program involving inmates that present 3 substantial challenges (substance abuse plus behavioral issues) or the lack of sufficient numbers of 4 women suitable for a gender exclusive program for troubled inmates. No precedent had held at 5 the time that a formal study and quantitative analysis must be performed. While it may be argued 6 that an administrative determination based on professional judgment and experience without a 7 close examination of data is constitutionally insufficient to uphold gender discrimination, the law 8 on this point was not clearly established. Nor did controlling precedent more generally explain 9 how courts should balance institutional deference against the “exceedingly persuasive 10 justification” requirement in the context of prison or custodial treatment units. 11 To be sure, the Ninth Circuit subsequently touched these issues in Harrison v. Kernan, 971 12 F.3d 1069 (9th Cir. 2020), which confirmed that intermediate scrutiny applies to sex-based 13 distinctions in correctional settings and emphasized that such institutions may not merely rely on 14 generalized empirical correlations between gender and behavior. Id. at 1078–81 (holding that 15 “gender-based distinctions must be rooted in reasoned analysis by policymakers, rather than the 16 mechanical application of traditional, often inaccurate assumptions about gender” and remanding 17 so that the California Department of Corrections could submit “more data” in support of its sex- 18 based policy). To the extent Harrison shed more light upon the applicable legal standard, 19 however, Mr. Diggs had been removed from the ISRU and transferred to a different institution 20 entirely. 21 In sum, it cannot be said that existing precedent placed the constitutional question here 22 “beyond debate.” White, 580 U.S. at 79. Even viewing the record in the light most favorable to 23 Mr. Diggs, a reasonable DSH-Napa administrator could have understood the governing law to 24 permit reliance on institutional experience and professional judgment about management and 25 safety when structuring specialized treatment units — without conducting a deeper analysis. 26 Defendants are therefore entitled to qualified immunity. 27 IV. CONCLUSION ] of entitlement to qualified immunity and DISMISSES Mr. Diggs’s claim of gender 2 || discrimination. 3 4 IT IS SO ORDERED. 5 6 || Dated: February 11, 2026 7 8 EDW. M. CHEN 9 United States District Judge 10 1] a 12
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