Family of San Quentin Inmate Says They’re Cut Out of Care Decisions, Visits at UCSF

On May 30, the California Department of Corrections and Rehabilitation (CDCR) transferred Alan Beisel — along with 120 other men — from the California Institution for Men in Chino to San Quentin State Prison. This transfer has been criticized for sparking the massive coronavirus outbreak at San Quentin, resulting in more than 2,000 people sickened and 25 deaths, as of Aug. 14.

Beisel, 74, was considered high risk due to his age and underlying health conditions. About a month after being transferred to the Marin County facility, Beisel was moved to a UCSF hospital for COVID-19 treatment. His daughter, D'Wanda Schwarz, said once he was transferred to UCSF, she was only provided with one virtual visitation of her father — at the beginning of July. She says this was despite having the appropriate authorization from CDCR to speak with her father.

About one month later, on Aug. 6, Beisel died from complications due to the coronavirus at a different hospital, Seton Medical Center in Daly City.

Now, Schwarz is accusing UCSF of discrimination. She says her father was denied contact with her there, even though CDCR authorized it.

The First Call

After his initial transfer to UCSF, Schwarz was able to speak with her father via Zoom.

“The communication was really good at this point," Schwarz said. She asked about her visitation options and was told that UCSF was providing Zoom visits because in-person visits were prohibited due to COVID-19.

According to CDCR and UCSF policy, incarcerated patients who wish to have Zoom visitations must have authorization from CDCR.

Schwarz said her father's first doctor went out of his way to connect with the correct personnel at San Quentin to receive authorization for her father.

“I had my first Zoom visit with my father — first and last visit with my father at UCSF — at midnight on that Saturday, July 4, or morning of July 5,” Schwarz said.

Later that Sunday, her father’s kidneys began to fail, so doctors placed him on dialysis. When he got out of the procedure, Schwarz said he was transferred to another ICU unit. That’s when things changed.

“The staff immediately let me know that they were no longer going to be providing me with any of his updates, and nor would I be able to access any Zoom visits,” Schwarz explained. “Of course, I was very confused.”

She spent the following Monday calling San Quentin, in an attempt to get answers.

“Sometimes it would just ring and nobody would answer, or sometimes somebody would answer and then transfer me to a voicemail, or sometimes it would transfer me to a recording that this was not a mailbox that would receive voicemails,” Schwarz said. The process was exhausting, but she persisted.

At the end of the day, Schwarz said she received a call from a lieutenant at San Quentin. He told her he had given UCSF the authorization for her to speak with her father, but UCSF was “denying the authorization.”

According to Schwarz, the lieutenant said he also contacted the warden, who gave UCSF authorization for Schwarz to receive both updates of her father and video visitations with him. But, she says, UCSF also denied the warden’s authorization.

UCSF maintains they work with CDCR to receive authorization. “Given the need to protect our patient’s privacy, we are not able to publicly discuss extenuating issues regarding patients and their families,” the hospital said in a statement, calling this case “exceptional.” The statement also included that they stand behind the policy, “which is aligned with the CDCR policy.”

Schwarz continued to write letters, make calls — sometimes spending all day on the phone — trying to get in touch with her father or, at the very least, get an update of his condition.

No More Updates

On July 7, just a few days after she spoke with her father, Schwarz got a call from UCSF’s Department of Patient Relations. A grievance coordinator from that department had informed her that UCSF would not be providing her any more updates on her father.

Schwarz was told contact between inmate patients and family members goes against UCSF policy and she would need to go through San Quentin, but Schwarz knew that wasn’t correct.

In a recorded call obtained by KQED, Schwarz asked the UCSF representative how her father was getting care without her permission.

The representative replied that decisions about care for forensic patients — patients who are under the jurisdiction of the Department of Corrections — are made by the institution they are incarcerated in. In this case, that would be San Quentin.

Frustrated, Schwarz added San Quentin Chief Medical Executive Dr. Elaine Tootell to the call.

Tootell asked the same question Schwarz had posed: "How do you make decisions for the patient?” Based on the recording, the UCSF representative said the decisions were “made by San Quentin, in this particular case."

Tootell, who’s been in her position for more than a decade, said, “Never will we ever make a decision for a patient, they have autonomy. And we're not allowed to.” She added that “in every case, we always get the surrogate decision maker and we discuss with our incapacitated patients ... and we always ask the family."

Tootell also said they’ve been asking for updates on Schwarz’s father every day but had yet to receive any from UCSF.

The conference call ended with UCSF and Tootell agreeing to reconnect on their own to discuss matters. But the UCSF representative told Schwarz specifically not to reach out, saying UCSF officials "will not speak to you."

Securing Approval from San Quentin

UCSF resident Anjali Jacob was working in the ICU at the same time that Beisel was a patient there.

She said navigating the authorization process for other patients was difficult, and she was continually referred to different people within CDCR.

Jacob said she couldn’t understand why CDCR wouldn't just require outside hospitals to provide Zoom visitations, especially when the state agency would go to great lengths to monitor incarcerated patients — referring to the handcuffs used to shackle inmates to their beds and the number of guards overcrowding the ICU unit, two per patient.

“It makes no sense that there are guards there, and it makes complete sense that these people should have Zoom visits,” she said. “Why is one thing so heavily enforced? And one thing is just, there are no consequences if we don't do it?”

Under the Hippocratic Oath, doctors swear to treat all patients equally in care, but the handcuffs and the guards create a culture of fear in hospitals against incarcerated patients and their families, Jacob said, which can potentially lead to unequal treatment.

“We're essentially asked to see them as dangerous," Jacob said.

"Their guards are watching their every move, even when they're clearly very sick,” Jacob explained. “We're told that we can't tell them or their families when their discharge date will be for fear that they'll plot an escape attempt. These are all things that are required by law.”

While Jacob said there’s no medical evidence to prove that Zoom calls aid in the recovery process, she said virtual visits are “especially meaningful” for families during the pandemic. Many “want to spend as much time as possible with their loved one in case this hospitalization does represent the end of life.”

When asked whether CDCR fights for incarcerated patients to have video visitations, CDCR said they couldn’t comment on that.

The Last Transfer — Seton Medical Center

Around mid-July, Schwarz was able to get her father transferred to Seton Medical Center, where she was able to communicate with him through Zoom.

According to Schwarz, doctors said her father was "incoherent and nonresponsive" during the 17 days he was intubated, but when he heard her voice through their first call at Seton, she said he opened his eyes.

“He blinked when I asked him to blink," Schwartz said. "And when I had to tell him goodbye, he moved his lips as though he were trying to speak to me.”

During her father’s time at Seton, Schwarz learned his body had become dependent on the machines, and when she asked him if he wanted to remain on them he shook his head no. “I asked him if he understood that meant he would not survive,” she said. “He shook his head yes.”

Her father, Alan Beisel, died Thursday, Aug. 6.