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Settlement Promises Improvements at Baltimore City Jail

by Matt Clarke

On August 18, 2009, a settlement was reached in a class-action lawsuit over conditions of confinement at the Baltimore City Detention Center (BCDC). The lawsuit dates back to 1971 and had been on the federal district court’s inactive docket from 1999 until 2004 following a 1993 consent decree. In 2004, the court granted a motion to restore the case to the active docket filed by attorneys from the National Prison Project (NPP) of the American Civil Liberties Union (ACLU) and the Public Justice Center (PJC) representing the prisoners. Since then, some improvements have been made, such as air conditioning the Women’s Detention Center. However, the conditions of confinement in the jail remained abysmal, especially in the areas of medical care, vermin infestation, inadequate ventilation and non-functioning plumbing.

“This agreement will help ensure that all detainees receive the kind of medical care that they are constitutionally entitled to, and state officials [deserve] credit for agreeing to these improvements,” said Washington D.C. attorney and former NPP Director Elizabeth Alexander. “Detainees have been forced to endure undue pain and suffering for far too long, and the hope is that this agreement will go great lengths toward alleviating the neglect of their medical needs by jail officials.”

“We are hopeful that this settlement will not only effectively provide access to health care for those in the jail, but will also address a serious public health concern for the city of Baltimore,” said Baltimore PJC attorney Wendy Hess. “Given the tens of thousands of people with treatable, chronic and often communicable diseases that move in and out of the jail every year, this agreement affects the health of everyone in the city.”

The specific steps required by the settlement include the following: Newly-arriving prisoners must receive medications they were previously prescribed within tight time limits. The sick-call system and medical records keeping are to be improved. New treatment protocols for asthma, cardiac disease, diabetes, hypertension, HIV, Hepatitis C, TB, drug-resistant staph, seizure disorder and pregnancy must be initiated.

Unlicensed medical staff are not to perform any function which might contribute to a medical evaluation, such as taking vital signs. LPNs are not to triage sick call requests. RNs may not diagnose or treat patients outside their specialties- Health care staff must make daily cell-to-cell rounds in segregation, speaking to each prisoner.

Mental health services will be improved. A psychiatrist shall be available five days a week and on-call within one hour at all times. Suicide watch cells must have fixtures that could be used for hanging removed. Pregnant prisoners must be provided pre- and post-natal care by a health care provider certified for obstetrical patients. Cells used by handicapped prisoners must be equipped for handicapped use and access. Staff may not interfere with access to medical care. The range of discipline for such interference must include termination.

All ventilation fans must be repaired. The ventilation fans and air exhaust system must be maintained and regularly cleaned. Low-security prisoners at risk from heat must be housed in air conditioned areas. Temperature monitoring equipment must be installed in all housing areas and heat injury prevention protocols followed when the temperature exceeds 88 degrees.

Plumbing shall be repaired. The laundry shall implement a procedure for routinely cleaning personal laundry. Issued linens must be cleaned at least once a week.

Sanitation must be improved and cleaning supplies made available to prisoners. Rodent and insect control shall be provided in the housing units and food service areas. Feral cats shall be removed. The use of common bar soap shall be discontinued and personal soap shall be supplied.

Plaintiffs’ attorneys may monitor compliance for two years and must be given access to prisoners and their medical records if released by the prisoners. BCDC must provide the attorneys with an annual list of prisoner deaths at BCDC and quarterly compliance reports. Plaintiffs may seek attorney fees. The settlement does not preclude future relief for medium- and high-security prisoners at high heat injury risk. See: Duvall v. O’Malley, U.S.D.C -D. Maryland, Case No. JFM-94-254. The settlement is available on PLN’s website.

Additional sources: ACLU Press Release; Baltimore Sun

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Related legal case

Duvall v. O’Malley

Please see the brief bank for documents related to this case.