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ICE, CCA Settle ACLU Lawsuit Regarding Health Care for Immigration Detainees

A lawsuit filed by the American Civil Liberties Union that alleged deficiencies in health care at the San Diego Correctional Facility (SDCF) in Otay Mesa, California has been settled, according to a December 16, 2010 press release issued by the ACLU.

The suit named as defendants the Immigration and Customs Enforcement agency (ICE), a branch of the U.S. Department of Homeland Security, as well as officials and employees of ICE and Corrections Corporation of America (CCA), the private company managing SDCF.

Originally filed in 2007 by the ACLU, the ACLU of San Diego and Imperial Counties, and the law firm of Cooley LLP, the lawsuit alleged that detainees at SDCF were routinely subjected to long delays before receiving treatment, denied necessary medication for chronic illnesses and refused essential referrals prescribed by medical staff.

According to the ACLU, “the lawsuit specifically cited the cases of 11 detainees, including several whose bipolar disorders and depression went untreated, a man who was forced to wait more than eight months for eye surgery and nearly suffered permanent disfigurement, and detainees who never received medical attention despite suffering from a variety of maladies including Type 2 diabetes, hypercholesterolemia, hypertension, abscessed and broken teeth, and severe chest pains.”

David Blair-Loy, legal director of the ACLU of San Diego and Imperial Counties, noted that “Immigration officials must ensure that immigration detainees do not suffer or die unnecessarily.” According to Anthony Stiefler of Cooley LLP, “It is at odds with our American values to allow people to suffer long-term health consequences or even death because authorities refuse to treat them.”

The plaintiffs sought class certification, which was denied by the district court. They appealed to the Ninth Circuit, which referred the case to mediation. The parties then worked out a settlement agreement in December 2010 and the district court certified a settlement class on April 21, 2011.

Although not conceding any wrongdoing, the defendants agreed to a broad-ranging series of improvements that the ACLU felt would bring health care at SDCF up to acceptable standards. The defendants agreed to provide health care “that meets or exceeds the following NCCHC standards as set forth in Standards for Health Services in Jails (2008)”: Access to Care, Medical Autonomy, Staffing, Pharmaceutical Operations, Medication Services, Receiving Screening, Initial Health Assessment, and a host of other provisions required by prison health care guidelines.

The settlement also provides that the federal defendants “shall expand the provision of mental health care professionals for Class Members by providing the equivalent of one full-time additional psychiatrist and four full-time additional psychiatric nurses.... If ICE requires a Treatment Authorization Request (‘TAR’), then a TAR prepared by a medical practitioner for off-site non-emergency medical treatment for a Class Member shall be [acted upon] within five business days....”

Additionally, the defendants “shall take all reasonable steps to ensure that authorized off-site medical treatment commences within a clinically appropriate period of time...,” and the federal defendants “shall maintain a tracking system for pending off-site appointments for Class Members.” Under the agreement the term “emergency services” will no longer be required for prisoners to receive health care, if to deny treatment “would cause deterioration of the detainee’s health or uncontrolled suffering....” The clear intention of the settlement is to address all “serious medical need(s), regardless of whether such medical condition requires emergency or urgent treatment.”

Pursuant to the agreement, “Defendant CCA shall also ensure that appropriate training, policies, and/or practices shall continue to be implemented at SDCF, or, as applicable, shall be implemented, to provide reasonable assurances that SDCF CCA staff carry out directives from medical staff related to treatment of Class Members.”

The agreement further required the defendants to produce various documents, including information related to current medical and mental health staffing; the status of hiring efforts; lists of new medication orders, including documents showing when each patient received medication; medical emergency logs; audits or evaluations conducted by any third parties regarding medical or mental health care; and all policy and procedure manuals and local operating procedures governing dental, medical, mental health and vision care.

The defendants were also required to provide the plaintiffs with a copy of all medical records for prisoners who die “during their confinement at SDCF during the time that the Agreement is effective.” Additionally, the parties agreed that on the one-year anniversary of the settlement agreement they “shall stipulate to dismiss this action with prejudice” unless the defendants are in non-compliance.

According to Elizabeth Alexander, former director of the ACLU National Prison Project and lead counsel in the case, “For the first time, ICE has committed to providing all necessary health care to immigration detainees beyond just emergency care. For too long ICE’s own policies allowed it to provide detainees with nothing beyond a narrow definition of emergency. This settlement is recognition that it is unconstitutional not to provide people in government custody with all necessary health care.”

The district court retained jurisdiction to oversee disputes among the parties arising from interpretation and enforcement of the terms of the settlement agreement. The parties agreed to pay their own costs and attorney fees. See: Woods v. Myers, U.S.D.C. (S.D. Cal.), Case No. 3:07-cv-01078-DMS-PCL.

Additional sources: ACLU of San Diego and Imperial Counties, ACLU National

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Related legal case

Woods v. Myers