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Illinois Agrees to Sweeping Prison Health Care Reforms

by Matt Clarke 

In a consent decree filed in federal district court on January 3, 2019, Illinois agreed to overhaul medical care in its Department of Corrections (DOC).

The resolution of the nine-year-old litigation was prompted by repeated reports of preventable prisoner deaths. The agreement includes the appointment of a monitor by the district court to ensure implementation of reforms intended to guarantee basic health care to Illinois’ approximately 49,000 state prisoners. 

Attorneys with the ACLU of Illinois filed the civil rights suit in 2010. On April 28, 2017, U.S. District Court Judge Jorge Alonso granted class-action status to include all prisoners in the DOC’s custody. That decision was spurred by a 2015 report by court-approved researchers who found serious problems with the health care provided to prisoners, including lengthy delays in receiving treatment, hit-and-miss follow-up care and poor record-keeping. A detailed review of 63 prisoners’ deaths cited “significant lapses” in 60 percent of those cases. In one incident, prison doctors ignored pleas for help from a prisoner who was coughing up blood for six months before finally locating a softball-sized tumor in his chest. He died four months later. The report called “the blatant disregard for this patient’s obvious symptoms ... stunning.” 

A second report, released on November 14, 2018, painted an even bleaker picture of health care in Illinois prisons and likely spurred the state to settle the lawsuit. That report concluded the frequency of preventable deaths was even worse than originally reported, and found Wexford, the DOC’s medical contractor, had failed to hire “properly credentialed and privileged physicians.” Among the 33 prisoner deaths it examined, the report documented “73 episodes of grossly and flagrantly unacceptable care” that was “so egregious” it typically would have led a licensing board to sanction the physicians involved. The consent decree requires all doctors working in state prisons to have a doctorate in medicine or osteopathic medicine or be “certified in internal medicine, family medicine, or emergency medicine.” 

The settlement requires the monitor and DOC medical director to determine whether a physician is providing an adequate level of care and to inform Wexford of any problems. It also requires the creation of two deputy chief of health services positions to provide additional oversight. Clinicians and registered nurses will be required to review prisoners’ intake information and compile a list of their medical issues. The report listed two deaths caused by the failure of staff to perform this basic review; one of the prisoners suffered excruciating pain for the last five months of his life.

The agreement also requires nurses to only perform sick calls in clinical areas that protect patient privacy and confidentiality, and prohibits them from restricting the number of complaints they address during a single sick call visit. 

Illinois has the second-most overcrowded prison system in the country behind Alabama. Nonetheless, it is in the lower 20 percent of DOCs for health care expenditures and has the second-lowest number of full-time equivalent medical staff positions. 

“I’m thrilled that my clients, the prisoners throughout the state of Illinois, will finally get the medical care that is constitutionally mandated,” said Alan Mills, executive director of the Uptown People’s Law Center, which partnered with the ACLU to represent the class members. “While Illinois has abolished the death penalty, the terrible medical care that is provided amounts to a slow-motion death penalty for far too many prisoners.” 

The district court granted preliminary approval of the class-action settlement on January 10, 2019. Over 250 Illinois prisoners have filed objections to the settlement, and final approval by the court remained pending as of mid-April 2019. See: Lippert v. Baldwin, U.S.D.C. (N.D. Ill.), Case No. 1:10-cv-04603. 

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Additional sources: apnews.com, chicagotribune.com, southernillinoisnow.com, shadowproof.com

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Related legal case

Lippert v. Baldwin