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Amended Consent Decree Entered in 11-Year-Old Class-Action Challenging Prisoner Healthcare in Illinois DOC

by Douglas Ankney

On June 24, 2022, U.S. District Judge Jorge L. Alonso of the Northern District of Illinois entered an amended consent decree in a class-action suit challenging prisoner healthcare in the state Department of Corrections (DOC).

Filed in October 2011 by the American Civil Liberties Union (ACLU) of Illinois, the suit was granted class-action status in April 2017. It now includes “all prisoners in the custody of [DOC] with serious medical or dental needs.” [See: PLN, Feb. 2018, p.35.]

The suit alleges that class members are denied adequate medical and dental care, putting them at substantial risk of serious harm because DOC, though its privately contracted healthcare provider, Wexford Health Sources: (1) fails to fill medical leadership and other medical staff; (2) allows under-qualified medical personnel to treat prisoners; (3) fails to timely identify medical problems at reception and transfers; (4) fails to manage chronic diseases such as diabetes, COPD, asthma, hypertension; (5) fails to promulgate appropriate infirmary policies; (6) delays and denies specialty care; (7) fails to keep adequate, reliable medical records; (8) fails to implement and follow DOC’s own improvement plan; and (9) fails to properly manage dental care services.

As a result of the lawsuit, two exhaustive evaluations by independent carceral healthcare experts described profound, systemic failures in DOC medical and dental services, causing needless suffering and preventable deaths. A follow-up report in 2018 revealed that the situation had not improved. There were prisoners with Type 1 diabetes not receiving insulin or medical diets. Prisoners in need of pacemakers were not being seen by a cardiologist or receiving a pacemaker. There were also a high number of preventable deaths.

The amended decree provides, among other things, that DOC - through its contractor - must find adequate qualified staff. It must provide adequate medical facilities, too, along with monitoring to assure that constitutionally adequate care is provided. All physicians providing direct care must “possess either an MD or DO degree.” They must also have board certification in internal medicine, family medicine, or emergency medicine. An exception to the latter requirement is provided for those who successfully complete a residency in internal medicine approved by the American Board of Internal Medicine or the American Osteopathic Association; or a residency in family medicine approved by the American Board of Family Medicine or the American Osteopathic Association; or a residency in emergency medicine approved by the American Board of Emergency Medicine.

New physicians who do not meet the criteria may be hired, but only after demonstrating to the court-appointed monitor that a recruitment effort failed to find qualified candidates. Medical personnel found rendering substandard services may be recommended for education to cure the deficiency. But they may not render further services before completing continuing medical education. Staff who place patients at risk must be promptly disciplined, up to and including termination of employment.

Prisoners with scheduled off-site medical appointments must be placed on a transfer hold until the services are provided. DOC must also keep current medical records of each prisoner and cease “drop-filing” — batching multiple prisoner medical records in one file to sort out later. Medical records must include off-site medical providers’ reports, and they must be placed in the correct prisoner’s file. Documentation from scheduled off-site services must be reviewed within three days. DOC must also seek an outside vendor for implementation of an electronic medical records system.

The amended consent decree also provides for several new medical supervisor positions, including two Deputy Chiefs of Health Services. Each prison must also have its own Health Care Unit Administrator. Registered nurses (RNs) must conduct sick calls, though DOC may use licensed practical nurses until RNs are employed. If a prison has an occupied infirmary, an RN must be readily available there. If it’s a maximum-security lockup, there must be at least one RN assigned to the infirmary 24/7.

Additionally, the consent decree provides for substantial changes to dental services, along with miscellaneous provisions such as monitoring medicines kept by prisoners. An independent monitor will have oversight to determine if DOC is substantially in compliance with the terms of the decree. Attorneys’ fees, costs, and other expenses remain to be determined. See: Lippert v. Jeffreys, USDC (N.D. Ill.), Case No. 10-cv-04603. 

Additional source: ACLU-Illinois

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