Investigation finds Alabama prison system violates federal law, fails to provide adequate medical care

An investigation by the Southern Poverty Law Center and the Alabama Disabilities Advocacy Program (ADAP) has concluded that Alabama’s overcrowded prison system is breaking federal law by failing to provide a humane level of medical and psychiatric care, and by subjecting prisoners with disabilities to discriminatory conditions.

In a report released today – Cruel Confinement: Abuse, Discrimination and Death Within Alabama’s Prisons – the groups described how the Alabama Department of Corrections (ADOC) and its private contractors are “deliberately indifferent” to the serious medical and mental health needs of the state’s prisoners.

The conditions in Alabama prisons violate the U.S. Constitution’s ban on “cruel and unusual punishments” and federal law protecting people with disabilities, the report says.

“When a person is sentenced to prison, they are not stripped of their humanity and they are not sentenced to the pain, agony or death that can result from the lack of health care,” said Maria Morris, the report’s lead author and managing attorney of the SPLC’s Montgomery legal office. “Whenever Alabama determines a person must be incarcerated, it must accept the legal – and moral – responsibility that comes from imprisoning a human being.”

St. Clair Correctional Facility

The investigation was based on inspections of 15 Alabama prisons, interviews with more than 100 prisoners and a review of thousands of pages of medical records, depositions and media accounts as well as the policies, contracts and reports of the ADOC and two major contractors.

It was led by the SPLC’s Morris, who, before joining the SPLC, represented prisoners with mental illness as part of a lawsuit that ultimately resulted in the U.S. Supreme Court upholding a federal court order requiring California to address its prison overcrowding.

The Alabama investigation found numerous examples of conditions that threaten the health and lives of prisoners:

  • A prisoner who had survived prostate cancer had a blood test indicating his cancer had probably returned, but no follow-up test was given until a year and a half later. By that time, the cancer had spread to his bones and was terminal. He died less than a year later, in February 2014.
  • A prisoner undergoing dialysis died after he was given an injection of a substance that sent him into cardiac arrest in January 2014. Although there was a cart stocked with emergency medical equipment in the dialysis unit, no one present knew how to use it.
  • A prisoner incarcerated eight years ago after being shot in the groin had been told at the time of the shooting that he would have a catheter and a colostomy bag for six months before having surgery to repair damage from the gunshot. Almost a decade later, he has not had the surgery. He is in constant pain, sometimes urinating blood.
  • Numerous prisoners have had toes, feet or portions of legs amputated as a result of poor diabetes care. Some diabetic prisoners have reported that they have not had their blood sugar measured in months.

The investigation also found the prisons to be severely understaffed. As of March 2014, the ADOC had 25,055 prisoners in in-house custody. Yet there are only the equivalent of 15.2 full-time doctors and 12.4 dentists to treat prisoners. A doctor’s average caseload is a staggering 1,648 patients, and a dentist’s is more than 2,000 patients, according to the report. Some facilities do not have full-time doctors or dentists.

The investigation found that numerous prisoners have been placed under “do not resuscitate” or “allow natural death” orders without their consent or knowledge. In addition, psychiatric medication is often stopped or changed without discussion between the psychiatrist and the patient.

Donaldson Correctional Facility

The ADOC also leaves prisoners with disabilities isolated, unable to participate in prison programs and deprived of the medical care they need – a violation of federal law. A hearing-impaired prisoner reported being hit by a corrections officer for not responding to an order he couldn’t hear.

“Many prisoners suffer daily humiliation and hardship simply because they have a disability, and some are needlessly placed in life-threatening situations,” said Bill Van Der Pol, ADAP counsel. “These conditions are clearly illegal and must be remedied to comply with the law.”

The prison system contracts with Corizon Inc. to provide medical care and MHM Services to provide mental health care.

The SPLC and ADAP alerted prison officials to the illegal conditions described within the report in an April 9 letter. During a meeting with the organizations in May, the ADOC and its medical and mental health care providers did not have proposals to resolve these conditions.