The Alabama Department of Corrections (ADOC) systemically put the health and lives of prisoners at risk by ignoring their medical and mental health needs and discriminating against prisoners with disabilities – violations of federal law by a prison system that has one of the highest mortality rates in the country. The SPLC and the Alabama Disabilities Advocacy Program filed suit to end the deplorable conditions in Alabama prisons.
The lawsuit, filed in the U.S. District Court for the Middle District of Alabama, describes how prisoners, including those with disabilities and serious physical and mental illnesses, were confined to prisons where discrimination and dangerous – sometimes life-threatening – conditions were the norm. Strokes, amputations and prisoner deaths that may have been prevented with proper care are detailed in the lawsuit.
An agreement was reached with the Alabama Department of Corrections in March 2016 to ensure that prisoners with disabilities receive treatment and services required under the Americans with Disabilities Act.
Federal judge declares mental health system in Alabama to be "horrendously inadequate"
After a two-month trial over the lawsuit’s mental health claims, a federal judge declared the mental health care system in Alabama prisons to be “horrendously inadequate” – an unconstitutional failure that has resulted in a “skyrocketing suicide rate” among prisoners. In the June 2017 opinion, U.S. District Judge Myron H. Thompson ordered the state to reform the system and directed them to work with the Southern Poverty Law Center and others who filed the lawsuit.
Within his 302-page ruling, Thompson identified multiple areas where the ADOC has failed to maintain a constitutionally adequate mental health care system – ranging from a failure to identify prisoners with serious mental health needs to inadequate treatment for suicidal prisoners.
“[T]he evidence from both sides … materially supported the plaintiffs’ claim,” Thompson wrote. He later added: “Simply put, ADOC’s mental-health care is horrendously inadequate.”
Thompson highlighted a key issue facing the system: “persistent and severe shortages of mental-health staff and correctional staff, combined with chronic and significant overcrowding.” The judge noted that during the trial, Corrections Commissioner Jeff Dunn “described the prison system as wrestling with a ‘two-headed monster’: overcrowding and understaffing.”
The judge also noted the ADOC fails to provide individualized treatment plans to prisoners with serious mental health needs as well as psychotherapy by qualified and properly supervised staff and with adequate frequency and sound confidentiality. He also described a system that disciplines mentally ill prisoners for the symptoms of their illness and segregates them for prolonged periods.
A separate trial regarding the lawsuit’s medical care claims is expected to be scheduled for 2017.
Lack of testing, medication and other examples of poor conditions
The lawsuit, which was filed in 2014, cites numerous examples of conditions that threatened the health and lives of prisoners:
The department had a policy and practice of not treating hepatitis C. In April 2014, 2,280 prisoners in ADOC custody had been diagnosed with it, but only seven prisoners were receiving treatment. A prisoner at Holman Correctional Facility died of complications from hepatitis C.
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.
A prisoner stabbed 15 times with an icepick did not have his wounds cleaned or treated. Instead, he was placed in segregation for three months. He also suffered a cracked lens in his right eye at the county jail where he was held before being transferred to prison. He was told the lens won’t be treated because he still has one good eye.
A prisoner at St. Clair Correctional Facility with a history of heart problems had a new stent placed in his heart in 2012. Afterward, he was not given the necessary blood thinners at the prison, though the doctor had prescribed them. The prisoner’s blood clogged the stent, requiring emergency open-heart surgery to correct.
In addition, prisoners were placed under “do not resuscitate” or “allow natural death” orders without their consent or knowledge, according to the lawsuit. Moreover, although “do not resuscitate” forms refer only to not resuscitating prisoners experiencing cardiac arrest, the department relied on them to deny other treatment to prisoners with such orders.
The lawsuit also describes how the ADOC leaves prisoners with disabilities isolated and deprived of the care and accommodations they need. Several prisoners reported incidents where they were verbally or physically mistreated due to their disabilities, including guards taunting blind or wheelchair-bound prisoners about their disabilities.
State contracts with Corizon Inc., despite the company failing every major health care audit
Alabama had the most overcrowded prisons in the nation and spent one of the lowest amounts, per inmate, on health care. The prison system contracted with Corizon Inc. to provide medical care and MHM Correctional Services to provide mental health care. In 2012, when the ADOC released a “Request for Proposal” for a new health care contract, applicants were scored on a 3,000 point scale. Out of a possible 3,000 points, contract price accounted for a possible 1,350 points. Qualifications and experience counted for only 100 points.
The ADOC renewed its contract with Corizon in 2012, even though Corizon (the company providing health care in Alabama prisons since 2007) failed every major audit of its health care operations in Alabama prisons under its first contract with the state.
Shortly before filing the lawsuit, the SPLC and ADAP released a report on the conditions within Alabama prisons, Cruel Confinement: Abuse, Discrimination and Death Within Alabama’s Prisons. The report’s findings were based on inspections of Alabama prisons, interviews with prisoners and a review of medical records, depositions and media accounts as well as the policies, contracts and reports of the ADOC and two major contractors.