Judge threatens prison with fines over health care

The Grand Rapids Press

Citing the state Department of Corrections for contempt of court and threatening to impose $2 million in fines, a U.S. District judge Thursday ordered it to improve medical care for inmates in its Jackson prisons.

Judge Richard Enslen described the current level of medical care as a "fiasco," and he found that the state's "deliberate indifference to serious medical needs" violated the U.S. Constitution's prohibition against cruel and unusual punishment.

"Wake up, Dorothy. You are not in Kansas anymore," he wrote, using the colorful language that has marked his earlier opinions in the case and conveyed his frustration with the state's failure to comply with his rulings.

"To explain this matter in the vernacular, a prisoner who receives a sentence of 2-10 years deserves to do 2-10 years," Enslen wrote. "What he does not deserve is a de facto and unauthorized death penalty at the hands of a callous and dysfunctional health care system that regularly fails to treat life-threatening illness."

Among other things, Enslen:

Cited the Corrections Department for civil contempt of court for failing to comply with an order he issued last January directing it to hire four more doctors and other medical providers at its Southern Michigan Correctional Facility. He threatened to impose a $1 million fine if the state does not comply within 120 days. After that, the state will be hit with an additional fine of $10,000 a day until it complies.

Found the department in contempt and threatened to impose another

$1 million fine if it does not hire a physician for its dialysis unit within 120 days, as he ordered last January. If the state still fails to comply, it will face another $10,000-a-day fine.

Ordered the state to hire more nurses for the Jackson facilities.

Directed it to improve its computerized medical records system, which has been blamed for many incidents in which prisoners received inferior care.

Gave corrections officials 90 days to develop a plan to decrease the length of time inmates must wait to see specialized physicians. He cited case after case in which patients with kidney disease, cancer, heart disease and other serious ailments suffered for weeks and months while awaiting appointments with outside specialists that often were canceled without explanation.

Ordered the state to provide an office and staff inside the Jackson prisons for an "independent monitor" to be sure his orders are followed this time. The reason, Enslen said, is patients who are in prison don't have the ability to choose another doctor or seek a second opinion and often die needlessly.

"This situation does not whimper for a remedy," he wrote. "It cries aloud in a voice acknowledged by all but the deaf and defiant. Starting today, however, prisoners shall have a voice in their medical care ... ."

Many of the medical problems that led to Thursday's order were uncovered by Dr. Robert Cohen, appointed by Enslen in 2003 as the independent monitor. Cohen periodically has visited the prisons over the past three years, but now will have a permanent office there and a staff to help him keep on an eye on what Enslen called "a mounting crisis in health care, which has fully consumed the resources of the parties, the court and the medical monitor in seeking solutions. We have been bailing, not sailing."

This is the latest in a series of orders Enslen has issued in the case. In November, he reopened a previously settled portion dealing with the treatment of mentally ill inmates, and he ordered prison officials to stop using four-point restraints to punish prisoners. That ruling came following the death of 21-year-old Timothy Joe Souders, who died after being shackled to a bed for most of four days in August.

Although Correctional Medical Services, the for-profit firm the state hired to provide medical care in the prisons, is not a defendant in the case, Enslen has criticized the company's quality of care.

He expressed doubt that an investigation of prison health care, ordered by Gov. Jennifer Granholm in August, will result in significant improvements. The Corrections Department recently signed a contract with the National Commission on Correctional Health Care to conduct the probe.

"At this point, it would be speculative to predict either any success or improvement as a consequence of a distant study," Enslen wrote, "particularly when such studies in the past have only served to cut timber and line file drawers."

He noted that this class-action lawsuit, known as the "Hadix case" for one of the inmates who filed it, has been before the court since 1980.

Elizabeth Alexander, an attorney representing the inmates and head of the American Civil Liberties Union's National Prison Project, said she hopes Enslen's order finally will solve the long-simmering problems.

"It's about time for the prisoners to receive a constitutional level of care," she said. "I don't think it will happen tomorrow. My hope is we've finally turned the corner. We're gratified the court saw the pattern of unnecessary death and suffering. We hope the system will address these faults before more patients die."

A Corrections Department spokesman said officials there had not yet read Enslen's 61-page opinion.

"We'll take a hard look at it and respond accordingly at a later time," spokesman Leo LaLonde said.

Send e-mail to the author: pshellenbarger@grpress.com