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Lawsuit raises questions about prison privatization: Complaint alleges abuse of mentally ill inmates

October 13, 2008

A newly filed federal lawsuit alleging widespread abuse of Indiana inmates raises questions about the state's privatization of prison health care.

The Indiana Protection and Advocacy Services Commission, a not-for-profit watchdog organization, sued the Indiana Department of Correction on Oct. 1, charging it regularly segregates mentally ill prisoners into isolation for 23 hours a day.

According to the suit, the prisoners are punished by stripping away their clothes and being fed a diet consisting entirely of "nutraloaf," described as "a food substance made by cooking vegetables together so they form a block."

The Department of Correction regularly uses solitary confinement to punish bad behavior among the general prison population, said attorney Ken Falk, who represents IPAS in the case. But it's ineffective and damaging to the mentally disabled, he said, who don't understand it.

"The idea is, a light bulb goes off, you behave better, and you want to get out," Falk said. "That environment is toxic if you're mentally ill."

The complaint also alleges the prisoners do not receive adequate mental health treatment. Most interactions between inmates and mental health professionals take place at cell fronts, the complaint says, requiring both to yell at each other through a solid cell door. The lack of privacy prevents candid conversations, the suit alleges.

The IPAS complaint argues the Department of Correction is violating the U.S. Constitution's Eighth Amendment prohibiting cruel and unusual punishment, as well as the Americans with Disabilities Act and the Rehabilitation Act. IPAS is investigating several suicides and suicide attempts by mentally ill prisoners.

"The bottom line is, they have to render treatment that's appropriate to the individual's condition and not engage in cruel and unusual punishment," said attorney Karen Davis, IPAS' client services director. "Those are minimal requirements of any prison."

Department of Correction spokesman Doug Garrison declined to answer questions about the case. However, in a written statement, he said, "We at the Department of Correction believe we have afforded appropriate and lawful mental health care and treatment to offenders in our custody and are fully prepared to defend against the allegations made by plaintiffs in their complaint."

The lawsuit notes that all prison health care, including mental health care, is outsourced to St. Louis-based Correctional Medical Services Inc. The company earned its four-year, $275.4 million contract in 2005, the first year of Republican Gov. Mitch Daniels' term.

Privatization of state government functions is a major point of contention in this year's gubernatorial election. On the campaign trail, Democrat Jill Long Thompson has called for a review of every contract Daniels authorized.

Ken Fields, a spokesman for Correctional Medical Services, declined to comment on the specifics of his company's care, citing patient confidentiality.

However, he defended the quality of the care and noted that the Department of Correction's health care programs have been reviewed and reaccredited in the last three years by the American Corrections Association.

"Mental health providers work collaboratively with medical and corrections staff to deliver comprehensive care for individuals, and crisis intervention is available 24 hours a day," Fields wrote in a statement. He noted that his company is not a defendant in the suit.

Falk, who is legal director for the American Civil Liberties Union's Indiana chapter, said the Department of Correction is the suit's target because it ultimately is responsible for prisoners' care.

"If the contract provider is told to do X, Y or Z, they'll do X, Y or Z," he said. "We're laying the blame here on the Department of Correction."

Daniels isn't the first governor to hire a private company to provide health care for Indiana's prisoners. From 2002 to 2005, a span when Indiana had Democratic governors, care was outsourced to Prison Health Services of Indiana LLC for $148.3 million.

Garrison said Prison Health received less money because, unlike Correctional Medical Services, it did not provide nursing.

IPAS' Davis suspects the cost of proper mental health care is the root of the problem.

Garrison said CMS won its contract because its bid was lowest.

"You often hear [in these types of cases] that you could have all kinds of treatment if cost weren't an issue," Davis said. "These are minimal requirements in our Constitution. I don't know that you can make excuses based on costs for that."
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