On November 7, 2007, mentally ill prisoners incarcerated by the Illinois Department of Corrections ("IDOC") filed a lawsuit in the U.S. District Court for the Central District of Illinois under 42 U.S.C. § 1983; the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12131 et seq.; and the Rehabilitation Act, 29 U.S.C. § 794, against the state of Illinois. The plaintiffs, represented by the Uptown People's Law Center, Equip for Equality, and private counsel, claimed that their lack of access to adequate mental health treatment constituted cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments, and discrimination under the ADA and Rehabilitation Act. They asked the Court for a judgment declaring defendants' conduct unconstitutional and an injunction against defendants' unlawful conduct.

Plaintiffs were incarcerated in various correctional centers of the IDOC. Most incoming inmates at these facilities did not receive a meaningful mental health screening upon arrival. Additionally, the plaintiffs alleged that care of those prisoners who were identified as needing mental health care was grossly substandard. What limited care was available was provided chiefly by medication and prisoners are only infrequently able to consult with mental health professionals. Only four of the IDOC's correctional facilities offered some form of specialized mental health services. As a result of defendants' failure to reasonably accommodate plaintiffs' disabilities, the plaintiffs alleged that they experienced mental and physical pain and, in many cases, the exacerbation of existing mental illnesses.

On May 8, 2013, Judge Michael Mihm entered an interim order to facilitate a consent decree. The order requires the parties to assess and negotiate the number of additional mental health staff and bed and treatment space needed, and mandates that the IDOC develop policies related to the segregation, protective custody, and discipline of mentally ill inmates.

On December 22, 2015, the case settled. Under the terms of the settlement:

• For the first time ever, Illinois would provide both long-term and acute care in residential treatment centers for prisoners who are so seriously mentally ill that they require hospitalization. Previously, these very ill people were housed in isolation.
  
• More than 300 new clinical staff would be hired to treat prisoners with serious mental illnesses, along with over 400 new security staff to work at the new residential treatment units. This woudl allow the state to provide group therapy and one-on-one therapy for prisoners.
  
• IDOC agreed to review the mental health of all prisoners with more than 60 days left in solitary, to determine if they should be given early release. IDOC also agreed to release from solitary all prisoners with serious mental illnesses who are confined there for minor, non-violent offenses, and in the future to consider mental health before sentencing someone to segregation.
  
• Prisoners with mental illnesses who are in solitary confinement for over 60 days would have their out-of-cell time increased from less than an hour a day to 20 hours a week.

Construction costs for the new facilities were estimated to be $40 million and the new personnel costs were expected to be approximately $40 million annually.

On May 10, 2016, parties filed a settlement agreement with the court. On May 23, 2016, the judge accepted the settlement with an amended settlement agreement. The agreement required IDOC to hire more mental health professionals, renovate 1258 beds, update health records to better indicate mental health problems and medication, provided staff with training in recognition and dealing with common mental disorders, provide mental health screenings for all prisoners upon, admission, conduct bimonthly review of prisoner mental health, conduct monthly review of prison mental health for those in segregation, provide for an initial mental health review within 7 days of putting a prison in segregation, and establish a referral program to all prisoners, staff, and those close to prisoners to refer prison for a mental health checkup. The settlement also provided that plaintiffs would be awarded attorney's fees, that the court retained jurisdiction for three years after the acceptance of the settlement, and that parties would try to resolve issues before taking the issue to the court.

Plaintiffs were awarded attorney's fees of $3.8 million, with half paid immediately on February 10, 2017. Multiple prisoners filed complaints alleging that the settlement was not being properly followed throughout 2017. The court indicated that complaints should be handled by the Department of Corrections grievance process.

On June 5, 2017, the Monitor submitted his first annual report. The report noted that although the defendants made many significant improvements to the mental health care delivery system during the first year of the settlement, the defendants continued to have challenges in meeting the first-year requirements. Specifically, the report noted the grossly insufficient and extremely poor quality of psychiatric services, which negatively impacted all aspects of the settlement and contributed to the defendants being non-compliant in the vast majority of areas.

On October 10, 2017, the plaintiffs filed a motion to enforce the settlement agreement in light of the defendants' alleged violations of the settlement terms. The court held an evidentiary hearing on December 12, 2017, which it continued in February and March 2018. On May 25, 2018, the court issued a preliminary injunction enforcing the settlement agreement and imposing additional requirements and deadlines to bring the defendants into constitutional compliance. The court found that there had been a systemic constitutional deficiency in addressing the psychiatric and mental health professional staffing shortage. The preliminary injunction was set to expire after 90 days.

On June 6, 2018, the plaintiffs filed a motion for a permanent injunction, which the court granted on October 30. The court found that the defendants had been deliberately indifferent to the medical needs of the plaintiffs in medication management, mental health treatment in segregation, mental health treatment on crisis watch, mental health evaluations, and mental health treatment plans within the meaning of the Eighth Amendment. Further, the court found that the plaintiffs have suffered or will suffer irreparable injury if a permanent injunction was not issued. The court deferred entering specific injunctive relief, and instead allowed the defendants to submit a proposal to address their constitutional deficiencies, which they submitted on November 13, 2018. The court approved the content of the permanent injunction on December 20, 2018. The permanent injunction contained staffing requirements, parameters for class members placed on mental health crisis watch, parameters for class members placed in segregation, parameters for class members prescribed psychotropic medication, and provisions on treatment plans. The injunction required the defendants to submit quarterly status reports, as well as quality assurance audits at least every 90 days. The injunction is to remain in place for two years.

The defendants appealed the permanent injunction to the U.S. Court of Appeals for the Seventh Circuit on January 23, 2019. On April 15, the court of appeals remanded the case to the district court for the limited purpose of permitting the district court to modify the preliminary injunction in order to conform to the requirements of Federal Rule of Civil Procedure 65.

On February 26, 2019, the court issued an order granting in part and denying in part the defendants' request to modify the injunction (making limited changes to three provisions of the injunction), denying the defendants’ motion for the court to reconsider its injunction orders, denying the defendants’ motion for partial stay, and granting the plaintiffs’ § 1988 petition for attorneys’ fees and costs in the amount of $841,137.98 in fees and $31,864.77 in expenses.

On May 22, 2019, the defendants appealed to the U.S. Court of Appeals for the Seventh Circuit the district court's October 30 and December 20 interlocutory orders, as well as the court's February 26 order.

On May 28, 2019, the Monitor submitted his third annual report. The report noted that although IDOC had greatly improved its ability to care for mentally ill offenders and was found to be in substantial compliance in eleven areas, a major problem preventing IDOC from being substantially compliant with the entire settlement agreement was inadequate staffing. The report also noted that IDOC still has much work to do with mental health evaluations and referrals, treatment planning, medication, segregation, confidentiality, use of force, and discipline.

Monitoring of compliance with the settlement agreement and the subsequent permanent injunction is still ongoing and the defendants' appeal to the Seventh Circuit is pending.

Nate West - 10/04/2014
- 12/23/2015
David Smellie - 03/30/2017
Eva Richardson - 05/29/2019


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