Four years after a federal court ordered a major overhaul of health care in Illinois prisons, the state has failed to address major shortcomings and lost ground on staffing mandates, according to a report filed by a court-appointed monitor.
The Illinois Department of Corrections has made progress in some areas, said the nearly 200-page report filed Monday, but “after four years, few of the major deficiencies and fewer of the essential elements that resulted in the Consent Decree have been corrected and several have worsened.”
PDF: Read the full report
The IDOC contends the prison network still needs more than 300 additional staff, but there are fewer staff employed with the agency now than when the decree was signed in the lawsuit filed in 2010 by inmate Don Lippert.
The plan that was expected to require a decade of work is woefully short of substantial progress, with many areas rated as non-compliant or partially compliant with the federal order. Major staffing shortages include a 50% vacancy rate for doctors and 46% vacancy rate for overall health care positions, said the report.
“This staffing shortage is critical and results in patients not receiving adequate care,” the monitor concluded.
The monitor singled out staffing issues at Dixon Correctional Center. During a visit to the facility, the monitoring team found nurse practitioners providing the majority of infirmary care and all of chronic disease care. The nursing staff was “unsupervised and had no formal relationship with the physician with respect to consultation and referral of complex cases,” the report stated.
Chicago lawyer Harold Hirshman, one of the lawyers representing inmates, said “we remain deeply disappointed that the governor proclaims progress and the court’s monitors finds persisting unmitigated failures almost across the board. We have asked the court to address Dixon because it was so bad the monitor devoted a special report to conditions there.”
In February, the judge handling the lawsuit in the U.S. District Court for the Northern District of Illinois’ Eastern Division accepted previous recommendations from the monitor and ordered IDOC to complete work on a comprehensive plan for improvements. Lawyers for inmates have cited severe healthcare deficiencies at Dixon in a recent motion seeking immediate action by the state.
Work on mandated policies and procedures is “sporadic and disorganized,” said the report. Among those reports is a required review of inmate deaths. The average number of inmate deaths for the past six years is about 90, the report noted, but has varied considerably due to the COVID pandemic.
All deaths should include an autopsy and be included in a comprehensive quarterly report, the monitor recommended, with an opportunity for staff to “provide anonymous information regarding events surrounding a death with an aim toward improving patient safety.”
Specific examples of alleged failures by IDOC to care for inmates who died in prison are cited in the report. A man identified as Mortality Patient 9 arrived at the state’s Northern Reception Center in Joliet on June 3, 2021 with three prescriptions for psychotropic medications. He refused to take the drugs on June 29 and 30 and accepted his final dose on July 2 before his transfer to Shawnee Correctional Center six days later.
The paperwork for the man’s transfer did not include the fact that his medication had expired six days earlier and that he had twice refused to see a psychiatrist the week before. A nurse noticed the lapsed prescription and another order was written but he did not receive the pills until July 15, a lapse of 13 days without the medications.
In December, Mortality Patient 9 was moved to Menard Correctional Center with paperwork that omitted major factors related to his medications and declining mental health, the report noted. Three months later, he committed suicide. A suicide review stated that the record sent to Menard “was missing documentation that would have indicated the need for crisis follow-up,” said the monitor’s summary.
Among areas of the decree still unaddressed, according to the monitor, is infection control in state facilities.
“IDOC has no policies on infection control,” said the report, adding that the manual used by staff is outdated and incomplete.
A spokesman for IDOC did not respond to a request for comment on the monitor’s updated report. The state will have an opportunity to provide the court with a response to the report.
