Michigan's Solution to Prisoner Healthcare: Close the Prison

by David M. Reutter

In December 2006, a federal district court found the Michigan Department of Corrections (MDOC) in contempt in the long-running Hadix case, and ordered prison officials to submit a plan to ensure that prisoners receive adequate medical care [See: PLN, May 2007, p.7].

Two months later, in February 2007, Michigan Governor Jennifer Granholm announced the state's plan to solve the problem of federal oversight of MDOC healthcare: Close the prison under the court's jurisdiction -- the 1,400-bed Southern Michigan Correctional Facility in Jackson -- which would save the state $35 million in the process.

U.S. District Court Judge Richard A. Enslen responded by requiring the MDOC to submit a prisoner transfer plan within 45 days, prohibiting the closure of the prison until the court gave its approval. The Sixth Circuit Court of Appeals denied the MDOC's request to stay the order, but required the district court to rule by May 9.

After the MDOC filed its transfer plan, the Hadix plaintiffs objected and the Office of the Independent Medical Monitor (OIMM) filed a special report. On May 4, 2007 the district court entered an order finding that the MDOC's plan was deficient.

"According to the Monitor, Defendants are presently providing specialty care within medically acceptable time frames only 63 percent of the time," Judge Enslen wrote. The court agreed with the Monitor "that a 90 percent goal is the appropriate goal for these specialty care appointments." This was necessary because such appointments provided needed medical treatment, and "the delay in services regularly results in avoidable suffering and disease."

The Monitor was unable to assess "certain aspects of the medical staffing" due to the state's plan to close the prison. The court found that the MDOC's plan failed to provide for the operation of the OIMM, or procedures for staff to comply with the OIMM's directives. The court then pointed to a case that illustrated the need for such procedures.

One Michigan prisoner, who had a family history of cancer, was diagnosed with a melanocystic skin mole. For six months he received only "hot compresses" and excuses in lieu of care. Not until ten months later did he receive a lymph biopsy, which revealed the cancer had spread to other parts of his body. The OIMM verified the prisoner's complaint that his cancer treatment had been interrupted; Correctional Medical Services (CMS) doctors had not ordered cancer treatment drugs in a timely fashion, and had placed half-orders for certain drugs the prisoner needed.

Judge Enslen observed that prison doctors who attempt to "save funds in the off-hand chance that the patient might either die or be paroled before the drugs are fully used are not worthy of the title of physicians."

The district court then criticized the MDOC's intention to scatter prisoners from the Southern Michigan Correctional Facility throughout the state's 35 other prisons. The court found that such a plan would not improve access to specialty care, since prisoners would still be subject to the limitations of CMS' specialty care providers, and that there would be greater transportation problems.

Additionally, the court found there was "no basis in science or fact" to assume the MDOC would protect the health of dialysis patients or ensure that chronically ill prisoners could access necessary medications, based on the department's past performance record.

Judge Enslen ruled that the MDOC's future plans must accommodate continued federal court intervention "until a remedial framework is shown to cure current and ongoing violations of the Eighth Amendment." The state's idea that "federal intervention may end simply by moving prisoners outside of one building within the court's jurisdiction across the street to another building outside of it" would not be accepted, the court held.

"The implicit suggestion made in such plans is that the court is willing to sign off on a shell game which substitutes mere movement of prisoners for significant improvement in medical healthcare," Judge Enslen wrote. The court noted that it "often sentences criminal financial miscreants" for engaging in such shell games.

"I am baffled at how the officials of the State of Michigan can continue to do what they are doing," said Elizabeth Alexander, an ACLU attorney representing the Hadix prisoners. "I have never seen a case in which there's more deliberate indifference."

The MDOC was ordered to revise its prison closure plan to accommodate the medical needs of the 600 remaining chronically ill and disabled prisoners who would be transferred to other facilities.

MDOC officials immediately appealed the court's order. See: Hadix v. Caruso, USDC, S.D. MI, Case No. 4:92-CV-110; Slip opinion, 2007 WL 1341958.

While the appeal was pending the case was transferred to U.S. District Court Judge Robert Jonker, who approved the state's plan subject to the review by the appellate court.

The Sixth Circuit Court of Appeals issued a decision on September 21, 2007. In a 3-0 opinion the Court declined to rule on the adequacy of the state's plan, and instead remanded various issues to the district court for further consideration. See: Hadix v. Caruso, 6th Cir., Case Nos. 06-2591, et al.; Slip opinion, 2007 WL 2753026.

Judge Jonkers gave a green light for the prison closure, and the MDOC began transferring the remaining prisoners out of the Southern Michigan Correctional Facility in October. The prison officially closed on November 17, 2007, and the facility's 338 employees were transferred to positions at other prisons.

The Hadix litigation has been on-going since 1985 and has been extensively covered by PLN.

Additional sources: Grand Rapids Press, woodtv.com, Jackson Citizen Patriot, Associated Press

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