Campbell v. McGruder
JC-DC-001-039

FILED

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA CLE

LEONARD CAMPBELL, et al. ,

Plaintiffs,

v.

: Civil Action No

ANDERSON McGRUDER, et al. ,

Defendants

,,
^ c: <£?•, A

INMATES OF D.C. JAIL, et al., :

Plaintiffs,

:

v.

: Civil Action No. 75-166T

DELBERT C. JACKSON, et al., :

Defendants.

:

CONSENT ORDER

As evidenced by the signatures of counsel set forth below

all parties to these actions jointly request that the Court amend

the Order of December 17, 1982, entered in the Campbell case, to

allow the administering of intake physical examinations by

Physician Assistar ;s who have graduated from a nationally iccredited

program and who are also certified by the National Commission on

Certification of Physician Assistants. This Consent Order so

provides.

Upon consideration of the representations made herein, it

is this _"> day of February, 1984:

ORDERED: That paragraph numbered (5) of the Order of

December 17, 1982 be and the same is hereby vacated and in lieu

thereof the following is inserted:

&
(5) No inmate shall be housed in double-cell or dormitory until he has received a medical examination, and it has been determined that he is not suffering from any contagious disease or other condition that would create a danger to his health or safety or to the health and safety of others if he were housed in a double-cell or dormitory.
These medical examinations are to be conducted by a Physician or by a Physician Assistant who has graduated from a nationally accredited program for the training of Physician Assistants and who has been certified by the National Commission on Certification of Physican Assistants, and under the supervision of a Physician pursuant to the procedures outlined in the attached proposed Health Services Order dated February 3, 1984.
INEZ SMITH REID Corporation Counsel, D. C.
JOHN H. SUDA Principal Deputy Corporation Counsel, D.C.
MARTIN L. GROSSMAN Deputy Corporation Counsel, D. C. Civil Division
By: MICHAEC^E. Assistant Corporation Counsel, D. C. Chief, General Litigation Section II Attorney for Defendants District Building, Rm. 314 1350 Pennsylvania Avenue, N. W. Washington, D. C. 20004 727-6303
-2-

Steven Ney C/ Mary E. McClymont The National Prison Project of the American Civil Liberties Union Foundation 1346 Connecticut Avenue, N.W. Washington, D. C. 20036 202/331-0500
J , jiPatrick 'Hickey Shitw, Pitman, Potts Trowbridge 1800 M Street, N. W. S uite 900 South Washington, D. C. 20036 202/822-1103
So Ordered:
ITED STATES
Z. -

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al., Plaintiffs,
v. ANDERSON McGRUDER, et al.,
Defendants.

INMATES OF D.C. JAIL, et ail.,

Plaintiffs,

V.

j

DELBERT C. JACKSON, et al.,

Defendants.

Civil Action. No. 1462-71
ftttt)
SEP 26 1390
Civil Action No. 75-1668

ORDER Upon consideration of plaintiffs' oral motion at a status hearing before this Court on September 25, 1990, defendants' opposition thereto, and the entire record herein, it is
ORDERED that defendants shall submit a detailed report to the Court on or before October 12, 1990 stating the defendants' plans for producing constitutionally adequate health care services at the D.C. Detention facility after termination of the current contract with National Capitol Systems, Inc. Such report shall include anticipated staffing levels, shift complements, governing medical policies and procedures, individuals actually hired by position, training and orientation procedures designed

0
to integrate new employees into the system, and all other significant aspects of these plans. It is
FURTHER ORDERED that a hearing to examine the adequacy of the defendants' plans for continuation of the provision of medical services after termination of the National Capitol Systems, Inc. contract shall be scheduled for October 17, 1990 at 10:00 a.m.; and it is
FURTHER ORDERED that defendants shall produce to plaintiffs the following documents by October 12, 1990:
1. Those documents requested by plaintiffs' counsel at the depositions of Mr. Benny 0. Hodges and Doctor Herman Branson;
2. All documents requested by Doctor Albert Raymond in his tour of the D.C. Detention facility, as detailed in September 14, and 19, 1990 letters from Edward Koren to Richard Love; and
3. Any and all documents in the custody or control of the defendants that have not previously been produced which refer or relate to termina ion of the current contract for the prr/ision of medical services at the facility and/or any plans for the provision of medical care at the facility after the termination of the contract.

Dated: SeptemberZ£, 1990

B. Bryant United States District Judge
-2-

Richard S. Love, Esq. Assistant Corporation Counsel 1923 Vermont Avenue N.W. Suite NLL-3 Washington, D.C. 20001 J. Patrick Hickey, Esq. Shaw, Pittman, Potts 6 Trowbridge 2300 N Street, N.W. Washington, D.C. Edward Koren, Esq. National Prison Project 1616 L Street, N.W. Washington, D.C. 20036
Z:24OJHZ9996.9O
-3-

wo-i-oo-oa-or
japnJ90|/\i A

 
 Campbell v. McGruder

JC-DC-001-056

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al.,

)

FILED
MAR 5 1993
CLERK, U.S. DISTRICT COURT DiSTRICT OF COLUMBIA

Plaintiffs, ) Civil Action No. 1462-71 (WBB)

v.

)

ANDERSON McGRUDER, e_t a_l. , )

Defendants. )

INMATES OF D.C. JAIL, et a].., ) Plaintiffs, )
v.
DELBERT C. JACKSON, et al., Defendants.

Civil Action No. 75-1668 (WBB)

ORDER A status conference was held in these consolidated actions on March 2, 1993. At the conference, defendants requested a postponement of any hearing on plaintiffs' Motion for Order to Show Cause Why Defendants Should Not be Held in Contempt of Court until after April 1, 1993. Plaintiffs requested some interim relief to ensure compliance with the prior orders of this Court. Upon consideration of the papers filed by the parties, the argument of counsel and the record as a whole, this Court finds that immediate steps are necessary to ensure that inmates at the District of Columbia Detention Facility ("Jail") receive the necessary medical and psychiatric care previously ordered. Consistent with the defendants' obligations under the June 9, 1980 and

August 22,_1985 Orders of this Court relating to the provision of psychiatric and medical services at the Jail, it is by the Court this 4*- - day of March, 1993
ORDERED, that no later than ten days after the date of this Order defendants shall employ on the mental health units at the Jail a licensed, full-time clinical psychologist to provide patient care; and it is
ORDERED that no later than ten days after the date of this Order defendants shall employ on the mental health units at the Jail only correctional officers who have received appropriate training in dealing with mentally ill residents, equivalent to the training developed by the Forensic Correctional Services Bureau of the Department of Human Services as described in Defendants' Response to Plaintiffs' Request for Production dated May 27, 1992; and it is
ORDE_RED^that no later than ten days after the date of this Order defendants shall provide sick call, performed by doctors or certified physician assistants, on each of the cell blocks at the Jail each and every weekday; and it is
ORDERED that no later than ten days after the date of this Order defendants shall establish chronic disease clinics for inmates to ensure that patients suffering from chronic illnesses, such as diabetes, hypertension and acquired immune deficiency
-2

syndrome ("AIDS"), are routinely and regularly followed and treated; and it is
ORDERED, that no later than ten days after the date of this Order defendants shall fully implement the Quality Assurance Program outlined in Division Operating Procedure 6005; and it is
ORDERED that no later than ten days after the date of this Order defendants shall employ a full time, on-site Health Administrator as described in the medical expert reports issued by Drs. Cohen and Harrison pursuant to the August 22, 1985 Stipulation and Order; and it is
FURTHER ORDERED that 'clef endants shall file their response to plaintiffs1 Motion for an Order to Show Cause on or before April 1, 1993, and shall file on the same date a report to the Court, certified in the form of a sworn affidavit by the appropriate Department of Corrections official, specifying the extent to which the defendants are or are not in compliance with each provision in this order and with the medical and psychiatric care requirements of the June 9, 1980 Order, the August 22, 1985 Stipulation, the 1985 Mental Health Plan and the expert reports of Drs. Cohen and Harrison, and indicating the length of any non-compliance.
WiMfiam B. Bryant / United States District Judge
-3-

 
 MOV 151993
(;•

UNITED STATES DISTRICT COURT FOR THE DISTRICT OP COLUMBIA

LEONARD CAMPBELL, et al.,

:

Plaintiffs, :

V.

ANDERSON McGRUDER, et al., :

Defendants. :

CLERK. U.3.W5TS5CT COURT DISTRICT OF COLUMBIA
C.A. No. 1462-71 (WBB)

INMATES OF D.C. JAIL, et al., :

Plaintiffs, :

V.

DELBERT JACKSON, et al.,

:

Defendants. :

C.A. No. 75-1668 (WBB)

ORDER

Upon consideration of the Plaintiffs' Motion for Interim Relief, defendants' opposition thereto, the Special Officer's Recommendations concerning Interim Relief, the Expert Reports oi. Medical and Mental Health Services at the District of Columbia Jail, and the record in this case, it is hereby

ORDERED that the plaintiffs' motion is granted; and it is

FURTHER ORDERED that within five days of the date of this

Order, unless otherwise provided:
• • • • i l l Campbell v. McGruder

JC-DC-001-060

'"

f •-.

(1) Inmates who exhibit symptoms or behavior indicating that they may be acutely suicidal, pose a danger to themselves or others, or. require physical restraint or constant observation, shall be promptly evaluated by trained mental health professionals in consultation with an on-call psychiatrist, as needed. If a psychiatrist determines, in the exercise of his or her clinical judgment, after reasonable initial intervention, that an inmate is acutely suicidal or poses an imminent danger to him/herself or others and is in need of hospitalization, the defendants must transfer that inmate to a hospital that provides psychiatric services within eight hours.

(2) The defendants shall implement the specific recommendations regarding restraints found in the mental health report [Dr. Richard Belitsky, Report on Mental Health at the Washington D.C. Jail, at 29-31 (September 15, 1993)].

(3) The defendants shall insure that the inmates identified in paragraph (1) above are not placed in cells that contain obvious hazards, or in cells where they cannot be appropriately observed in accordance with physician orders.

(4) Under the direct supervision of Dr. Henry Edwards,

the Chief Psychiatrist, psychiatrists shall

evaluate the psychiatric condition of the following

inmates of the jail: all inmates housed on the

Mental Health Units, the infirmary, or the medical

step-down units; all inmates on suicide watch

status; and any inmate currently receiving

psychotropic medication or being seen in the

psychiatric clinics. This evaluation shall be

completed w'thin two weeks of the date of this

Order. F< r those inmates identified in the

screening as psychotically agitated, or as having

unusually complex psychiatric or combined medical-

psychiatric conditions, the evaluating psychiatrist

shall recommend to Dr. Edwards whether

hospitalization is appropriate. If Dr. Edwards

determines that hospitalization is appropriate,

defendants shall transfer the inmate to a hospital

that provides psychiatric services as soon as

possible and in any case within a maximum period of

two weeks following the completion of the

screening.

If Dr. Edwards determines that

hospitalization is not appropriate, a detailed

treatment plan will be prepared and implemented for

the inmate.

(5) The Jail shall have a trained mental health professional available on telephone call on a 24 hour basis, seven days a week.

(6) Medications for the treatment of psychiatric conditions shall be given on a "watch take" basis and such medications shall be provided in liquid form.

(7) The new intake screening form developed by Dr. Henry Edwards (attached as Exhibit 1) shall be completed on each new admittee to the Jail by the physician who conducts the intake physical examination.

(8) The infirmary shall be maintained in a clean and vermin-free condition.

(9) The defendants shall conduct sick call sessions five days a week on each housing unit and insure that all prisoners who sign up for sick call are seen in a timely fashion by a licensed health care provider.

(10) The defendants shall clean sick call areas in each cell block daily.

(11) The defendants shall refrain form conducting sick call through cell bars, but must hold sick call in an appropriate setting (i.e. f in sick call rooms or in the infirmary).

(12) The defendants shall chest x-ray or anergy test

every prisoner on intake to tho facility and

promptly identify any prisoner suspected of

suffering from infectious tuberculosis.

The

defendants shall, in consultation with the Special

Officer and her medical expert, develop and

implement, within two weeks of the date of this

Order, a protocol identifying who shall receive

chest x-rays and the procedure for tuberculosis

screening on intake to the facility. Plaintiffs'

counsel shall have an opportunity to review and

comment on the protocol before it is finalized.

(13) The defendants shall identify appropriately
equipped isolation rooms for persons with
infectious tuberculosis and insure that all
infectious cases are isolated.

(14) The defendants shall, in consultation with the Special Officer and her medical and mental health experts, develop and implement, within two weeks of the date of this Order, an appropriate emergency response plan to insure that medical staff promptly respond to medical emergencies. The plan shall also address the appropriate inventory of emergency equipment and its location. Plaintiffs' counsel shall have an opportunity to review and comment on the emergency response plan before it is finalized.
(15) The defendants shall treat inmate #15 described in the report of Dr. Richard Belitsky and provide inmate #15 with humane living conditions.
(16) The kitchen shall be maintained in a clean and vermin-free condition.
(17) Within forty-five days of the date of this Order, defendants shall arrange for an inspection of the entire Jail by the Department of Consumer and Regulatory Affairs (DCRA). DCRA will promptly provide a report indicating the Jail's compliance or non-compliance with all applicable environmental, sanitary, plumbing, electrical, construction, dietary, pharmaceutical, and health codes and regulations. Within thirty days of receipt of the DCRA report, defendants will provide an abatement plan which addresses the findings of the DCRA report to the Special Officer and counsel for plaintiffs. DCRA will re-inspect the facility and report at four-month intervals thereafter, ad the defendants will file responsive abatement plans as herein provided.
(18) Defendants shall initiate Quality Assuranc ; review of (a) medical and psychiatric morbidity and mortality; (b) active tuberculosis cases; and (c) lithium use and monitoring. Defendants shall report on the results of these reviews on a monthly basis.
IT IS FURTHER ORDERED that John S. Henderson, Administrator of
the Jail, is hereby designated as the official responsible for
promptly reporting, no later than the next business day, directly

to the Court, counsel for the parties, and the Special Officer, any non-compliance with this Order. He shall receive appropriate staff support to perform this reporting and monitoring function.
IT IS FURTHER ORDERED that the defendants shall report on their compliance with this Order in their Bi-Weekly Reports to this Court
So ORDERED this <fr — day of November, 1993.
••-?,
William -B^ Bryant Senior United States District Judge

Serve:
J. Patrick Hickey Janice H. Ziegler
Shaw, Pittman, Potts & Trowbridge
2300 N Street, N.W. Washington, D.C. 20037
Jonathan M. Smith D.C. Prisoners' Legal Services
Project, Inc. Suite 117 1400 20th Street, N.W. Washington, D.C. 20001
John Payton Michael E. Zielinski Richard S. Love David A. Flyer Correctional Litigation Section 441 4th Street, N.W. Washington, D.C. 20001
Grace M. Lopes Special Officer of the U.S. District Court
for the District of Columbia 1130 17th Street, N.W. Suite 400 Washington, D.C. 20036

IKTAJCI: MSHTAt HAtTR SC2SBBXBCI

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( ) PHXVIOU8 MfBTAL HIALTH

( ) PRBV10U8 PSYCUAflZC DtAGIOSlS:. ( ) HISTORY Of 80XCXSAL/3XLP IWtfRlOOS B8BVVI0K:

( ) SfSBBTAMCM ABOfll H8TOJY:, ( ) PSYCEZATRIC

(CHBOC ALL TEAT All APPB0PB2ATS)

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Exhibit 1

DATB

NOU 9 '92 18:13 FROM SPC OFFICER OF COURT

PAGE.002

UNITED 6TATBS DISTRICT COORT FOR TOT DISTRICT OF COLOMBIA

E 11 E D
^0V S 1993

LEONARD CAMPBELL, &t. f).. •

CLERK, U.S. DISTRICT COURT DISTRICT Of COLUMBIA

Plaintiffs,

v.

C.A. NO. 1462-71 (WBB)

ANDERSON McGRUDER,fi£Al>'

Defendants.

INMATES OF D.C. JAIL, ££ &1., :
£
Plaintiffs, t

t

v.

$

*

DELBERT JACKSON, ££ Al.,

I

*

Defendants. :

C.A. NO. 79-1668 (WBB)

ORDBB
Upon consideration of the Plaintiffs' Motion for Interim Relief, defendants' opposition thereto, the Special Officer's Recommendations concerning r.terim Relief, the Expert Reports on Medical and Mental Health Services at the District of Columbia Jail, and the record in this case, it is hereby
ORDERED that the plaintiffs' motion is granted; and it is
FURTHER ORDERED that within five days of the date of this Order, unless otherwise provided;

'• *

-

•.

vv.r

(1) inmates who exhibit symptoms or behavior indicating that they may bo acutely suicidal, pose a danger to themselves or others, or require physical restraint or constant observation, shall be promptly evaluated by trained mental health professionals in consultation with an on-call psychiatrist, as needed. If a psychiatrist determines, m the exercise of his or her elinical judgment, after reasonable initial intervention, that an inmate is acutely suicidal or poses an Imminent danger to him/herself or others and is in need of hofpitalization, the defendants must transfer that inmate to a hospital that provides psychiatric services within eight hours.

(2) The defendants shall implement the specific recommendations regarding restraints found in the mental health report [Dr. Richard Belitslcy, Report on Mental Health at the Washington D.c- Jail, at 29-31 (September 15, 1993)].

(3) The defendants shall insure that the inmates identified in paragraph (1) above are not placed in cells that contain obvious hazardsf or in cells where they cannot be appropriately observed in accordance with physician orders.

( O Under the direct supervision of Dr. Henry Edwards,

the Chief Psychiatrist, psychiatrists shall

evaluate the psychiatric condition of the following

inmates of the jail: all inmates housed on the

Mental Health Units, the infirmary, or the medical

step-down units; all inmates on suicide watch

status; and any inmate currently receiving

psychotropic medication or being seen in the

psychiatric clinics. This evaluation shall be

completed within two weeks of the date of this

Order. For those inmates identified in the

screening ar psychotically agitated, or as having

unusually complex psychiatric or combined medical-

psychiatric conditions, the evaluating psychiatrist

shall recommend to Dr. Edwards whether

hospitalization is appropriate. If Dr. Edwards

determines that hospitalization is appropriate,

defendants shall transfer the inmate to a hospital

that provides psychiatric services as soon as

possible and in any case within a maximum period of

two weeks following the coapletion of the

screening*

*f Dr. Edwards determines that

hospitalization is not appropriate, a detailed

treatment plan will be prepared and implemented for

the inmate.

3 S

r n<->n -.r>_. u i r l i h K OF COURT

PAGE . 004

(5) The Jail shall have a trained mental health professional available on telephone call on a 24 hour basis, seven days a week*
(6) Medications for the treatment of psychiatric conditions shall be given on a "watch take11 basis and such medications shall be provided in liquid form.
(7) The new intake screening fora developed by Dr. Henry Edwards (attached as Exhibit 1) shall be completed on each new admittee to the Jail by the physician who conducts the intake physical examination*
(8) The infirmary shall be maintained in a clean and vermin-free condition.
(9) The defendants shall conduct sick call sessions five days a week on each housing unit and insure that all prisoners who sign up for sick call are seen in a timely fashion by a licensed health care provider.
(10) The defendants shall clean sick call areas in each cell block daily*
(11) The defendants shall refrain form conducting sick call through cell bars, but must hold sick call in an appropriate setting fi.e.. in sick call rooms or in the infirmary).
(12) The defendants shall chest x-ray or anergy test every prisoner on intake to the facility and promptly identify any prisoner suspected of suffering from infectious tuberculosis. The defendants shall, in consultation with the Special Officer and her medical expert, develop fe.nd implemeru, within two weeks of the date of this Order, a protocol identifying who shall receive chest x-rays and the procedure for tuberculosis screening on intake to the facility. Plaintiffs' counsel shall have an opportunity to review and comment on the protocol before it is finalized.
(13) The defendants shall identify appropriately equipped isolation roosts for persons with infectious tuberculosis and insure that all infectious cases are isolated.

MOU a '93 18:14 FROM SPC OFFICER OF COURT

PAGE.00!

(14) The defendants shall, in consultation with the Special Officer and her medical and mental health experts, develop and implement, within two weeks of the date of this Order, an appropriate emergency response plan to insure that medical staff promptly respond to medical emergencies. The plan shall also address the appropriate inventory of emergency equipment and its location. Plaintiffs' counsel shall have an opportunity to review and comment on the emergency response plan before it is finalized*
(15) The defendants shall treat inmate #15 described in the report of Dr. Richard Belitsky and provide inmate #15 with humane living conditions.
(16) The kitchen shall be maintained in a clean and vermin**free condition.
(17) Within forty-five days of the date of this Order, defendants shall arrange for an inspection of the entire Jail by the Department of Consumer and Regulatory Affairs (DCRA). DORA will promptly provide a report indicating the Jail's compliance or non-compliance with all applicable environmental, sanitary, plumbing, electrical, construction, dietary/ pharmaceutical, and health codes and regulations. Within thirty days of receipt of the DCRA report, defendants will provide an abatement plan which addresses the findings of the DCRA report to the Special Officer and counsel for plaintiffs. DCRA will re-inspect the facility and report at four-month intervals thereafter, ad the defendants will file responsive abatement plans as herein provided.
(18) Defendants shall initiate Quality Assurance review '"f (a) medical and psychiatric morbidity and mortality; (b) active tuberculosis cas^s; and (c) lithium use and monitoring. Defendants shall report on the results of these reviews on a monthly basis.
IT IS FURTHER ORDERED that John S. Henderson, Administrator of
the Jail, is hereby designated as the official responsible for
promptly reporting, no later than the next business day, directly

NOU 9 ' 9 3 I S : 15 FROM S P C O F F I C E R OF COURT

_

-,

u ^ s u ttvz

JUKiE flRYAM^v -SLOPES

PAGE . 0 0 6
©005/00^

to the Court, counsel for the parties, and the Special officer, any non-compliance with this Order* He shall receive appropriate staff support to perform this reporting and monitoring function*
XT IS FURTHER ORDERED that the defendants shall report on their compliance with this Order in their Bi-Weekly Reports to this Court
so ORDERED this *fr^- day of November, 1993.

*"""

William JT Bryant

senior United States District Judge

NOU 9 '93 18:15 FROM SPC OFFICER OF COURT

.

Serve:
J. Patrick Hicfcay Janice H. Ziegler Shaw, Pittaan, Potts & Trowbridge 2300 N Street, N.W. Washington, D.c. 20037
Jonathan M. Smith D.C. Prisoners' Legal Services
Project, Inc. Suite 117 1400 20th Street, N»w. Washington, D.C. 20001
John Payton Kiohael S. Zielinski Kichard S. Love David A. Flyer Correctional Litigation Section 441 4th Street, N.W. Washington, D.C. 20001
Grace M. Lopes Special Officer of the U.S. District court
for the District of Columbia 1130 17th Street, K.W. suite 400 Washington, D.c. 20036

PAGE.007

6

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 Campbell v. McGruder

-MAR 181994

JC-DC-001-062
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

FILED.
«V.AR 1 * 1334

LEONARD CAMPBELL, et al.,

<i s DISTRICT COURT

Plaintiffs, v. ANDERSON McGRUDER, et al. ,

) ) C.A. No. 1 4 6 2 - 7 1 (WBB)

Defendants.

INMATES OF D.C. JAIL, et al. , Plaintiffs,
v. DELBERT JACKSON, et al.,

) )
) ) C.A. No. 7 5 - 1 6 6 8 (WBB)
)

Defendants.

)

CONSENT ORDER Upon consideration of the Report of the Special Officer on Medical Care at the District of Columbia Jail, the Special Officer's Outline of her Findings on Mental Health Care at the District of Coluirjia Jail, the Expert Reports on Medical and Mental Health Services at the District of Columbia Jail, the Plaintiffs' Motion that the Court Adopt the Special Officer's Report on Medical Care at the District of Columbia Jail as the Court•s Findings and that the Defendants be held in Contempt of Court, the Court's findings in its April 20, 1993 Order Appointing Special Officer, the Court's findings in its March 5, 1993 Order, the defendants' acknowledgement and representation

that while it disagrees with some of the statements in the

Special Officer's Reports, it is in non-compliance with numerous

material provisions of the orders of this Court, that it intends

to remedy its non-compliance and does not oppose entry of this

remedial order, and the entire record in this case,

it is by this Court this

/<£"£? day of March, 1994

ORDERED that the defendants are found to be in Contempt of

this Court, and it is further

ORDERED that the Special Officer shall, within 120 days of this Order submit a plan to cure the defendants1 contempt and

that will insure that the defendants render medical and mental

health services to prisoners at the Jail in a manner consistent

with the United States Constitution, and it is further

ORDERED that the Special Officer's remedial plan shall

address all issues raised in her reports, the Expert Reports on

Medical and Mental Health Services, as well as any additional

issue that may come to the attention of the Special Officer or

the Court that adversely impacts on the defendants' compliance

with the Court's orders concerning the delivery of medical and

mental hea]ch services at the Jail or that adverse"y impacts on

the defendants' delivery of medical and mental health services at

the Jail in a manner consistent with the United States

Constitution, and it is further

ORDERED that the remedial plan shall include a time table

for implementation, graduated automatic fines for failure to meet

- 2-

implementation deadlines, and a procedure for the defendants to report on their compliance, and it is further
ORDERED that in developing the remedial plan that the Special Officer shall consult with the defendants and their counsel, with counsel for the plaintiffs, and with such experts as she deems necessary, the fees and expenses of any expert hired pursuant to this paragraph shall be paid by the District of Columbia, and it is further
ORDERED that the defendants shall implement the remedial plan in accordance with the time table established by the Special Officer unless good cause is shown by any party why the plan should not be implemented or should be modified, and it is further
ORDERED that the Special Officer shall file, and the defendants shall implement, such interim remedial plans as the Special Officer deems necessary in order to address conditions that, in the opinion of the Special Officer, must be addressed on an expedited basis, and it is further
ORDFRED that the defendants shall implement within 30 days the recommendation of the Special Officer for a compliance monitor contained at 127-8 of her report.
William B.Bryant^/ United States District Judge
- 3-

m
Agreed to:
/kichard S. Love Correctional Litigation Unit Corporation Counsel 441 4th Street, N.W. Washington, D.C. 20001 Counsel for the Defendants dated:
J.PatricKHickey Teresa Diaz Shaw, Pittman, Potts &
Trowbridge 2300 N Street, N.W. Washington, D.C. 20037 Counsel for the Plaintiffs Campbell v. McGruder dated
JonaUhk^l M ./&ni/th
r.C. Prisoners1 Legal Services Project,line.
1400 20th Street, N.W. Washington, D.C. 20036 Counsel for the Plaintiffs Inmates of D.C. Jail v. Jackson
dated: 3/7,
- 4-

Serve: Grace M. Lopes 1130 17th Street, N.W. Suite 400 Washington, D.C. 20036 Jonathan M. Smith D.C. Prisoners' Legal Services
Project, Inc. 1400 20th Street, N.W. Washington, D.C. 20036 J. Patrick Hickey Shaw, Pittman, Potts &
Trowbridae 2300 N Street, N.W. Washington, D.C. 20037 Richard S. Love Correctional Litigation Unit Corporation Counsel 441 4th Street, N.W. Washington, D.C. 20001
- 5-

 
 Campbell v. McGruder

141394

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JC-DC-001-064

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al., Plaintiffs,
v.
ANDERSON McGRUDER, et al.. Defendants.

Civil Action No. 1462-71 (WBB)

INMATES OF D.C. JAIL, et al., Plaintiffs,
v.
DELBERT C. JACKSON, et al., Defendants.

Civil Action No. 75-1668 (WBB)

NOTICE OF FILING
The defendants hereby file the attached completed drafts of
the Emergency Response and Tuberculosis Protocols to be implemented
by the Defendants according to the November 9, 1993 Order of the
Court.
JOHN PEYTON Corporation Counsel, D.C. MICHAEL E. ZIELINSKI Assistant Deputy Corporation Counsel Civil Division RICHARD S. LOVE Assistant Corporation Counsel, D.C. Chief, Correctional Litigation Section

DAVID A. FLYER, #430535 Assistant Corporation Counsel, D.C. Correctional Litigation Section 441 4th Street, N.W. 6th Floor, South Washington, D.C. 20001 (202) 727-6295 (Ex. 3468)

CERTIFICATE OF SERVICE I hereby certify that a copy of the foregoing Notice of Filing was mailed, postage prepaid, to Patrick Hickey, Tara Flynn, Shaw, Pittman, Potts & Trowbridge, 2300 N. Street, N.W., Washington, D.C. 20037; and to Jonathan Smith and Aurie Hall, D.C. Prisoners' Legal Services, 1400 20th Street, N.W., Suite 117, Washington, D.C. 20036 this /J? day of April, 1994.
DAVID A. FLYER Assistant Corporation Counsel

PPD reading within the prior three (3) months, shall have a PPD test. All inmates shall have a screening test for pregnancy during intake.
2. The results of the pregnancy test shall be obtained within 24 hours. If the pregnancy test is negative, the female inmate shall have a chest x-ray within 24 hours. Lead apron screening shall be used.
3. Pregnant inmates who are PPD negative shall be tested for anergy to a panel of two or more antigens in addition to the PPD. All anergic patients shall have a chest x-ray. Lead apron screening shall be used.
4. A pregnant inmate shall only be x-rayed if she is PPD positive or exhibits signs or symptoms of TB. Lead apron screening must be used.1
5. All new female intakes shall be housed on the female intake tier of the female cellblock and segregated from the other inmates until the results of the PPD test and chest xray are read and a negative TB result is determined. The intake units shall be evaluated within 60 days to determine if the ventilation is adequate. The identity of the inspectors and the standards to be applied will be determined by the parties in consultation with the Special Officer within 30 days.
C. Reading and Recording of PPD Tests and Chest X-rays
1. The Chief Medical Officer of the Jail shall designate a sufficient number of licensed health care providers on each shift who will be responsible for the reading of PPD tests and the proper documentation of the results of all TB screening tests in the inmates1 medical records. These individuals shall be responsible for the tracking of PPD tests and chest x-rays in accor .ance vJLth a protocol to be developed by the TB Coordinator or an appropriately trained and qualified individual by May 18, 1994.
2. The site of the PPD injection is to be examined for any reaction by a designated licensed health care provider within 48 to 72 hours after implantation.
3. The diameter of any induration is to be measured, disregarding erythema or bruising. The result of this PPD reading is to be charted on the form appended as Attachment A and
1 With proper lead apron screening, there is no contraindication to x-raying a pregnant woman who has signs and symptoms of TB. Chest x-ray using proper lead screening is essential in these inmates.

©

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placed in the inmate's medical record.

(mm) :

4. The PPD reading is to be recorded in millimeters

Positive - 10 mm or greater induration

Negative - 0 - 4 mm induration

Questionable - 5 - 9 mm induration

Consider questionable reading to be positive if:

* patient is HIV positive; * patient has had a close recent contact
with an infectious person; or * patient has an abnormal chest x-ray
consistent with TB.
If the reaction is swollen, red and painful, but there is no measurable induration, the PPD may have been given subcutaneously. If it appears that the PPD was improperly administered, it should be repeated, but only after 10 days from the original date of administration, to avoid the booster phenomenon.

5. Chest x-ray readings are to be recorded on the forms appended as Attachments A and B.

D. Preventive Therapy

1. PPD tests are to be repeated annually for all inmates.

2. All inmates with a positive PPD should be evaluated for INH prophylaxis tr atment when a negative chest x-ray rul s out active disease. Evaluation shall include the performance, of liver function tests (SGOT, SGPT, Alkaline Phosphatase, Total Bilirubin).

3. Medical providers shall advise inmates of the potential risks and side effects associated with TB prophylaxis prior to prescribing the medication. Inmates who are prescribed TB medication solely as prophylaxis have the right to refuse the medication. Inmates who are PPD positive, but without active disease, are not subject to medical holds for refusing prophylactic medication.

4. The following PPD positive patients shall receive INH preventive therapy:

* Under 35 years old;

* previously untreated or inadequately treated persons with abnormal chest x-rays consistent with old healed TB - under 35;
* persons with HIV infection - any age; * close contacts of infections TB cases - any age; * new tuberculin convertors: persons who have had a
history of negative PPD or a change in size greater than 6 mm increase in skin test reaction within a two year period - any age; * persons of any age with medical conditions that increase the risk of TB infection, including:
- Silicosis - Diabetes Mellitus - Prolonged corticosteroid therapy - Inununosuppressive therapy - Hematologic and reticuloendo-'-helial
diseases - End-stage renal disease - Intestinal bypass - Postgastrectomy - Chronic malabsorption syndrome - Carcinomas of the oropharynx and upper
GI tract - 10% or more below ideal body weight
5. Inmates over 35 years of age may be offered prophylactic treatment but the risks of liver toxicity must be clearly explained.
6. If an inmate is PPD positive and has an abnormal chest x-ray consistent with TB, the inmate shall be referred for TB therapy. HIV counseling and testing shall also be offered to any inmate who is PPD positive.
7. Prophylactic treatment shall be given as follows: Isoniazid (INF 300 mg daily or',900 mg 2x weekly. Inmates who are HIV negative shall receive this course of treatment for 6 months. Inmates who are HIV positive shall receive this course of treatment for 12 months. This medication shall be given on a watch-take basis to ensure that the inmate ingests the medication. This involves watching the inmate swallow and checking the hands and mouth to ensure compliance.
8. Inmates receiving prophylactic INH shall be evaluated to determine if Vitamin B 6 therapy is necessary with particular attention to inmates with past or present signs or symptoms of neuropathy and inmates with signs of malnourishment. Inmates who are HIV positive shall receive multivitamins.
E. Positive Chest X-rav or Syptomatic Inmate
1. Any inmates with an abnormal chest x-ray consistent
4

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with TB or with symptoms of TB, i.e., productive cough, coughing up blood, weight loss, loss of appetite, lethargy, weakness, night sweats, or fever shall be referred for therapy and to D.C. General Hospital for a sputum smear and culture within 24 hours.
2. Until the results of the sputum smear or culture are known, the symptomatic patient is a "suspect" case and shall be placed in respiratory isolation which conforms with the guidelines established for respiratory isolation by the Centers for Disease Control (CDC).
3. In accordance with D.C. Health Regulations, Chapter 5, Section 8-5:104, the medical provider who identifies any suspected or diagnosed case of TB must report to the Bureau of Tuberculosis Control in writing within 48 hours of diagnosis or the appearance of suspicious symptoms by completing the attached Tuberculosis Case Report form. (See Attachment C.)* The medical provider shall also provide a duplicate copy of the Tuberculosis Case Report to the TB Coordinator at the Jail for monitoring and follow-up.
P. Isolation
1. Inmates with active or suspected TB shall be transferred to isolation rooms that conform with current CDC guidelines in the Correctional Treatment Facility (CTF) or D.C. General Hospital until they are no longer infectious. Respiratory isolation rooms must have separate ventilation to the outside, negative air pressure in relation to adjacent areas, a minimum of six room air exchanges per hour, and properly shielded ultraviolet lights.
2. Any inmate who has had a positive sputum smear shall not be released from isolation until three (3) negative sputum smears are collected on consecutive days and the patient is receiving appropriate therapy.
3. Procedures such as sputum collection, bronchoscopy and the administration of aerosolized pentamidine are to be conducted at the CTF or D.C. General Hospital in an appropriate treatment room or booth with negative pressure in accordance with current CDC guidelines. Patients are to remain in the treatment room or booth until coughing has subsided.
4. DOC shall obtain proper inspections of the isolation rooms at the CTF annually.
2 This may be sent by facsimile in accordance with the correspondence appended as Attachment D.

6. Treatment

1. The following medications are used for the

treatment of TB:

Isoniazid (INH)

300 mg daily or

900 mg 2x weekly

Rifampin (RIF)

600 mg daily if greater than 50 kg 450 mg daily if less than 50 kg or same dosages 2x weekly

Pyrazinamide (PZA)

20-30 mg/kg daily or 50 mg/kg 2x weekly

Ethambutol (EMB) OR

25 mg/kg daily or 50 mg/kg 2x weekly

Streptomycin

1 gm 2x weekly

2. Inmates receiving TB treatment shall be evaluated to determine if Vitamin B 6 therapy is necessary with particular attention to inmates with past or present signs or symptoms of neuropathy and inmates with signs of malnourishment. Inmates who are HIV positive shall receive multivitamins.
3. When symptoms and/or results of PPD test, chest xray, and sputum smear suggest active pulmonary TB, the inmate should be placed on a TB treatment regimen of medications as follows:

Regimens

Recommended Treatment Regimer^

HIV Negative

HIV Positive

Initial Phase

2 months INH/RIF/ PZA/EMB daily

2 months INH/RIF/ PZA/EMB daily

Continuation Phase

4-7 months INH/RIF daily or 2x weekly

10 months INH/RIF daily or 2x weekly

Total

6-9 months

12 months

4. The treatment regimen of each patient shall be determined in accordance with the culture and sensitivity laboratory test result.

•£••••
5. "Watch take" requirements should be implemented for all patients with evidence of active TB to ensure that the inmate ingests the medication.
6. Inmates with clinically active disease shall receive sputum examinations in an appropriate treatment room or booth with negative pressure at D.C. General Hospital or the CTF in accordance with standard medical practice, at least weekly until sputum conversion and then monthly until discharged. Discharge from the hospital or CTF will be based on the acquisition of three negative sputum smears on consecutive days.
7. Persistence or reappearance of organisms in the sputum smear necessitates an immediate evaluation of compliance with the medication regimen and the performance of drug susceptibility tests. All inmates shall remain in isolation until three consecutive sputum smears are negative.
H. Side Effects of Medication
1. Clinical staff who administer TB medications must be familiar with common side effects and adverse reactions. Specific protocols for management and evaluation of side effects shall be developed and the clinical staff shall receive the appropriate training.
2. The following patients should receive careful monitoring when given INH:
* Dilantin users - may need to decrease Dilantin; * Alcohol users - higher incidence of INH hepatitis; * Previous INH users - discontinued due to headaches; * Concurrent use with other medications.
3. If an inmate exhibits signs or symptoms of drug tcxicity, the medication shall lje discontinued and the Bureau of Taberculosis (202) 724-2191 shall be contacted for expert advice.
4. Expert advice for the handling of adverse reactions to medications and for the management of complicated cases (i.e., drug resistance, extrapulmonary disease, or disease in pregnant women) will be obtained from the Bureau of Tuberculosis Control at (202) 724-2191.
I. Refusal of TB Screening Procedures - Medical Hold
1. Any inmate who refuses any TB screening procedure shall be placed on "medical hold" for the protection of the prison community. A medical hold is the process by which an inmate is placed in an isolated area when refusing to accept screening, diagnosis, or treatment for a communicable disease which poses a public health threat to the safety of the inmate or

others.
2. Any inmate placed on medical hold due his/her refusal to participate in TB screening shall receive immediate, comprehensive and appropriate education from a licensed health care provider regarding the refused procedure at the time of refusal. All available literature regarding TB shall be provided. Inmates on medical hold shall receive counseling daily from the TB Coordinator regarding the importance of the screening procedure. Inmates on medical hold shall also be seen daily by a physician or physician assistant in order to observe any signs or symptoms of TB. Proper documentation of each visit by the TB Coordinator and physician or physician assistant shall be noted in the medical record.
3. If the inmate does not consent to the screening procedure within two weeks, and the inmate shows no signs or symptoms of TB in the judgment of a DOC physician, s/he shall be released to the general population. When a medical hold is extended beyond the initial two week period, the requirements of section I, paragraph 2 remain applicable.
J. Inmate Education and Referral to Community Services
1. When an inmate's PPD is read, the licensed health care provider shall distribute and explain written educational materials regarding TB control, prevention and treatment. The TB Coordinator shall be responsible for selecting appropriate materials in Spanish and English written at a basic literacy level.
2. When an inmate is prescribed INH or any other medication as TB prophylaxis or treatment, written information regarding follow up care in the event of release from the Jail during the course of treatment shaM be given and explained. This information shall direct th,e tnmate to contact Dr. James Wills, Area C Chest Clinic, 1905 ii' Street, S.E., Washington, D.C., 20003 at (202) 727-5155. The TB Coordinator shall develop the form to be provided and explained.
3. The TB Coordinator shall monitor daily the releases from the Jail to determine if any inmate on TB medications has been released. The identity of any such inmate shall be reported to the Bureau of Tuberculosis Control and the Area C Chest Clinic.
4. If the release date of an inmate taking TB medication is known to be prior to the completion of the inmate's treatment regimen, the inmate shall be provided with a two week supply of the prescribed medication upon release along with written instructions to contact the Area C Chest Clinic.
8

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M

K. Tuberculosis Coordinator
1. The DOC shall hire a properly credentialed and appropriately trained full-time TB Coordinator to work at the Jail by April 18, 1994.
2. The TB Coordinator shall monitor the ongoing screening program at the Jail for continuity of care and followup. The TB Coordinator shall be responsible for monitoring TB intake screening, inmates placed on prophylactic treatment, inmates with active disease, inmates placed in the hospital for therapy, and those placed on medical hold related to TB.
3. The TB Coordinator shall function as the liaison with the Bureau of Tuberculosis Control, D.C. General Hospital and the laboratory.
4. The TB Coordinator shall obtain a comprehensive daily list of all persons undergoing intake physical examinations with TB screening. Results of PPD tests and chest x-rays shall be placed on the appropriate forms by the medical staff and monitored daily by the TB Coordinator. The TB Coordinator shall develop a protocol for the tracking of PPD tests and chest x-rays to be approved by the Chief Medical Officer of the Jail by May 18, 1994. The TB Coordinator shall monitor all inmates receiving prophylactic treatment or treatment for active TB.
5. The TB Coordinator shall maintain an accurate account of inmates tested, cleared, inmates not tested, inmates on medical holds, and referrals for inmates released into the community.
6. The TB Coordinator shall coordinate referrals and discharge planning for inmates receiving TB prophylaxis or treatment.
7. The TB Coordinator shall monitor the case reporting to the Bureau of Tuberculosis Control to ensure that all appropriate cases are reported properly and within the required time limits.
8. The TB Coordinator shall monitor at least monthly all inmates taking anti-TB medications. Special attention shall be given to inmates who are taking other medications or who have a history of alcohol abuse or liver disease.
9. The TB Coordinator shall develop and implement an educational program regarding TB for the inmate population, including monitoring the distribution of any written materials that are to be provided to the inmates housed at the Jail.
10. The TB Coordinator shall answer directly to the
9

Chief Medical Officer of the Jail and shall provide information and education to other providers at the Jail. The TB Coordinator shall submit a monthly report to the Chief Medical Officer at the Jail and the Bureau of Tuberculosis Control.
11. The TB Coordinator shall coordinate in-service training which will be provided to all staff at the DOC training academy. Specialized training will be provided to clinical staff by specialists from the Public Health Commission, Bureau of Tuberculosis Control, community hospitals and from other correctional institutions regarding clinical signs, symptoms, and treatment issues involving TB.
12. The TB Coordinator shall be responsible for conducting any contact investigations when pulmonary or laryngeal TB disease is suspected or diagnosed.
13. The TB Coordinator shall be responsible for developing a tracking system to provide notification to the medical units at other DOC facilities when a patient under treatment for TB or on prophylaxis is transferred from the Jail. This duty may be delegated to another licensed health care provider, however, the TB Coordinator is responsible to ensure that it is developed and implemented.
L. Contact Investigation
1. Whenever pulmonary or laryngeal TB disease is suspected or diagnosed, all close contacts should be skin tested unless there is a documented history of a positive skin test. Close contacts include all cell mates, all inmates and staff on the same tier, or all inmates and staff in the same building who share air, and visitors who have shared airspace.
2. The "concentric circle* approach can be used to determine the extent of contact tinvestigation needed. First, identify those persons rfho were \nost likely to have been infected by the source case. This first group should include: persons who shared breathing space with the source case for the longest time, persons who may have spent less time with the source case but are immunosuppressed; and persons who have TB symptoms. If positive PPD tests are identified among persons in this first group or "circle" ( with no previous history of TB infection) , new infections have probably occurred. Expand the investigation into widening circles until PPD testing identifies a group of persons with no evidence of new TB infection
3. If exposure was less than 10 to 12 weeks prior to PPD testing, a contact with a negative PPD test should be retested 10 to 12 weeks after the initial negative PPD test.
10

-<§

ray:

4. The following contacts should receive a chest x-
a) those who have a positive skin test — greater than 5 nun;
b) those with a history of a positive skin test; c) those who are HIV positive, regardless of skin
test results.

If the chest x-ray is negative for evidence of the disease, these contacts should receive preventive therapy, unless medically contraindicated.

5. During contact investigations, the confidentiality of the infected person must be maintained.

M. Screening of DOC Employees

1. All DOC staff shall be strongly encouraged to receive PPD tests annually and these tests shall be made available to all employees free of charge. The defendants shall determine whether mandatory testing can be required and shall report to the Special Officer and plaintiffs' counsel within 60 days regarding this matter.

N. Review of Protocol

1. This procedure and protocol shall be reviewed annually by the DOC Assistant Director for Health Services to determine if any revisions should be made in light of new developments in the treatment of TB. Any proposed revisions shall be submitted to the Special Officer for approval. Plaintiffs' counsel must be advised of all proposed revisions to this document.

III. Effective Date

1. The defendants shall immediately implement fie policies and procedures set forth in this document.

11

ATTACHMENT D

>•; :._ I ~6 . 0

GOVERNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF HUMAN SERVICES WASHINGTON. D. C. 200O2

IN REPLY REFER TO-

To whom It may concern:

November 20, ".990
D.c. Commission of Pubiic Health 3ureau of Tuberculosis Control 1905 E St., s.E. Washington, D.C. 20003

The Bureau of Tuberculosis Control, Registry, ' has installed a racs*nrrie- fFAX) machine to be used for the expressed purpose of receiving both case and laboratory reports or suspected and confirmed tuberculosis from health care providers.

Tie Fax machine will be available for receiving reports 24 hours a day, including weekends. It is anticipate! that the availability of the Fax machine will improve both tie 'timeliness and the accuracy of Tuberculosis case reporting.

The District of Columbia requires, as written In the D. C. Health

Regulations, for Communicable and Heportable Diseases, Chapter 5,

1963, section 8-5:104 Denomination of communicable Diseases: "tne

following diseases

Tuberculosis

are hereby

denominated communicable diseases and shall be reported in writing

within 48 hours of diagnosis or the appearance of suspicious

symptoms in the manner indicated in sections 8-5:106 and 8-5:107 of

this part. The transmission of case and laboratory TB reports by

Fax machine within 48 hours of diagnosis, fully satisfies the

reporting requirements of the D.C. Health aegulatlons.

The Bureau of Tuberculosis Contrql, Reglstn Fax macl? .ne telephone number la: 2C2-724-2363. If there are any duestions regarding the use of the Fax machine, please call Glenn Ac&am, supervisory Public Health Advisor, at 724-2193.
sincerely yours,

P.S.

HazeTM. Swann, M.D., Chief Bureau of Tuberculosis Control
Enclosed is a letter to infection Control Practitioners, dated September 18, 1990, regarding the reporting of tuberculosis cases.

I •!

SI ATTACHMENT A
D.C iPARTMENT OF CORRECT _JNS HEALTH SERVICES
TUBERCULOSIS SCREENING

Date:

1. Patient has / has not had previous skin testing for tuberculosis.

2. Last PPD was done on

at

and was neg / pos.

3.Mantoux skin testing was performed on

by (initials)

4. Date read:

Results: ;

mm induration which is neg / pos. (initials)

5. Chest X-Ray done on tuberculosis.

Is neg / positive / auspicious for active

6. Recommendations:

Patient's Name: (Last)

(First)

. DCDC #: -

D.O.B.:

Race:

Sex:

•• Center for D U M M Controlrecommend*that an induration of 3mm or greater in the Ixnmunocompromlsed be considered positive. In the non-immunoconiproniised host an induration of 10mm or greater Is positive.

ATTACHMENT B

PATIENT? IDENTIFICATION

AO6

SEX

Pfl

NAME DOS oeoct

EXAMINATION AEOUE8TEO ( J ROUTINE CMEST
• OTHER

FACILITY

REQUESTED 0Y

PfiflTlNENT CLINICAL HISTORY, OPERATIONS. PHYSICAL WN0IN08. ANO PROVISIONAL, 0MQNOSIS

£1

PWQNANT

-v

\

DATE OF REQUEtT

DATE OF EXAMINATION (hoMf r # ^ RAOKKIflAPHIC REPOAT

DATE & REPORT

OATB OF TRANSCRIPnON

M0 9IQNATURE IDPS 1M7

AAOIOLOGV RCOUEST/R6PORT

Name (lust)

(llrsi)

ATTACHMENT C

&

ENT OF THE DISTRICT OF CC ^i DEPARTMENT OF HUMAN SERVICES

TUBERCULOSIS CASE REPORT

SSN »

Address

Telephone

Marital Status
Occupation

Sex Race D Black
D Whits

D American Indian or Alaskan Native Asian or Pacific Islander

Ethnic Orgin Q Hispanic D Not Hispanic

School or Place of Employment

Address

Date of Report
1 L
Oats of Birth JL
Country of Orgin if not U.S.
Date arrv. in U.S.

Classification • Tuberculosis:
current disease
D Tuberculosis no current disease
D Tuberculosis Suspect*
D Tuberculosis Infection No disease
(If applicable)
OHS • 1447 (At*. 3f»\\ l-UM-1

Diagnosis
O Pulmonary D Non-Pulmonary (sptci/y)

Q Miliary

D Meningitis

D Bones & • • Pleural Joints

O Lymphatic D Peritoneal

D GenltoUrinary

O Other (spicily)

O Reported at time of death SIGNS & SYMPTOMS

Bacteriology

PCS. NEG. Pending Not Done

Smear D O

D

•

Culture D D

O

O

Type of Specimen

D Sputum

a Fluid

Q Tissue D Other (spicity)

(date<sj of collection Laboratory Performed

Chest X-Ray
O Not done
Q Normal
O Abnormal D Cavitary D Non-cavitary
Q Stable D Worsening Q I tprovlng
DATE OF X-RAY

Tuberculin Skin Test
a Not done a Mantouz (PPD) a Tine a Other a (specify)
Significant
a Not Significant

.mm

Chemotherapy Dosage

D Isoniazfd

D Ethambutol _

D Rlfampin

D Pyrazlnamlde

Q Streptomycin

D Other

(specify)

atient to be followed by: OMMENTS:

3 Send Additional Report Forms sported by (Print Name)

Signature

Previous diagnosis D Yes date / /
Hospitalixation Chart No Admission Date: Discharge Date:.

D-No

Office or Hospital Address

3uce No.

Ward

TO BE COMPLETED BY HEALTH DEPARTMENT

Census Tract

Date Recorded in Registry

Case *

Verified

m
MEDICAL EMERGENCY RESPONSE PROTOCOL
I. Introduction
The parties, in consultation with the Special Officer and her experts, agree that this Medical Emergency Protocol, filed with the Court on April 11, 1994, will govern the policies and procedures regarding the response to medical emergencies at the Central Detention Facility pursuant to the November 9, 1993 Consent Order issued in Campbell v. McGruder. C.A. No. 1462-71 and Inmates of D.C. Jail v. Jackson. C.A. No. 1462-71. The defendants understand that they are obligated to promulgate policies which implement this protocol.
II. Procedures
A. Notification and Response
1. Any employee who determines that a medical emergency exists shall immediately notify the Command Center using the Emergency Direct Line Communication system where possible, or by calling extension 38136 through 38144. If an emergency occurs in a location where there is no telephone, the employee will go to the nearest telephone, or notify the Command Center by walkie talkie. The employee will then return to the location of the emergency.
2. The employee placing the call will give all necessary information to the Command Center Officer including the location of the injured or ill person, type of injury or illness, and if the injured person is conscious.
3. The Command Center Officer will immediately page the Medical Emergency Response Team (MERT) Leader. The Command Center Officer will then immediately notify a supervisor and the Sick Call Officer by the Direct Line communication System, and inform them of the location of the person, type of injury or illness, and if the injured person is conscious. The Command Center Officer will then make the emergency announcement over the public address system. The Command Center Officer will only relay the location of the injured person on the public address system. The Command Center Officer shall also notify the Shift Commander who will immediately dispatch a correctional officer to ensure the proper operation and reception of the medical elevator on the floor where the eaergency exists.
4. The respective Zone Supervisor will immediately respond to the location of all medical emergencies. The Supervisor will assist the MERT and ensure full cooperation by the correctional force to include timely correctional coverage, as well as security and escort requirements. Other correctional duties may include lifting residents onto stretchers.

5. The MERT will immediately respond to all medical emergencies with the portable emergency medical cart. They will use the medical elevator for all medical emergencies. K service elevator will be used when the -medical elevator is inoperable. All employees will assist the MERT as requested.
6. The MERT Leader is responsible for directing emergency care and treatment. The MERT Leader shall determine the means of transportation to D.C. General Hospital, if necessary, and shall call 911 in all life-threatening emergencies.
7. The MERT Leader shall notify the Shift Commander when an injured person must be transported to D.C. General Hospital. The MERT leader shall inform the Shift Commander of the means of transportation, i.e., 911 or DOC ambulance. The Shift Commander shall facilitate the entry of the 911 staff as well as the prompt dispatching of EMTs and other designated staff for operation of the DOC ambulance. When the DOC ambulance is inoperable, 911 will be used for all emergency transfers to D.C. General Hospital.
8. The MERT Leader is responsible for ensuring that all medical emergencies are documented on the Medical Emergency Information Form immediately after each emergency. A copy of the form is appended as Attachment A. All completed Medical Emergency Information Forms shall be filed in a MERT log. The Sick Call Officer shall record all emergency call information in the Sick Call Officer's log-book.
B. Medical Emergency Response Team Composition
1. The MERT will be composed of three medical personnel. The MERT Leader will be a physician, with two other licensed medical providers (nurses or physician assistants).
2. The Chief Medical Officer is responsible for devising and posting a MERT schedule that includes alternates. This schedule will be completed by the second Monday in January and July of each year. The posting of the schedule will be accessible to the Sick Call Officer who must review it at the beginning of each shift.
3. The MERT Leader will wear a pager while on duty at all times. The pager will be transferred from MERT Leader to MERT Leader on each shift.
C. Location and Inspection of Emergency Medical Equipment and Supplies
1. The on duty charge nurse is responsible for having the emergency medical cart and the portable crash boxes inspected at the beginning of each shift and will make an entry in the

VO'
designated log books indicative of same. The Sick Call Officer in charge is responsible for inspection of the medical elevator and on board stretcher at the beginning of each shift. The officer will ride the elevator to all floors and check the operation of the gate locks on all floors. The inspection of the medical elevator and gate locks shall be noted in the shift activity report.
2. The elevator key shall be kept in the Infirmary Control Bubble and the Emergency Medical Cart shall be located in room 326. The medical cart will be taken to all medical emergencies and a medical stretcher will be kept on the medical elevator at all times.
3. The Zone Supervisor will include as part of her/his regular duties an inspection of the medical elevators to ensure that the medical stretcher is on the medical elevator. This inspection must be conducted at least twice daily ani all efforts will be exhausted to replace the stretcher if it is not on the elevator.
4. The Chief Nurse is responsible for ensuring that the Charge Nurse restocks the Medical Emergency Cart per the inventory sheet as prescribed after each emergency. If it is necessary to restock the Medical Emergency Cart when the pharmacy is closed, back up medication will be stored in the psychotropic medication room.
5. The security bubble on each cellblock, the medical unit and the receiving and discharge unit shall be equipped within 60 days with an Ambu Bag to assist with mouth-to-mouth resuscitation and an Addis Wonder Knife or an equivalent emergency rescue tool to assist in cutting down hanging victims. Pending the receipt and installation of this equipment, each of the aboveidentified security bubbles shall be equipped with blunt-nosed scissors. All correctional officers shall be trained in the most effective use of the Ambu bag, .emergency rescue tool aid bluntnosed scissors v:rthin 14 days of the installation of the equipment.
D. Ambulance Inspection and Restocking
1. The supervisory nurse is responsible for certifying that the ambulance has been sanitized and restocked at the beginning of each shift and after each use. The nursing assistant will sanitize the ambulance. The EMT will restock the ambulance and oversee sanitizing the unit after each use. Two separate log books will be maintained: one to indicate each medical run and the other to indicate each inspection. Both log books will be certified by the Chief Medical Officer bi-weekly. Maintenance documentation will be completed by the DOC Transportation Unit.
2. The DOC ambulance assigned to the Jail will be operated and maintained in full compliance with all applicable laws

-#

•#

and regulations of the United States and the District of Columbia. The ambulance shall not be used for any purpose other than emergency medical transport and shall not be used in circumstances necessitating advanced life support. The DOC must certify in writing to the Special Officer and plaintiffs' counsel when the DOC ambulance can be operated in accordance with the applicable laws and regulations of the United States and the District of Columbia. Until the DOC provides this written certification, only 911 will be used for all emergency medical transports.
E. Training
1. All medical staff and correctional personnel assigned to the Detention Facility shall receive C.P.R. training and training regarding the identification and appropriate clinical response to medical emergencies through DOC's in-service training program within 30 days. The training will include the following areas: medical emergencies such as asthma, heart attacks, strokes, seizures, outward effects of diabetics, hangings and other psychiatric emergencies. Refresher training will be held each year for all staff.
2. All medical staff and officers assigned to the Detention Facility will receive training in this emergency response protocol within three weeks. Refresher training will be held for all staff on an annual basis.
F. Officers' Duties
1. The duties of each and every correctional officer described in this procedure shall be specified in their respective post orders.
III. Effective Date
1. The defendants .shall immediately inclement the policies and practices outlined In this protocol.

ATTACHMENT A

Medical Emergency Log Boole Form

Patient's Name:.

DCDC No.:

Housing Unit:

Date:

If transportation was used, circle one: 911 DOC ambulance

Time Medical Staff Notified of Emergency:

Time Medical Staff Responded to Patient:

Identity of MERT Team Members who Responded:

Nature of Emergency:. Describe Medical Intervention:

Outcome:
Full Name and Title of Staff Member Completing this Form:
Comments:
THIS FORM MUST BE INSERTED IN EMERGENCY LOG

ATTACHMENT B

SUPPLY INVENTORY

Emergency Box Proventil Epinephrine (1:1,000) (1:10,000) Benadryl 2% Lidocaine Sodium Chloride .9% Isuprel HCL .2 mg/ml Narcan .4mg Atropine .4mg Monoject (Insulin reaction jell) Ipecac Nitrostat Bottle . 4mg Ammonia Inhalants Surgilube Syringes 35cc Butterflys Scissors Tongue Blades Compazine 5 mg/ml

1 inhaler
10 injectable 1 injectable 1 injectable 1 bottle 1 bottle 50 ml 2 vials 1 box 2 vials 2 packs 1 bottle 1 bottle 1 box 1 tube 2 2 2
12
1 vial

Page 2 Supply Inventory
Angiocaths Syringes 3cc Gloves Oxygen Tubing Ambu Bag and mask 2nd Emergency Box Laryngoscope and blade Oral Airway IV tubing Mask Sterile Gloves Oxygen Mask Angiocaths Syringes 3cc Endotracheal Tubes Alcohol pads 4x4 Oxygen tank Stretcher Stethoscope Blood Pressure Cuff Nasal Cannula

@

2 2 1 box 2 1

v

l

2

2

2

2 pair

2

2

2

3

,

l box

6 packs

1

1

1

1

2

Page 3 Supply Inventory
Tape IV Solution Lactate Ringers Normal Saline Flashlights

1 roll
1 1 2

TUBERCULOSIS SCREENING, PREVENTION, AND TREATMENT PROCEDURE AID PROTOCOL
I. Introduction
The parties, in consultation with the Special Officer and her experts, agree that this Tuberculosis Screening, Prevention, and Treatment Procedure and Protocol, filed with the Court on April 11, 1994, will govern the policies and procedures regarding tuberculosis screening, prevention and treatment at the Central Detention Facility pursuant to the November 9, 1993 Consent Order issued in Campbell v. McGruderf C.A. No. 1462-71 and Inmates of D.C. Jail v. Jackson. C.A. No. 75-1668. The defendants understand that they are obligated to promulgate policies which implement this protocol.
II. Procedures
A. Intake Procedure for Male Inmates
1. Upon entry into the Central Detention Facility, all male inmates, except those with a documented prior positive PPD reading or a documented negative PPD reading within the prior three (3) months, will be screened for tuberculosis (TB) with the Mantoux skin test. The Mantoux skin test Is to be administered by intradermal injection of purified protein derivative (PPD) of killed tubercle bacilli on the inmate's inner forearm by a licensed medical provider.
2. All incoming inmates will have a chest x-ray within 24 hours except asymptomatic inmates who have had a documented normal chest x-ray within the previous six (6) months. Lead aprons will be used to minimize radiation to the gonads.
3. Any inmat* exhibiting a clinical indication for a chest x-ray, i.e. fever, cough, weight loss, recent exposure to TB, or a new conversion to positive PPD status, shall have a chest x-ray within 24 hours regardless of the date of his last chest x-ray.
4. All new male intakes shall be housed on the intake cellblocks and fully segregated from inmates on other cell blocks until the results of the PPD test and chest x-ray are read and a negative TB result is determined. The intake units shall be evaluated within 60 days to determine if the ventilation is
adequate. The identity of the inspectors and the standards to be
applied will be determined by the parties in consultation with the Special Officer within 30 days.
B. Intake Procedures for Female Inmates
1. All incoming female inmates, except those with a documented prior positive PPD reading or a documented negative

PPD reading within the prior three (3) months, shall have a PPD test. All inmates shall have a screening test for pregnancy during intake.
2. The results of the pregnancy test shall be obtained within 24 hours. If the pregnancy test is negative, the female inmate shall have a chest x-ray within 24 hours. Lead apron screening shall be used.
3. Pregnant inmates who are PPD negative shall be tested for anergy to a panel of two or more antigens in addition to the PPD. All anergic patients shall have a chest x-ray. Lead apron screening shall be used.
4. A pregnant inmate shall only be x-rayed if she is PPD positive or exhibits signs or symptoms of TB. Lead apron screening must be used.1
5. All new female intakes shall be housed on the female intake tier of the female cellblock and segregated from the other inmates until the results of the PPD test and chest xray are read and a negative TB result is determined. The intake units shall be evaluated within 60 days to determine if the ventilation is adequate. The identity of the inspectors and the standards to be applied will be determined by the parties in consultation with the Special Officer within 30 days.
C. Reading and Recording of PPD Test3 and Chest X-rays
1. The Chief Medical Officer of the Jail shall designate a sufficient number of licensed health care providers on each shift who will be responsible for the reading of PPD tests and the proper documentation of the results of all TB screening tests in the inmates' medical records. These individuals shall be responsible for the tracking of PPD tests and chest x-rayr in accordance w,ith a protocol to be developed by the TB Coordinator or an appropriately trained and qualified individual by May 18, 1994.
2. The site of the PPD injection is to be examined for any reaction by a designated licensed health care provider within 48 to 72 hours after implantation.
3. The diameter of any induration is to be measured, disregarding erythema or bruising. The result of this PPD reading is to be charted on the form appended as Attachment A and
1 With proper lead apron screening, there is no contraindication to x-raying a pregnant woman who has signs and symptoms of TB. Chest x-ray using proper lead screening is essential in these inmates.

placed in the inmate's medical record.

(mm) :

4. The PPD reading is to be recorded in millimeters Positive - 10 mm or greater induration

Negative - 0 - 4 mm induration

Questionable - 5 - 9 mm induration

Consider questionable reading to be positive if:

* patient is HIV positive;
* patient has had a close recent contact with an infectious person; or
* patient has an abnornal chest x-ray consistent with TB.
If the reaction is swollen, red and painful, but there is no measurable induration, the PPD may have been given subcutaneously. If it appears that the PPD was improperly administered, it should be repeated, but only after 10 days from the original date of administration, to avoid the booster phenomenon.

5. Chest x-ray readings are to be recorded on the forms appended as Attachments A and B.

D. Preventive Therapy
1. PPD tests are to be repeated annually for all inmates.
2. All inmates with a positive PPD should he evaluated for INH prophylaxis treatment when a negative chest y ray rules out active disease. Evaluation shall include the performance of liver function tests (SGOT, SGPT, Alkaline Phosphatase, Total Bilirubin).

3. Medical providers shall advise inmates of the potential risks and side effects associated with TB prophylaxis prior to prescribing the medication. Inmates who are prescribed TB medication solely as prophylaxis have the right to refuse the medication. Inmates who are PPD positive, but without active disease, are not subject to medical holds for refusing prophylactic medication.

4. The following PPD positive patients shall receive INH preventive therapy:

* Under 35 years old;

* previously untreated or inadequately treated persons with abnormal chest x-rays consistent with old healed TB - under 35;
* persons with HIV infection - any age; * close contacts of infectious TB cases - any age; * new tuberculin convertors: persons nho have had a
history of negative PPD or a change in size greater than 6 mm increase in skin test reaction within a two year period - any age; * persons of any age with medical conditions that increase the risk of TB infection, including:
- Silicosis - Diabetes Mellitus - Prolonged corticosteroid therapy - Immunosuppressive therapy - Hematologic and reticuloendothelial
diseases - End-stage renal disease - Intestinal bypass - Postgastrectomy - Chronic malabsorption syndrome - Carcinomas of the oropharynx and upper
GI tract - 10% or more below ideal body weight
5. Inmates over 35 years of age may be offered prophylactic treatment but the risks of liver toxicity must be clearly explained.
6. If an inmate is PPD positive and has an abnormal chest x-ray consistent with TB, the inmate shall be referred for TB therapy. HIV counseling and testing shall also be offered to any inmate who is PPD positive.
7. Prophylactic treatment shall be given as follows: Isoni zid (INH) 300 mg daily or',900 mg 2x wer xly. Inmates who are HIV negative shall receive this course or treatment for 6 months. Inmates who are HIV positive shall receive this course of treatment for 12 months. This medication shall be given on a watch-take basis to ensure that the inmate ingests the medication. This involves watching the inmate swallow and checking the hands and mouth to ensure compliance.
8. Inmates receiving prophylactic INH shall be evaluated to determine if Vitamin B 6 therapy is necessary with particular attention to inmates with past or present signs or symptoms of neuropathy and inmates with signs of »alnourishment. Inmates who are HIV positive shall receive multivitamins.
E. Positive Chest X-rav or Symptomatic Inmate
1. Any inmates with an abnormal chest x-ray consistent
4

with TB or with symptoms of TB, i.e., productive cough, coughing up blood, weight loss, loss of appetite, lethargy, weakness, night sweats, or fever shall be referred for therapy and to D.c. General Hospital for a sputum smear and culture within 24 hours.
2. Until the results of the sputum smear or culture are known, the symptomatic patient is a "suspect" case and shall be placed in respiratory isolation which conforms with the guidelines established for respiratory isolation by the Centers for Disease Control (CDC).
3. In accordance with D.C. Health Regulations, Chapter 5, Section 8-5:104, the medical provider who identifies any suspected or diagnosed case of TB must report to the Bureau of Tuberculosis Control in writing within 48 hours of diagnosis or the appearance of suspicious symptoms by completing the attached Tuberculosis Case Report form. (See Attachment C>* The medical provider shall also provide a duplicate copy of the Tuberculosis Case Report to the TB Coordinator at the Jail for monitoring and follow-up.
P. Isolation
1. Inmates with active or suspected TB shall be transferred to isolation rooms that conform with current CDC guidelines in the Correctional Treatment Facility (CTF) or D.C. General Hospital until they are no longer infectious. Respiratory isolation rooms must have separate ventilation to the outside, negative air pressure in relation to adjacent areas, a minimum of six room air exchanges per hour, and properly shielded ultraviolet lights.
2. Any inmate who has had a positive sputum smear shall not be released from isolation until three (3) negative sputum smears are collected on consecutive days and the patient is receiving appropriate therapy.
3. Procedures such as sputum collection, bronchoscopy and the administration of aerosolized pentamidine are to be conducted at the CTF or D.C. General Hospital in an appropriate treatment room or booth with negative pressure in accordance with current CDC guidelines. Patients are to remain in the treatment room or booth until coughing has subsided.
4. DOC shall obtain proper inspections of the isolation rooms at the CTF annually.
2 This may be sent by facsimile in accordance with the correspondence appended as Attachment D.

6. Treatment

1. The following medications are used for the

treatment of TB:

Isoniazid (INH)

300 mg daily or

900 mg 2x weekly

Rifampin (RIF)

600 mg daily if greater than 50 kg 450 mg daily if less than 50 kg or same dosages 2x weekly

Pyrazinamide (PZA)

20-30 mg/kg daily or 50 ag/kg 2x weekly

Ethambutol (EMB) OR

25 «g/kg daily or 50 Mj/kg 2x weekly

Streptomycin

1 g» 2x weekly

2. Inmates receiving TB treatment shall be evaluated to determine if Vitamin B 6 therapy is necessary with particular attention to inmates with past or present signs or symptoms of neuropathy and inmates with signs of malnourishment. Inmates who are HIV positive shall receive multivitamins.
3. When symptoms and/or results of PPD test, chest xray, and sputum smear suggest active pulmonary TB, the inmate should be placed on a TB treatment regimen of medications as follows:

Regimens

Recommended Treatment Regimens

HIV Negative

HIV Positive

Initial Phase
Continuation Phase

2 months INH/RIF/ PZA/EMB daily
4-7 months INH/RIF daily or 2x weekly

2 months INH/RIF/ PZA/EMB daily
10 months INH/RIF daily or 2x weekly

Total

6-9 months

12 months

4. The treatment regimen of each patient shall be determined in accordance with the culture and sensitivity laboratory test result.

5. "Watch take" requirements should be implemented for all patients with evidence of active TB to ensure that the inmate ingests the medication.
6. Inmates with clinically active disease shall receive sputum examinations in an appropriate treatment room or booth with negative pressure at D.C. General Rospital or the CTF in accordance with standard medical practice, at least weekly until sputum conversion and then monthly until discharged. Discharge from the hospital or CTF will be based on the acquisition of three negative sputum smears an consecutive days.
7. Persistence or reappearance of organisms in the sputum smear necessitates an immediate evaluation of compliance with the medication regimen and the performance of drug susceptibility tests. All inmates shall remain in isolation until three consecutive sputum smears are negative.
H. Side Effects of Medication
1. Clinical staff who administer TB medications must be familiar with common side effects and adverse reactions. Specific protocols for management and evaluation of side effects shall be developed and the clinical staff shall receive the appropriate training.
2. The following patients should receive careful monitoring when given INH:
* Dilantin users - may need to decrease Dilantin; * Alcohol users - higher incidence of INH hepatitis; * Previous INH users - discontinued due to headaches; * Concurrent use with other medications.
3. If an inmate exhibits signs or symptoms of drug toxicity, the medication shall je discontinued and the Bureau of Tuberculosis (202) 724-2191 shull be contacted; for expert advice.
4. Expert advice for the handling of adverse reactions to medications and for the management of complicated cases (i.e., drug resistance, extrapulmonary disease, or disease in pregnant women) will be obtained from the Bureau of Tuberculosis Control at (202) 724-2191.
I. Refusal of TB Screening Procedures - Medical Hold
1. Any inmate who refuses any TB screening procedure
shall be placed on "medical hold" for the protection of the prison community. A medical hold is the process by which an inmate is placed in an isolated area when refusing to accept screening, diagnosis, or treatment for a communicable disease which poses a public health threat to the safety of the inmate or

others.
2. Any inmate placed on medical hold due his/her refusal to participate in TB screening shall receive immediate, comprehensive and appropriate education from a licensed health care provider regarding the refused procedure at the time of refusal. All available literature regarding TB shall be provided. Inmates on medical hold shall receive counseling daily
from the TB Coordinator regarding the importance of the screening
procedure. Inmates on medical hold shall also be seen daily by a physician or physician assistant in order to observe any signs or symptoms of TB. Proper documentation of each visit by the TB Coordinator and physician or physician assistant shall be noted in the medical record.
3. If the inmate does not consent to the screening procedure within two weeks, and the inmate shows no signs or symptoms of TB in the judgment of a DOC physician, s/he shall be released to the general population. When a Medical hold is extended beyond the initial two week period, the requirements of section I, paragraph 2 remain applicable.
J. Inmate Education and Referral tnffnnnnunityServices
1. When an inmate's PPD is read, the licensed health care provider shall distribute and explain written educational materials regarding TB control, prevention and treatment. The TB Coordinator shall be responsible for selecting appropriate materials in Spanish and English written at a basic literacy level.
2. When an inmate is prescribed INH or any other medication as TB prophylaxis or treatment, written information regarding follow up care in the event of release from the Jail during the course of treatment shall be given and explained. This information shall < irect th,e inmate to contact Dr. James Wills, Area C Chest Clinic, 1905 E Street, S.E., Washington, D.C., 20003 at (202) 727-5155. The TB Coordinator shall develop the form to be provided and explained.
3. The TB Coordinator shall monitor daily the releases from the Jail to determine if any inmate on TB medications has been released. The identity of any such inmate shall be reported to the Bureau of Tuberculosis Control and the Area C Chest Clinic.
4. If the release date of an inmate taking TB medication is known to be prior to the completion of the inmate's treatment regimen, the inmate shall be provided with a two week supply of the prescribed medication upon release along with written instructions to contact the Area C Chest Clinic.

K. Tuberculosis Coordinator
1. The DOC shall hire a properly credentialed and appropriately trained full-time TB Coordinator to work at the Jail by April 18, 1994.
2. The TB Coordinator shall monitor the ongoing screening program at the Jail for continuity of care and followup. The TB Coordinator shall be responsible for monitoring TB intake screening, inmates placed on prophylactic treatment, inmates with active disease, inmates placed in the hospital for therapy, and those placed on medical hold related to TB.
3. The TB Coordinator shall function as the liaison with the Bureau of Tuberculosis Control, D.C. General Hospital and the laboratory.
4. The TB Coordinator shall obtain a comprehensive daily list of all persons undergoing intake physical examinations with TB screening. Results of PPD tests and chest x-rays shall be placed on the appropriate forms by the medical staff and monitored daily by the TB Coordinator. Hie TB Coordinator shall develop a protocol for the tracking of PPD tests and chest x-rays to be approved by the Chief Medical Officer of the Jail by May 18, 1994. The TB Coordinator shall monitor all inmates receiving prophylactic treatment or treatment for active TB.
5. The TB Coordinator shall maintain an accurate account of inmates tested, cleared, inmates not tested, inmates on medical holds, and referrals for inmates released into the community.
6. The TB Coordinator shall coordinate referrals and discharge planning for inmates receiving TB prophylaxis or treatment.
I
7. The TB Coordinator shall monitor the case reporting to the Bureau of Tuberculosis Control to ensure that all appropriate cases are reported properly and within the required time limits.
8. The TB Coordinator shall monitor at least monthly all inmates taking anti-TB medications. Special attention shall be given to inmates who are taking other medications or who have a history of alcohol abuse or liver disease.
9. The TB Coordinator shall develop and implement an educational program regarding TB for the inmate population, including monitoring the distribution of any written materials that are to be provided to the inmates housed at the Jail.
10. The TB Coordinator shall answer directly to the

Chief Medical Officer of the Jail and shall provide information and education to other providers at the Jail. The TB Coordinator shall submit a monthly report to the Chief Medical Officer at the Jail and the Bureau of Tuberculosis Control.
11. The TB Coordinator shall coordinate in-service training which will be provided to all staff at the DOC training academy. Specialized training will be provided to clinical staff by specialists from the Public Health Commission, Bureau of Tuberculosis Control, community hospitals and from other correctional institutions regarding clinical signs, symptoms, and treatment issues involving TB.
12. The TB Coordinator shall be responsible for conducting any contact investigations when pulmonary or laryngeal TB disease is suspected or diagnosed.
13. The TB Coordinator shall be responsible for developing a tracking system to provide notification to the medical units at other DOC facilities when a patient under treatment for TB or on prophylaxis is transferred from the Jail. This duty may be delegated to another licensed health care provider, however, the TB Coordinator is responsible to ensure that it is developed and implemented.
L. Contact Investigation
1. Whenever pulmonary or laryngeal TB disease is suspected or diagnosed, all close contacts should be skin tested unless there is a documented history of a positive skin test. Close contacts include all cell mates, all inmates and staff on the same tier, or all inmates and staff in the same building who share air, and visitors who have shared airspace.
2. The "concentric circle" approach can be used to determine the extent of contact dnvestigation needed First, identify thore persons who were ^nost likely to have jeen infected by the source case. This first group should include: persons who shared breathing space with the source case for the longest time, persons who may have spent less time with the source case but are immunosuppressed; and persons who have TB symptoms. If positive PPD tests are identified among persons in this first group or "circle" ( with no previous history of TB infection), new infections have probably occurred. Expand the investigation into widening circles until PPD testing identifies a group of persons with no evidence of new TB infection
3. If exposure was less than 10 to 12 weeks prior to PPD testing, a contact with a negative PPD test should be retested 10 to 12 weeks after the initial negative PPD test.
10

•-•i..'

ray:

4. The following contacts should receive a chest x-
a) those who have a positive skin test — greater than 5 mm;
b) those with a history of a positive skin test; c) those who are HIV positive, regardless of skin
test results.

If the chest x-ray is negative for evidence of the disease, these contacts should receive preventive therapy, unless medically contraindicated.

5. During contact investigations, the confidentiality of the infected person must be maintained.

M. Screening of DOC Employees

1. All DOC staff shall be strongly encouraged to receive PPD tests annually and these tests shall be made available to all employees free of charge. The defendants shall determine whether mandatory testing can be required and shall report to the Special Officer and plaintiffs1 counsel within 60 days regarding this matter.

N. Review of Protocol

1. This procedure and protocol shall be reviewed annually by the DOC Assistant Director for Health Services to determine if any revisions should be made in light of new developments in the treatment of TB. Any proposed revisions shall be submitted to the Special Officer for approval. Plaintiffs' counsel must be advised of all proposed revisions to this document.

III. Effective Date
i
1. The defendants shall immediately .mplement the policies and procedures set forth in this document.

11

ATTACHMENT A
D.C IPARTMENT OF CORRECT . JNS HEALTH SERVICES
TUBERCULOSISSCREENING

o = i. i ps . si

Date:

1. Patient has / has not had previous skin testing for tuberculosis.

2. Last PPD was done on

_ at

and was neg / pos.

3.Mantoux skin testing was performed on

by (initials)

4. Date read:.

Results:

mm Induration which is neg / pos. (initials)

5. Chest X-Ray done on, tuberculosis.

is neg / positive / suspicious for active

6. Recommendations:

Patient's Name:
D.O.B.:

(Last)

Race:

(First)

DCDC #:
Sex:

*• Center for Disease Control recommends that an Induration of 3mm or greater In the imnjunocompromlsed be considered positive. In the non-lmnjunocomprombed host, an Induration of 10mm or greater U positive.

•i, u >J 3 z> c

ATTACHMENT B

PATlENtS loeNTtFICATTON

Aoe sex Pf«

NAMC DOS
ococ»

EXAMINATION AEQUE8T6O ( J ROUTINE CMEST
QOTHER

FACIUTY

REQU6STIO8Y

K R T I N E N T CUNICAU HIS TORV, OPEAAtiONS. PHYSICAL FINOINOd. AND PROVISIONAL OtAONOSIfl

fS. SI dbW

PWSONANT OfSB

\ ^NQ^

DATE OF REQUC8T

DAT? OF EXAMINATION <lnokj4*y*tr) RAOKXWAPHIC REPORT

DATEOfHEPORT

OATH OP TRANSCRIPTION

MO SIGNATURE IDP8 I M 7

AAOIOLOGY BEQUEST I REPORT

Name U*st) Address Marital Status
Occupation

ATTACHMENT C

OF THE DISTRICT OF CC ^IBIA

DEPARTMENT OF HUMAN SERVICES

TUBERCULOSIS CASE REPORT

(Hrtt)

(middltlmsidea)

SSN •

Telephone

Sex Race D Black
Q White

D American Indian or
Alaskan Native Asian or Pacific Islander

Ethnic Orgin D Hispanic D Not Hispanic

School or Place of Employment

Address

Oate of Report

/

/

Oate of Birth

/

/

Country of Orgin if not U.S.

Oate arrv. In U.S.

Classification
• a Tuberculosis: current disease a Tuberculosis no current disease • Tuberculosis Suspect:
a Tuberculosis Infection No disease
(It applicable)
OMS • 1*47 (A*v. 3191) I-11M-1 -fl-360

Diagnosis

Bacteriology

O Pulmonary O Non-Pulmonary (sptdty)

D Miliary

D Meningitis

PCS. NEC Pending Not Oone

Smear D D D

D

n a Culture a

a

• Bones & • • Pleural Join;*

Type of Specimen

a Sputum

Q Fluid

D Lymphatic D Peritoneal

D Tissue • Other (specify)

• GenitoUrinary

O Other (specify)

D Reported at time of death

(date(s) of collection

SIGNS & SYMPTOMS

Laboratory Performed

Chest X-Ray
Q Not done • Normal D Abnormal
• Cavitary D Non-cavitary O Stable • Worsening Q Improving
DATE OF X-RAY

Tuberculin Skin Test

D Not done D Mantouz (PPD)

D Tine

a Other

(specify)

a Significant Not Significant

D

.mm

Chemotherapy Dosage

D Isoniazid

Q Ethambutol _

D Rlfampin

D Pyrazinamide

n Streptomycin

D Other

(specify)

itient to be followed by: DMMENTS:

] Send Additional Report Forms aported by (Print Name)

Signature

Previous diagnosis D Yea date /

D- No

Hospitallzation

Chart No Admission Oate:

Discharge Date:.

Office or Hospital Address

)uce No.

Ward

TO BE COMPLETED BY HEALTH DEPARTMENT

Census Tract

Oate Recorded in Registry

Case

Verified

ATTACHMENT D

5 Z - >_ t ~6 .

GOVtRNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF HUMAN SERVICES WASHINGTON. D. C. 2OOO2

•$. 5

IN REPLY nzrcn TO-

To wnosi it may concern:

November 20, ".990 D.C. Commission of Public Keaisn
3ureau of Tuberculosis Control 1905 S St., S.E.
Washington, D.C. 20003

Tne 3urea.u of Tuberculosis Control, Registry,'has installed a racsTBrrre- (FAX) machine to be used for tne expressed purpose of receiving both case ani laboratory reports of suspected and confirmed tuberculosis from nealtn care providers.

Tne Fax machine will be available for receiving reports 24 nours a day, including weekends. It is anticipated that tne availability of tne Fax macnine w i n improve both tne 'timeliness and the accuracy of Tuberculosis case reporting.

Tne District of Columbia requires, as written in tne D. C. Healtn

Regulations, for communicable and Reportable Diseases, cnapter 5,

1963, section 8-5:104 Denomination of Communicable Diseases: "tne

following diseases

Tuberculosis

are hereby

denominated communicable diseases and snail be reported in writing

within 48 hours of diagnosis or tne appearance of suspicious

symptoma in tne manner Indicated in sections 8-5:106 and 8-5:107 of

this part. The transmission of case and laboratory TB reports by

Fax macnine within 48 hours of diagnosis, fully satisfies tne

reporting requirements of the D.C. Healtn Regulations.

The Bureau of Tuberculosis Ccntrql, Registry Fax mac&ine telephone number la: 202-724-2363- I there are any questions regarding the use of the Fax machine, please call Glenn Acham, Supervisory Public Health Advisor, at 724-2193.

sincerely yours,

P.S.

HazeT M. Swann, M.D., Chief Bureau of Tuberculosis control
Enclosed is a letter to Infection Control Practitioners, dated September 18, 1990, regarding the reporting of tuberculosis cases.

OHl-IOf

MEDICAL EMERGENCY RESPONSE PROTOCOL
I. Introduction
The parties, in consultation with the Special Officer and her experts, agree that this Medical Emergency Protocol, filed with the Court on April 11, 1994, will govern the. policies and procedures regarding the response to medical eaergencies at the Central Detention Facility pursuant to the November 9, 1993 Consent Order issued in Campbell v. McGruder. C.A. No. 1462-71 and Inmates of D.C. Jail v. Jackson. C.A. No. 1462-71. The defendants understand that they are obligated to promulgate policies which implement this protocol.
II. Procedures
A. Notification and Response
1. Any employee who determines that a medical emergency exists shall immediately notify the Command Center using the Emergency Direct Line Communication system where possible, or by calling extension 38136 through 38144. If an emergency occurs in a location where there is no telephone, the employee will go to the nearest telephone, or notify the Command Center by walkie talkie. The employee will then return to the location of the emergency.
2. The employee placing the call will give all necessary information to the Command Center Officer including the location of the injured or ill person, type of injury or illness, and if the injured person is conscious.
3. The Command Center Officer will immediately page the Medical Emergency Response Team (MERT) Leader. The Command Center Officer will then imrediately notify a supervisor and the Sic) Call Officer by the Direct Line Communication System, and inform tiem of the location of the person, type of injury or illness, and if the injured person is conscious. The Command Center Officer will then make the emergency announcement over the public address system. The Command Center Officer will only relay the location of the injured person on the public address system. The Command Center Officer shall also notify the Shift Commander who will immediately dispatch a correctional officer to ensure the proper operation and reception of the medical elevator on the floor where the emergency exists.
4. The respective Zone Supervisor will immediately respond to the location of all medical emergencies. The Supervisor will assist the MERT and ensure full cooperation by the correctional force to include timely correctional coverage, as well as security and escort requirements. Other correctional duties may include lifting residents onto stretchers.

5. The MERT will immediately respond to all medical emergencies with the portable emergency medical cart. They will use the medical elevator for all medical emergencies- A service elevator will be used when the medical elevator is inoperable. All employees will assist the MERT as requested.
6. The MERT Leader is responsible for directing emergency care and treatment. The MERT Leader shall determine the means of transportation to D.C. General Hospital, if necessary, and shall call 911 in all life-threatening emergencies.
7. The MERT Leader shall notify the Shift Commander when an injured person must be transported to D.C. General Hospital. The MERT leader shall inform the Shift Commander of the means of transportation, i.e., 911 or DOC ambulance. The Shift Commander shall facilitate the entry of the 911 staff as well as the prompt dispatching of EMTs and other designated staff for operation of the DOC ambulance. When the DOC ambulance is inoperable, 911 will be used for all emergency transfers to D.C. General Hospital.
8. The MERT Leader is responsible for ensuring that all medical emergencies are documented on the Medical Emergency Information Form immediately after each emergency. A copy of the form is appended as Attachment A. All completed Medical Emergency Information Forms shall be filed in a MERT log. The Sick Call Officer shall record all emergency call information in the Sick Call Officer's log-book.
B. Medical Emergency Response Team Composition
1. The MERT will be composed of three medical personnel. The MERT Leader will be a physician, with two other licensed medical providers (nurses or physician assistants).
2. The Chief Medical Officer is responsible for devising and porcing a MERT schedule that includes alternates. This schedule will be completed by the second Monday in January and July of each year. The posting of the schedule will be accessible to the Sick Call Officer who must review it at the beginning of each shift.
3. The MERT Leader will wear a pager while on duty at all times. The pager will be transferred from MERT Leader to MERT Leader on each shift.
C. Location and Inspection of Emergency Medical Equipment and Supplies
1. The on duty charge nurse is responsible for having the emergency medical cart and the portable crash boxes inspected at the beginning of each shift and will make an entry in the

designated log books indicative of same. The Sick Call Officer in charge is responsible for inspection of the medical elevator and on board stretcher at the beginning of each shift. The officer will ride the elevator to all floors and check the operation of the gate locks on all floors. The inspection of the medical elevator and gate locks shall be noted in the shift activity report.
2. The elevator key shall be kept in the Infirmary Control Bubble and the Emergency Medical Cart shall be located in room 326. The medical cart will be taken to all medical emergencies and a medical stretcher will be kept on the medical elevator at all times.
3. The Zone Supervisor will include as part of her/his regular duties an inspection of the medical elevators to ensure that the medical stretcher is on the medical elevator. This inspection must be conducted at least twice daily and all efforts will be exhausted to replace the stretcher if it is not on the elevator.
4. The Chief Nurse is responsible for ensuring that the Charge Nurse restocks the Medical Emergency Cart per the inventory sheet as prescribed after each emergency. If it is necessary to restock the Medical Emergency Cart when the pharmacy is closed, back up medication will be stored in the psychotropic medication room.
5. The security bubble on each cellblock, the medical unit and the receiving and discharge unit shall be equipped within 60 days with an Ambu Bag to assist with mouth-to-mouth resuscitation and an Addis Wonder Knife or an equivalent emergency rescue tool to assist in cutting down hanging victims. Pending the receipt and installation of this equipment, each of the aboveidentified security bubbles shall be equipped with blunt-nosed scissors. All correctional officers shall be trained in the most effective ur?e of the Ambu bag, ,emergency rescue tc ol and bluntnosed sciss /rs within 14 days of the installation of the equipment.
D. Ambulance Inspection and Restocking
1. The supervisory nurse is responsible for certifying that the ambulance has been sanitized and restocked at the beginning of each shift and after each use. The nursing assistant will sanitize the ambulance. The EMT will restock the ambulance and oversee sanitizing the unit after each use. Two separate log books will be maintained: one to indicate each Medical run and the other to indicate each inspection. Both log books will be certified by the Chief Medical Officer bi-weekly. Maintenance documentation will be completed by the DOC Transportation Unit.
2. The DOC ambulance assigned to the Jail will be operated and maintained in full compliance with all applicable laws

and regulations of the United States and the District of Columbia. The ambulance shall not be used for any purpose other than emergency medical transport and shall not be used in circumstances necessitating advanced life support. The DOC must certify in writing to the Special Officer and plaintiffs1 counsel when the D O C ambulance can be operated in accordance with the applicable laws and regulations of the United States and the District of Columbia. Until the DOC provides this written certification, only 911 will be used for all emergency medical transports.
E. Training
1. All medical staff and correctional personnel assigned to the Detention Facility shall receive C.P.R. training and training regarding the identification and appropriate clinical response to medical emergencies through DOC's in-service training program within 30 days. The training will include the following areas: medical emergencies such as asthma, heart attacks, strokes, seizures, outward effects of diabetics, hangings and other psychiatric emergencies. Refresher training will be held each year for all staff.
2. All medical staff and officers assigned to the Detention Facility will receive training in this emergency response protocol within three weeks. Refresher training will be held for all staff on an annual basis.
F. Officers' Duties
1. The duties of each and every correctional officer described in this procedure shall be specified in their respective post orders.
III. Effective Date
1. The defendants shall immediately implement the policie , and practices outlined In this protocol.

ATTACHMENT A

Medical Emergency Log Book Form

Patient's Name:.

DCDC No.:

Housing Unit:

Date:

If transportation was used, circle one: 911 DOC ambulance

Time Medical Staff Notified of Emergency:

Time Medical Staff Responded to Patient:

Identity of MERT Team Members who Responded:

Nature of Emergency:. Describe Medical Intervention:

Outcome:
Full Name and Title of Staff Member Completing this Form:
Comments: THIS FORM MUST BE INSERTED IN EMERGENCY LOG

ATTACHMENT B

SUPPLY INVENTORY

Portable Emergency Box

Proventil

Epinephrine (1:1,000)

(1:10,000)

Benadryl

2% Lidocaine

Sodium Chloride .9%

Isuprel HCL .2 mg/ml

Narcan .4mg

Atropine .4mg

Monoject (Insulin reaction jell)

Ipecac

Nitrostat Bottle .4mg

Ammonia Inhalants

Surgilube

'

Syringes 35cc

Butterflys

Scissors

Tongue Blades

Compazine 5 mg/ml

Quantity of Supplies 1 inhaler
10 injectable 1 injectable 1 injectable 1 bottle 1 bottle 50 ml. 2 vials 1 box 2 vials 2 packs 1 bottle 1 bottle 1 box 1 tube 2 2 2 12 1 vial

Page 2 Supply Inventory
Angiocaths Syringes 3cc Gloves Oxygen Tubing Ambu Bag and mask 2nd Emergency Box Laryngoscope and blade Oral Airway IV tubing Mask Sterile Gloves Oxygen Mask Angiocaths Syringes 3cc Endotracheal Tubes Alcohol pads 4x4 Oxygen tank Stretcher Stethoscope Blood Pressure Cuff Nasal Cannula

2 2 1 box 2 1

. 1

2

2

2

2 pair

2

2

2

3

.

1 box

6 packs

1

1

1

1

2

Page 3 Supply Inventory
Tape IV Solution Lactate Ringers Normal Saline Flashlights

1 roll
1 1 2

 
 < V

^to 191994

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al., Plaintiffs,

)

C.A. No. 1462-71

)

(WBB)

v.

)

ANDERSON McGRUDER, et al., )

Defendants.

)

INMATES OF D.C. JAIL, et al. , )

m
c~>
CO m
rn —_ o

Plaintiffs,

v. DELBERT C. JACKSON, et al.,

C.A. No. 75-1668 (Cases consolidated before
Judge William B. Bryant)

Defendants.

NOTICE OF FILING Pursuant to the April 20, 1993 Order appointing her Special Master in the above-captioned matters, and with the consent of the defendants, the Special Officer retained James Balsamo to evaluate environmental health and safety at the D.C. Jail. During August of 1994 Mr. Balsamo conducted an audit of the Jail. This audit Ailminated in a report which was issued oy Mr. Balsamo in November of 1994. Mr. Balsamo's report, which is attached hereto, describes many substantial violations of this Court's Orders related to environmental health and safety and also sets forth recommendations for curing each violation. The Special Officer provided the parties with copies of Mr. Balsamo*s report and recommended that the defendants develop a

own.

The Special Officer adopts Mr. Balsamo's findings as her
Campbell v. McGruder

JC-DC-001-068

proposed corrective action plan and implementation schedule that could be submitted to the Court for approval. The defendants have failed to meet the deadlines established by the Special Officer for submission of a proposal to cure the deficiencies identified in Mr. Balsamo's report. However, defendants' counsel advised the Special Officer today that the defendants may be able to submit a proposal by the last day of January, 1995. Accordingly, if this matter cannot be resolved informally by the end of January, 1995, the Special Officer shall submit a report recommending that the Court impose contempt sanctions and that the Court order that the defendants implement the recommendations made by Mr. Balsamo.

Date: December 16, 1994

Grade M. Lopes Bar No. 358650 Special Officer of the Court 1130 - 17th Street, N.W. Washington, D.C. 20036 (202) 778-1168

Certificate of Service

I hereby certify that a copy of the Notice of Filing was

mailed first class, ppostage prepaid, on this IU

day r£ $jm^-*-~ —

1994 to the following:

Richard S. Love, Esq. David Flyer, Esq. Correctional Litigation Section Office of the Corporation Counsel 441 - 4th Street, N.W. Room 6S065 Washington, D.C. 20001

J. Patrick Hickey, Esq. Tara Flynn, Esq. Shaw, Pittman, Potts & Trowbridge 2300 N Street, N.W. Washington, D.C. 20037

- 2-

Jonathan Smith, Esq. D.C. Prisoners' Legal Services Project, Inc. 1400 - 20th Street, N.W. Suite 117 Washington, D.C. 20036
- 3-

m
RECEIVED
ENVIRONMENTAL HEALTH AND SAFETY SURVEY
DISTRICT OF COLUMBIA JAIL WASHINGTON, D. C. ON AUGUST 1-5, 1994 BY
J . BTOSAMO, J R . , M . P ^ H . , CSP, R . S .

I, James J. Balsamo, Jr., was retained by Grace M. Lopes, Special Officer of the United States District Court for the District of Columbia to evaluate the District of Columbia Jail during a visit August 1-5, 1994.
Prior to this inspection, I was provided with two Reports of Environmental Health and Safety Inspections of the District of Columbia Jail prepared by the Department of Consumer and Regulatory Affairs (DCRA) and these were reviewed prior to my inspection. I later received for my review, a copy of the Department of Corrections abatement plan which was prepared in response to the May 1994 DCRA Environmental inspection of the jail facilities. During my inspection of the jail facilities, I spoke with many jail personnel, both correctional officers and administrative personnel and reviewed on site documents that related to safety and environmental issues.
My findings and recommendations are based on all of the above information, but especially my tour of the facility.
In summary fashion, fire safety, food sanitation, housekeeping and general cleanliness, insect and rodent control, disaster preparedness, clothing issues, staff knowledge and training and inadequate written policies and procedures are issues that must be corrected in order to provide a safe, clean, and healthful environment for the inmates. Bloodborne pathogen and tuberculosis awareness and training are not being adequately addressed.

I. Introduction

I toured this facility after having read the detailed

environmental reports of the District of Columbia Department

of Regulatory Affairs. My findings corresponded very well

with the July 18, 1994 report in so far as sanitation and

safety are concerned. Many cells have very dirty walls and

floors; showers are filthy and rusty; flying insects near the

showers are in evidence; lighting is inadequate in the cells;

pest control is inadequate; vents are obstructed; inadequate

bedding and clothing is provided; water temperatures in

showers and lavatories are not well regulated; food sanitation

in the kitchen is poor; and, some plumbing fixtures are in bad

repair. Bloodborne pathogen and fire safety training, food

service staffing, and refrigerated and non-refrigerated

storage space, is totally inadequate.

Electrical and

plumbing systems need upgrading and ventilation and

temperature control needs to be updated.

Because of this, I did not feel the need to repeatedly list these items in each and every cell or area. I summarized the items with which I am concerned, discussed the problems and attempted to offer reasonable solutions.

II. Inspection Results
The twenty-five major issues that need attention in order to improve the safety and sanitation in this facility are as follows:
A. Fire Exits
Problem:
Fire exits at the rear of the cell blocks are not readily available for inmate egress.
Discussion:
Section 6, page 6-3, of the description of the fire protection system of this facility as designed states: "All stairs are locked, unlike ordinary buildings, therefore quick access to emergency keys is essential for basic safety of the building occupants. All exterior doors can be unlocked only from the exterior therefore the need for a quick and deliberate response in the event of a fire cannot be stressed enough. There are three areas where inmates may be relocated or evacuated:
1. Other interior portions of the facility 2. The recreation yard

3. The periphery of the building
Use of the periphery for evacuation poses a more serious problem from a security standpoint. Review of all Fire Department Procedures by correctional personnel on a regular basis is recommended to assure that a positive and aggressive policy is available for use during any fire emergency."
I was told that in the event of a fire on a tier that would require evacuation through the exit at the rear of the unit, an officer would be sent to the command center to get the key and proceed to the periphery exit doors. This officer is not pre-designated and would have to be identified at the time of the emergency. Someone in authority should be pre-assigned to make sure this assignment is carried out. This should be part of the fire emergency plan and be part of the drill process and critique.
I asked if any training is provided with respect to this task and is it part of the drill. Security Lt. Givan said that he is not aware of any such training.
I then asked to be shown the exits on the perimeters of the building and determine if the locks worked. After about ten (10) minutes of futile efforts to get a key to the recreation yard the proper key was secured from the locksmith. When we did enter the recreation area, it was learned that we could not get to the perimeter of the building from the recreation yard. We then went back into the building and exited the perimeter area through the staff exit. Finally arriving at the fire exit doors at the ground level, correctional officers tried to open the doors and were unable to open them with the set of keys they said were for the doors. After going back to the command center, another set of keys were secured from the locksmith. Upon returning to the perimeter of the building, '.he exterior fire stairwell doors were opened, but the correctional officers were unable to open the interior doors leading to the inmate confinement units.
This took approximately forty-five (45) minutes and the exercise was unsuccessful. This points out that this vital part of the fire exit plan is in shambles and is not a routine part of the fire drills held at this facility. Not having keys readily available for safe escape and not being able to open the rear exit doors on the housing units, thereby creating "dead end" corridors, is prohibited by the 1986 APHA "Fire Protection and Fire Safety Practices Standards." Plans for extra security, when this avenue of evacuation must be taken, must also

be part of the overall exit plan. Keys for fire exiting purposes are clearly not readily available and it should be recognized that there is only one (1) locksmith for this entire facility and he had to determine which keys to use to open these exits. When he is on vacation or is sick, who is the person with the knowledge to be able to provide the needed information on keys and locks. If a fire occurs when he is off work what alternate plan is available to have someone with his knowledge available? Even the facility officer in charge of Security and keys could not find the correct keys.
Solution:
1. The keys for these perimeter locks understandable must be secured at all time, but must be readily available if needed or time and lives may be lost in a fire emergency.
Standard: 1986 APHA Standard for Correctional Facilities (APHA-SCF), Part 8-D^3 F&G
2. A fire safety plan must incorporate fire exit access and evacuation in a pre-determined plan of action in coordination with the Washington, D. C. Fire Department and jail personnel. This must become part of all fire drill exercises.
Standard: 1986 APHA-SCF, Part 8-D-3 G & M
3. Plans and personnel assignments requirements SCBA's to be brought to the unit for search and evacuation purposes is not in the version of the Fire Drill/Evacuation of Housing Units plan provided for my review. This must also be part of the plan and be part of the fire drill exercise.
Standard: 1986 APHA-SCF, Part 8-D-3 L N, 0
4. Many of these perimeter doors are rusted and are in need of immediate repair.
Standard: 1986 APHA-SCF, Part I-D-3 F, G & M
B. Training and Documentation
Problem:
Civilian employee training for such things as fire safety, bloodborne pathogens, and hazardous materials is lacking. Fire safety training for correctional personnel at this facility only began in June 1994.

•&••
Discussion:
In speaking with correctional, maintenance, and other civilian personnel, it became very clear that civilian personnel have not received fire safety training and that correctional officers had just begun their on-site fire safety training. The duties of civilian personnel during such emergencies are not fully understood. If in fact they have any such assignments.
In trying to determine if correctional personnel understand the hazards of the chemicals they use, sometimes in inmate areas, I feel there is a great lack of such knowledge. They have a right to know the hazards of such chemicals and how to protect themselves and others (including inmates) when these materials are used. Material Safety Data Sheets (MSDS) could not be located in this facility.
Solution:
1. Institute a "Chemical Right to Know" Program for officers and civilian staff to include the provision of MSDSs and how to read them, the hazards of such chemicals, and the methods of protecting themselves, and others in the area, from the hazards of such chemicals.
Standard: 1986 APHA-SCF, Part 8-D-l H and OSHAHazard Communication Standard
2. Provide fire safety training to those civilian employees who have a role in fire safety at this facility and continue officers training.
Standard: 1986 APHA-SCF, Part 8-D-3 0
3. Bloodborne pathogen training shouJ d be provided to all employees, civilian and corre tional officers, who may be exposed to blood and body fluids as part of their job. This is to include the laundry staff and inmates working in the laundry, as well as correctional officers and other staff in this facility. This is not being done.
Standard: 1986 APHA-SCF, Part 8-D-l H and OSHA Bloodborne Pathogens Standard
4. All training should be documented.
Standard: 1986 APHA-SCF, Part 8-F-l

C. Housekeeping
Problem:
The entire facility has many areas that are extremely dirty, making these areas unhealthy for the inmates.
Discussion:
In checking the various housing units and reviewing the reports of the District of Columbia Department of Consumer and Regulatory Affairs, it is very apparent that the showers, cells, and storage closets are very dirty, harbor roaches and flies, and are very odoriferous. Showers have corrosion and scum on them. Lt. Bonaparte, who supervises the Environmental Squad which assists in abating sanitary problems, was very helpful during our visits to the housing units. The "Environmental Squad" assists in cleaning common areas such as vent shafts, utility rooms, etc. They also remove trash from the cell blocks. Inside cell blocks, inmate details clean the showers and some cells of those who will not clean their own areas. In SE-3, food cartons and other items were noted in the ventilation shaft in the utility room. Standing water was noted on the floor outside of NE-3.
In SO-2, inmates claimed that they are not provided with buckets and brushes to clean their cells. Sgt. Cooper said that they are given soap, sanitizers, and brushes to clean their cells. The inmates say that sometimes this is done but there are not enough to go around to all cells.
In SW-2, lower left tier, there are broken valves, water standing on the floor, cobwebs, and dirt in the janitor's closet.
In N-2, lower right tier, cell number 55, there are no mattress covers provided; the l£/atory runs constantly; floor tiles are missing; moisture is on the floor; and, the cell is generally dirty. In this same area, the utility closet door between cells is filthy and clogged with dust and dirt. Air circulation is impeded especially when smoke evacuation is necessary.
In the intake area, paint is peeling and corrosion exists in the showers and on stall dividers. Scum is on the floor of the shower area and mildew is present on the ceiling.
Cells in SE-3 are dirty and in cell number 56 a yellowish-brown scum was evident in the toilet. The

inmate said only a few brushes are available and they try to get them but are not always successful.
In the two-man cells in NW-2, the cells have very dirty walls and floors.
These are just some examples of the sanitation problems which also include roaches, mice and other insects but which will be discussed in a separate section.
Solution:
1. A Housekeeping Plan must be developed for this facility to include cells, day rooms, storage areas, showers, utility areas, loading dock, and receiving areas. This plan should identify areas to be cleaned, frequency of cleaning, assignments to make sure cleaning is done, procurement plans for securing appropriate and needed items, training needs of jail personnel as to how to obtain needed supplies for their areas, schedules for the cleaning various cells per day, and adequate storage areas for supplies. This must also include a schedule of trash removal from the cell blocks. This is called a "Program Cleaning Schedule or Guide" listing surfaces and fixtures to be cleaned and methods and chemicals to clean these various surfaces and fixtures. If facility personnel can not do this, an executive housekeeper accredited by the National Executive Housekeeping Association could be retained to develop such a plan.
Standard: 1986 APHA-SCF, Part 8-B-5 & 9
2. A routine inspection of all cells must be undertaken weekly by correctional officers and reports of deficiencies sent to the highest ranking person who can effect compliance.
Standard: 1986 APHA-SCF, Part 8-F-2
3. The housekeeping plan should include a schedule whereby all mop heads are cleaned daily or they are used for a short limited number of days, such as one or two days, and then discarded. The laundry does not process the nopheads and I could not find anyone who knew if they were ever cleaned. They must also be put on a programmed cleaning schedule.
Standard: 1986 APHA-SCF, Part 8-5
4. The Housekeeping Plan must include the types of
7

V-v
chemicals and their use strengths, and the types of cleaning implements needed for cleaning the walls, floors, toilets, and showers. The floors should be cleaned, using an appropriate cleaning solution, in a two-bucket system. The buckets must be emptied as they become soiled after cleaning several cells. The buckets must be cleaned and air dried each day.
Standard: 1986 APHA-SCF, Part 8-5
D. Clothing
Problem:
Insufficient underwear, socks, t-shirts, and jumpsuits.
Discussion:
Underwear and socks are not issued at intake. One d*y each week Officer Smith, the clothing issue officer, sends a package of six socks, six t-shirts, and twelve underwear (shorts) to each cell block to be issued to those inmates supposedly most in need of then. Cell blocks such as SW-2 holds one hundred forty (14 Of inmates and the small number of socks, t-shirts, and underwear is insufficient. Officer Smith said if he had to issue underclothes at intake he would need more storage space. Because of this, inmates often wash their underwear in buckets and toilets. They say if they send these to the laundry, they may never get them back and they don't have but one or two sets. Some floors have washing nachines and dryers for inmates to wash their own personal items, but this doesn't exist throughout the jail. The dryer was broken in one area where provided. Upon admission inmates are issued two shirts and pants or two jumpsuits according to jail personnel. Several female inmates in Housing Unit SO-3 said they got one jumpsuit, one bra, and one pair of underwear. When they turn in one jumpsuit they ge - one. This is done twice a week. Mr. Singleton, Laundry Superintendent, said that clothing is exchanged twice a week. Mr. Smith, clothing issue person, made very confusing and often conflicting statements as to clothing exchange schedules. He said he has it (the schedule) in his head and it is not written anywhere.
Solution:
1. Adequate amounts of underwear should be provided to all inmates so they can have at least one change of clothing per week.

Standard: APHA-SCF, Part 8-E-l
2. Provide more space in the clothing issue area so this increased amount of clothing can be stored.
Standard: APHA-SCF, Part 8-E-l
3. Increase the equipment capacity of the laundry to handle personal clothing or extend the work hours of the laundry so they can process the increased load.
Standard: 1986 APHA-SCF, Part 8-B-6
4. Personal laundry bags need to be issued to the inmates with their names on them so they can be returned with clothes intact.
Standard: 1986 APHA-SCF, Part 8-E-l an<? B-6
5. An alternate plan to increasing the laundry size or capacity is to provide adequate washers and dryers on each cell block and assign tier workers to wash these items. Bags with the inmates name could be used so the bags, with contents could be returned to the correct person.
Standard: 1986 APHA-SCF, Part 8-B-6
6. A written plan must be put in place so there are three exchanges of clean towels per week and one exchange of clothing per week for each inmate. Inmates assigned to work details must be provided with at least three changes of clothes per week. If this takes more clothing, then the current supply may be inadequate and must be corrected.
Standard: 1986 APHA-SCF, Part 8-E-l
E. Purchasing System
Problem:
Inadequate monitoring of requested equipment and nonrequests for Material Safety Data Sheets (MSDSs) for chemical items purchased.
Discussion:
During my inspection in August 1994, it was learned that one of the large washers had been non-operational since about June 2, 1994, nearly two months. Mr. Roland

Singleton, who operates the laundry, said that he was told the jail could not get any parts because there is no money. Mr. Singleton is unaware of any further status of the broken washer. Officer Etienne, procurement officer, was contacted and no record of such a request on an appropriate form, BUS 2, could be found. Apparently the request was not put on the appropriate form and no one has been checking to see why the washer is still broken.
It should be noted that inmates fill the chemical containers for the washing machines and no HBDSs are available in the laundry for such chemicals as Fluor-ocide, Perchloroethylene, and Dowper Solvent.
Mr. Fillard of the Receiving Department has no MSDSs.
Also, Officer Etienne stated that no requests for MSDSs have been made when items are requested through her office. In summary, there is no concentrated effort to acquire MSDSs for the chemicals used in this facility.
Solution:
1. All areas of the jail, including the laundry need to be checked and an inventory of all chemical based materials made. Then MSDSs for these materials must be secured from the manufacturers or distributor and kept in locations where personnel who use these materials, including inmates, can be trained how to read MSDSs and how to protect themselves from hazards listed on the MSDSs.
Standard: 1986 APHA-SCF, Part 8-D-l H and OSHA Hazard Communication Standard
2. Every purchase order for chemicals such as dry cleaning chemicals, cleaning solutions, soaps, bleaching agents, etc. must contain a statement requesting a current MSDS. These should be collected, kept in a central location and copies sent to the areas where these chemicals are being used. Only Sgt. Poe of the Environmental Squad receives MSDSs and if he does not get them for the materials he orders, he calls and requests them. These are only for chemicals he uses.
Standard: 1986 APHA-SCF, Part 8-D-l H and OSHA Hazard Communication Standard
3. When a request for equipment parts or repairs is made, there must be put in place a system to periodically check and determine if the request is
10

being processed and if not why! Personnel should be taught which forms are to be used when requesting items.
Professional observation and need to maintain adequate institutional controls.

4. Based on the hazards of the chemicals noted in the

laundry area (as will be noted when MSDSs are

received and reviewed) environmental sampling for

the hazardous chemicals must be undertaken to

determine if the inmates (and also facility

employees) are being subjected to dangerous levels

of these chemicals. I was told that OSHA and

District Environmental people have done some type

of air studies in the laundry but laundry personnel

did not know what tests were done nor the results

of such tests. MSDSs state the acceptable airborne

levels. I was told by Mr Singleton, Laundry

Superintendent, that if there is a chemical spill,

he would clean it up with a blanket and discard the

blanket. The proper procedures are listed on the

MSDS and his stated actions may constitute improper

disposal of hazardous materials.

Purchased

chemicals must be accompanied by MSDSs.

Standard: 1986 APHA-SCF, Part D-l H and OSHA Hazard Communication Standard

F. Insect and Rodent Control
Problem:
An inadequate and in-effective pest control program now exists at this facility.

Discussion:
Starting in the intake area, roach iriestation is very apparent. The reasons include the fact that the showers provide for high humidity in the area, food is eaten in the area, vents are blocked in the clothing storage room, where inmates's old clothes are kept for three weeks, and Sgt. Davis said that the area is not treated for roaches.
Many roaches were noted in the laundry, as it is very warm and humid in the area and the inmates eat there. Roach infestations were noted throughout the facility including the Pharmacy, infirmary bathroom, inmate cells, janitor closets, pipe chases, the dry storage areas of the dietary facility, and the storage areas under the stairs in the cell areas.
11

Only one rodent burrow was noted on the perimeter of the building near the loading dock but this means there are several more borrow openings concealed in the area. Dead mice and mice droppings and nesting material were noted under the stairs in Units SE-3 and N-2 lower right. Rats were sighted and movement was heard in the warehouse area. The canteen, pipe chases and utility closets show evidence of mice infestation. Officer Hicks, the pest control exterminator and facility Fire Marshall says that he cleans dead rodents from pipe chases and tries to rebait the area. He said the entire jail was once baited but he has not had time to go through the entire jail for rebaiting purposes. He started keeping a log in June of 1994 of the areas treated and baited.
Some types of flying bugs were noted in many showers in the areas surrounding the showers and in the floor drains in front of the showers. They are drawn there because of the constant wet and unsanitary condition of the showers, utility closets, and janitor rooms in the immediate area. Water is standing in the open areas and most probably under and around the showers thereby giving rise to the infestation of these insects.
Officer Hicks stated that spraying of the jail takes place weekly but he also said that the housing units are not completed except every three months. The entire jail is covered approximately only two times a year. No spraying is done in the intake area. Mr. Charles told me that all 1,800 cells and administrative offices are treated every six weeks. This is apparently a goal but is not realistic with the personnel now performing the task. Mr. Charles is the licensed pest control person for nine institutions and four half-way houses in the District. He uses personnel at each facility to perform daily tasks.
Mr. Charles told me that every t me he comes to this facility they assign a different person to work with him and he has to again train that person and looses time and momentum in his quest to provide adequate pest control for this facility. Mr. Charles told me that he rotates roach spraying chemicals every two to three weeks. This may not be the best procedure if it takes three months to get back to an area to spray and if resistance to a pesticide is the reason for rotating the materials. Resistance is a factor to be considered, however there should be some written technical information to support this effort. If resistance to some type of synthetic pyrethrins is suspected, there are products which require a long period before resistance is noted.
12

Solution:
It is my considered opinion that the program now in effect and operated as it was operating in August 1994 is ineffective and needs to be greatly upgraded. I believe a reputable Pest Control Company like Prism could offer this facility the manpower and knowledge base to effectively bring this institution's pest control problem under control. After a concerted effort and control is achieved, they may be willing to train and advise adequate numbers of in-house personnel in the proper methods of pest control. This facility could then maintain the program with oversight by Prism. Special problems could then be dealt with quickly and effectively, thereby preventing the problem from becoming overwhelming. The industry is now using the words "Integrated Pest Control Management" (IPM). This is the effective use of all tools, not only pesticides, to control insects and rodents. Sanitation is a major part of any pest control program as is eliminating entry, travel and ideal harborage sites. I have enclosed an article to give you some idea of the elements of an IPM Program. IPM includes inspections, housekeeping, the elimination of harborage areas, physical, mechanical, and chemical means of control. These include the use of moisture control, temperature control, electric fly traps, glue boards, sealing of openings and the use of general use and restricted pesticides.
Standard: APHA-SCF, Part 8-B-10 and Professional Evaluation
G. Ventilation:
Problem:
There are areas in this facility where adequate air circulation especially in the shower, utility rooms, storage rooms, and cell a' eas is not being provided. This leads to odors, mold and mildew build-up, slip and fall events, and insect control problems.
Discussion:
In general, ventilation control is poor and is exacerbated by inmates obstructing the vents in their cells. They do this mostly because they say it is too cold or too hot in an area. I was informed that in the new section of the cell blocks, return air is monitored for temperature control and automatically adjusts. In the old section this is done manually, but because manpower is short, this activity is limited. In these
13

times, with tuberculosis becoming a major health problem, proper ventilation for disease prevention is very important. The obstruction of vents must become an issue jail personnel will have to deal with during their daily and weekly tours of the facility. If proper balance of air volume and temperature is achieved, I feel most inmates will stop obstructing the vents and enforcement will help with the remaining inmates who insist on such actions.

Ventilation in two-man cells is of special concern. In some areas the mal-odor is very pronounced. Areas where inmates have occluded the vent opening usually fit in this category. APHA Standards call for a minimum of 7 cfm of outside air or recirculated air with 33% being fresh air. Air flow volumes varied from 22-87 cfm in cells in the NW-2 area and from 34-94 era in cells in the SE-3 area. In N-2 LR the air volume was measured at 33 cfm and in SW2-LL air volume varied from 31-49 cfm. This is adequate volume, however these measurements were taken at non-occluded vents. Also, please note in many cells, the vents were obstructed because there is too much air and it either makes the cells too cold or too hot. Inmates take charge and effectively block the flow for temperature reasons and interfere with the proper flow of air. Better volume control and temperature regulation could make inmates' actions unnecessary.

Many janitor closets and utility closets where mops and buckets are kept, have inadequate or no ventilation and this leads to mold and mildew build-up, insect harboraging, and odors. The vents in the intake clothing store room has been sealed with plastic and the area is very odoriferous.

Solutions:

1. Proper balancing of air in the housing units to

provide air at 7-1' cfm per inmate of outside air

or recirculated air that has 33% fresh air make-up

provided.

Higher volumes can be used if

temperature controls are adequately maintained.

Standard: 1986 APHA-SCF, Part 8-1
2. Temperature control of at least 65°F during the coldest months must be maintained and temperatures at other times should be comfortable for sedentary type living. If it is too cold in the cells
because the combination of low temperature air and
high volume, the inmates will continue to obstruct the openings and unbalance the system.

14

i
Standard: 1986 APHA-SCF, Part 8-2 E
3. Proper enforcement of the obstruction of the ventilation system by inmates through cell inspections will also help maintain a balanced ventilation system providing comfortable air temperatures.
Standard: 1986 APHA-SCF, Part 8-B-2 E
4. The janitor closets and utility closets need to be properly ventilated so as not to be breeding areas for roaches, flying bugs, mold and mildew, and offensive odors. Ventilation will help dry out mop heads and mop buckets.
Standard: 1986 APHA-SCF, Part 8-B-5
H. Staffing of Maintenance Department
Problem:
Inadequate control of hot water systems in the cell area, inadequate control of temperatures in the housing units, dirty vents in pipe chases, dirty, dingy discolored walls in cells and poor upkeep of the showers in so far as corrosion and mildew are concerned.
Discussion:
The above listed items are items that require painters, not plaster foremen, and plumbers not pipe fitter foremen. In looking at the maintenance staff list of authorized positions only four vacancies exist. Maintenance management, when questioned, said they need plumbers and painters and another locksmith instead of plasterers and pipe fitter forenen. I feel that some positions need to be reassigned to the needed trades. Even though addi -ional personnel may be needed because maintenance personnel from this facility also provide much maintenance at other facilities operated by the Department of Corrections, a reassignment of positions would lessen this need.
Only one locksmith is at this facility and the other authorized position is vacant. If he get sick or goes on vacation a serious problem exists at this facility.
Solutions:
1. Review the authorized staffing levels to determine if the authorized positions «eet today's needs.
15

Professional observation for adequate staffing/maintenance.
2. Bring the maintenance staff up to full authorized level.
Professional observation for adequate staffing/maintenance
3. While implementing item #2 above, reassign those vacancies to needed positions such as painters and plumbers.
Professional observation for adequate staffing/maintenance
4. Current staff allocations need to be changed to reflect current needs. Strict adherence to an old outdated staffing pattern does not appear to be serving this facility well.
Professional observation for adequate staffing/maintenance
5. The position of locksmith must be immediately filled to provide assistance with repairing fire door locks, cell door locks and providing keys for areas in emergency situations. Only the locksmith knew which keys opened the rear stairwells in the housing units.
Professional observation for adequate staffing/maintenance
I. Staffing and Training in the Food Service Area
Problem:
Both civiliftii staff and inmate staff are below t.iat needed to provide for adequate preparation and delivery of food to the inmates and for proper cleaning and sanitizing food contact surfaces, equipment, walls and floors in the food service area. Inadequate numbers and ill-trained inmate workers present a truly serious food safety issue.
Discussion:
Food contact surfaces are not being properly sanitized as workers are not using a sanitizing agent in the solution used to wipe down these surfaces. This is needed to prevent cross contamination of foods.
16

©
Pots and pans are being inadequately cleaned in that food particles were noted on four of four pans checked.
Standing water is in evidence on the floor of the milk refrigerator. Hand soap is not provided at the lavatory in the kitchen and food from a freezer that went out the night before was delayed in being moved to a working unit.
Mr. Sanders, the steward, said that he is authorized to have a thirty-five (35) «an detail and he is getting only seven (7) man details. He has four civilian food service workers who have little time to train or supervise inmate workers because they have to actively cook all foods.
On August 2, 1994, on Unit 2N, sliced meat registered 80°F and the beans registered 120°F.
On August 3, 1994, the time delay between tray preparation and delivery to inmates was 30-45 minutes and the spaghetti which had registered 150°F on the serving line now registered 112°F when served to the inmates. Food must be served to inmates at 140°F.
The freezer inside the kitchen registered 10°F and it should be at or very near zero. The garbage disposal unit drain is in bad repair. It is draining to the floor. The meat slicer, which was said to be cleaned, contained food particles. Food was uncovered in the refrigerator.
The blast freezer located in the warehouse registered 48°F and the turkey inside the freezer registered 20°F. Food was still being stored in this inoperative freezer. This was discovered early in the morning and at about noon, a D.C. Sanitarian, Mr. Howard Maupin, had to advise Mr. Fitzgerald that he could use a standing order to get. a freezer truck delivered to the jaiT so the freezer contents could be moved to a properly temperature controlled freezer.
On the day of this inspection, Mr. Fitzgerald, the Food Steward, said that there were not enough single service trays for dinner, but he expected a shipment to arrive very soon. There is inadequate storage space provided.
A hand sink was being used for cleaning foods and this must be stopped. A three-compartment sink was not being used correctly.
Solutions:
17

1. Adequate inmate staffing to a full complement (long term inmates should be considered for this detail) will allow the civilian staff to supervise and train the inmate workers so that the problems noted in the discussion can be corrected.
Standard: 1986 APHA-SCF, Part 8-B-4-2
2. More training for the Food Steward and the four civilian workers so that they can transmit proper food handling information to the inmates. Knowledge of the ability to activate a standing order for a freezer trailer when a freezer breaks needs to be provided to all supervising personnel, especially the Food Steward.
Standard: 1986 APHA-SCF, Part 8-B-4-2
3. Adequate food supplies and cooking and holding equipment should be reviewed in light of routine operations and especially during disaster situations. More storage spaced is needed.
Standard: 1986 APHA-SCF, Part 8-B-4-3 & 4
4. The proper way to set up a three-compartment sink must be better transmitted to those responsible for equipment cleaning and sanitizing.
Standard: 1986 APHA-SCF, Part 8-B-4-2
5. A system must be put in place so food service equipment and systems can be quickly (without delay) repaired.
Standard: 1986 APHA-SCF, Part 8-B-4-3
J. Fire Safety
Proclem:
Fire safety issues such as the flammability of mattresses used in this facility, obstructed fire dampers, an inoperative fire department notification system, the absence of a hot work permit system, inadequate knowledge of fire extinguishers, and the lack of a written preventive maintenance and servicing schedule for fire extinguishers are serious problems that must be corrected. Smoke detector testing is not being routinely accomplished and documented. There are no extinguisher service contracts for refilling ABC and C02 extinguishers nor is hydrostatic testing part of a service contract.
18

Fire drills must be conducted in all areas and on all shifts.
Discussion:
Neither the flammability of the covered foam mattresses and the cotton mattresses nor the provision of mattress covers for each inmate upon assignment to a cell, could be determined. Because some foams emit very toxic combustion products this information is needed. Also, because of the dense population in this facility these need to be as fire resistant as possible.
Hot work permits should be issued at a central point, either at the command center and/or at the maintenance office before either jail maintenance personnel or outside contractors are allowed to do any hot work, welding or cutting, in the jail. The permit lists pertinent fire safety instructions to those doing hot work. Also, when the job is completed, correctional officers and/or correctional facility maintenance personnel can go back to the area later to check for any smoldering fires. An example is appended to this report.
In the clothing issue area, there is a flex conduit traversing the openings in the fire damper and this prevents the fire damper from closing properly.
When the Coded Gamewell Fire Alarm Manual Station, located in the Command Center, was activated in order to directly notify the fire department of a mock fire emergency at this facility, the unit did not work.
Corporal Hicks answers to Lt. Bonaparte and keeps tract of fire extinguishers and their monthly checks, yearly maintenance inspections, six year refills, and twelve year hydrostatic tests. No written Departmental Operating Procedure (DOP) exists for this function in so far as I could determine. A water ( xtinguisher in 2-SO had no pin in it. The water extinguishers in the laundry had no pin in one of them and the pin was pulled on the other one. The last annual maintenance of these extinguishers was September 1992, which is greater than one year. The gauges indicated that the extinguisher maintained a full charge. In the clothing issue area one carbon dioxide (C02) extinguisher had no pin or seal on it and no inspection date was noted on it. The gauge on the water extinguisher in the clothing issue area was in the "unsafe" zone and it had not been checked since April 1992.
In Unit NE-3, Correctional Officers T. Jenkin and C. Bush
19

m

&

did not know what type of fire the C02 extinguisher was effective against. Officer Jenkin could not lift the extinguishers. The safety pin on the C02 extinguisher had been pulled out of its proper position. The water extinguisher in the bubble had no pin in the extinguisher handle and it had been discharged. Neither officer had reported the condition of these extinguishers nor really knew how to use these extinguishers. In the bubble of N1, two ABC extinguishers had been discharged. One pin was in place and the other one was missing, however the condition of the extinguisher had not been reported.
Smoke detectors were checked one time when they were installed about a year ago. Mr. Simpson stated that these are single station smoke detectors and only sound in the area where smoke or a fire is detected. No smoke detectors are in the air return system according to Mr. Simpson.
Fire extinguishers are checked monthly and this is documented on the grey sticker on each extinguisher. Carbon dioxide (C02) extinguishers are weighed if they do not have a pressure gauge on them. A policy needs to be developed stating how yearly maintenance and inspection service, six year refilling and inspections and twelve year hydrostatic tests will be carried out since service contracts for these services do not exist.
Fire drills are never conducted on the 10:00 p.m. to 6:00 a.m. shift when the laundry is operational according to laundry personnel.
Solutions:
1. The flammability of all mattresses used in this facility must be determined and those not providing adequate fire protection should be discarded. Foams should be checked tc make sure they do not give off toxic combustion products.
Standard: 1986 APHA-SCF, Part 8-D-3 A & C
2. A "Hot Works Permit System" with appropriate DOP should be instituted for this facility.
Standard: 1986 APHA-SCF, Part 8-D-3 E & B
3. The flex conduit traversing the fire damper in the clothing issue area must be removed and re-routed.
Standard: 1986 APHA-SCF, Part 8-D-3 F

20

4. The Gamewell Fire Alarm Manual Station needs to be repaired so a direct signal of a fire emergency can be sent to the D. C. Fire Department.
Standard: 1986 APHA-SCF, Part 8-D-3 J
5. A Departmental Operating Procedure must be developed to set forth the tine table and actions to be taken with reference to the upkeep of all fire extinguishers in this facility after a complete fire extinguisher inventory has been made. Monthly checks of all extinguishers must be undertaken to help find and replace defective extinguishers.
Standard: 1986 APHA-SCF, Part 8-D-3 J
6. Proper fire extinguisher training must be undertaken at this facility and such training must be documented.
Standard: 1986 APHA-SCF, Part 8-D-3 0
7. Smoke detectors must be provided in sleeping areas, areas of public assembly, in boiler rooms, kitchens, laundry, shops, and other work areas of the facility. The detectors now in place must be checked at least twice a year or at a frequency that can assure the proper operation of these units.
Standard: 1986 APHA-SCF, Part 8-D-3 K
8. A fire extinguisher policy must be developed that includes provisions delineating how monthly checks, annual maintenance inspections, six year refills on ABC extinguishers and twelve year hydrostatic testing will be accomplished and documented.
Standard: 1986 APHA-SCF, Part 8-D-3 J
9. As per APHA Standards, fire drills that include building evacuation when possible must be conducted at least twice annually for each shift and the results documented and drills critiqued. More frequent drills are recommended such as quarterly for each shift.
Standard: 1986 APHA-SCF, Part 8-D-3 N
K. Lighting in Cells and Janitor and Utility Closets
21

Problem:

Lighting levels in cells are below APHA Standards and impede good sanitation, personal hygiene and a safety. Lights in many janitor and utility closets are either inoperative, missing bulbs, or devoid of fixtures. Adequate lighting is needed to properly clean the mops, buckets, and other items stored in these utility or janitor's closets.

Discussion:

Lighting levels in cells are very low. Examples are noted below but please note, not all cells were checked.

Location & Cell No.

Lighting Levels in Footcandles

SW-2 Cell #26 SW-2 Cell #30 SW-2 Cell #74 N-2 Upper Left Cell #16 N-2 Medical Room SE-3 Cell #65 SE-3 Cell #53 NW-2 Cell #54

<20 f.c. <10 f.c. <10 f.c. No Lighting
24 f.c. <10 f.c. <10 f.c.
17 f.c.

Bulbs are missing in many utility or janitor's closets, the fixtures are broken, or the fixtures were never put in these closets. Cleaning of oops and other cleaning utensils can not be properly carried out in dark closets.

Solutions:

1. Adequate lighting must be installed to provide minimum lighting levels in cells at 30 f.c, and in medical rooms at 30-50 f.c.

Standard: 1986 APHA-SCF, Part 8-B-7 and American Society of Illuir mating Engineers Standards (ANSI)

2. Bulbs must be replaced in closets where they are missing or burned out. Electrical repairs may have to be made in some closets on the tiers. New fixtures will have to be installed in closets that have none.

Standard: 1986 APHA-SCF, Part 8-B-7

L. Hot Water for Showers and Lavatories

Problem:

22

In some areas the hot water temperature in showers and at lavatories varied from low (inadequate) to very high (scalding).

Discussion:

Examples are noted below. Please note that not all locations in this facility were checked.

Location

Hot Water Temperature

Shower SO-3

81"F

Lavatory SE-3 Cell #56

138"S

Shower 2-South

100"F

Lavatory N-l Cell #55

No Hot Water

SW-2 Cell #26 Lavatory

77°F

SW-2 Cell #30 Lavatory

78"F

N-2 Cell #55 Lavatory

No Hot Water

N-2 Lower Right Shower

80*F

N-2 Cell #65 Lower Right Lavatory No Hot Water

N-2 Cell #16 Upper Left Lavatory 87°F

SE-3 Cell #65 Lavatory

130°F

SE-3 Cell #53 Lavatory

138*F

I was told that lavatory hot water is provided from boilers in the penthouse area and that they are not the fast recovery type. Hot water for showers comes from hot water heaters on each floor and control should be possible.

Solutions:

1. Replace the hot water heating units in the penthouse with new fast recovery type and then control at these fixtures can be aaintained in the optimal range of 105-120°F but as near to 110°F as possible.

Standard: 1986 APHA-SCF, Part 8-B-8 and 8-D-l E

2. Better regulation of shower water temperature through proper settings on the mixing valves should be undertaken. The hot water heaters in the units should be regulated better.

Standard: 1986 APHA-SCF, Part 8-B-8 and 8-D-l E

The missing hot water valve rods jEst be replaced in order that hot water can be provided in all cells. Inmates should not have access to the equipment chases between cells where they can remove these rods and make shanks. These rods do

23

no appear to be able to be removed from the front of the lavatory inside the cell.
Standard: 1986 APHA-SCF, Fart 8-B-8
M. Plumbing
Problem:
Several fixtures are not properly plumbed to drain and backsiphonage protectors are not being used to protect the potable water system from contamination due to backflow.
Discussion:
Even though all areas were not checked, the following are examples of this problem.
There are three hose bibs an sinks in Receiving and
Discharge which are not protected by vacuum
breakers.
In the laundry area toilet room, the sink is cracked and the pipe under the sink leaks water on the floor. No towels are provided in this toilet room.
- Generally accepted practice dictates that fixtures (sinks) used to wash utensils and equipment have a solid waste line connection to the sewer pipes.
- Sinks used to wash (soak) foods, such as lettuce, chickens, etc. are not normally hard connected to the sewer but rather have indirect waste lines to a floor drain. This is done to protect food from being contaminated. While unattended, a drain line may bnck up into the sink where foods are located and +iien clears itself out very quickly, thereby contaminating the food without anyone knowing this ever happened.
The hot water in the mop closet in the main kitchen will not stop flowing. The valve is leaking.
There is a submerged inlet in the mop closet which is not protected by a vacuum breaker and which has the potential to contaminate the potable water supply.
The lavatory faucet in SW-2 Cell #26 will not turn off.
24

-<sxk
Solutions:
1. It should be noted that maintenance managers feel they need more plumbers and not pipe fitters to correct the above problems.
Professional evaluation
2. Vacuum breakers must be provided at all hose bibs to prevent back siphonage.
Standard: 1986 APHA-SCF, Part 8-B-8
3. All plumbing pipes from fixtures must be properly plumbed.
Standard: 1986 APHA-SCF, Part 8-B-8
4. Severely cracked sinks must be promptly replaced.
Standard: 1986 APHA-SCF, Part 8-B-8
5. Broken or leaking faucets need to be repaired.
Standard: 1986 APHA-SCF, Part 8-B-8
N. Electrical
Problem:
Electrical outlets in wet areas are not protected by Ground Fault Circuit Interrupters (GFCI) and these devices can protect people from shock in areas around sinks in the kitchen and medical areas. Some outlets are broken or cracked and some have no tension on the hot, neutral, or ground prongs thereby possibly causing a spark and fire. Some power cords are frayed and plugs broken.
Discussion:
In the laundry area, the electrical receptacles near the maintenance cabinet have no tension on the hot, neutral, nor ground prongs.
In the laundry area the ground prong on the fan power cord is broken and needs to be repaired.
In the Pharmacy, electrical cords are draped behind the
sink and the outlet is within one (1) foot of the sink. No GFIC is provided.
25

The electrical outlets in the hall in N-2 lower right are cracked and must be repaired.
The electrical outlets in the hall of N-2 lower right are not protected by GFCIs.
Solutions: (In confonnance with NFPA-70 National Electric Code)
1. All electrical outlets should be tested for polarity and tension. Those found to be wired improperly or having no tension on the hot, neutral, or ground prong must be repaired and or replaced.
Standard: 1986 APHA-SCF, Part 8-B-3
2. The ground prongs on the plugs of the equipment must keep remain intact to prevent a shock hazard.
Standard: 1986 APHA-SCF, Part 8-B-3
3. All electrical receptacles within close proximity of sinks or lavatories (i.e. wet areas) must be protected by ground fault circuit interrupters.
Standard: 1986 APHA-SCF, Part 8-B-3
4. Frayed power cords must be replaced.
Standard: 1986 APHA-SCF, Part 8-B-3
5. All cracked, burned, or broken wall receptacles must be repaired or replaced.
Standard: 1986 APHA-SCF, Part 8-B-3
Asbestos
Problem:
Asbestos, if released into the air and breathed by people, can cause asbestosis, mesothelioma, and other stomach and lung diseases or abnormalities. Many asbestos insulated pipes in the laundry area are in need of repair, especially on the ends. No asbestos management plan could be produced for this facility.
Discussion:
Mr. Burgess said that he remembered that an OSHA inspector did check the laundry about five year ago.
26

Some abatement was undertaken when new laundry equipment was installed. No management plan exists for this facility.
Solutions:
1. Repair loose and frayed asbestos materials.
Standard: 1986 APHA-SCF, Part 8-A-2 and OSHA and EPA
2. Enlist the support of a private Asbestos Inspector/Management Planner or a D. C. Environmental Quality person knowledgeable of asbestos inspections and management plans development to help inspect the facility and develop a Management Plan for handling the asbestos remaining in the building.
Standard: 1986 APHA-SCF, Part 8-A-2 and OSHA and EPA
P. Emergency Power and Lights
Problem:
There are three emergency generators which according to facility personnel are supposed to be exercised for one hour per week and tested under full load for one hour per month. This is not being done. When the generators are operating, all the systems that are supposed to be on the emergency circuits are not being checked and the information recorded. Also, there are battery powered emergency light packs in some of the bubbles that are not on anyone's maintenance schedule and several did not operate when tested. Noise levels are a problem when these emergency generators are running in enclosed areas.
Discussion:
I was told thai monthly testing under full load is th: policy at this jail, however records indicate that this was not done in January, February, or March, 1994, and not since February 1992 in the South Tunnel. I was told by a maintenance worker who just transferred back to the jail that when he was at this jail, monthly load testing was done and now that his is back at the jail, he will make sure it is again done properly.
Excessive noise levels were recorded in the North Tunnel when the generator was tested. The sound level reached
a steady 108 dBA. Sound attenuating ear protection, ear
muffs, ear plugs, etc. having at least a 30 Noise Reduction Rating must be utilized if a worker is to stay
27

in the area with the generator operating.
Also, the battery powered emergency lights in the bubbles need to be operational in case of an emergency outage.
Solutions:
1. Weekly testing and monthly full load testing in accordance with emergency generator manufacturers' instructions must be routinely performed and documented.
Standard: 1986 APHA-SCF, Part 8-B-3 and 8-F-2
2. The battery operated emergency lights in some bubbles must be put on a routine, weekly or monthly, preventive program and these checks must be properly documented.
Standard: 1986 APHA-SCF, Part 8-B-3 and 8-F-2
3. Proper hearing protectors of at least 30 Noise Reduction Rating must be worn inside the generator area when they are operating.
Standard: 1986 APHA-SCF, Part 8-D-5 and OSHA Standard
Q. Overcrowding and Inadequate Number of Showers
Problem:
Overcrowding exists in double bunked two-man cells and the showers in all areas are inadequate in number for the occupancy especially in the double bunk cells.
Discussion:
The gross size of the cells is only about 68 square i^et. Considering the space occupied by the bed, 60 square feet of floor space indicated as a requirement in the APHA Standards is not being met.
The situation becomes extremely serious in the two-man cells where the APHA Standards call for 120 square feet of floor space and less than 60 square feet is being provided.
Also, the APHA Standards call for one shower for every eight inmates and in the single man cell area the ratio is 1:10. In the double bunked cells the shower to man ratio is 1:20.
28

Solution:
Discontinue two-man cells or provide at least three more showers in these areas.
Standard: 1986 APHA-SCF, Part 8-E-3 C and Part 8-E-4 A
R- Disaster Preparedness
Problem:
Other than the fire safety and evacuation plans and the work stoppage plan there appears to be no hurricane, winter storm, tornado, flooding, earthquake, utility (electricity and water) outage, or civil unrest plans developed for this facility in so far as I could determine.
Discussion:
Emergency plans for all natural and man-made disasters that could reasonably be anticipated to occur in the area need to be developed and tested in conjunction with the D. C. emergency operations and planning units. This should include communications, food and water service, life safety, personnel deployment, and medical services.
Solution:
Prepare the needed emergency planning documents, train all personnel, and then annually test the system to determine if the plan meets the needs of the facility in emergency situations.
Standard: 1986 APHA-SCF, Part 8-D-2
S. Inadequate Bedding
Problem:
Many mattresses, including foam and cotton ones were noted without mattress coverings. The blankets are so worn, many are down to the weave only.
Discussion:
Mattress covers are needed for fire prevention purposes, sanitary reasons, and comfort. Blankets with some thermal insulating capability are needed for comfort when sleeping.
Solutions:
29

1. Provide mattresses with fire retardant covers where applicable and at least 2 sheets or 1 sheet and a mattress cover for cotton type mattresses. Sheets, mattress covers, and pillow cases must be changed at least weekly.
Standard: 1986 APHA-SCF, Part 8-E-2
2. Replace the old worn blankets with thicker, more comfortable ones that still retain some thermal insulating properties.
Standard: 1986 APHA-SCF, Part 8-E-2
T. Barberina
Problem:
Inmates are performing barbering procedures in an insanitary manner.
Discussion:
Skin disease may be transmitted either through direct contact or by objects such as towels, combs, or clippers.
Solution:
Combs, clippers and similar objects must be routinely sanitized between use on different inmates. Common brushes are not to be used. Also hands must be washed with soap and running water before cutting the next person's hair.
Standard: 1986 APHA-SCF, Part 8-C-3
U. Safety Issues in The Laundry
Problem:
Many steam pipes are not insulated at all. Eye protection and eye wash fountains are not provided in the laundry.
Discussion:
The uninsulated pipes can cause severe burns if accidently touched. Several chemicals, including a corrosive one, are used in the laundry by inmates and these materials can damage the eyes, if splashed in them.
Solution:
30

m
1. The pipes must be insulated with non-asbestos material. Standard: 1986 APHA-SCF, Part 8-D-l E
2. Provide suitable eye protection and eyewash fountains in the laundry. Standard: 1986 APHA-SCF, Part 8-D-l D & G & H and OSHA Standard
V. Bloodborne Pathogen Training and Supplies

Problem:

Areas such as the medical area and just about any area in the jail because of accidents and fights, may subject personnel to exposure to blood and body fluids. No sanitizing agents could be located in the medical facility nor on the tiers.

Discussion:

HIV and Hepatitis, as well as other bloodborne pathogens

can be transmitted by blood and body fluids and medical

and correctional officers are potentially exposed to

these substances.

Training, personal protective

equipment, vaccines, and sanitizing agents are needed to

protect jail personnel.

Solution:

1. Provide the Hepatitis Vaccine for those subject to exposure.

Standard: 1986 APHA-S .F, Part 8-D-l H and Appendix II

2. Train personnel how to protect themselves by wearing personal protective equipment when cleaning up a spill of blood or body fluids.

Standard: 1986 APHA-SCF, Part 8-D-l G and 8-F-l

3. Provide proper sanitizing solutions and waste bags,
so that spills can be properly cleaned and
sanitized and the waste properly discarded in red
or properly labelled bio-hazardous bags.

31

Standard: 1986 APHA-SCF, Part 8-D-l H and Appendix II
W. Outdated Medical Supplies
Problem:
A box of 0.9% Sodium Chloride Injection, Lot #C215 94 7 with the expiration date of June 1994 was noted in the medical unit on a cart in the hallway on August 2, 1994.
Discussion:
Outdated medical supplies could loose their effectiveness.
Solution:
Discard this box and retain properly dated materials.
Standard: 1986 APHA-SCF, Part 8-C-4 B
X. Self-contained Breathing Apparatuses fSCBA)
Problem:
SCBSs need to be positioned where they can be used for rescue purposes, by trained, medically fit, personnel.
Discussion:
Two (2) airpacks are in one of the floor control stations and one (1) unit is in the Fire Marshall's Office.
Solution:
Personnel need to ye medically qualified and properly trained to use SCBAs. The units must be located where qualified personnel can have ready access to them.
Standard: 1986 APHA-SCF, Part 8-D-3 L & 0 and Part 7-C-3
Y. Askarel Liquid Filled Transformers
Problem:
Documents describing the electrical distribution system indicate that Askarel, an oil containing Polychlorinated Biphenyls, which are said to be carcinogenic, is the transformer oil used in this facility.
32

Discussion: Leaks of this material or spread of this material in smoke should the transformers catch on fire and explode could subject personnel to PCBs and the entire facility could become contaminated. Solution: The transformer can be replaced or retro-filled with nonPCB containing cooling oils. EPA Standard and Toxic Substances Control Act
III. Conclusion There are many problems existing in this facility and not all require additional resources but the better application of existing resources. Yes, lighting, pest control, ventilation system balancing, more clothing and storage space, more refrigerated storage space and more housekeeping supplies will cost money but many things can be done in-house with current staffing. Some positions may no longer be needed and they can be replaced with the types of personnel that will help improve the facility. Training, written DOPs, and documentation should not cost very much to improve. Overall this facility can be greatly improved if the steps outlined in the body of this report are implemented.
33

I p

What's it all About Anyway?

bv Eric Snell

cian on the use of this new tool or

When you think about the term Integrated Pest Management (IPM). do you

Integrated

provide adequate understanding of cockroach movement and habits.

Management islmgice'

Other examples of what is not IPM include:

automatically think of sticky traps and bait stations? Do you think about accounts that will "accept a

than eliminating^ • Telling someone that they need pesticides"lfs3^ to clean their drains to solve a fruit
fly problem, and not providing fur-

few bugs?" Are you reminded of accounts with pests that the previous pest control company had left uncontrolled while trying to caulk cracks and use sticky traps?

knowing abouMp insects; you t r e a r "
staying one^sfr

ther assistance.
• Removing a tool used too often, such as a dust bulb, toforcea technician to use other tools.

Are you currently trying to dig through the debns of information to

ahead of themJII Evaluating IPM Needs The first step toward effectively

incorporate various components of

using IPM is choosing the tools and

IPM into your own programs? This

methods for a particular pest man-

article will discuss what components

agement program. It is important to

should be considered

be familiar with all of

crucial to the success

the tools and methods

of any IPM program

available, and then

without sacrificing

determine how effec-

program effectiveness.

tively each meets the

Integrated Pest

specific needs of an

Management means

individual program.

having access to a

For instance, one

wide variety of tools to

aspect of a German

solve pest problems in

cockroach manage-

the most effective and

ment program is mon-

efficient manner possi-

itoring. To meet this

ble. All too often,

requirement, the pos-

when describing IPM.

sible ools include:

only the products are

flash'ights. sticky

considered. For

traps, double stick

instance, the effective-

tape and various

ness of a particular

chemical flushing

bait, sticky trap, or

agents.

vacuum cleaner is doc-

Obviously the flash-

umented. IPM is more. It is a process Some tools used for erfecuve Integrated Pest Management include flashlitftts. that implies an under- caulking guns and non-toxic tracking powder, in addition to traps and baas.

light is a must for any program. The remainder of the list

standing and use of

is variable, and

an equal balance of methods and less explain what is not IPM. A perfect depends on the needs of your prodependency on one particular tool. exampie of abusing the term IPM is a gram. Sticky traps may be consid-

situation in which a company uses ered a priority during the long peri-

What is Mot IPM? ,

•c..- T ;ch bait stations as their

ods between services. The particular

Integrated Pest Management ha been defined in hundreds of wa; However, after years of being li buzz word" for the pest control

Integniied" program and then places them in the middle of a wall. This is not IPM!
In this example, the company has

flushing system(s) you choose may depend on a number of issues. For example, do you perform all services at nieht? Does the customer prep the

industry, perhaps it is best to

failed jo properly train the techni-

continued an page 76

; C ~ 3 E 3 -39* 0557CONTROL 7 5

continued from page 75

control methods between service

;&hd in a crack, immediate kill may

calls (i.e. baits), void treatment

be required. Certain chemical formu-

kitchen for each service? Do two

methods, exclusion mediods and

lations and active ingredients pro-

technicians perform every service?. communication with the customer. vide instant results. For accounts

Effective IPM programs can be

A few examples of tools and tech-

such as nursing homes or hospitals,

devised by summarizing the needs of niques that fit each of these needs various types of vacuums may be the

your accounts and considering all of are reviewed here.

ideal choice for eliminating pests

the options carefully. Once the tools

Inspection Methods: All pro-

when sighted.

have been determined, training pro- grams should include methods of

Between Service Control Meth-

grams should be completedforeach inspection. The best approach

ods: In most situations it is possible

method.

should involve on-site method(s) as to immediately eliminate only a cer-

When an adequate balance of

well as inspection systems that can tain percentage of a pest population.

tools and methods is not included

monitor pest activity between ser-

into the program, problems are likely vices.

Many of the remaining pests can be controlled with products that work

to occur. A perfect example involves

Following is a list of tools that can between services. Baits are an excel-

an IPM program that depended upon be used:

lent example, since this method

sticky traps as the primary means of

• flashlight

causes little disruption of pest behav-

inspection. The monitors were

• flushing agents (mixed or pre- ior. For methods to be effective

placed in precise locations through- packaged)

between services, it is most efficient

out a commercial

to use tools that allow the

restaurant. One

pests to live naturally, instead

particular location

of avoiding chemical residues.

was in the back

Cockroach bait stations

comer on a shelf

actually provide two crucial

under a table. This

components for pest survival

trap had no cock-

including food and harborage.

roach activity for

Other "between service" medi-

months. A kitchen

ods can be used to exploit

employee recog-

known pest activities. For

nized that the tech-

example, glueboards can be

nician was not con-

successful in controlling occa-

trolling the cock-

sional invaders (such as crick-

roaches in that

ets) entering under doors and

tocation and com-

moving close to the edge of

plained that he had

walls. By understanding how

been seeing cock-

crickets may enter a house,

roaches on the

glueboards can be used to

table.

intercept them before they are

After flushing

sighted by the customer.

with pyrethrins, a

Some of those tools

large number of

include:

cockroaches were

• cockroach baits

flushed from the

• ant baits

framing of the

• rcient baits

table, not one foot

• ne«dent traps - snap traps,

from the trap! In this illustration the

Using non-toxic powder, such program to track rodents.

as

baby

powder,

can

be

IuPsMed

in

manu•luf-lycattrcahpstrjaapr.s,ligglhute,bboaaitredds

cockroaches were

glueboards. etc.)

foraging for food on

• glueboards

the table and on the floor and had no • compressor powered void injec- Void Treatments: When pest

reason to move in the direction of

tion equipment

infestations are identified inside

the trap (i.e. onto the shelf). This

• sticky traps & glueboards

voids and out of reach, a variety of

example is not intended to diminish

• [racking patches of non-toxic methods for treating each pest

the value of the sticky trap, but to

powder

and/or void should be available. For

caution against the dependance on only one tool for a specific program need.
Selecting the IOIS
An IPM approach to a t >icai pest problem will normally fquire:

• inspection mirrors & graph
pacer •eference books
Elimination of Pest Sightings: It is otten necessary to provide at least one method for quickly killing pests when they are found in an area. For

instance, an ant nest in a wall void with insulation may require baits, but an ant nest in a hollow void may be treated with dusts or aerosol-type formulations. Effective programs should include treatments for specific voids, using:

inspection methods, rr Ihods for

example, when an ant nest is located

• dusts

eliminating pests as ih are sighted. under a carpet or cockroaches are

continued on page 78

7 6 PESTCCMTRCL :

continued from page 76
• aerosol-type sprays • baits Exclusion/Prevention: IPM programs should include preventing pest entry into an area, as well as. minimizing ideal harborage sites. Once the population is eliminated it will be important that the service focuses on long-term prevention ot pest infestations. It is often necessary to use combinations of exclusion methods. For

instance, if the account is pest free, but the adjacent facility is infested, you may need to caulk around pipes and baseboards as well as use repellent dusts and/or liquid residuals inside and around the adjoining wall in order to keep cockroaches from moving into your account.
Following are tools that can be used:
• chemical exclusion (repellent dusts or liquids)
• caulking and stuffing material (insect and rodent)

A Good Case For Pest Control.

air curtains • plastic strips for doors • screen doors • door sweeps Communication: The customer should be included as part of any solution, but they should newer be used as an excuse for unsolved pest problems. It is critical that die customer understand the length of time before results can be expected and how they can help achieve good results.
• show the customer the pest breeding sites
• provide detailed instructions on how to clean problem areas
• inform the customer as to how they can help your IPM methods (don't move equipment, don't spray around baits, etc.)
• provide printed information • follow-up on any promises to the customer
Once you have evaluated the needs of your individual programs, it will be important to compile a list of tools and pest management methods that will include a variety of solutions, such as those just discussed. Any one solution may be used for different programs. With more overlap between programs, there will be more efficient strategies and less training will be required.

This sturdy leather-bound storage case holds 12 issues of PEST CONTROL A one->:me offer for only $12.95 each, while quartzes last.
M A I order form with check or credit card informaiion to: PEST CONTROL, 750., Old Oak Boulevard, Cleveland, Ohio 44130 Or FAX completed order form to PEST CONTROL at: 1. 216. 891. 2675.

Please send me

leather-bound

storagecase|s) for just SI2.95.

METHOD OF PAYMENT

Subtotal S _ 'Shipping & Handling S .
• • S d e j Tax S. Total Enclosed S .

Z C h e c k enclosed, poyabiejo PEST CONTRCLMogazine.

Charge my: Z Visa _ MasterCard _ American Express

Account No

—

E*p. Date _

Signature (required)

.—

Dole

Nome

Summary
Integrated Pest Management is more than the use of a few token tools. It is important to keep an open mind to the methods available to you as opposed to the brand name products. Having an adequate selection of ools and proper training to make decisions are the fundamentals of IPM.
To establish effective IPM. the pest management needs of individual programs must be determined. Tools should then be selected to provide a full range of solutions for the wide variety of problems confronted. After the methods are chosen, training and learning must be a constantfocusof any company. PC

Address Cry

Stan-

' SMoanq & Hanoimq • oom.UK: aaa $2.90 otf <*tm turn St DO "ttKMMlOfCA CO. C . ZA L MN Nl. N* CH IX. a KCWI
r**o» ottow 3-4 M««I» tar c«uv«rv

Zip-

Enc Snell is a technical director at B&G Equipment Co.. Plumsteadvilie. Pa.

78 ==S" :c:;r=CL

SUCTION 19: ELECTRICAL-DISTRIBUTION SYSTEMS A. POWER DISTRIBUTION I. PURPOSE
The ELECTRICAL POWER DISTRIBUTION SYSTEM consists o(jhreej incoming primary lines from the Potomac Electric Power Company (PEPCO) feeding four substations to transform the 13750 three phase primary voltage to an utilization level of 480/277 volt grounded wye 3 phase 4 wire system. The system is a secondary network arrangement wherein each substation has two primary entrance switches, one for each of two transformers, with each primary switch fed from a different primary line and the secondaries of the two transformers paralleled through their individual network protectors forming a system with an extremely high service reliability. J5jjic.a_Ltie._lggs of any feeder or primary transformer will not cause any loss of power and the loss of any two primary feeders or transformers at the same time cannot most only cause partial loss of power to the entire complex, and in that case only if the two primary feeders lost are feeding the same substation or if both transformers in the same substations fail.
II. ±D2F CRIPTION The three incoming primary electric services from PEPCO, enter tiie facility on the west side in an underground duct bank which passes between the north and south cell modules, and continue underground below the Male Inmates Recreation Yard and terminate in the Primary Switchgear located in the Administrative Module Basement Electrical Substation
19-1

DETENT/MN CENTER MANUALS (16A)
m

two primary feeders, one to each end of the substation. The feeders

for each substation are as follows:

SUBSTATION NORTH CELL MODULE SUBSTATION

Line #1 Line #2 Line //3

750 KVA Transformer (A) 750 KVA Transformer (B)

x
x

SOUTH CELL MODULE SUBSTATION 750 KVA Transformer (A) 750 KVA Transformer (B)

x x

ADMINISTRATIVE MODULE BASEMENT SUBSTATION

1000 KVA Transformer (A)

x

/

1000 KVA Transformer (B)

x

ADMINISTRATIVE MODULE PENTHOUSE SUBSTATION 1000 KVA Transformer (A) 1000 KVA Transformer (B)

x x

Each primary feeder to its double end' d substation is connected to the transformer through a 3-position oil selector switch having a ground, line and open position.
Transformers are non-flammable AskareL, liquid filled, air cooled with 2 - 2*5% rated KVA tap9 in the high voltage winding to allow for setting secondary above and below rated voltage of the primary system. Tap changer is operable in the de-energized position only.

19-3

Page 3 Staffing Authority

MAINTENANCE STAFF

AUTHORIZED ON 3OAP.D VACANCIES

DS-12 F a c i l i t y Manager

SW-12 B i d g . M a i n e . G e n . F o r e .

.RW-ll Maine. Mechanic

2

SW-10 Maint.Mech. Foreman 2

SW-lO E l e c t r i c i a n Foreman

SW-09 E l e c t r i c i a n Foreman 5

SW-09 Mason Foreman

SW-09 P l a s t e r Foreman. " • 2*

SW-09 Metal Worker Forerr.ar. i

SW-09 A/C E q u i r . M e c h . F c r e . 5

£nri-09 P i p e f i t t e r Foreman 5

SW-09 l a u n d r y / K i t c h e n Mech

SW-CS M e c h . P a r t s r e p a i r e r

3W-0S P a i n t Foreman

• 1

3W-CS l o c k s m i t h Foreman

2

SV-05 E l e c t r o n i c s Foreman

2S-06 Supply Technician

L

1

1

0

1

1

0

2

2

2

1

1

1

0

5

0

1

1

0

2

0

1

0

6

0

4

1

1

1

0

1

1

0

1

0

1

1

1

1

0

1

C

FORWELDINC AND CUTTING OPERATIONS OUTSIDE OF THE WELDING SHOP
CUTTING-WELDING-HOT WORK PERMIT

IMPORTANT: Precautions on reverse side must be followed.

Dal* Building A DepL Flooi & Room No
Time Started. Work Done _

Estimated Completion . Dale/Time

if Fire Occur*, Phone Security at and Activate the Building Fire Alarm Foreman Shop & Dept. Signature of Responsible Employee.
COPIES TO: „ Maintenance.
SEE OTHER SIDE

Security.

DANGER
PREVENT FIRES
DO NOT CUT, WELD, OR USE OTHER OPEN-FLAME OR SPARK-PRODUCING EQUIPMENT UNTIL THE FOLLOWING PRECAUTIONS HAVE BEEN TAKEN:
The location where the work Is to be done has been personally examined.
1. Sprinklers, If provided, are operational and will not be shutdown until this work has been completed.
2. rhere are no flammable orcombustible materials In the work area. Drums, tanks, equipment, or other containers in the area previously containing such materials have been properly purged.
3. Work will be confined to the area or equipment specified In the permit
4. Floors and surroundings have been swept dean. Wood floors have been wet down or property covered with flame retardant covers.
5. Adequate portable lire extinguishers have been provided and fire hoses, If available, are accessible and operational.
& All combustibles have been located 25 feet from the work area or property covered with metal guards or flame retardant covers.
7. All floor and wall openings within 25 feet of the work area have been properly covered.
8. Aresponsibleworker has been assignedtowatch for sparks In the area and on the floors above and below.
9. Flame or spark-producing equipment to be used has been Inspected, found to be In goodrepair,and contains ail safety devices.
10. A copy of Mils pwmH will be hand carried to Security so that a patrol of the area can be made at least one hour after hot work has been completed for the day.
Date and Time of Site Inspection by Security

••

m

EQUIPMENT LIST

1. Light Meter General Electric Type 214 Light Meter, Footcandle Range 10-50, 50-250, 200-1000 fc. General Electric, Nela Park, Cleveland, OH 44112 or

Photo-meter 1, Digital Footcandle/Foot Lambert meter, Range .01-99,000 fc: Quantum Instruments, Inc., Garden City, N.Y. 11530.

2. Airflow Meter

Alnor Velometer, Jr.; Hi/Low Range 0-200 and 0-800 rpnx: Distributed by MSA Co., Pittsburgh, PA 15205 or

Kurz Air Flow Meter, Model 441S-R, Serial No. VP3541. Kurz Instruments, Inc., 2411 Garden Road, Monterey, CA 93940.

3. Noise Meter: General Radio, Model GR 1565-B-Sound Level Meter and Type 1562-Sound Level Calibrator. General Radio Company, Concord, MA 01742.

4. Smoke Tubes with Bulbs: Drager Smoke Tubes

5. pH Paper Acid-Base: pHydrion INSTA-CHEK 0-13 JUMBO. (See below.)

6. pH Paper-Chlorine: Strips; pHydrion Micro-Chlorine, Cat No. CM 240; Range (light to dark) 10-50-
100-200 ppm: Micro Essential Laboratory, Brooklyn, N.Y. 11210. 7. Temp. Dishwashing Strips: Thermolable Temperature Sensitive Tape; Range 160°F/71°C: Paper
Thermometers Co., P.O. Box 129, Greenfield, NH 03047.

8. Electrical Oulet Tester

Daniel Woodhead Model #1760 Tension Tester. Daniel Woodhead Co., 3411 Woodhead Drive, Northbrook, IL 60062.

ETCON Receptacle/GFI Tester, Cat. No. CT 101. ETCON Corp., BunRidge, IL. 60521.

9. Microwave Tester Micro-Detector, Econmetrics, P.O. Box 206, North Hollywood, CA 91' 03.

10. Smoke Detector Tester Model No. 25 S, FM approved. Home Safeguard Ind., Security Products Division, PO Box 4073, Malibu, CA. 90265.

11. Alcohol Swabs:

PDI Alcohol Prep Rad, 70% Isopropyl Alcohol: Professional Disposables, Inc., Orangeburg, NY 10962.

12. Camera: 35 mm, Flash, and Black and White Film.

13. Taylor Dial Thermometer Taylor Bi-Therm; Range 0°F - 220°F: Pre-Calibrated and Post-Calibrated using 2 quarts of water boiling - set at 212°F and with 10 oz. of water plus 10 ice cubes - set at 32°F (5 min. at roaring boil and 5 min standing with ice cubes before reading and adjusting).

14. Miscellaneous: Tape Measure (12 Ft), Plastic Bags, Scissors, Calculator, Ear Plugs, Safety Glassesgoggles/gloves, Marks-a-Lots, Hemostats.

 
 UNITED STATES DISTRICT COURT FOB THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et aLs., Plaintiffs, :
V.
ANDERSON McGRUDER, et aJLs., : Defendants. :

INMATES OF D.C. JAIL, gt al*., : Plaintiffs, :

V.

DELBERT JACKSON, et al^,

:

Defendants. :

C.A. No. 1462-71 (WBB)
FILED
JAN??
CLEHK. U.S. DliilRICT COURT DISTRICT OF COLUMBIA
C.A. No. 75-1668 (WBB)

ORDER
On October 12, 1994, the Court ordered the parties to show cause why the Defendants should not be ordered to implement the Special Officer's Initial Remedial Plan for Mental Health Care, Med? ;al Care and Compliance Monitoring at th . District of Columbia Jail ("Initial Remedial Plan"). Briefs have been filed by the parties, and upon consideration of the Report of the Special Officer on Medical Care at the District of Columbia Jail, the Special Officer's Outline of her Findings on Mental Health Care at the District of Colunbia Jail, the Special Officer's Interim Remedial Plan Regarding Isolation of Inmates with Suspected and Diagnosed Tuberculosis, the Expert Reports on Medical and Mental
Campbell v. McGruder

JC-DC-001-069

@
Health Services at the District of Columbia Jail, the Report of the Special Officer's expert on medical diets, the Report of the Special Officer's expert on suicides, the Court's findings in its Order of March 5, 1993, the Court's findings in its April 20, 1993, Order Appointing Special Officer, the Court's findings in its Order of March 16, 1994, the Defendants' objections to the Initial Remedial Plan, the Plaintiffs' response thereto, and the record in this case, the Court finds that:
(1) the Defendants have engaged in a persistent pattern of non-compliance with material provisions of the Orders of this Court governing the delivery of medical and mental health services to prisoners confined to the District of Columbia Central Detention Facility ("D.C. Jail");
(2) the Defendants' failure to implement the Orders of this Court has caused substantial harm to the prisoners confined to the D.C. Jail;
(3) the Defendants' failure to implement the Orders of this Court has jeopardized the public health and potentially put at risk all citizens of the District of Columbia;
(4) the Court has provided the Defendants with numerous opportunities throughout the lengthy history of this case to develop and implement their own plan to remedy violations of this Court's Orders and the Defendants have failed meaningfully to avail themselves of these opportunities;
(5) the Defendants' implementation of the Special Officer's Initial Remedial Plan is necessary for the Defendants to come into

K#
compliance with the Orders of this Court, to provide medical and mental health services to prisoners confined to the D.C. Jail in a manner consistent with the United States Constitution, and to protect the public health; and
(6) neither the Defendants' assertion that the District of Columbia has not budgeted sufficient resources to the Department of Corrections to implement the Initial Remedial Plan nor any of the Defendants' other objections constitute good cause for the Initial Remedial Plan to be modified or not implemented.
It is therefore by the Court this £7 - day of January, 1995, hereby
ORDERED that the Defendants shall implement the Special Officer's Initial Remedial Plan.
It is so ordered.
William B. Bryajrf: Senior United States District Judge

Serve:
J. Patrick Hickey Shaw, Pittman, Potts & Trowbridge 2300 N Street, N.W. Washington, D.C. 20037
Jonathan M. Smith D.C. Prisoners' Legal Services Project, Inc. Suite 117 1400 20th Street, N.W. Washington, D.C. 20036
Richard S. Love Correctional Litigation Section 441 4th Street, N.W. Washington, D.C. 20001
Grace M. Lopes Special Officer of the U.S. District Court
for the District of Columbia 1130 17th Street, N.W. Suite 400 Washington, D.C. 20036

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al. . Plaintiffs,
V. ANDERSON McGRUDER, et al.,
Defendants.

) ) C.A. No. 1 4 6 2 - 7 1 (WBB)
FILED

INMATES OF D.C. JAIL, et al. , Plaintiffs,
v.

JIA 1 1 1995
Clerk, U.S. District Court District of Columbia
j C.A. No. 75-1668 (WBB)

DELBERT JACKSON, et al..

Defendants.

FINDINGS AND ORDER APPOINTING RECEIVER
The Court, having considered the plaintiffs' Motion for the Appointment of a Receiver, the defendants' opposition thereto, the Special Officer's Report on Defendants' Compliance with the Initial Remedial Plan and the November 9, 1993 Order ("Report"), and the record in this case, the Court finds that the appointment of a receiver to ensure tae provision of medical and mental health care, and to obtain compliance with the orders of this Court, is appropriate and necessary.
Over the more than 20 year history of this litigation the Court has attempted all measures short of the appointment of a receiver to obtain the defendants' compliance with its orders. The Court finds that no other less intrusive remedial measure

Campbell v. McGruder

JC-DC-001-07

will succeed in compelling the defendants to satisfy their court-
ordered obligations.
A brief history of this case reveals that the defendants
have failed to take advantage of repeated opportunities to
satisfy the requirements of the court's orders as far back as the
1979 mental health plan.
On August 22, 1985, the parties entered into a remedial
Stipulation which required, inter alia:
Within 30 days, the Plaintiffs and the Defendants shall each respectively appoint one medical expert whose reasonable costs and fees will be paid by defendants, to review the health services delivery system at the D.C. Jail and make recommendations for improvements in a report to be submitted to the Court and the parties by Nov[ember] 1, 1985 and implemented by March 1, 1986, unless good cause is shown by either party why they should not be.
Over the next eight years the defendants were in persistent
non-compliance and on April 20, 1993, the Court appointed a
Special Officer to monitor and report on the District's efforts
to meet its court-ordered obligations. Pursuant to the Court's
Order, on September 15, 1993, the Special Officer issued the
reports of her experts on medical and mental health services at the District of Columbia Jail.1 These reports describe very
serious deficiencies in the delivery of basic services that
violate this Court's prior orders and the defendants' obligations
under the United States Constitution.
1 Expert Reports on Medical and Mental Health Services at the District of Columbia Jail (September 15, 1993).
- 2-

In response to the reports of the Special Officer's experts,
on November 9, 1993, this Court granted the plaintiffs' motion
for interim relief. The interim relief was designed to address
the most serious problems identified in the delivery of medical
and mental health services. The defendants have failed to
implement material provisions of the November 9, 1993 Order,
including the provisions that address measures to prevent the
spread of tuberculosis, and the identification and treatment of
prisoners at risk for suicide.2
On February 2, 1994, the Special Officer issued her own
report on the District's Compliance. The Special Officer found
significant problems with the delivery of health care that
violated material provisions of this Court's orders. These
violations include core provisions of Court orders designed to
improve health care at the Jail. The Special Officer concluded:
[T]he defendants have violated this Court's orders with impunity, including the Orders of March 5, 1993 and November 9, 1993 granting interim relief. Among other violations, they have failed to properly conduct sick call, failed to operate a chronic disease clinic, failed to implement a quality assurance progr jn, failed to maintain a full-time health services administrator at the Jail, failed to properly conduct intake, failed to properly provide meaningful access to specialty services, failed to appropriately and professionally respond to life threatening emergencies, failed to properly
2 In the nine months since the November 9, 1993 Order, six prisoners have committed suicide at the Jail. Based on the findings of the Special Officer's experts, many of these suicides would have been preventable had the procedures contemplated by the November 9, 1995 Order been implemented.
- 3-

provide medical diets and failed to keep their own kitchen and medical clinic clean.3
In response to the Special Officer's findings, on March 16,
1994, the defendants consented to a finding of contempt and to a
consent order that required them to implement a remedial plan'.*
The defendants admitted, as they had previously, their ongoing
violations of the Court's Orders and the need for significant
corrective action to provide medical and mental health services
which met the legal requirements od the United States
Constitution and this Court's orders. The remedial plan was to
be drafted by the Special Officer with input from the parties.
Pursuant to the Order, the remedial plan was to contain a
specific timetable to achieve compliance as well as a schedule of
automatic fines for non-compliance.
3 Special Officer's Report at 124-125.
* The March 16, 1994, Consent Order provided, inter alia:
ORDERED that the Special Officer shall, within 120 days of this Order submit a plan to cure the defendants' contempt and that will insure that the defendants render medical and mental health care in a manner consistent with the United States Constitution, and it is further
ORDERED that the Special Officer's remedial plan shall address all issues raised in her reports, the Expert Reports on Medical and Mental Health Services, as well as any additional issue that may come to the attention of the Special Officer or the Court that adversely impacts on the defendants' compliance with the Court's orders concerning the delivery of medical and mental health services at the Jail in a manner consistent with the United States Constitution.
- 4-

On May 4, 1994, the Special Officer filed an Interim
Remedial Plan that addressed the District's failure to properly
isolate prisoners with infectious tuberculosis as was required by the Court's November 9, 1993 Order.5 The Special Officer also
recommended that the District be fined up to $10,000 per day for
any future violation and $1,000 for each future false report or failure to report.6
Following the Interim Plan on tuberculosis, an initial Remedial Plan7 addressing the range of medical and mental health
issues was drafted by the Special Officer. The plan was prepared
over a several month period and after lengthy discussions with
the defendants about its contents and the time table for
implementation. The Initial Remedial Plan was filed with the
Court on October 11, 1994. According to the Special Officer,
"substantial revisions were made in order to ensure that the
defendants could meet the substantive requirements as well as the deadline requirements set forth [in the plan].11 Remedial Plan at
6. After considering objections from the defendants, on January
The Special Officer's Interim Remedi?r. Plan Regarding Isolation of Inmates with Suspected and Diagnosed Tuberculosis, May 4, 1994.
6 Id., at 13-14. As is clear from the Special Officer's Report, the defendants have ignored the requirements of the plan and their responsibilities to prisoners, the public and staff. Even the threat of significant fines has not deterred these violations.
7 Given the seriousness of the deficiencies in the defendants' system to deliver medical and mental health care, the Special Officer concluded that the remedial process must be undertaken in phases. [cite to initial remedial plan]
- 5-

27, 1995, this Court ordered the defendants to implement the
plan.
The defendants have failed to implement the Remedial Plan as
ordered. They are in non-compliance with numerous material
provisions of the plan and the Court finds that the defendants
are in contempt of court. As are described in the Special
Officer's report the defendants' non-compliance with the plan has
resulted in significant harm to prisoners and places prisoners at
unreasonable risk for injury.
On July 3, 1995, the Special Officer submitted a report
describing the defendants' refusal to comply with the orders of
this Court. The Special Officer found:
Instead of improving [since the Court ordered the implementation of the remedial plan], the medical and mental health system has deteriorated. Among other serious deficiencies, there is an absence of medical leadership; a chronic shortage of life saving supplies, medication and equipment; and a failure to provide consistent access to sick call services. The defendants have not yet implemented an effective tuberculosis control program. They have failed to conduct timely tuberculosis screening, failed to provide appropriate treatment, and failed to properly isolate inmates with suspected nd/or diagnosed tuberculosis. This substantial risk to the health of staff, inmates, and the community into which inmates are released is exacerbated by defendants' failure to practice basic infection control principles and to implement even a rudimentary housekeeping and preventive maintenance program.
Report at 2.
- 6-

mm

The evidence in the Special Officer's thoroughly documented

report is extensive, persuasive and unchallenged by the

defendants.

Therefore, it is this

day of

, 1995,

ORDERED that the plaintiffs' motion for the appointment of a

receiver is granted; and it is further

ORDERED that the Court adopts the findings contained in the

Special Officer's Report on Defendants' Compliance with the

Initial Remedial Plan and the November 9, 1993 Order as its own;

and it is further

ORDERED that a receiver will be appointed with

responsibility to implement the Remedial Plan and other orders of

this court relating to the delivery of medical and mental health

services at the District of Columbia Jail; and it is further

ORDERED that the parties and the Special Officer shall

confer regarding the selections of the receiver. If the parties

cannot agree within 30 days on the person to be appointed as a

receiver, the parties and the Special Officer shall submit

nominations to the Court and the Court will appoint the receiver;

and it is further

ORDERED that the receiver shall have the following duties

and responsibilities:

1. To correct all deficiencies in the delivery of medical

and mental health services at the Jail and to operate the program

for the delivery of medical and mental health services in a

M1 *7 M

km
manner consistent with the orders of this Court and the Constitution of the United States.
2. To implement, in coordination with the Special Officer, the Remedial Plan in accordance with this Court's January 27, 1995 Order.
3. To establish procedures and systems within the Department of Corrections in order to ensure that compliance with Court orders is maintained after the receivership has been terminated.
4. To work with the Special Officer and the parties to ensure compliance with all Court ordered obligations.
5. To report periodically to the Court, the Special Officer and the parties regarding the receiver's efforts and any obstacles encountered by the receiver to performing her or his responsibilities; and it is further
ORDERED that the receiver shall have the following powers: 1. All powers currently held by the Mayor, City Administrator, Director of the Department of Corrections, Assistant Director for Health Services and Chief Medical Officer regarding the delivery of medical and mental health services at the District of Columbia Jail. 2. The power to create, modify, abolish or transfer positions; to hire, terminate, promote, transfer, evaluate and set compensation for staff to the extent necessary to obtain compliance with this Court's orders, the cost of such activity to be borne by the defendants.
- 8-

3. The power to procure such supplies, equipment or services as are necessary to obtain compliance with this Court's orders, the cost of such procurement to be borne by the defendants.
4. The power to contract for such services as are necessary to obtain compliance with this Court's orders, the cost of such contracts to be borne by the defendants.
5. The power to hire such consultants, or to obtain such technical assistance as he or she deems necessary to perform her or his functions, the cost of such consultants or technical assistance to be borne by the defendants.
6. The power to petition the Court for such additional powers as are necessary to obtain compliance with this Court's orders; and it is further
ORDERED that within 30 days of the appointment of the receiver, the receiver, after consultation with the Special Officer and the parties, shall submit a plan to the Court that contains the procedures for the receiver to exercise these powers. These procedures shall ensure that the receiver shall not be unreasonably impeded in her or his work by District procedures, regulations or laws. If an agreement cannot be reached regarding the exercise of these powers, the parties shall submit suggested procedures to the Court; and it is further
ORDERED that the District shall provide the receiver with the following:
1. compensation at a rate to be determined by the Court;
- 9-

2. an appropriate office, and such equipment and support staff as are deemed necessary by the receiver;
3. unrestricted access to all records of the Department of Corrections deemed necessary by the receiver to perform her qr. his duties; and
4. access to all areas of the Jail; and it is further ORDERED that the defendants shall instruct all personnel that they are to cooperate with and assist the receiver in the performance of her or his duties, and it is further ORDERED that this receivership shall expire five years from the date that the receiver is appointed, unless the Court finds good cause to extend the appointment. The Court may terminate the receivership prior to the expiration of five years if the Special Officer certifies that the defendants are in compliance with all orders of this Court concerning medical and mental health services at the Jail and that management structures are in place to ensure that the there is no foreseeable risk of future non-compliance.
B. Bryant United States District
Judge
- 10 -

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

FILED

LEONARD CAMPBELL, et al., Plaintiffs,
v. ANDERSON McGRUDER, et al..

AUG - 3 1995
Clerk, U.S. District Court District of Columbia
)
) C.A. No. 1462-71 (WBB)

Defendants.
INMATES OF D.C. JAIL, et al., Plaintiffs,
v. DELBERT JACKSON, et al.,
Defendants.

) ) ))
) ) C.A. No. 75-1668 (WBB)
) ) )

ORDER Upon consideration of the Plaintiffs' Motion that the Court Adopt the Special Officer's Findings on Environmental Health and Safety at the District of Columbia Detention Facility as the Court's Findings and th t the Defendants Be Ordered to Show Cause Why They Should Not Be Held in Contempt of Court, the defendants' response thereto, the Court's findings in its April 20, 1993 Order Appointing Special Officer, and the record in this case, the Court finds that the Special Officer's findings on environmental health and safety at the District of Columbia Detention Facility are accurate and fully supported by the record.
Campbell v. McGruder

JC-DC-001-073

The Court further finds that the defendants are in non-

compliance with material provisions of the Orders of this Court

concerning the health and safety at the Jail as is detailed in

the Special Officer's Notice of Filing and the attached report of

James Balsamo.

Accordingly, it by this Court this -5 ***! day of

1995:

ORDERED that the findings of the Special Officer, which

incorporate the report of James Balsamo on environmental health

and safety at the District of Columbia Detention Facility are,

pursuant to Fed.R.Civ.P. 53(e)(2), adopted as the findings of

this Court; and it is further

ORDERED that the defendants must show cause on or

before Au^ij

^K

1995 as to why they should not be

held in contempt of this Court.

B. Bryant / United States District Judge

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al., Plaintiffs.
v. ANDERSON MCGRUDER, et al.,
Defendants.
INMATES OF D.C. JAIL, et al.. Plaintiffs,
v. DELBERT JACKSON, et al..
Defendants.

Civil Action No. 1462-71 (WBB)
RLED AUG 19 1997
NANCY MAYER-WHITTINGTON, CLERK US. DISTRICT COURT
Civil Action No. 75-1668 (WBB)

CONSENT ORDER

Upon consideration of plaintiffs' motion that the Special

Officer be requested to investigate violations of security related

orders at the D.C. Jail and to make a report with recommendations

for remedial action, the memoranda of points and authorities filed

in support thereof and in opposition thereto, the record here .n,
, -y
and the agreement of che parties, it is by the Court this /y'"1

day of .A"?;-' c I

1997,

ORDERED: That the Special Officer shall conduct a security

audit of the D.C. Jail, utilizing her security expert, James

Henderson. In the course of conducting the audit, Mr. Henderson

shall consult with an expert who is selected by the defendants and

who is agreeable to the Special Officer. The defendants' expert

shall be free to express his or her own opinions on the issues
illinium Campbell v. McGruder

JC-DC-001-079

&
which are subject to the audit in a report that will be made an appendix to Mr. Henderson's report.
tJTTfTEt) STATES DISTRICT JUD£E
Consent and Copies to:
Richard S. Love Assistant Corporation Counsel 441 Fourth Street, N.W., 10th Floor North Washington, D.C. 20001
Jonathan M. Smith, Esquire, D.C. Prisoners' Legal Services Project, Inc., 1400 20th Street, N.W., Washington, D.C. 20036
J. Patrick Hickey, Esquire, Shaw, Pittman, Potts & Trowbridge, 2300 N. Street, N.W. Washington, D.C. 20037
Grace Lopes Special Officer of the Court, 1130 17th Street, N.W., Suite 400, Washington, D.C. 20036

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

INMATL'S, D.C. JAIL, et al. , )

)

Plaintiffs

)

)

v.

) Civil Action No. 75-1668

)

DELBERT C. JACKSON, et al., )

)

Defendants

)

AMENDED COMPLAINT

I. JURISDICTION

1. This is a class action on behalf of all convicted persons ,: confined in the District of Columbia Jail against the Director

'• of the District of Columbia Department of Corrections, the

.: Superintendent of Detention Services of the Department of

;' Corrections, and the Mayor of Washington, D . C , alleging

unconstitutional and illegal acts, practices, and ommissions

!| of defendants in violation of the plaintiffs' rights arising
! i
jj under the First, Fourth, Fifth, Eighth, and Ninth Amendments
{: of the United States Constitution, as well as provisions of the ji

j: District of Columbia Code, and praying for declaratory and

I, injunctive relief.

l|

2. Jurisdiction is conferred on this Court under 28 U.S.C.

ji § 1331 relating to federal questions, 28 U.S.C. § 1361 relating

to injunctive and mandamus relief, 28 U.S.C. § 2201 and 2202 re-

lating to declaratory judgements, and 11 D.C. Code § 521

conferring general equity jurisdiction on the District Court and

by the Court's ancillary jurisdiction to hear non-federal claims,

amount in controversy exceeds $10,000.

Inmates D.C. Jail v. Jackson

JC-DC-002-001

- 2-

II. PARTIES

3. Plaintiffs are all citizens of the United States and

are convicted prisoners incarcerated at the District of

Columbia Jail.

::

4. Plaintiff Norman Barksdale is a sentenced prisoner

'• incarcerated in the District of Columbia jail since June 2,

1975, to serve a suspended sentence of one year confinement and

two years probation re-imposed after a probation violation.

5. Plaintiff Harry Brown was incarcerated in the District

of Columbia Jail on July 28, 1975,- and convicted on October 14,

1975, and is presently awaiting sentencing.

6. Plaintiff Pleasant Burke-El is a sentenced prisoner

incarcerated in the District of Columbia Jail on August 30, 1975,

for an alleged parole violation and is presently awaiting his

parole revocation hearing and trial on the charge which constitutes

the alleged parole violation.

7. Plaintiff James DeVaughn is a sentenced prisoner on

parole from another jurisdiction. He was incarcerated in the

District of Columbia Jail on July 11, 1975, to await trial on

local charges and is being held by virtue of a detainer filed by

his parole board pending outcome of the local charges.

8. Plaintiff James Hargrove, Jr., was incarcerated in the

District of Columbia Jail on June 18, 1975, and convicted in
ji
I! November, 1975, and is presently awaiting a Youth Act Study.
li
' Plaintiff is also being held on detainer from another jurisdiction

on a separate charge.

'• 9. Plaintiff Rudolph Jenkins is a sentenced prisoner

' incarcerated in the District of Columbia on September 24, 1975,

- 3~

for violation of work release. Plaintiff is presently awaiting 1 a Work Release Review Board hearing and trial on new charges.

•

10. Thomas W. Robinson is a sentenced prisoner who has

been incarcerated in the District of Columbia Jail since June

29, 1975, pursuant to a writ of habeas corpus ad. proseguendum.

He is presently awaiting return to the Federal Medical Center

in Springfield, Missouri, where he had been sent for court ordered

psychiatric treatment. Mr. Robinson's case in the District of

Columbia which was the basis for the writ was disposed of in

September, 1975.

11. Plaintiff Bonarell Scott is a sentenced prisoner

• incarcerated in the District of Columbia Jail on February 25, 1975 jl

;• for an alleged parole violation and is presently awaiting a

i; parole revocation hearing and trial on the charge which

i! constitutes the alleged parole violation. i! '<•- 12. Plaintiff Robert L. Scruggs is a sentenced prisoner
j-
i! incarcerated in the District of Columbia Jail on March 27, 1975, !; for an alleged parole violation. A parole revocation hearing
• i
j; was held in May, 1975, which resulted in a continuance pending
I:
ii
|i final disposition of the charge which constitutes the alleged

ii parole violation. The charge has been dismissed and he is now

awaiting a revocation hearing.

jl

13. Plaintiff George Watts is a sentenced misdemeanant

il

jl prisoner incarcerated in the District of Columbia Jail on

i August 23, 1975 after removal for emergency medical treatment

|. to a hospital. He was eligible for parole in September, 1975,

. and is presently awaiting a parole hearing.

':

14, Defendant Delbert C. Jackson is Director of the District

gf Columbia Department of Corrections and is responsible for the

_ 4-
'.. overall administration of the Jail. He is sued individually and . in his official capacity.
15. Defendant Aubrey B. Kearney is Superintendent of Detention Services for the District of Columbia Department of Corrections and is directly responsible for the operation of the Jail. He is sued individually and in his official capacity.
16. Defendant Walter R. Washington is Mayor and Commissioner of the District of Columbia. He is sued individually and in his official capacity as chief executive officer of the District oc. Columbia.
17. The plaintiffs are representative of a class within the meaning of Rule 23 of the Federal Rules of Civil Procedure. The ; class consists of all persons, except pre-trial detainees, •• incarcerated at the District of Columbia Jail. The class is an on-going one and includes individuals who will be incarcerated : at the D.C. Jail in the future. Due to the nature of the class ; and its size, joinder of all members is impracticable. The ••'• members of the class are readily identifiable from the Defendant's records. There are questions of law and fact common to the class and the claims of the plaintiffs are typical of those of the remainder of the class. The plaintiffs will fairly and adequately protect the interest of the class.
III. STATEMENT OF CLAIM
18. Plaintiffs allege, upon information and belief, that the defendants, by their intentional acts and omissions, are violating their constitutional rights, in that:
a. The physical conditions of plaintiffs' confinement constitute punishment in violation of the Fifth, Eighth, and Ninth Amendments. They are confined

- 5-
in cells and dormitories which are overcrowded, and which violate minimal architectural standards as well as American Correctional Association standards. The overcrowding, heating, ventilation, and other aspects of the physical conditions all constitute a health threat. b. The living conditions and extreme overcrowding at the D.C. Jail have a severe deleterious effect on the health and wellbeing of the plaintiffs and the class they represent who are confined in those conditions. These conditions cause or contribute to anxiety, tension, nervousness, insomnia, and are psychologically debilitating. c. These conditions are not limited to the period within which the individual is confined at the Jail, but may also have a permanent effect on prisoners after they are released. d. Numerous violations of the District of Columbia Building Code, Plumbing Code, Housing Regulations, Health Regulations, Food Regulations and Fire Code exist at the D.C. Jail. The food service operation clearly falls below recognized public health standards, and affords a high opportunity for the transmission of disease among the Jail population. e. Although Departmental Order 4740.1 (October 28, 1971) requires a medical examination of food handlers at least twice a month, that regulation has not been complied with. No regular medical examination of civilian employee food handlers at the Jail is conducted by the medical staff of the Department of Corrections, and medical examinations of prisoner food handlers have been sporadic.

- 6-
f. Laundry services for most jail residents are inadequate. There is no procedure for laundering underwear, except for prisoners on Captain's Detail, and if a resident wishes to wash his underwear (T-shirt, shorts, and socks) he must do so in the shower, and without an extra set to wear while his clothes are drying.
g. Laundering of bed linen and blankets is also sporadic, and prisoners frequently must sleep without pillows or pillowcases, or on a dirty sheet and blanket. The jail laundry, which launders the outer garments and. underwear of the Captain's Detail, also does all the laundry for the guard force, the kitchen employees, and the medical staff.
h. The inadequacy of food and the lack of recreational facilities constitute punishment in violation of the Fifth and Eighth Amendments.
i. There are inadequate facilities for out-door recreation at the Jail, and the prisoners do not receive adequate opportunity for out-door recreation or exercise. In addition, the absence of suitable clothing prevents out-door recreation in inclement weather.
j. There are no adequate in-door recreational facilities at the Jail.
k. Hospital and other medical services are inadequate to ensure health and safety of plaintiffs, in violation of their Fifth and Eighth Amendment rights.
1. Substantial numbers of prisoners at the Jail display psychiatric symptoms during the course of their incarceration. The Jail medical staff is not

- 7-

equipped to house, care for, or treat the

psychiatric patient, yet many prisoners who display

these symptoms remain at the jail for long periods

of time.

m. Inadequate security measures subject plaintiffs to

the threat and danger of assault by other prisoners,

thus violating their rights under the Fifth and

Eighth Amendments.

n. The Metropolitan Police Department refuses to

investigate allegations of criminal assaults by

prisoners on other prisoners at the Jail, unless

they result in a homicide or "near-homicide". The

Police do investigate all allegations of assaults

or threats by prisoners against guards, civilian

employees, or visitors occurring at the Jail.

o. Plaintiffs and the members of their class are sub-

ject to the use of indiscriminate and excessive

;

force by defendants, their agents, and employees,

i

j!

which force is not related to any legitimate

i]

ii

interest of the institution and which inflicts severe

ij

bodily injury and damage upon the plaintiffs.

|l

ij

p. Prisoners are confined in the "Control Cells" and

ji

j]

"Treatment Segregation" cells without prior due

II

\'.

process procedural safeguards.

q. The conditions of the "Control" and "Treatment

:

Segragation" cells violate plaintiffs' rights under

i

the Fifth and Eighth Amendments.

r. The lack of programs enabling plaintiffs to better

themselves through education or work training

violates plaintiffs' Fifth and Eighth Amendment

rights.

s. Volunteer groups have attempted to assist residents of the Jail, particularly in the area of educational programs. The Department has frequently failed to cooperate with these groups, with the result that the Jail residents have been denied access to programs which would ameliorate the conditions of their confinement at no cost to the Department and without damage to legitimate security interests.
t. There is no classification program at the Jail for determining the level of security needed for each prisoner. As a result, many prisoners who do not require maximum security are housed in the maximum security areas of the Jail under the most stringent living conditions. Only a small percentage of Jail residents require maximum security housing, and the remainder could safely be housed in less rigorous and less secure conditions of confinement.
u. Plaintiffs are denied adequate contact with the general community. The censorship of mail, limitations on visitors, lack of access to telephones, newspapers, and other means of communication violate plaintiffs' First, Fifth and Eighth Amendment rights.
v. Prisoners are denied access to legal materials and adequate access to counsel.
w. There have been instances of substantial delays in allowing lawyers access to their clients at the Jail. There is no procedure for telephone calls to be made into the jail from lawyers seeking to contact their

- 9-

clients, and the procedure and facilities for

allowing prisoners to make out-going calls from the jail are inadequate.

x. "Contact visits", available to jail residents on

Captain's Detail (whether sentenced or unsentenced), are denied to the rest of the Jail population. Contact visits are the principal attraction to

obtain prisoners for the Detail jobs, and this is the main reason for withholding this privilege from other prisoners. Contact visits, for the

most part, are not withheld from jail residents because of security or custody concerns.

y. All of the above conditions and practices make

incarceration at the D.C. Jail more restrictive and onerous than incarceration at other correctional

institutions for men operated by the District of Columbia Department of Corrections.

z. All of the above actions of the defendants and their agents are in violation of the consitutional and

statutory rights of the plaintiffs and more particularly the rights to freedom of speech, right to counsel, freedom from cruel and unusual punishments,

H

right to privacy and rights of due process and

|i

l!

equal protection of the law.

!j

!i 19. Defendants Jackson, Kearney, and Washington, each within

the scope of his authority, and under color of law, and as a matte:

of custom and practice, planned, executed, and enforced the

practices and policies constituting the violations alleged in

paragraphs "a" through "z" above.

20. There is an actual and continuing controversy requiring

- 10 -

a declaration of the rights of the named plaintiffs and the members of the class. There is no adequate remedy at law.
21. The existence and continuation of the unconstitutional practices, policies, acts and omissions alleged herein have subjected and will continue to subject the class to irreparable suffering and injury unless defendants, and each of them, are enjoined by this Court from continuing such practices, policies, acts and omissions and are required to perform their respective duties according to law.
IV. PRAYER FOR RELIEF

,,

WHEREFORE, Plaintiffs, on behalf of themselves and all other

.. prisoners similarly situated, pray:

'••]

1. That the Court allow this case to proceed as a class

•: action and that all members of the class be notified by defendants
i •
I :
j. of the pendency of this action by posting one copy of the complaint

and a copy of this Court's order on this motion in a conspicuous

place in each section of the jail and that several attorneys

designated by plaintiffs' attorneys and several attorneys designa-

ted by defendants' attorneys be permitted to move through the

I:jail so as to answer questions by members of the class.

i

2. That the Court order defendants to permit correction

experts designated by the Court to inspect the jail and all of

" its facilities and to report to all parties and the Court on the

iresults of their inspection.

;

3. That the Court declare that the individual and

collective acts, practices, and omissions of the defendants:

a. have subjected plaintiffs and the class they

represent to punishment without Due Process of Law,

- 11 -

and to cruel and unusual punishment within the

meaning of the United States Constitution;

b. have subjected plaintiffs and the class they

represent to summary discipline without due process

in violation of the Sixth and Fifth Amendments;

c. have deprived plaintiffs and the class they

represent of the equal protection of the law to

which they are entitled under the Fifth Amendment;

d. have deprived plaintiffs and the class they

represent of their rights to effective assistance

of counsel in violation of the Sixth and Fifth

I

Amendments;

'•

e. have deprived plaintiffs and the class they

''

represent of their rights under the First and

r

Fifth Amendments.

i j

.',

4. That a preliminary and permanent injunction be

ii issued, enjoining and restraining defendants from engaging in any

i;
ii of the unlawful acts, practices or omissions complained of in

!;

]] this complaint.

i

I

5. That the Court order that, within 60 cays, defendants

I

| submit to the Court a plan for assuring that plaintiffs and the

! class they represent are accorded all of the rights and priviledges
ii
J: due them; to specifically include: ii

||

a. that the District of Columbia Jail and the cells

j: •

and dormitories therein be kept safe and sanitary,

j.

with proper electrical connections, plumbing, heating

and ventilation, and, at a minimum, that the jail's

conditions be maintained in accordance with the

District of Columbia Housing Law;

b. that prisoners not be overcrowded at the D.C.

Jail and that each cell, ward, and dormitory contain

- 12 -

no more prisoners than the designed capacity of

the cell and cellblock;

c. that a regular recreational and exercise program

outside of the cells be established, and that all

prisoners be permitted outside of the jail for

sufficient periods to assure their continuous

physical and mental well-being;

d. that the isolation and punishment of prisoners

in the treatment segregation cells be terminated;

e. that all prisoners be fed in suitable, sanitary

facilities outside of their cells and that edible

food in accordance with recognized nutritional needs

be furnished;

f. that the prisoners be permitted enough showers

to ensure that they remain clean;

g. that the prisoners be furnished clean mattresses

and beds, a complete set of bedding and clothing,

including socks and undergarments, which are cleaned

and changed at least once weekly, adequate towels,

proper cleaning equipment, and other personal

necessities (such as tooth paste, soap, etc.);

h. that prisoners be accorded essential preventive

:i

medical practices and receive adequate and sound

i

medical, dental, and mental health care;

i

i. that an educational and vocational program and

M

•

voluntary work program be established;

:

j. that prisoners have continuous opportunity to

talk and associate with each other;

:

k. that prisoners have access to books, magazines,

and newspapers, law books, and legal materials;

1. that visiting conditions be established which

ensure decency, comfort, privacy of conversations,

- 13 -

• \ (.! |

conjugal rights, and additional visiting periods; m. that no limitations be placed on persons a prisoner may see, communicate with, and receive communication from; n. that no censorship be exercised on incoming or outgoing mail, newspapers, books, and periodicals. The only control on incoming mail be inspection for contraband such as drugs or weapons; that adequate phones be installed and the prisoners have access to them in order to make local, outgoing calls without charge, and that such phones not be wiretapped or monitored in any manner; o. that a code of intra-jail behavior providing for prisoner rights be promulgated and provided to every prisoner upon entry into the jail; p. that no discipline on prisoners be inflicted without first affording them notice, a hearing, the assistance of counsel, the confrontation of accusers, the right to cross-examine, written records of a hearing decision, reasons therefor and evidence relied upon, and a hearing before an impartial official; q. that defendants, their agents and employees shall not employ excessive force upon the person of any prisoner; that no guard or other employee shall be permitted to keep upon his person any weapon not issued or authorized by the Department of Corrections and that any of defendants' agents or employees who uses force upon the person of a prisoner shall file a written report, which shall be a public record,

- 14 -
with the Superintendent of the D.C. Jail setting forth the time, date, and place of the occurance, the prisoner's name and D.C. number, the type of force used, the reason for its use, the witnesses to its use, the injuries inflicted, and the medical attention recieved, if any. 6. That the Court order the defendants to implement the plans submitted pursuant to paragraph 5. 7. That if a satisfactory plan cannot be submitted and implemented, the defendants be enjoined and restrained from incarcerating or detaining any and all of plaintiffs and members of the class they represent, in the District of Columbia Jail and further enjoined from transferring plaintiffs and their class to an alternative facility unless defendants can provide evidence satisfactory to the Court that the alternative does not suffer from the conditions herein complained of and that it is accessible to visitors and counsel. 8. That each plaintiff be compensated for the wrongful and arbitrary punishment suffered in the amount of ten thousand dollars ($10,000) against \:he defendants jointly and. severally. 9. That the Court enter its order permanently directing defendants Washington and the City Commissioners to appropriate funds and to take such further steps as may be necessary and appropriate within their powers for the implementation of the provisions contained in paragraphs (5) and (8) above. 10. That the Court appoint as an impartial advisor a recognized expert in the field of corrections to evaluate the plans submitted pursuant to paragraph (5) and to report to the Court. 11. That during the pendency of this action and 1 thereafter, defendants Jackson and Kearney and each of the jail officials and guards under their direction or control be restrciined

- 15 -

and enjoined from any and all acts of punishment and reprisal with respect to the named plaintiffs and the members of the class they represent by reason of this action.
12. That the Court retain jurisdiction over defendants until such time as the Court is satisfied that the practices, policies, acts and omissions alleged herein no longer exist and will not recur.

Respectfully submitted,

Dated: December

f Nancy C. ^Crisman Alvin J. Bronstein The National Prison Project of the American Civil Liberties Union 1346 Connecticut Ave, N.W. Suite 1031 (202) 331-0500 Washington, D.C. 20036
, 1975.

 
 Inmates D.C. Jail v. Jackson

JC-DC-002-002
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

INMATES, D.C.JAIL, et al., )

Plaintiffs

v.

.

DELBERT C. JACKSON, et al., Defendants

)

'

) ) Civil Action No. 75-1668

)

)

) )

>

FILED

DEC 1 9 1975

ORDER

JAMES F/DAVEY, Clerk

Plaintiffs having moved the Court to amend the Complaint, and the Court having considered the Motion, i t is this / £* day of December , 1975,
ORDERED, that the motion be granted and that the Complaint be hereby amended; and it is
FURTHER ORDERED, that proper process be issued and served upon all parties to this action; and it is
FURTHER ORDERED, that the Clerk of the Court shall so note on all pleadings, memoranda, dockets and other documents pertaining to this action. <\

I United States District Judge
Dated: December //'$Y> 1975.

r)

 
 Inmates D.C. Jail v. Jackson
Illillllll JC-DC-002-003
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

INMATES, D. C. JAIL, et al.,

Plaintiffs,

v. DELBERT C. JACKSON, et al.,
Defendants.

Civil Action No. 75-1668
FILED
MAY 2 4 1976

MEMORANDUM AND ORDER

JAMES F. DAVEY, Clerk

This matter is now before the Court on plaintiffs'

Motion For Partial Summary Judgment and defendants'

opposition thereto. In this class action suit,

plaintiffs, who comprise a class consisting of all

post-trial detainees at the D. C. Jail, seek to have

the Court declare unconstitutional various conditions

at the Jail and order defendants to remedy the deficien-

cies found.

This case is substantially identical to Campbell v.

McGruder, CA No. 1462-71, decided by this Court November 5,

1975. The plaintiffs here challenge the same conditions

and request the same relief. The sole material difference

is the class itself: the plaintiff class consists of all

those inmates not members of the plaintiff class in

Campbell. Plaintiffs therefore ask for summary judgment

as to all those issues which have been resolved in

Campbell, invoking the doctrines of collateral estoppel

and judicial notice.

The Court finds both doctrines applicable to the present situation. Collateral estoppel requires that the facts sought to be foreclosed from relitigation be the same as in the previous case. Hurley v. Beech Aircraft. 355 F.2d 517 (7th Cir., 1966). Those facts and issues must have been fully litigated in the prior action, so that the party against whom the estoppel is sought has had an adequate opportunity to contest the disputed facts. Hurley v. Beech Aircraft, supra. The facts subject to the estoppel must have been judicially determined, and must have been material to and in support of the holding. Hurley v. Beech Aircraft, supra. Finally, the party against whom the estoppel is sought must be the same party or in privity with the party against whom the original determination was rendered. Blouder-Tongue Laboratories, Inc. v. University Foundation, 402 U.S. 313 (1971).
All of these tests are met here. There could hardly be a case more appropriate for application of collateral estoppel than this one, where all the issues have been fully litigated and resolved. The defendants have had every opportunity to contest the facts involved, and those facts can no longer be open to any dispute. Even in the absence of the requisite elements of collateral estoppel, the Court could judicially notice the record in Campbell to arrive at the same result. See, e.g.,
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Shuttlesworth v. Birmingham, 394 U.S. 147 (1969); Dixon v. Jacobs, 138 U.S. App. D.C. 319, 427 F.2d 589 (1970).
The defendants' opposition to plaintiffs' motion raises no arguments which were not raised and decided in Campbell. The only legal distinction to be drawn between these two cases is that the plaintiff class in Campbell consists of persons not yet convicted of the crimes with which they are charged, while in the present case all class members have been convicted of such crimes. Whatever the force of that distinction in borderline circumstances, the reality of conditions at the D. C. Jail is so bad as to compel the Court to hold that they constitute cruel and unusual punishment for any human beings incarcerated there. In so holding, the Court is cognizant of the expanding meaning of the Eighth Amendment, which evolves from " . . . standards of decency that mark the progress of a maturing society". Trop v. Dulles, 356 U.S. 86, 101, 78 S. Ct. 590, 598, 2 L.Ed. 2d 630 (1950).
The current meaning of the Eighth Amendment is apparent in such cases as Holt v. Sarver, 309 F. Supp. 362 (1970) affirmed 442 F.2d 304 (1971); Jones v. Wittenburg, 323 F.Supp. 93 (1971), aff'd sub nom Jones v. Metzger, 456 F.2d 854; James v. Wallace, 382 F.Supp. 1177 (1974); Costello v. Wainwright. 397 F.Supp. 20 (1975); Pugh v. Locke (CA No. 74-57-N, U.S. District Court M.D. Alabama N.D., January 13, 1976).
Holt consisted of eight class actions brought on
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behalf of inmates in the Arkansas prison system.
Plaintiffs argued among other things that confinement
under the conditions and practices of that system
amounted to cruel and unusual punishment. The Court
found that the conditions were indeed such that confine-
ment of persons in the system amounted to cruel and
unusual punishment. The significance of Holt lies in
the Court's recognition that conditions of confinement
themselves under certain circumstances can amount to
cruel and unusual punishment. The Court found
" . . . the concept of 'cruel and unusual punishment' is not limited to instances in which a particular inmate is subjected to a punishment directed at him as an individual. In the Court's estimation confinement itself within a given institution may amount to a cruel and unusual punishment prohibited by the Constitution where the confinement is characterized by conditions and practices so bad as to be shocking to the conscience of reasonably civilized people even though a particular inmate may never personally be subjected to any discipline." Holt at 372-373.
While the Court believes that the conditions and
practices at the District of Columbia Jail on their face
are "so bad as to be shocking to the conscience of
reasonably civilized people", Holt, supra, it finds
further support for this position in the analogous cases
of Jones, James, Costello, and Pugh. Each deals with the
abridgment of constitutional rights of sentenced prisoners.
Each deals with one or more of the factual issues before
the Court in the instant case. Jones and Pugh (which was
consolidated with James) are of particular significance in
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that the facts leading the Court in one to find cruel and unusual punishment are very similar to the facts of the other and of those in Campbell v. McGruder, supra, and therefore facts in the instant case.
Jones was a class action brought on behalf of all prisoners in the Lucas County (Ohio) Jail. The class included both sentenced inmates and pretrial detainees. Pugh was a consolidated class action brought on behalf of all inmates incarcerated in Alabama state penal institutions and subjected to conditions in violation of their Eighth and Fourteenth Amendment rights. Similarly, in the present case the Court has been asked to provide relief to all non-pretrial detainees at the District of Columbia Jail.
The Courts in both Jones and Pugh held that the conditions in the respective prisons or prison systems constituted cruel and unusual punishment. Both decisions base their determinations of law on findings of fact similar to those found by this Court in Campbell v. McGruder (CA 1462-71) and judicially noted as the basis of this decision. These are overcrowded, unsafe and unsanitary conditions, lack of proper care for inmates with psychiatric problems, lack of recreation and overly restrictive visitatic rights.
In Campbell this Court noted that overcrowding was the most flagrant and shocking encroachment on the
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constitutional rights of pretrial detainees at the D. C. Jail. The Jones and Pugh Courts similarly emphasized overcrowding. The Lucas County Jail in Jones was built in the last decade of the 19th century and was about 76 years old at the time of the decision. The Jail was designed to hold 150 prisoners, has held up to 272 and at the time of the opinion was holding 200. Inmates in the Lucas County Jail were held in two-man cells each 6 x 9 feet in floor area. The cells are equipped with two bunks, a toilet and sink with running cold water. The Alabama District Court was equally concerned with overcrowding in Pugh when it cited population statistics for the four principal institutions in ttv>. State prison system, showing actual capacity
1/ running one-third or more over maximum capacity. Overcrowding in the D. C. Jail is equally bad, as the Campbell litigation has demonstrated. Indeed, the cells in the D. C. Jail are even smaller than those outlined in Jones (6' x 7' 10", compared to 6' x 9') and often house two men.
All three Courts have noted the unsafe and unsanitary conditions existing at each prison facility. In Jones the Court noted that when a prisoner enters the Lucas County Jail he is given a towel which is replaced once a week. He is also given a blanket which may or may not have been washed before it was issued, and usually but not always a
1/ Fountain (maximum capacity of 63 2, actual capacity of 1,000); Holman (maximum of 540, actual 750); Draper (maximum 632, actual 1,000); Kilby (maximum of 700, actual 700).
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mattress consisting of a small piece of foam rubber. The Court in Pugh also notes the issuance of old and filthy mattresses leading to the spread of contagious diseases and body lice. Similarly, inmates at the D. C. Jail are frequently issued old mattresses, not cleaned or sterilized and stained with urine and other excreta.
The Jones Court listed other health and safety hazards including a dishwasher unable to meet health standards, food storage not in accordance with health regulations, improper ventilation in the kitchen, and a kitchen crossed by leaking water and sewage pipes. The Pugh Court paints a similar picture of conditions in the Alabama system, i.e., broken windows, inadequate heating or ventilation, exposed wires, poor lighting, broken plumbing, roaches and other vermin, unsanitary food service conditions. In Campbell this Court noted the equally base conditions in the D. C. Jail. The Court pointed to the myriad violations of the District of Columbia Building Code, Housing Regulations, Health Regulations, Food Regulations and Fire Code. The Court also noted that there were rats, mice and roaches in abundance at the Jail.
All three Courts found constitutionally inadequate health care in their respective institutions. In Jones the Court found the health facilities in general to be primitive. In Pugh the Court pointed out that 10% of its inmates were considered psychotic, while another 60%
2/ These findings were subsequently confirmed by the court-ordered inspections of the Jail, which found literally thousands of violations.
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were disturbed enough to need treatment. The Court in Campbell found that the D. C. Jail was similarly unequipped to treat patients with psychiatric problems. In addition to the lack of treatment noted in the other cases, the Court found frequent use of ordinary handcuffs and leg irons to shackle some severely disturbed inmates to their beds.
Parallel findings also exist as to the lack of adequate recreation for the incarcerated. In Jones there were no recreation facilities, while the Court in Pugh found them inadequate. The Court in Campbell emphasized the lack of adequate recreation both in time and space. It pointed out that prisoners on deadlock receive no outdoor recreation time and only one-half hour daily of "tier" recreation.
Finally, both the Jones and Pugh Courts found that certain limitations on visiting privileges also constituted cruel and unusual punishment. In Jones the Court found that prisoners were only permitted visits on Saturday afternoons from 1 to 4 p.m. Visits had to be conducted through heavy screening. The Court in Pugh found that the irrational classification system in Alabama institutions prevented visitation for certain inm«t««. This Court in Campbell similarly found lacking any rational classification system at the D. C. Jail for allowing contact visits for inmates there.
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Other cases also deal with invidual issues in the instant one. See, e.g., Costello v. Wainwright, supra, where the Court issued a preliminary injunction to reduce inmate population in the Florida Corrections system after finding that overcrowding and the resulting deprivations in medical and psychiatric care amounted to unconstitutional cruel and unusual punishment. The Court has also been guided by cases specifically noting the rights of prisoners to adequate medical and psychiatric care. See Negron v. Preiser, 382 F.Supp. 535 (1974), Battle v. Anderson, 376 F.Supp. 402 (1974); Finney v. Arkansas Board of Correction, 505 F.2d 194 (1974).
The Court is also persuaded that the conditions and practices in the D. C. Jail are not rational means of advancing a valid state interest, and that the reality of conditions at the Jail subvert the legitimate purposes of incarceration. See Procunier v. Martinez, 416 U.S. 396 (1974); Pell v. Procunier, 417 U.S. 817 (1974).
It is apparent, therefore, that the conditions in which inmates are housed at the D. C. Jail constitute cruel and unusual punishment in the sense currently contemplated in American society. These conditions simply are not to be tolerated in a civilized society, much less in our national capital. These are conditions which turn men into animals, conditions which degrade and dehumanize.
In some senses the punishment they inflict is more painful
and enduring than the stocks or the rack, long since discarded as barbaric or primitive. Imprisonment in
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conditions such as these absolutely guarantees that
the inmates will never be able to return to civilized
society, will never feel any stake in playing by its
rules. For imprisonment under such conditions, where
a man may be stuffed into a tiny cell with another,
surrounded by the nocturnal moans or screams of
mentally disturbed but untreated fellow inmates, plagued
by rats and roaches, sweltering by summer and shivering
by winter, unable to maintain significant contact with
his family in the outside world, sometimes going for
long periods without real exercise or recreation, can
only have one message for him: society does not
acknowledge y->ur existence as a fellow human being. And
when that message is delivered in the D. C. Jail, whatever
small chance may have existed that a person might act as
though he were a member of a civilized society is
V
obliterated, along with his decency and humanity.
_3/ The Court has confirmed the continuing nature of the conditions by a personal visit to the Jail on April 7, 1976, as well as by extensive hearings conducted on April 29th and 30th, 1976 with regard to the instant motion for summary judgment and pursuant to the remand directions of the Court of Appeals in Campbell. The specifii findings made as a result of those hearings are also issued today by the Court. They indicate, in sum, that the conditions at the Jail continue to violate the constitutional rights of the inmates on a daily basis. There are however certain matters which, because of changes in the situation at the Jail since the Court's order of November 5, 1975 (including the partial opening of the new detention facility require different treatment today than they did at that time
In their report to the Court with respect to corrective action taken as a result of health, fire, safety, building and food inspections at the Jail (paragraph 1, Order of November 5, 1975), the defendants indicated that certain violations would not be remedied because the portions (Cont'<
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3/ (Cont'd) of the Jail involved were soon to be vacated. It now appears that cell blocks 3 and 4 and the dormitory area will remain in use for the indefinite future. The Court therefore orders remedial action in those portions of the Jail.
It appears to the Court that the defendants have complied with paragraph 2 of the November 5th order (clothing, linen, towels), and that no further action is required in that regard.
With respect to contact visits (paragraph 4 of the November 5th order), the latest hearings in this case and in Campbell indicated that the defendants plan to seal off the area at the Jail currently suitable for such visits, and that the new facility is prevented from affording contact visits by the presence of plexiglass barriers in the visiting area. The evidence in Campbell also shows, however, that contact visits are afforded to some prisoners at defendants1 Lo;ton facility. There are obvious equal protection problems inherent in this situation, especially considering the fact that the convicted persons at Lorton are felons, whereas the convicted persons at the Jail are misdemeanants. The Court does, of course, realize that there may be valid security reasons for prohibiting contact visits in correctional institutions. Such a determination must, however, be the result of a reasoned analysis of the relevant factors, which the defendants1 practice is clearly not. The Court nevertheless believes that it is the Department of Corrections which must make this analysis in the first instance, and therefore directs it to do so.
The Court believes that defendants are complying with paragraph 5 of the November 5th order (medical inspections of food handlers).
The overcrowding at the Jail is clearly the single most severe problem that the Court has faced in this case and in Campbell. Since the entry of the Court's original interim overcrowding order more than fourteen months ago, that situation has continued to plague the institution. As today's findings in Campbell indicate, a significant number of approaches remain available to defendants to alleviate this problem. Today's findings in Campbell also indicate, however, that there has been no substantial effort on the part of high level city and corrections officials to pursue these possibilities, which the Court believes -- taken together -- could virtually eliminate overcrowding. As the Court notes to -lay in Campbell, apparently only pressure of a continuing and daily nature will suffice to motivate these officials to fully exhaust the possibilities open to them. The Court therefore today enters an order which, it expects, will create such pressure and will protect the constitutional rights of plaintiffs in this action. The Court is confident that no inmate in the custody of the Department of Corrections need ever be released under today's order unless the high city and corrections officials ultimately responsible for operating the corrections system feel that it is easier to continue their current inaction than to vigorously pursue their responsibility to the citizenry they serve.
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Accordingly, it is by the Court this 24th day of May, 1976,
ORDERED: 1) That plaintiffs' motion for partial summary judgment be, and hereby is, granted; and 2) That defendants shall forthwith initiate action to correct all remaining violations reported to the Court in response to the Court's order of November 5, 1975 in Campbell v. McGruder, insofar as those violations relate to cell blocks 3 and 4, the dormitories, the food service area, and any other areas currently expected to continue in use beyond July 1, 1976. A report of the remedial action taken to correct each violation shall be submitted to the Court and to counsel in this case no later than July 15, 1976; and 3) That defendants shall provide at least one hour of out-door recreation daily for each resident of the Jail, except for medical patients and work crew; and 4) That defendants shall, no later than August 1, 1976, adopt a comprehensive policy with regard to "contact visits" at Department of Corrections facilities, taking into account the security of the institutions involved, differences among those institutions, the desirability of equal treatment of similarly situated inmates, and any other factors the Department considers relevant. Defendants shall submit such a policy statement to the Court upon completion, and shall accompany it with an expression of the rationale for the policy so adopted; and
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/"*>
5) That the defendants shall establish the following procedures at the Jail and the new detention facility: In the event an inmate displays unusual behavior suggestive of possible mental illness, such behavior shall be immediately reported to the medical staff. The inmate will be seen by a psychiatrist within twenty-four (24) hours. If the inmate is found to be mentally ill, he will be transferred within forty-eight (48) hours of such finding to a hospital having appropriate facilities for the care and treatment of the mentally ill; and
6) That defendants shall establish the following procedures governing use of restraints:
a) inmates requiring restraints will be housed only in a hospital setting, and not with the general population;
b) unpadded handcuffs and leg irons shall not be used under any circumstances. Medically appropriate restraints, padded or pliable to prevent injury to the inmate, may be utilized;
c) restraints may be imposed only on the specific written authorization of a medical doctor;
d) if required in an emergency situation when a doctor is not present, a Medical Technical Assistant (MTA) or a Registered Nurse may order the temporary use of restraints, subject to the receipt, by telephone or otherwise, of approval from a medical doctor within two (2) hours of the imposition of such restraints;
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e) a log will be kept reflecting the use of restraints, and stating for each such use the name of the person restrained, the date and time he was placed in restraints, the name of the doctor approving the use of restraints, and the time of such approval;
f) orders by a doctor authorizing the use of restraints are valid for twenty-four (24) hours only, and if no further written order has been entered within that period, the inmate shall be released from restraints;
g) no restrained inmate shall be housed in such a manner as to permit access to him by non-restrained inmates, with the exception of inmates approved by the medical staff for employment in the hospital area; and
7) (a) that defendants, their agents, servants and employees are enjoined after June 1, 1976 from housing more than 960 persons at the New Detention Facility, and more than 215 persons in cell block 4, 161 persons in cell block 3, 110 persons in dormitory 1 and 91 persons in dormitory 2 at the old Jail;
(b) that after July 1, 1976 no persons shall be housed in cell blocks 1 and 2 at the old Jail;
(c) that if compliance with this order requires a reduction in the inmate population at either facility, and other efforts to reduce the population are not successful within forty-eight (48) hours after compliance ceases, the Director of the Department of Corrections and the Superintendent of Detention Services are directed to release on their own recognizance, within forty-eight (48) hours of the admission to either facility of persons in
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excess of the numbers stated in paragraph 7a of this Order, those pre-trial detainees held in default of the lowest amount of bail, and among those detainees held in the same amount of bail those held for the longest time, until compliance with this Order is obtained; provided that if the Board of Judges of the Superior Court, or the Chief Judge thereof, specify a different method of selecting the persons to be released, the defendants shall be governed accordingly;
(d) that the defendants submit to the Court and serve on opposing counsel within forty-five (45) days their plan to reduce the population and/or increase the facilities available to house committed persons so that future overcrowding may be avoided; and
8) that there being no just reason for delay, the Clerk shall enter this order as a final judgment pursuant to F.R.C.P. 54(b).
JUDGE J
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 f -••
Campbell v. McGruder

JC-DC-001-041

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF. COLUMBIA

LEONARD CAMPBELL, et al. ,

:

Plaintiffs,

:

v.

:

ANDERSON McGRUDER, et al.,

:

Defendants.

:

C.A. No. 1462-71

INMATES OF D.C. JAIL, et al., :

v.

:

C.A. No. 75-1668

DELBERT C. JACKSON, et al.,

:

Defendants.

:

RECEIVED

MEMORANDUM AND ORDER

JUL 15 1985
JAMES F. DAVEY,

I. Background

Campbell v. McGruder, which is on remand from the Court of Appeals, 580 F.2d 521 (D.C. Cir. 1978), involves the conditions of confinement for pre-trial detainees housed at the District of Columbia's Department of Corrections Central Detention Facility— more commonly known as the D.C. Jail (the jail). The Campbell plaintiffs are a class comprised of unconvicted pre-trial detainees. The defendants are the Mayor of the District of Columbia, the Director of the Department of Corrections and the Superintendent of the jail.

The issues in Inmates v. Jackson are substantially identical to those in Campbell. Plaintiffs in Inmates complain about the same jail conditions, at issue in Campbell and request the same relief. The defendants in both cases are the same. The sole material difference is the mutually exclusive composition of the classes: the Inmates' plaintiffs comprise a class of all convicted residents of the jail, i.e., all prisoners who are not members of the plaintiff class in Campbell.
Throughout the history of these two cases numerous hearings have been held and' evidence taken regarding the conditions of confinement at the jail. While the court has heard testimony concerning several aspects of the conditions at the jail, including medical care, recreation, classification, and visiting procedures, two of the most recent hearings, in November 1983 and in October 1984, have focused on the rising jail population, the substantial overcrowding which has resulted, and the consequences of such overcrowding. The testimony has been supplemented by written submissions to the court and by deposition testimony. In addition, the court and all counsel have conducted a series of thorough on-site inspections, most recently on February 21, 1985. The court also conducted an unannounced inspection on June 3, 1985.
The evidence clearly reveals that the massive overcrowding at the jail has unacceptably diminished services that are recognized as necessities in a prison setting, and has resulted in increased violence at the institution. Plaintiffs claim that the overcrowding is responsible for conditions so acute that they
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;v'' '
violate their rights under the fifth and eighth amendments, and they seek appropriate relief.
II. Findings of Fact
A. The Place and Its Population
The jail is a relatively new facility, which first opened in April 1976. Tt was initially designed to house and provide services for a maximum population of 960 prisoners. The 1980 addition of 395 cells brought the design capacity of the cellblocks up to 1,355.2 On June 30, 1985 the jail reached a record population of 2,663—96% over the design capacity of the cellblocks and 177% above the figure the administrative facilities of the jail were designed to service.
Since November 1980 not a month has passed in which the average number of residents has not surpassed these design capacities, and the population levels have persistently maintained an upward trend. The average daily monthly population
^•Official Department of Corrections' reports frequently do not specify where pre-trial detainees (the Campbell plaintiffs) or convicted inmates (the Inmates plaintiffs) are housed, or which class is involved in a particular activity. "Prisoners", -residents", and "incarcerees" are used interchangeably to describe members of both classes. 2As oriqinally constructed, the jail consisted of two separate units: a housing section, comprising 12 cellblocks with 960 single-bed cells; and an administrative section—an infirmary, kitchen, storerooms, recreation yards, library, visitation area, and offices—designed to provide services for the prisoners and the staff. This administrative section has never been expanded.
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has increased from 1,491 in 1981 to 2,116 in 1983 and 2,534 in 1985.3
B. Use of "Floor-space" Areas for Housing
The jail holds 18 cellblocks, each of which is designed to hold 80 cells. The cellblocks are in a "V" shape. Both sides of the "V" have a lower and upper tier, each of which holds 20 cells. Aisles run down the center of each tier. A glassenclosed security module or "bubble" lies at the apex of the "V"s, from which guards can look down the aisles of each tier and into the four lounges or "dayrooms", a small gymnasium, and a
small dining area. 4
On June 4, 1985 the jail housed 2,618 prisoners. Only 71% of the prisoners were housed in cells, and more than half of these were double-bunked in single cells. All told, 29% of the jail population is housed in dayrooms, aisles, gymnasiums, various holding "cages", and even a converted warehouse, none of which was ever designed as housing space.
3January 1 thru June 30, 1985. Unless otherwise indicated all population figures and
percentages are based on the Department's report to the court for June 4, 1985. On that date the jail housed 2,618 prisoners. Jail officials could specify the precise location and status of only 2,538 of the 2,618 incarcerees; they could not account for
the exact location of the remaining 80 prisoners other than to
say they were were "unassigned" or in "orientation". Pre-trial detainees accounted for 36.9% of the population, 25% of whom were awaiting trial on misdemeanors; the remaining detainees were held on felony charges. Of the inmates, 29% had been convicted of misdemeanors; 68% had been convicted of felonies; and 4% were being held for parole violations.
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These areas were principally designed to provide recreation and breathing room and to serve as safety valves for the pressures and tensions normally incident to life in a jail. With the conversion of dayrooms and other common areas from recreational outlets to housing units, the pressures have intensified, the opportunities for respite and relief have diminished, and the expected tensions and problems of incarceration have been exacerbated. The safety valves are now sealed shut.
1. "North-3 'Dorm'" — This large open storeroom is located in the two upper tiers of one cellblock. Originally designed (and formerly used solely) as a warehouse for supplies, it holds 103 unsegregated prisoners, pre-trial and convicted, violent and non-violent, in an area 3,744 square feet in size. As many as 167 prisoners have been lodged in the "dorm". This "dorm" has only four toilets and four showers. The residents sleep in double bunks. At times prisoners have slept on mattresses placed directly on the concrete floor, and blankets and newspapers have carpeted the area. The double bunks are jammed tightly together, leaving little space in which to move around. Prisoners must lie idle in their bunks or stretch out on the concrete. One of plaintiffs' expert witnesses, E. Eugene Miller, described these conditions, with considerable justification, as "absolutely incredible.... To call it a dormitory is glorifying it."
No permanent lockers or shelves are provided for prisoners to secure their personal property. Instead, residents must store these items in unsecured paper grocery bags or shoe boxes. There
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it
are no tables or chairs. Most residents eat standing up, sitting in their bunks, or on the floor. The double bunks are situated very close together and the aisles between the bunks are very narrow; consequently guards in the security bubble have no clear line of sight into most of the "dorm". The numerous blind spots permit guards to monitor only a small fraction of the warehouse area, notwithstanding the so-called patrolling of the area. Consequently, this dorm is conceded to be the most violent and dangerous housing unit in the jail.
2. Dayrooms — Each of the 18 cellblocks contains four dayrooms, each approximately 15 by 20 feet in size. The dayrooms were designed as recreational, not housing, areas. In 16 of the 18 cellblocks two of the four dayrooms are used for housing, with inmates and pre-trial detainees, felons and misdemeanants frequently living side by side. These dayrooms now hold 344 prisoners. Typically 14 residents are housed in each dayroom, providing each prisoner with 21.6 square feet of living space. At times as many as 32 prisoners have been housed in two dayrooms. These rooms have neither toilets nor sinks. They have no showers. Instead, prisoners must share the showers and toilets set aside for celled incarcerees. As in the North-3 "dorm," prisoners store their belongings in paper bags.
No guards are stationed in the dayrooms. As in the "dorm," blind spots cannot be supervised from the centrally-positioned security bubble. Privacy is completely absent. Except for his assigned bunk, a resident has no place to call his own. Even while he is sleeping a prisoner is typically surrounded by five
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other residents—one at each side, one at his head, another at his feet, and one either directly above or below him.
3. Aisles — Overcrowding has become so severe that defendants have been forced to convert passageways between rows of cells into areas for housing. The aisles of 11 of the cellblocks now hold 238 prisoners, who are double-bunked down the center of each tier. Personal property lies in open cardboard boxes, ready prey for all who amble by.
4. Mini-gymnasiums — Each cellblock contains a small gym, 29 x 29 feet. The gyms were designed to provide residents with a place to exercise the body and exorcise the built-up tensions of confinement. There are 44 prisoners housed in three gyms. One of these gyms is now designated for housing 30 "intake" prisoners. There are no toilets, sinks or showers in the gyms. There are no windows. Lighting is poor; during a recent inspection by the court, only 6 of 36 overhead fluorescent bulbs in one gym worked. There are no provisions for the storage of personal property, aside from the commonplace paper boxes.
5. Infirmary "cage" — This 'ock-up facility is located in the jail infirmary and is designed to temporarily hold prisoners waiting to be seen by medical personnel. The cage is roughly 15 feet by 23.5 feet — 352.5 square feet — in size. On weekends and evenings the cage has been used as sleeping quarters for as many as 47 prisoners at a time. The cage contains no beds or mattresses, no toilets, sink or shower, no drinking facility, no table, no chairs or other places to sit (other than the concrete floor). The prisoners assigned to the cage are not screened to
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determine if they have any communicable diseases or other medical or psychological conditions which might require that they be segregated from other prisoners. Similarly, individuals are placed in the cage without regard to whether they pose a security risk to other prisoners.
6. "Police holding" cells and "cage" — This facility houses women awaiting arraignment. The average stay is one night during the week and up to 30 hours on weekends. Although there are only six double-bunked cells in the unit, each 58.1 square feet in size, on occasion more than 20 women have been housed in this area, with cots placed in a 60 square foot "cage" or in the aisle. When the court visited the jail in February 1985, four of the six cells had filthy, uncovered foam rubber mattresses on the floor.
C. Double Celling
As we have noted, the majority of convicted inmates (924 of 1,601) are double-bunked in ce'is originally designed for single occupancy. The cells are 70 square feet in size, and are spartanly equipped with two stacked beds, a table, a chair, a combination sink and toilet, and a 24" by 42" plexiglass window. There is centrally controlled heating in the winter and air-conditioning in the summer. The cells have only average light, which often constitutes a problem for inmates assigned to the lower bunk. The windows are opaque, which reduces the natural light that might otherwise supplement the artificial
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illumination. The windows cannot be opened.
D. Time Out of Housing Units and-Average Length of Stay
All prisoners must stay in their assigned quarters for an average of 16 hours a day. They must remain locked up for even longer periods if the population count (held six times a day) does not match the master prison list, an event which recurs more frequently than not.
As of October 20, 1983 the average length of stay for convicted inmates was 125.5 days. More than 22% of the inmates had been incarcerated for longer than six months; more than 10% had been in jail for over nine months.
E. Recreation, Idleness, and Lack of Privacy
Numbers alone cannot fully convey the human consequences of housing so many people in such limited and unsuitable spaces. One of plaintiffs1 exper . witnesses, Dr. Francis L. Rundle, testified that overcrowding in one cellblock was so severe "it was almost impossible to walk between [sic] the aisles that were formed by the double bunks in the gymnasium. It was not possible, for example, to squeeze by another person in some of these spaces they were so narrow." Another of plaintiffs1 expert witnesses, E. Eugene Miller, reported that the inhabitants were "stacked like cordwood .... The overall conditions in the women's cellblock are absolutely appalling." In the North-3
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"dorm" the court observed double bunks considerably less than 3 feet apart, forcing one to walk sideways in order to pass between them.
There are virtually no activities for prisoners while they are locked up in their assigned cells or floor-space housing units. No individual radios or TVs are allowed. Double-celled inmates and floor-space residents have little room in which to move around or exercise. These conditions would not be so important if residents were permitted to spend more out-of-cell time in various activities.
The dayrooms were designed to provide prisoners with the jail equivalent of a home den. Each dayroom was intended to serve 20 prisoners. Overcrowding has now rendered nearly all the dayrooms actually or practically inaccessible, because nearly half are used as sleeping quarters and thus jammed with beds, and because many more prisoners than anticipated are forced to share the remaining number of open dayrooms. Now, instead of 80 prisoners sharing four dayrooms, in 16 of 18 cellblocks as many as 204 prisoners mus . make do with only two of such rooms. l'hus each dayroom must serve as many as five times the number of persons originally contemplated.
Defendants' most recent reports indicate that only 319 prisoners (approximately 12%) are enrolled in educational classes: reading, mathematics, typing, needlecrafts, art, commercial housekeeping, "adult basic education," "general education development", and "vocational development."
Overcrowding has greatly reduced opportunities for physical
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recreation, which are particularly needed by prisoners, Campbell v. McGruder, 580 F.2d at 565. The oft-times poorly lit gyms, when not used to house prisoners, are too small for any sport other than a quarter-court basketball game. Moreover, the gyms are open for use only a few hours each day.
Prisoners receive a maximum of three hours of outdoor recreation per week, less than that if the weather is bad. There are two exercise yards, one for men and one for women. The larger male yard is a nearly square walled-in area approximately 36 yards long by "36 yards wide. Prisoners from three male cellblocks share the male yard at one time, forcing up to 479 prisoners to share space that contains but a single full-size basketball court, a volleyball court and one punching bag. Protective custody prisoners have no access to the yard and are allowed no outdoor recreation.
Rather than providing an opportunity for the release of tension, the overcrowded gyms and recreation yard have been transformed into another source of frustration, another arena of competition fcr limited space and equipment, and another cause for conflict and violence.
There are four telephones in each cellblock. These are used for phone calls to attorneys and family members. The phones are turned on for use during a few hours in the morning and in the evening. They are frequently broken. Large numbers of residents must share these scarce resources; fights over access to the phones are common. More residents also means more noise. Because the phones are located in the midst of the crowded dining
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?;•-••
area and adjacent to the gym and because of the noise from the TV set and from other prisoners, telephone users often cannot hear those whom they call. This was apparent on all visits to the site.
The visiting facilities are overloaded and visiting privileges have been curtailed. Jail Administrator William Long stated "visiting used to be allowed on any day, but due to overcrowding visiting is now limited to two designated days per week for each inmate." Overcrowding and delays occasioned by problems with the count have resulted in longer waits to see visitors and increased frustration, which is often taken out on the jail staff. Only non-contact visits are permitted.
Residents who want to do their own legal research face strenuous obstacles. Only 15 residents of each cellblock are permitted access to the 4,240 volume law library each week. Consequently, many prisoners are not able to do any effective research on their own behalf.
Each cellblock has a small dining area, with enough tables and benches to seat 40 prisoners. Originally, prisoners in each block were fed in two shifts, thereby permitting all 80 singlecelled prisoners in each block the opportunity to sit down for meals. Now, prepared food trays are distributed to cellblock residents at one time. With as many as 204 prisoners housed in a single block, and only 40 seats in the dining area, many
prisoners are forced to eat their meals standing up, in their
5The Department of Corrections inmates at Occoquan and federal prison inmates enjoy contact visits.
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A
bunks, or on the floor. Privacy is at a premium. No one is ever outside the
presence of other prisoners. Dr. Rundle testified that residents he interviewed "stressed that they could never be alone, even in the toilets, because the toilets tended to be either open to view or, if enclosed, in the middle of an area where there were many, many people around ...." This was apparent when we visited the jail. The facilities and services which are ordinarily contemplated as escape valves have been effectively transformed into pressure points.
F. Classification and Parole
Classification and parole (C & P) officers play a crucial role in the lives of all prisoners. As the title implies, C & P officers are charged with classifying and segregating prisoners so that conflict and violence are minimized, and with providing social services to residents to enable prisoners to qualify for parole and reintegration into the community.
Classification of prisoners, by status (convicted or pretrial), by offense (misdemeanor or felony), by medical or psychiatric condition, and by charge (violent or non-violent offense) is supposed to separate residents so that they pose the least danger to each other; with whom residents are housed is often just as important as where they are housed. Overcrowding at the jail has greatly undermined the ability of jail authorities to categorize and segregate prisoners in a timely
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t
r
fashion. For example, on June 3, 1983 then Assistant Administrator William Long wrote to Administrator Jesse Jones: "As a result of the population explosion and the increase of inexperienced new correctional officers, it has become extremely difficult to identify the extremely assaultive, and special handling type inmates returning to the institution whether from the community, [the Federal] Bureau of Prisons, or other institutions." Incoming residents are assigned to whatever floor-space "beds" are available on a catch-as-catch-can basis. Violent and non-violent prisoners, pre-trial and convicted residents, youthful first offenders and obdurate recidivists, the healthy and the sick, all live side by side in these areas, creating an extremely volatile situation and subjecting residents to a high risk of assault. Although defendants have denominated all cellblocks as either "pre-trial" or "convicted", in reality most cellblocks house both classes of prisoners. Overcrowding has obliged jail officials to house protective custody prisoners in double cells and even in open floor-space areas.
A single Classification and Parol . (C & P) officer is responsible for classifying the 40-70 new residents that arrive at the jail each day. Performing this duty accurately has become a daunting task, with speed often supplanting precision. This officer has little time to make these critical assessments and because the "intake records" that accompany each new prisoner are often incomplete, the C & P officer usually lacks the background material (the prisoner's criminal record, his past institutional behavior, and any existing medical or mental health problems)
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needed to make an informed decision. Nine other C & P officers function as social workers and are
entrusted with contacting attorneys, arranging for psychiatric referrals, and bridging the gap between a prisoner and his family and his employer. The number of C & P officers has increased only 43% during the period when the jail population has nearly doubled. Their average caseload has swollen to nearly 300. Not surprisingly, a new prisoner can spend months in jail before having his first full discussion with his C & P officer.
George E. Holland, Assistant Director of the District of Columbia Department of Corrections, acknowledged that the inordinately high caseloads prevent the C & P officers from adequately performing their assigned duties. Instead, C & P officers are often only available to prisoners in emergencies, and even then only after lengthy delays. Residents who seek the relatively secure confines of protective custody, either because they have received specific threats from other prisoners or because they have a generalized fear of jail violence, must wait weeks to see C & P officers and have their transfer requests processed.
The C & P officers are also responsible for assisting sentenced inmates in qualifying for parole. Once again, the sheer numbers of cases assigned to a single officer hampers his ability to provide effective service to individual inmates. Lack of contact with C & P officers has frequently led to delayed parole hearings. On numerous occasions inmates have remained incarcerated seven to nine months past their parole dates.
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(©;
G. Shelter and Sanitation
1. Food Service
Evidence presented at the November 1983 hearing revealed a concededly appalling situation — filthy and vermin-infested cooking facilities, unsanitary dishes, trays and utensils, inadequate storage space, and spoiling meats, fruits, and vegetables.
Defendants have made laudable and largely successful efforts to correct these problems. New equipment has been purchased and sanitation shortcomings have been reduced. Nevertheless, overcrowding and the sheer shortage of kitchen space have created problems which even the most dedicated exertions and the most modern equipment cannot solve. Thus, the kitchen, which was built to feed 960 prisoners, must now provide for nearly three times that number. It is forced to run nearly 24 hours a day. As a result, the jail's meal sc'edule is geared to the kitchen's round-the-clock operation, with the ludicrous consequence that breakfast is delivered to some prisoners as early as 2:50 in the morning.
2. Personal Hygiene
Each cell has a sink and toilet." Each tier of 20 cells has two showers. However, since the aisles, gyms, dorm, and dayrooms
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were never designed for housing purposes they were never furnished with toilets, sinks, or showers. This lack of facilities has three consequences.
First, floor-space residents are obliged to share the eight cellblock showers originally intended for use by a maximum of 80 celled residents, thereby increasing the ratio of use from one shower per ten residents to as many as one per twenty-five. Second, floor-space residents are forced to make do with what amounts to "public" toilets in cells left vacant for that purpose. Instead ot one toilet and sink for each resident, as originally designed, or one for two prisoners, as in the doublebunked cells, as many as 40 floor-space residents can be allotted to a single toilet and sink.
The final consequence is that many of the showers and most of the toilets and sinks set aside for use by floor-space incarcerees are overused, poorly maintained, filthy, and unsanitary. Many of the toilets lack toilet paper. Most show stains from urine and feces. None have toilet brushes. Few of the sinks have soap or sanitary towels.
Unsanitary conditions pervade other areas of the jail as well. Observation by plaintiffs' experts, and by the court as well, revealed dirty mattresses and bedding. Some were fouled with urine, fecal material, food and vomit. Others were in poor repair. With many more prisoners housed than ever planned for, jail authorities are forced to require more senior residents to use the dirty mattresses longer than desirable and are obliged to issue decrepit and unclean mattresses to incoming prisoners.
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H. Health Services
Systemic deficiencies pervade all aspects of the health care services provided at the jail — medical, pharmaceutical, psychiatric and dental. Dr. Robert W. Yancey, Jr., a Medical Officer at the jail who testified extensively at the November 1983 hearing, characterized the health services system as being overwhelmed by the endlessly increasing numbers of prisoners. He acknowledged that the system is so overburdened that it "is like a dam in which you are just trying to keep the water ... from coming through ...," a situation in which n[i]t is just a matter of time until it just floods everybody ...." At the time Dr. Yancey testified the average daily population was 1,979. Increased overcrowding since that time has only exacerbated the problems.
The jail infirmary was built to serve the needs of a maximum population of 960. Initially, 24 beds were provided for nonpsychiatric patient .—a ratio of 40:1. Although the population is now 177% higher than it was in 1976, since one-half of the infirmary beds are typically used by mentally ill residents, the number of beds actually available for non-psychiatric cases has been cut in half, producing a ratio of 218:1.
Dr. Yancey stated that the over-population of the jail had substantially impaired the ability of physicians and other staff to deliver prompt and adequate health care. The rise in the jail population since November 1983 has further increased the number
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of residents requiring physical examinations, x-rays, and admission to the jail infirmary, as well as the number of medications dispensed. As a result, ill and injured prisoners do not receive proper and timely treatment. According to Dr. Yancey: "With the increased population it is more difficult .... We are really stretched now. We see everything [sic] we can, but some fall through the cracks."
The increase in the jail population and the diminution in the number of beds available for medical cases has not been offset by an increase in the number of health care personnel. In fact, although the jail population has nearly tripled from January 1980 until the present the number of health care personnel has remained virtually constant. The health services system is chronically short of staff and space. In January 1980 there were 25 medical personnel at the jail: three full-time physicians, two part-time physicians, one pharmacist, two dentists, seven nurses, one physician's assistant, eight medical technical assistants, and one x-ray technician. At that time the jail population was 921; the ratio of prisoners to n.edical staff was 37:1.
Currently, there are 26 medical personnel to care for a population that is 184% larger than it was in January 1980. The ratio of prisoners to medical staff is now 101:1. Furthermore, the composition of the medical staff has changed. There are now four fewer doctors and nurses than there were in 1980. There are now only two full-time physicians (one of whom is a supervisor) and two part-time physicians. The decline in the
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number of nurses from seven to five is equally critical. Dr.
Yancey testified that "[t]hey are the glue that holds everything
together."
The shortage of medical personnel is not only acute, it is
chronic; there were too few medical staff members before
overcrowding became severe. A March 29, 1982 memorandum from Dr.
Robert E. Lee, Assistant Director of Health Services to
Department of Corrections Director Holland reported:
Explosively within the last year or less there has "been an added number of inmates^ further diluting medical services .... This increase has not had a concomitant increase in already depleted medical personnel which have never been up to the arbitrary freeze complement ....
The Public Health Survey of 1968 concluded that minimally seventy-three (73) medical personnel were necessary to carry out medical functions at that time.
One wonders what such a survey would reveal at this time with the drastic increase in both numbers and sophistication of incarcerees!l '
A November 4, 1982 letter to Director Holland from the jail's
Chief Medical Officer, Dr. Francis L. Smith, reached an identical
conclusion:
The Health Care Delivery Program is severely hampered in carrying out its responsibility to provide medical care to incarcerated persons. This condition exists because of increased demand for
6At the time the memo was written, the average daily population in the jail stood at 1,769. A year before the average daily number was 1,419. 7 A year later, Dr. Lee explained that "the original staffing of 30 was not adequate to handle an inmate population of 1,353...."
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health services on the part of inmates. In spite of a large increase in the jail population, staffing levels have remained the same and~~have caused major deficiencies in the health care delivery program .... Present medical staff members have been compelled to forego daily sick call to all residents who place their names on lists for medical attention. They are confined basically to caring for (1) new commitments, (2) referrals from correctional staff, (3) surgical conditions, and (4) emergencies. [Emphasis added.]
On March 3, 1983 Dr. Lee recommended that an additional 32 medical personnel should be hired, including one more physician (for a total of six) and eight more nurses (for a total of twelve). These warnings and requests have been ignored.
The drastic cut-back in the number of available beds, the "explosive" growth in population and the defendants' failure to provide more facilities and to hire more personnel also has had a predictable effect on staff morale. Dr. Yancey said: "You kind of wonder when you are going to get more help. Where is it going to end?" Defendants' reports indicate that medical personnel have requested more sick leave, more overtime, more annual leave, and more leave without pay. Defendants concede that this situation has made the hiring and retention of "qualified dedicated" personnel a "perpetual problem". Director James F. Palmer acknowledged that the overcrowded conditions have rendered the jail unattractive as a work site for professionals and is probably the biggest obstacle to acquiring additional medical staff.
1. Medical Care
In January 1980 sick call was available to each resident five
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©
t
times a week during daytime hours. By the time of the November 1983 hearing shortages of space and staff had forced defendants to hold sick call between 12:30 and 4:00 a.m. Nonetheless, sick call was still available to every resident on every weekday. Now sick call is again conducted during normal business hours, but is available to each prisoner only once a week. Donald R. Soskin, Health Services Administrator at the jail, reported on April 25, 1985 that "[slick call service ... continues to be marginal in effectiveness." Initial screening examinations are performed by physician's assistants, who decide whether a physician's attention is required. During evenings and weekends untrained guards are often pressed into service to make the initial determination of who will be treated and who will not. Accordingly, it is not surprising that many residents with medical complaints are never seen by a physician, and thus, as Dr. Yancey concluded, "some fall through the cracks."
Prisoners who are denied an appointment with a physician must sign up again. Weeks can pass before they are seen by a physician. Uncontroverted evidence de.ailed numerous incidents in which prisoners' complaints were ignored and treatment delayed for lengthy periods. For example, on one occasion a guard told a prisoner that the latter did not appear to be acutely ill and therefore had neither reason nor right to be sent to the infirmary and seen by a physician. Coverage is particularly thin during evenings and weekends. On occasion, the infirmary has been closed because of frequent emergency calls to the cellblocks,. The converse is also true; personnel have refused to leave the
-22-

infirmary to provide emergency medical assistance to inmates. Thus this past March a guard lieutenant who had requested assistance for a resident was informed that none would be forthcoming—only one staff person was in the infirmary. A similar instance occurred three days later.
Even when access to the infirmary is not denied outright it is often delayed. One inmate, complaining of pains symptomatic of a heart attack, waited two and one-half weeks before being seen by a physician. Numerous other instances were reported where residents repeatedly had to sign up for sick call before they were "sick enough" to be seen by a physician.
Once prisoners have been examined and their illnesses diagnosed they frequently have to wait additional lengthy periods to receive prescribed medication or treatment. One prisoner who had been stabbed in a fight was denied medication that had been ordered by hospital surgeons. Another resident waited three weeks to receive asthma medication. A third waited three weeks to receive medication that had been prescribed by his private physician before his incarceration.
Another prisoner, who had broken his toe while working in the jail kitchen, waited more than two months for surgicallyrecommended orthopedic shoes. On another occasion a prisoner with hypertension, who had been placed on a special diet by a jail doctor, never received the ordered meals.
Prisoners in need of the services of medical specialists fare even worse. Long delays in obtaining initial appointments are commonplace. One prisoner, who was instructed by a jail physician
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, •
to schedule an appointment with a psychologist, waited seven weeks before he received an appointment. Another waited six months before recommended oral surgery was performed.
Prisoners with optometrical problems apparently go to the bottom of the list. One prisoner, whose eyeglasses had been broken during his arrest and without which he was virtually blind, was required to wait three weeks just to get his eyes examined. He was relatively fortunate; two other residents had to wait seven months before they received eyeglasses. Yet another prisoner was told by a guard captain that "it takes at least one year incarcerated before an eye exam and the prescription can be accomplished."
The medical records system is conceded to be "chaotic". Patients who are examined by physicians at the District of Columbia General Hospital must wait for the "Recommended Treatment" and laboratory reports to be reviewed and acted upon by the jail infirmary staff. According to Dr. Yancey, because of the large number of prisoners and the large volume of hospital records transmitted, these reports remain unreviewed for "weeks, months."
The distribution of medications violates generally recognized standards of medical care. Because of the shortage of pharmaceutical personnel, prescription drugs are not passed out on
weekends or evenings.8 Sometimes medical technical assistants
80n October 18, 1983, the Chief Medical Officer, Dr. John H. Seipel, in a memorandum to Dr. Lee, then Assistant Director for Health Services, reported: "(t]he continuing lack of pharmacists/pharmacy technicians makes it necessary for physicians, nurses, and unlicensed MTAs to fill and dispense medications resulting in a partial absence of control .... (continued)
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distribute a one or two week supply of medications to residents at one time. Distribution of prescriptions containing narcotics is more carefully controlled, but even these drugs, which may be required to be taken three or four times a day, and which should be dispensed in individual doses no less frequently, are passed out but once or twice a day. Dr. Yancey lamented "[t]here is no other way we can do it right now.... We have too many people."
2. Mental Health Services
Medical care at the jail is, in Dr. Yancey's words, "coming apart at the seams." Mental health services never came together in the first place. Dr. Irwin J. Papish, Associate Chief of Forensic Psychiatry, conceded that the population increases have overloaded the psychiatric facilities and services.
Instances of bizarre and self-destructive behavior by prisoners are routine. Defendants1 cellblock logbooks and other records reveal repeated suicide attempts, residents pounding their heads against cell alls, fights and assaults, setting of fires, hoarding of medicine and overdosing, destruction of mattresses and bedding, urinating on the floor, smearing feces on themselves, incessant shouting and yelling—in short, as the court described five years ago, "a bedlam." Campbell v. McGruder, C.A. No. 146271, slip op. at 2 (D.D.C. June 9, 1980).
Two cellblocks have been set aside for the treatment of
Patient.workload has increased steadily at a rate of about five percent per month over the past six months, further impacting our overloaded staff and services." (Emphasis added.)
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- -yr *
mentally ill residents. Nonetheless, population pressures have forced defendants to house some of the mentally ill among the general population, despite the court's order that the two groups should be separated. As the Corrections Mental Health Coordinator Wendell S. Plair lamented some nslip[] through the cracks."
Care of the mentally ill is further hampered by bureaucratic disputes among the mental health care staff, creating a situation plaintiffs' experts, Dr. Frank L. Rundle and Dr. Ron Sable, aptly characterized as an "administratively chaotic" "non-system." Two different groups of personnel attempt to provide mental health services to prisoners, without any coordination, and without any unified administrative or clinical authority, responsibility or supervision. This lack of coordination diminishes the quality of care provided to patients.
Dr. Henry E. Edwards, Chief of the jail Mental Health Program reported in 1982 that the overlapping lines of authority had led to^"conflicts, tensions, ... morale problems, ... confusion, inconsistencies, and at times, non-performance of, or interference with, actual program delivery to inmates." While this situation has improved somewhat over the last year, Dr. Papish acknowledged that overall conditions have not.
There are no full-time psychiatrists or psychologists to provide daily care and counseling. No mental health professionals are in the jail on evenings or weekends. Instead of full-time staff, six part-time psychiatrists provide rotating coverage of "screening clinics" held five days a week. This situation presents serious problems in the diagnosis and treatment of
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residents with mental health needs. Dr. Yancey stated that patients "can be seen by three different people and the other three [sic] not know- it .... U ] t is hard to make a judgment if you have only seen [a patient] one time ... It has [sic] problems for the patient adjusting to the physician." According to Dr. Yancey, the jail has no "psychiatrists under our control. It is a tremendous handicap for us. It is very; very bad. They are not here when we need them."
No intake psychiatric screening is performed at the time of a prisoner's commitment to the jail, despite testimony that incoming prisoners are more likely to have mental health problems than the average citizen. See Campbell v. McGruder, 416 F. Supp. 100, 104 (D.D.C. 1975). Instead, screening occurs only if a prisoner requests mental health services or manifests a condition that appears to require such services. This initial screening is carried out on an ad hoc basis and is performed by guards, unlicensed MTAs, certified physicians assistants or registered nurses, few of whom are trained to assess psychological problems. Thus prisoners with mental health problems may never be seen by mental health professionals.
The increased number of prisoners who are determined to be in need of mental health care face delays in being diagnosed and additional delays in receiving scheduled follow-up examinations. Currently, residents are required to wait up to three weeks after their placement in the special cellblocks before they are examined by a psychiatrist. A noncertified physician's assistant, who lacks training in mental health care, performs the "triage"
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function of deciding when residents will be seen by a psychiatrist.
These delays are commonplace despite the fact the psychiatrists are forced to evaluate large numbers of patients in short periods of time. Although Dr. Papish asserted that he never lacked for time, it appears to the court that frequently such evaluations are largely pro forma. For example, on one recent day 33 patients were "examined" in 75 minutes.
As a result of the increased population pressures, few patients receive individualized treatment. The activities provided for residents do not even approach those provided at a typical out-patient "day-care" facility. Instead, the standard regimen calls for the prescription of psychotropic drugs. Mr. Plair "conservatively" estimated that 80% of the mentally ill residents receive daily doses of these medications—250-300 residents in all.
Although this is by far the most common "treatment" provided to the mentally ill the record is replete with examples of abuses in the dispensation and administration of such drugs. Individual residents often do not receive their prescribed medications. Staff shortages have forced entire cellblocks to go without their medications, for up to three days at a time. On some of these occasions guards have been obliged to "deadlock" entire cellblocks in order to prevent disruptions by the anguished patients.
Medications are dispensed in an extremely short period of time to the residents of the mental health cellblocks, making it very difficult to monitor the residents for possible adverse side-
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effects. To make matters worse, because of staff shortages medications are frequently prepared and dispensed by personnel who lack specialized psychopharmaceutical training.
Prisoners who are diagnosed as potentially suicidal or otherwise in need of more intensive care scarcely fare any better than those who are never evaluated and examined. "Diagnosed" residents often do not receive the treatment they need at the time they need it. Long delays are the rule. Suicide precautions, when ordered, are frequently not carried out. Because the special mental health facility is itself invariably filled beyond capacity, potential suicides are placed in the regular medical infirmary or housed in administrative segregation. Neither placement comports with generally recognized correctional or mental health standards. Tyically, 50% of the beds in the infirmary are filled with psychiatric patients, persons who require more intensive and specialized care than that facility can provide. The "treatment" potential suicides receive there is often nothing more than a steady diet of sedatives and the imposition of physic?, restraints. Compare Campbell v. McGruder, 416 F. Supp. at 104.
Tragically, but not surprisingly, there were four suicides at the jail from January 1983 to January 1984, and numerous attempted suicides since then, including three suicide attempts in one cellblock in a single recent month. Dr. Rundle and Dr. Sable testified that the two suicides that occurred in the six months preceding the November 1983 hearing could have been prevented had the prisoners received even minimally adequate mental health care
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and monitoring. The quality and organization of the jail's mental health
services does not come even close to complying with minimum professional standards.
3. Dental Care
"Prisoners generally have more extensive dental problems than the average citizen. Consequently dental care is one cf the most important medical needs of inmates." Ramos v. Lamm, 639 F.2d 559, 576 (10th Cir. 1980), cert, denied, 450 U.S. 1041 (1981). Nevertheless, "dental care" at the jail is an oxymoron. In years past a dental sick call was held daily. Dr. Yancey testified that it "had to be abandoned because there were just too many people." Now only emergency cases are treated; "routine" dental needs, the kind that would prompt a free citizen to seek the services of a dentist — examinations, cavities, tooth extractions, — are left for another day and another place. According to Dr. Yincey, non-emergency but otherwise "ser*ous" dental needs are "not being met for weeks, even months." As a consequence, prisoners must endure prolonged and severe pain. Plaintiffs, however, disputed that even emergency cases, as that term is defined by the jail medical staff — abscesses and infectious diseases requiring oral surgery — were being seen and treated as quickly as the prisoners' needs required.
The lack of even the pretense of an adequate dental care system has led to untold pain and suffering among both classes of
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prisoners.
I. Jail Violence
Overcrowding and the concomitant overburdening of facilities and services has created an atmosphere of apprehension, frustration, and hostility. It has also decreased the ability of guards to supervise the cellblocks. As a result, violence at the jail has reached alarmingly high levels. "Disciplinary" and "incident" reports of violence, compiled by defendants, reveal numerous physical assaults by prisoners on other prisoners or on the jail staff and frequent fights, sexual attacks, attempted escapes, and attempts to incite riots. In 1984, with an average daily population of 2,024, the total number of violent incidents was 1,541. Significantly, the number of violent incidents has increased at a disproportionately higher rate than the increase in the jail population, nearly two-and-a-half times faster.
In the first four months of 1984 the average daily population at the jai'.; was 1,854; for the last four months oi that year the average was 2,242 — an increase of 20.9%. During the same periods the total number of violent incidents (as reflected in the "disciplinary" or "incident" reports for assaults, attempted assaults, threats, sexual abuse, fights, escapes and escape attempts, inciting to riot, and creating a disturbance) increased from an average of 105 per month to 155 per month — a 48% jump,
q nearly two-and-a-half times the rate of increase in population.
Defendants contend that the dramatic increase in the number
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(&
of reported incidents reflects better reporting by more guards and thus does not constitute an increase disproportionate to the increase in the jail population. In an affidavit supplied to the court, Administrator Long stated: "it is my opinion that the most significant factors which produced the increase in the number of reported incidents ... were the increase in the number of officers assigned to the institution, more direct supervision of officers with emphasis on reporting, plus the increase in the number of residents housed at the institution."
The number of guards has increased approximately 11% — from an average of 498 for January through April to an average of 552 for September through December 1984. At the same time, however, the critical ratio of prisoners to guards has actually decreased from 3.7:1 for the first four months to 4.1:1 for the last four months.
The court also finds the thorough explanation provided by plaintiffs1 expert Eugene Miller more credible, illuminating and probative than defendants' self-serving speculations: Mr. Miller reported:
[A]dditional staffing is not the answer to the security problems ...; the real threats to security go beyond throwing increasing numbers of staff at the problems .... These threats include the increased levels of anxiety and tension among the inmate population brought on by cramped living conditions, lack of sufficient out-of-cell time, and a routine of continual and debilitating boredom. Given these factors, realistically staff
^These figures take on perhaps added significance when we consider that less than half of the population are incarcerated for violent offenses.
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G
increases can be expected to heighten staff response to incidents, but will do nothing to alleviate the causes of such incidents.... The new officers will be used to bolster staff observation potential, not to increase the level, variety and frequency of inmate activity. To put it bluntly, the most serious single factor currently constituting a threat to the safety of other inmates and staff is the pervasive overcrowding and its corresponding negative human impact upon the inmates, not lack of an adequate number of staff. Given that, as the level of tension escalates among the inmates, the likelihood for an increased level of assaults and more serious incidents, such as the fire-setting in the past several months, also increases dramatically.
The statistics corroborate what testimony averred — that the
jail is an increasingly hostile and dangerous place in which to
live and that the chief cause of the ever-widening violence is the
growth of the jail population and the resultant strain on
prisoners, staff, facilities, and services. As Director Holland
admitted: "you decrease the boiling point as you cut off services
that should be available to [the prisoners]." The evidence
convinces the court that the disproportionately increasing number
of violent incidents is caused by crowding too many people into
too small a space.
A disproportionate amount of violence occurs in the makeshift
open housing areas, where "violent" residents are allowed to
mingle among the "non-violent", and where the deterrent presence
of guards is most noticeably absent. Indeed, when defendants
first asked this court to temporarily authorize double-celling of
pre-trial detainees, they justified their request on the fact that
prisoners in cells can be more easily observed and more readily
controlled than prisoners in open housing areas. Campbell v.
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<• . *
McGruder, 554 F. Supp. 562, 563, 565 (D.D.C. 1982). Residents are more susceptible to gang attacks in the "floor-
space" areas, where there are more opportunities for violence, and more potential collaborators as well. The physical arrangement of these areas reduces the ability of guards to monitor the conduct of prisoners and diminishes the willingness and ability of guards to stop attacks or fights once the incidents are noticed. These areas are virtually unguardable.
Many floor-space residents told Dr. Rundle that they lived in constant fear of assaults and rape. Eugene Miller concluded that n[t]hese temporary housing quarters ... pose a significant and continuing threat to the safety of the [residents] housed in that fashion.... As long as these dormitories remain, there will be a serious actual and potential threat to the overall security of the [jail] .... [T]hey virtually constitute an assault waiting to happen." (Emphasis added.)
Furthermore, there are dangers greater than individual assaults and fights. On July 22, 1983 a riot occurred at the jail. Hundreds of prisoners engaged in armed resistance to jail authorities. Fires were set in the exercise yard and in a number of the cellblocks. There was large-scale destruction of jail and residents1 property and the staff and prisoners suffered numerous injuries. Order was not restored until large numbers of heavily armed police and guards arrived.
10This is also reflected in the number of persons in protective custody and the increased number of requests by prisoners for the same.
-34-

<?••
(••'•••
In the month that preceded this disturbance, the jail population reached a then all-time high of 2,433. At the time of the riot jail officials identified overcrowding, and the long train of miseries that follow in its wake, as the principal causes of the riot. The jail population is now nearly 8% higher than it was at the time of the riot. Overall conditions have worsened. Health care services, substandard for a long time, have further deteriorated. There are fewer doctors, fewer nurses, and less frequent sick call. Violence has become a daily habit. During the February visit to the jail Sgt. Cynthia Coleman told the court: "We expect a riot any day now. Any day now."
Summary of Facts
The overcrowding at the jail has placed unreasonable demands on every jail resource — both in terms of the physical plant and personnel. The facility's ability to provide essential services has been seriously undermined. As a result living conditions at the jail are doubtless dangerous and uncomfortable and inmates and pre-trial detainees suffer sevei.e privations.
III. Conclusions of Law
The Supreme Court has reiterated that some discomfort, inconvenience, deprivation, and even physical danger are to be expected—and countenanced in the prison setting. Hudson v. Palmer, 104 S. Ct. 3194, 3199 (1984); Rhodes v. Chapman, 452 U.S.
-35-

337, 349 (1981); Bell v. Wolfish, 441 U.S. 520, 537, 542 (1979); Wolff v. McDonnell, 418 U.S. 539, 555 (1974); Pell v. Procunier, 417 U.S. 817, 822-23 (1974). However, at the same time the Court has admonished the lower courts to be aware of their responsibility to intercede when these adverse conditions reach a point at which they strip a prisoner of constitutional protections. Hudson, 104 S. Ct. at 3198-3200; Rhodes, 452 U.S. at 351-52; Bell v. Wolfish, 441 U.S. at 545; Wolff, 418 U.S. at 55556; Pell v. Procunier, 417 U.S. at 822.
A. The Eighth Amendment Standard
The Rhodes Court promulgated three alternative tests for determining whether prison conditions violate the constitutional rights of convicted inmates. The eighth amendment prohibits conditions of confinement which: (1) "involve the wanton and unnecessary infliction of pain"; (2) are "grossly disproportionate to the severity of the crime warranting imprisonment"; or (3) "alone or in combination may deprive inmates of the minimal civilized measure of life's necessities", as tested by "contemporary standard[s] of decency." 452 U.S. at 347. The determination of whether prison conditions are inconsistent with "contemporary standards" of society is to be made on the basis of "'objective factors to the maximum possible extent,'" _id_. at 346 (quoting Ruminell v. Estelle, 445 U.S. 263, 274-75 (1980)).
-36-

B. The Fifth Amendment Standard
Overcrowding at the jail directly affects pre-trial detainees as well as convicted inmates. Detainees suffer from excessive violence, inadequate medical care and numerous other indirect effects of overcrowding. Consequently, the conditions at the jail must be squared with the Due Process Clause of the fifth amendment as well as the Cruel and Unusual Punishment Clause of the eighth amendment. The standards set by the fifth amendment are even less forgiving than those established by the eighth amendment. The latter proscribes only cruel and unusual punishment; the fifth amendment bans any punishment at all. Bell v. Wolfish, 441 U.S. at 535 nn.16, 17, 536-37; Inqraham v. Wright, 430 U.S. 651, 671-72 n.40 (1977).
Determining whether particular conditions or restrictions, singly or in the aggregate, amount to punishment requires a twostep inquiry: first, a determination of whether the purposes of the challenged conditions are "legitimate"; and second, an examination of whether *he means used to achieve these purposes are "reasonably related" to these goals. Bell v. Wolfish, 441 U.S. at 538-39.
C. The Eighth and Fifth Amendment Standards Applied
The living conditions created by the overcrowding at the District of Columbia Central Detention Facility violate both the eighth and fifth amendments. There are three reasons why, each of
-37-

which fully authorizes intervention by the court.
1. The Violence at the Jail Inflicts Unnecessary and Wanton Pain on Inmates and Imposes Punishment on Pre-trial Detainees.
The concept that excessive violence may offend the Constitution is in accord with the well-established duty of correctional officials to protect prisoners from excessive violence. "[P]rison administrators ... are under an obligation to guarantee the safety of the inmates themselves." Hudson, 104 S. Ct. at 3200. See Youngberg v. Romeo 457 U.S. 307, 315 (1982). See also Estelle v. Gamble, 429 U.S. 97, 102-04 (1976).Xl
Some amount of jail violence may be unavoidable "due to the character of the prisoners." Martin v. White, 742 F.2d 469, 475 (8th Cir. 1984). See Hudson, 104 S. Ct. at 3200; Doe v. District of Columbia, 701 F.2d 948, 951 (D.C. Cir. 1983) (MacKinnon, J.; separate statement). Isolated incidents do not equal a constitutional violation, Withers v. Levine, 615 F.2d 158, 161 (4th Cir.), cert, denied, 449 U.S. 849 (1980); "a prisoner has no right to demand the level of protection necessary to render an institution assault-free." Murphy v. United States, 653 F.2d 637,
^Indeed, it is because of the critical need to maintain prison security that correctional authorities are granted extraordinarily broad powers over incarcerated persons. See e.g., Hudson, 104 S. Ct. at 3194 (prison officials may search cells without probable cause; fourth amendment protections inapplicable as prisoners have no reasonable expectation of privacy); Block v. Rutherford, 104 S. Ct. 3227 (1984) (random shakedown searches of pre-trial detainees' cells in their absence are permissible; all contact visits may be banned). See also Bell v. Wolfish, 441 U.S. at 540 & n.3; Phillips v. Bureau of Prisons, 591 F.2d 966, 972 (D.C. Cir. 1977).
-38-

(£•
644 (D.C. Cir. 1981). A successful eighth amendment challenge on the issue of prison violence must show that
"violence and sexual assaults occur ... with sufficient frequency that the ... prisoners ... are put in reasonable fear for their safety and to reasonably apprise prison officials of the existence of the problem and the need for protective measures." [Murphy, 653 F.2d at 645 (quoting Withers, 615 F.2d at 161).]
In the cases under consideration, the evidence establishes that violence is pervasive, that the increase in the number of violent acts is disproportionate to the increase in the jail population, and that overcrowding is the direct cause of the increasing violence. The evidence also shows that the prisoners are justifiably in great fear of such violence, and that defendants are well aware of the actual violence, the potential risks of more violence, and the well-grounded fears of the residents and the staff.
Indeed, defendants' earlier request for permission to doublecell pre-trial detainees was premised on their recognition of the need to control what hitherto had been, and apparentJy is now again, unmanageable violence.
In considering defendants1 1982 motion to permit doublecelling of pre-trial detainees, this court deferred to the defendants' assessment that make-shift floorspace housing was inadequate and unsafe.
The Department offered two justifications for resorting to double-celling .... The first was that dormitories cannot be adequately patrolled and therefore pose a severe security risk.... The second justification was that double-celling would
-39-

0
enable the Department to remove dormitory beds from dayrooms and gymnasiums and use these facilities to provide inmates with needed recreational opportunities.
In light of this testimony, the court will defer to the Department's judgment that doublecelling is a lesser evil than the continued use of make-shift dormitories.... [Campbell v. McGruder, 554 F. Supp. 562, 563, 565 (D.D.C. 1982).]
The arguments advanced by defendants were persuasive then; they remain so now. Indeed, these concessions about the undesirability of make-shift housing take on even more significance in light of the greater overcrowding and the worsened conditions at the jail.
The failure of defendants to alleviate the overcrowding and the resultant inability to protect prisoners from violence inflicts unnecessary and wanton pain and violates the eighth amendment.
In the fifth amendment context, the pervasive risk of violence and the imposition of wanton and unnecessary pain affects all prisorers at the jail, pre-trial detainees as well as convicted inmates. If the overcrowded conditions and concomitant violence are evaluated as ends in themselves, they obviously, and by definition, serve no legitimate penological purpose. See Bell v. Wolfish, 441 U.S. at 538-40. If the overcrowding and the violence are viewed as means to a permissible end, e.g., securing a detainee's presence at trial, they still must be seen as irrationally and unnecessarily harsh and excessive. From either perspective, and by either test, conditions at the jail violate
-40-

the fifth amendment. In sum, the jail conditions that violate eighth amendment rights of all convicted inmates a_ fortiori violate the fifth amendment rights of unconvicted pre-trial detainees. Union County Jail Inmates v. DiBuono, 713 F.2d 984, 998 (3d Cir. 1983); cert, denied sub nom., DiBuono v. Fauver, 104 S. Ct. 1600 (1984). See Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3d Cir. 1979). These constitutional violations, by themselves, entitle plaintiffs to relief.
2. The Inadequate Health Care System Inflicts Wanton and Unnecessary Pain on Inmates and Imposes Punishment on Pre-trial DetaineesT
The eighth amendment's proscription against the "unnecessary and wanton infliction of pain", Gregg v. Georgia, 428 U.S. 153, 173 (1976) (joint opinion of Stewart, Powell, and Stevens, J J . ) , obligates prison officials to provide all prisoners with ready access to adequate medical care. Estelle v. Gamble, 429 U.S. 97, 103 (1976). "An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met .... Such a failure may actually produce physical 'torture or a lingering death', ... or pc:in and suffering which no one suggests would serve a penological purpose." ld_. (citations omitted) (quoting In re Kemmler, 136 U.S. 436, 447 (1890); see Campbell v. McGruder, 580 F.2d at 549.
The medical care provided must be adequate, and access to this care must be readily available. _Id_« See Estelle v. Gamble, 429 U.S. at 104-05. The health services system must be able to meet both "'the routine and emergency health care needs'" of
-41-

residents. Ramos v. Lamm, 639 F.2d 559, 574 (10th Cir. 1980), cert denied, 450 U.S. 1041 (1981) (quoting Battle v. Anderson, 376 F. Supp. 402, 424 (E.D. Okla. 1974)). Satisfactory dental care and mental health care must also be provided. Hoptowit v. Ray, 682 F.2d 1237, 1253 (9th Cir. 1982); Ramos, 639 F.2d at 574. New prisoners must be appropriately screened for communicable diseases. Lareau v. Manson, 651 F.2d 96, 109 (2nd Cir. 1981).
Occasional, inadvertent, or negligent denials of adequate care, which might lead to civil liability for medical malpractice, do not become violations of the eighth amendment merely because the victims are prisoners. Estelle v. Gamble, 429 U.S. at 10506. "[D]eliberate indifference to serious medical needs" must be established in order for plaintiffs to prevail. ld_. at 106.
Deliberate indifference to the medical needs of a class of prisoners can be established either by proving repeated examples of negligent care "which disclose a pattern of conduct by the prison medical staff", Ramos, 639 F.2d at 575; Todaro v. Ward, 565 F.2d 48, 52 (2d Cir. 1977) (Kaufman, C.J.), or by showing there are "such systemic and gross deficiencies in staffing, facilities, equipment or procedures that the inmate population is effectively denied access to adequate medical care." Ramos, 639 F.2d at 575 (citing cases). See Todaro, 565 F.2d at 52; Wellman v. Faulkner, 715 F.2d 269, 272 (7th Cir. 1983), cert, denied, 104 S. Ct. 3587 (1984).
We are cognizant of the fact that the Supreme Court has cautioned the lower courts not to "assume that the opinions of
-42-

•
experts as to desirable prison conditions suffice to establish
contemporary standards of decency", Rhodes, 452 U.S. at 348 n.12,
and thus "do not establish the constitutional minima", Bell v.
Wolfish, 441 U.S. at 543-44 n.27. Nevertheless, in Gamble the
Court suggested that "[m]odel correctional legislation and
proposed minimum standards" could be used for guidance. 429 U.S.
at 103-04 n.8. At the very least, such proposed standards provide
some alternative to the subjective opinions of the court or the
partisan views of expert witnesses. Though the court is not bound
to defer to such proposed standards, it is not prohibited from
drawing upon whatever sensible guidelines they might offer. This
would appear to be particularly so regarding medical standards,
which courts have traditionally viewed as well deserving of
respect.
The court has consulted several of the models cited in Gamble. 1 2 While recognizing that these standards may reflect the
*2American Correctional Association, Standards for Local Detention Facilities(2d ed. 1981) Standards 2-5277, 2-5278, 25 279; American Correctional Association, Standards for Adult Correctional Institutions, (2d < d. 1981) Standards 2-4279, 24281, 2-4295; American Bar Association, Proposed Standard of Joint Committee on Legal Status of Prisoners (1981) Standard 235.2; American Bar Association, Standards for Criminal Justice; Legal Status of Prisoners (Fourth Tentative Draft 1980) Standards 23-5.l(a), 23-5.2; U.S. Department of Justice, Federal Standards for Prisons and Jails (1980) Standards 5.09, 5.19, 5.20, 5.28; American Medical Association, Standards for Health Services in Prisons (1979) Standards 143, 14b, 14b, ibb, lbl; American Public Health Association, Standards for Health Services in Correctional Institutions (1976) §§ I-, V-A, V-B, V-C; National Sheriffs1 Association, Standards for Inmates Legal Rights (1974) Right No. 3.2; National Advisory Commission on Criminal Justice Standards and Goals, Corrections (1973) Standard 2.6; American Law Institute, Model Penal Code, Part III on Treatment and Correction (1962), §303.4(1); Fourth United Nations' Congress on Prevention of Crime and Treatment of Offenders, Standard Minimum Rules for (continued)
-43-

<t
ideal more than the practical, it appears to the court that the medical conditions at the jail fall so far short of any one of them that they cannot be said to be consistent with any contemporary standard of decency. For example, these standards mandate that sick call be available to prisoners no less than four or five times per week, not once a week, as is the practice at the jail.
Here, the evidence discloses continuing shortcomings in staffing, intolerable delays in access to appropriate health care personnel, lack of training and lack of supervision of nonprofessional medical and psychiatric staff, haphazard and illconceived administration and organization, sloppy record keeping, "screening" improperly delegated to unqualified personnel, improper dispensation of prescription drugs, and the woeful lack of dental and psychiatric care. These deficiencies cause needless suffering and the purposeless infliction of pain without any conceivable penological justification. The evidence shows numerous incidents of gross and wanton neglect and establishes a pattern of misconduct and ma1.feasance. These serious conditions amount to deliberate indifference to the health care needs of all prisoners; they violate the eighth amendment rights of inmates and impose punishment on pre-trial detainees. Once again, these constitutional violations, standing alone, justify plenary relief.
the Treatment of Prisoners (1955) Rules 22(3), 25(1)
-44-

Q

Q

3. The Conditions Created by Overcrowding, Taken As a Whole, "Deprive Inmates of the Minimal Civilized Measure of Life's Necessities". 3 These Conditions Also Inflict Punishment on Pre-trial Detainees.
In Rhodes, prisoners complained that double-celling confined
them too closely together and therefore violated the eighth
amendment. They also contended that the prison population was 38%
over design capacity and that this overcrowding overwhelmed the
prison's staff, services and facilities. Rhodes, 452 U.S. at
340. Although recognizing that conditions, "alone or ir combination," 4 id. at 347 (emphasis added), could violate the
Constitution, the Court held that "under [the] circumstances" in
that case they did not. _Id_. at 348.

13Rhodes, 452 U.S. at 347.
"It is important to recognize that various deficiencies in prison conditions 'must be considered together.' The individual conditions 'exist in combination; each affects the other; and taken together they [may] have a cumulative impact on the inmates.1 Thus, a court considering an eighth amendment challenge to conditions of confinement must examine the totality of the circumstances." Rhodes, 452 U.S. at 362-63 (Brennan, J., concurring in judgment) (quoting Holt v. Sarver, 309 F. Supp. 362, 373 (E.D. Ark. 1970)), citations and footnote omitted, emphasis added). See Hutto v. Finney, 437 U.S. 678, 687, 688 (1978)—("interdependence of the conditions", "taken as a whole"); Campbell v. McGruder, 580 F.2d at 531. "It is the totality which the Constitution regulates." Lareau v. Manson, 651 F.2d 96, 107 (2d Cir. 1981). "Various prison conditions do not exist in isolation. Rather, challenged conditions must be viewed in the light of other prison conditions that may aggravate or mitigate the effect of other challenged conditions." See also Wellman v. Faulkner, 715 F.2d 269, 274 (7th Cir. 1983), cert denied, 104 S. Ct. 3587 (1984); Hewitt v. Helms, 459 U.S. 460, 474, 477 & n.9 (1983); Samoson v. King, 693 F.2d 566, 569 (5th Cir. 1982); Union County Jail Inmates v. DiBuono, 713 F.2d 984, 999-1000 (3d Cir. 1983), cert, denied sub nom., *DiBuono v. Fauver, 104 S. Ct. 1600 (1964) . _But see Hop tow it v. Ray, 682 F.2d 1237, 1246-47 and n.3 (9th Cir. 1982); Wright v. Rushen, 642 F.2d 1129, 1132 (9th Cir. 1981).
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In determining whether the totality of prison conditions
violates the eighth amendment, a court must evaluate the
cumulative effect upon inmates
of the condition of the physical plant (lighting, heat, plumbing, ventilation, living space, noise levels, recreation space); sanitation (control of vermin and insects, food preparation, medical facilities, lavatories and showers, clean places for eating, sleeping, and working); safety (protection from violent, deranged, diseased inmates, fire protection, emergency evacuation); inmate needs and services (clothing, nutrition, bedding, medical, dental, and mental health care, visitation time, exercise and recreation, educational and rehabilitative programming); and staffing (trained and adequate guards and other staff, avoidance of placing inmates in positions of authority over other inmates). [Rhodes, 452 U.S. at 364 (Brennan, J., concurring in judgment) (emphasis added).]
Defendants contend that, in accord with Rhodes, plaintiffs
are not entitled to relief. They point out that the jail is a
relatively new and modern facility and that overcrowding per se is
no cause for judicial intervention. But this case is not
comparable to Rhodes, and, as a matter of fact, Rhodes cuts not in
favor of the defrndants but against them.
While it is true that the jail was built in the 1970s, and
that it is centrally air conditioned and heated, those appear to
be the only common features shared by the jail and the Southern
Ohio Correctional Facility (SOCF), the maximum security prison at
issue in Rhodes. Furthermore, even the apparent similarity of
overcrowding is characterized by a marked difference, i.e., the
rate over design capacity in Rhodes was 38%; in this case the
population is 96% over the cell capacity and 177% over the service
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capacity. In the Ohio facility all inmates were housed in cells, and although they were double celled, 75% of them had the option of spending up to 15 hours per day outside their cells in school and work programs and in outdoor recreation. The Ohio prison had eight bright, well ventilated and well equipped classrooms, and various workshops including a machine shop, shoe factory, engine repair shop, sheet metal shop, print shop and sign shop. It also had a commissary and a barbershop. The cells in the Ohio facility were equipped with individual radios. In Rhodes the dayrooms were spacious and well equipped and completely available to the prisoners. None was used for any purpose other than those originally intended.
By contrast, at the jail 29% of the jail inmates are in makeshift housing. The incarcerees at the jail have but 8 hours out-of-cell time to spend in crowded dayrooms and hallways. They enjoy only 3 hours per week of outdoor recreation. There are a few classrooms at the jail but no workshops as in the Ohio facility. At the jail, nearly half of the dayroom space has been preempted for housing, leaving the remainder to serve nearly double the intended population, thereby geometrically compounding the problem.
The library at the Ohio institution was one "superior in quality and quantity", where the 2,300 inmates had access to 25,000 volumes, including law books. Chapman v. Rhodes, 432 F. Supp. 1007, 1010 (S.D. Ohio 1977). At the jail, 2,600 prisoners have access to only 4,200 volumes. In Rhodes, "there [was] no indication whatsoever that the food facility [had] been taxed by
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the prison population." Id., at 1014. The kitchen facilities at the jail are overtaxed and operate on an around-the-clock basis. In Rhodes there were no complaints concerning unsanitary toilets, sinks and showers such as the ones we have at the jail. Apparently the classification and parole services at the Ohio prison were completely satisfactory, and that is not so at the jail. Visiting privileges and facilities had not been affected in the Ohio facility and contact visits were allowed. By contrast, at the jail visiting hours have been reduced and long delays are commmonplace for the noncontact visits which are permitted. At the Ohio facility medical and dental care was completely adequate. Sick call was held daily. Initial sick call and screening was performed by a nurse. Prescriptions were passed out daily and any backlogs for dental patients "were temporary". 434 F. Supp. at 1015-16. In sharp contrast are the systemic deficiencies in medical, dental and mental health care at the jail.
In Rhodes the Court emphasized that the plaintiffs produced no evidence that double celling caused greate" violence, and that "the number of acts of violence had increased only in proportion to the increase in population." 452 U.S. at 342-343. Finally, there were no riots or suicides. This is not the picture at the jail where the violence is widespread and disproportionately increasing to the population increase; in addition, a riot in July 1983 occurred at the jail, and there have been four suicides since that time. The obvious implication is that the figures we have in this case reflect a nexus between the gross overcrowding and the
-48-

€<
rate of violence. Obviously the conditions in Rhodes are sharply
distinguishable from those at the jail. In Rhodes the Court essentially determined that overcrowding had not adversely affected, in any substantial way, the quality of daily life of the SOCF inmates. Ever-increasing violence did not threaten their safety and poor medical care did not jeopardize their health. Under no circumstances can similar conclusions be drawn in these cases.
Viewed in the aggregate, it is clear that the serious overcrowding at the jail has created conditions which are so acute that they deny inmates the minimum of life's necessities and inflict punishment on pre-trial detainees, thus establishing plaintiffs' claims of constitutional violations.
IV. Relief
The development of intolerable overcrowding and its negative effects on persons housed in the jail were obvious and predictable early o n — a t least to this court and the Court of Appeals. In light of these predictions both this court and the Court of Appeals have oftentimes identified specific avenues by which the population pressures could be reduced, emphasized the necessity for defendants to develop a long-range, comprehensive approach to overcrowding, and warned of the legal consequences if defendants did not use their presumed expertise to rectify ongoing constitutional violations. See e.g., Campbell v. McGruder, 416 F.
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Supp. 106, 108-11 (D.D.C. 1975); Campbell v. McGruder, 416 F. Supp. Ill, 114-17 (D.D.C. 1976); Campbell v. McGruder, 580 F.2d at 538 n.35 and _id_. at 526, 542-44 (1978); Campbell v. McGruder, 554 F. Supp. at 566 (1982). Nevertheless, instead of a sustained drive against the effects of a population crisis, defendants1 efforts have been sporadic, and largely unproductive; and conditions have steadily worsened.
Time and again, defendants have requested the court to defer to their accumulated wisdom, to ?tay its hand and to give them more time. Time and again, these requests have been honored in the hope and expectation that defendants would solve these problems expeditiously and effectively. However, instead of matters improving they have deteriorated. For example, at the October 1984 hearing defendants represented to the court that the jail population, which had steadily risen over the summer months, would fall with the onset of winter. This did not happen; in fact, the opposite occurred. The court was further given to understand that a new 400 bed Department facility, which was scheduled to open in late winter, would reduce the jail population by 400. That facility has opened, and is currently 20 persons shy of its design capacity—yet the jail is still packed with record numbers.
Moreover, there has been no indication of stepped up compliance with provisions of the Bail Reform Act, despite the fact that similar efforts in the past have been successful in reducing the jail population. Similarly, there has been no indication of approaches to the parole commission, or application
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to the courts that have imposed population ceilings on other Department facilities for reconsideration or modification of those orders; and there are other facilities not under court order where massive overcrowding does not exist. Nor is there any indication of thought given to utilizing the various empty buildings available to the District of Columbia government. In other words, for the most part there is no indication of anything except complacency.
This court is not eager to encroach upon the responsibilities entrusted to defendants. However, in this case, the court has "learned from repeated investigation and bitter experience that judicial intervention is indispensable if constitutional dictates-not to mention considerations of basic humanity are to be observed...." Rhodes, 452 U.S. at 354 (Brennan, J. concurring; emphasis in the original).
It appears that any effort to alleviate the specific results of overcrowding on a one by one basis is foredoomed. For example, five years ago we ordered defendants to hire additional medical staff. Campbell v. McGruder, C.A. No. 1462-71, slip op. (D.D.C. June 9, 1980). Defendants now assert their inability to hire or retain qualified professionals. This is to be expected inasmuch as the conditions of employment that flow from overcrowding already overtaxed facilities are completely unattractive to professional employees. It appears clear that when, as is the case here, constitutional violations are the direct result of, and inextricably tied to, what amounts to unattended runaway overcrowding, nothing short of an order placing a ceiling on the
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population can be an effective remedy. In addition, an order that attempted to rectify each particular infirmity would ineluctably and perpetually entangle the court in the "minutiae" of jail administration, a burden we are advised to avoid. Bell v. Wolfish, 441 U.S. at 562.
The ceiling need not be set at the jail's design capacity of 1,355. Since double-celling is not unconstitutional per se, the total jail population can rise above the limit set when it was assumed that all prisoners must be single-celled. At the same time, even if individual cells can house twice as many prisoners as originally intended, the institution as a whole cannot. At least, it cannot, consistent with the Constitution. Thus some reasonable midpoint must be established. Fortunately, defendants have provided some guidance, albeit inadvertent, on what that point should be.
In the spring of 1983, a few months before the riot, Director James Palmer asked then Assistant Director George Holland to forward recommendations on the maximum number of people that could be safely housed at the jail. Holland replied on July 1, 1983. "Ideally", he said, "I would recommend that 1,356 be our fixed capacity." Noting, however, that defendants had "capability and experience" in dealing with larger populations, 5 Holland concluded that the jail could safely hold nearly 25% more than design capacity. Holland recommended that the fixed limit should be set at 1,694.16
15At the time Holland wrote to Palmer, the average daily jail population was 2,325. (continued)
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The court will adopt Holland's expert assessment and. recommendation. The evidence confirms that the figure he proposed represents the largest number of prisoners that can be confined at the jail without inflicting cruel and unusual punishment on the residents.
In order to minimize the intrusion into the administrative concerns within the competence of jail officials, the court will order a prohibition on the intake of new residents rather than prescribe what should be done with the prisoners currently held at the jail. "A ban on intake will also serve the salutory purpose of forcing all of the various ... local agencies who either have a need to place people in confinement or the responsibility for providing detention facilities, or both, to face up to the challenge of making alternative arrangements." Badgley v. Varelas, 729 F.2d 894, 902 (2d Cir. 1984). This is also the method of implementing a ceiling specifically proposed by the Court of Appeals. Campbell v. McGruder, 580 F.2d at 536-37 n.28.
The court is aware of the fact that local agencies which would normally e:pect to send prisoners to the jail "are entitled to some brief period of time to make alternative arrangements ...." Id. The court will therefore direct that the prohibition
Subsequent testimony by Holland which raised the tolerable limits was thoroughly impeached and had the ring of incredibility.
-53-

«
on the intake of new prisoners not take effect until 40 days after the entry of the accompanying order.
.^>^;^:. JO v^....,„/
UNITED STATES DISTRICT JUDGE 1985
-54-

»•

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al.,

:

Plaintiffs,

:

v.

:

ANDERSON McGRUDER, et al. , • :

Defendants.

:

C.A. No. 1462-71

INMATES OF D.C. JAIL, et al. , :

v.

:

DELBERT C. JACKSON, et al.,

:

Defendants.

:

ORDER

C.A. No. 75-1668
RECEIVED JUL 1 5 1985
JAMES F. DAVEY, ClerJ-

Upon consideration of the Findings of Fact and Conclusions of Law entered this date in the above captioned matter, it is by the ccurt this / ~s '- day of July 1985,
ORDERED that beginning on the 40th day after the entry of this Order the defendants, their agents or designees shall not accept at the District of Columbia Department of Corrections Central Detention Facility any new residents, whether sentenced, awaiting trial, or in any other status, until such time as the population of the facility is no more than 1,693; and after such limit has been reached defendants shall accept no persons as incarcerees if such persons will increase the population above

.,.. V
1,694. And it is FURTHER ORDERED that defendants promptly notify all agencies
that send persons for confinement at the facility of the terms and effective date of this Order.
•'*.//:• 7~: 7* , -'-—UNITED STATES DISTRICT/JUDGE
-2-

 
 E i(
Campbell v. McGruder

I N THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

.LEONARD CAMPBELL, e t a l . ,
Plaintiffs, v.
ANDERSON McGRUDER, e t a l . ,
Defendants.

1 1 1 1 1 C.A. No. 1462-71 1 1 1 1

INMATES OF D.C. JAIL, e t a l . ,
Plaintiffs, v.
DELBERT C. JACKSON, e t a l . ,
Defendants.

1
1 1 1 1 C.A. N o . 75-1668 1 1 1 1

MEMORANDUM I N SUPPORT OF JOINT MOTION TO AMEND THE STIPULATION AND ORDER OF AUGUST 2 2 , 1 9 8 5
The o r d e r o f t h i s Court dated August 22, 1985, provides t h a t
a m e d i c a l e x p e r t s h a l l be a p p o i n t e d by each o f t h e parties "to r e v i e w t h e h e a l t k s e r v i c e s d e l i v e r y s y s t e m a t t h e D.C, J a i l a n d make recommendations f o r improvements i n t h e report to be s u b m i t t e d t o t h e C o u r t a n d t h e p a r t i e s by November 1, 1 9 8 5 , a n d i m p l e m e n t e d b y March 1, 1 9 8 6 , u n l e s s good c a u s e is shown by
e i t h e r p a r t y why t h e y s h o u l d n o t b e n . The e x p e r t s h a v e now
completed t h e i r s t u d i e s and are i n t h e process o f p r e p a r i n g t h e i r
r e p o r t s , The defendants' e x p e r t , Dr. Bernard Harrison, has
r e q u e s t e d t h a t separate reports be prepared by t h e experts. P l a i n t i f f s ' e x p e r t , Dr. R o b e r t L. Cohen, s u g g e s t e d t h a t t h e

experts exchange draft reports prior to submission of the reports
4
to the Court. This exchange of drafts will necessitate
additional time but hopefully will result in a work-product which
will reconcile and harmonize the recommendations of the experts
and lead to a consensus on as many items as possible. Therefore,
the parties have agreed, subject to the Court's approval, to an
enlargement of the time for submission of the final reports to
December 1, 1985.
Respectfully submitted,
Steven N* Alvin J. Bronstein ACLU National Prison Project 1616 P Street, NW Suite 340 Washington, D.C. 20036 (202) 331-0500
Counsel for Plaintiffs in Inmates v. Jackson
J. Patrick Hickey John H. Mort? Douglas Hilleboe Shaw, Pittman, Potts 6
Trowbridge 1800 M Street, NW Washington, D.C. 20036 (202) 822-1000
Counsel for Plaintiffs in Campbell v. McGruder

 
 Campbell v. McGruder

JC-DC-001-046
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al., Plaintiffs,
V
ANDERSON McGRUDER, et al., Defendants.
INMATES OF D.C. JAIL, et al., Plaintiffs,
V• DELBERT C. JACKSON, et al-,
Defendants.

[

j

Civil Action No. 1462-71

\

(Judge Bryant)

"
FILED

:

rAU822tt5

: JAMES F. DAVEY, Cferk

• Civil Action No. 75-1668 : (Judge Bryant)

:

STIPULATION OF THE PARTIES TO REDUCE THE POPULATION AT THE D.C. JAIL
The partieJ to the above actions hereby agree as ollows: (1) They will urge the Court to stay the effective date of the Memorandum and Order dated July 13, 1985 in the above cases conditioned on compliance with the provisions of this stipulation.
(2) The defendants will reduce the population at the D.C. Jail so that it will not exceed the levels indicated

m

- 2-

on the following dates:

August 23, 1985 September 1, 1985 September 13, 1985 September 27, 1985 October 11, 1985 October 25, 1985 November 8, 1985 November 22, 1985
and thereafter

2200 Residents 2050 Residents 1990 Residents 1930 Residents 1870 Residents 1810 Residents 1750 Residents 1694 Residents

If within 48 hours of a violation of the above levels, the population still exceeds the level indicated, the Court's Order dated July 13, 1985 will automatically be reinstated in full force and effect, and the defendants will be enjoined from admitting any residents to the D.C. Jail until the Order is complied with.

(3) The Mayor fully supports the Prison Overcrowding Emergency Powers Act, Bill 6-63, and he will personally lobby the Councilraembers in an all-out effort to get it passed as soon as possible. He will request that this bill be one of the first pieces of legislation considered by the Council when it returns from recess in September. The Mayor further agrees

- 3

that if the bill is passed by the Council, he will sign it and he will effectively use the authority granted thereby to insure compliance with the Order of July 13, 1985.

(4) The District commits that all parole eligible residents

(felons and misdemeanants) in the D.C. Department of Corrections

will have parole decisions made by the Parole Board within 45 days

of Aug. 22,1985 unless waived by the resident. Henceforth, a

parole determination shall be made by the Parole Board no later

;

than ten days prior to a residents' parole eligibil

r

f

(5) The District will begin negotiating the terms of

contracts for delivery of Half Way Houses for Fiscal Year 1986

during the week of August 26. The Department will increase its

Half Way House capacity to no less than 736 by September 30,

1986.

:

(5' In addition to existing programs, at least $100,000

in funding for the Third Party Custody Program described below

>

will be immediately transferred to the Pretrial Service Agency,

r

to be used to fund a Third Party Custody contract directed

1

i

specifically toward the implementation of a program which will

?

deal with persons who might otherwise be confined to the D.C.

|

t

Jail pretrial.

\

- 4-

(7) The Mayor will communicate formally with the Chief Judge of the Superior Court within one week requesting him to assure that bond review hearings are regularly conducted on all pretrial detainees who remain in custody within 10 days of commitment. The Executive Branch of the Government will then monitor the results of this request to determine its effectiveness.

If bond review hearings are not being regularly conducted by September 30, 1985, the Acting Corporation Counsel will assign attorneys to appear specially before Superior Court judges to request bond review hearings on detainees at the D.C. Jail.

(8) Within the next thirty days the District will obtain

the services of nationally recognized experts agreeable to the

parties, such as Doctors Austin and Chrisberg of the National

Council on Crime and Delinquency, to assess the institutional

and internal classification system of the Department of

,

Corrections. The reasonable costs and fees of these experts

\

will be paid by the defendants. The results of such assess-

[

raent will be made available to the Court and counsel by

f

i

January 30, 1986, and implemented within a

{

r

- 5-

reasonable time thereafter, unless either party shows good cause why they should not be.

(9) After November 22, 1985, the North-3 area of the Jail shall not be used for housing, other than in cells, more than 36 residents, appropriately classified for group housing.

(10) Attached hereto is the commitment of defendants regarding "Special Employment Outreach." The defendants will make good faith efforts to provide furloughs for residents to obtain employment for parole purposes.

(11) The defendants will urge the Parole Board to

exercise regularly its authority under O.C. Code $24-201c

;

to seek reductions of minimum sentences in all appropriate

I

i

cases to reduce overcrowding.

\

v

(12) The defendants will move expeditiously to implement

<

ir

the Plan for Improvement of Mental Health Services at the Jail,

filed with the Court in July 1985.

(13) Within 30 days, the Plaintiffs and the Defendants

shall each respectively appoint one medical expert whose

reasonable costs and fees will be paid by defendants, to

- 6-*
review the health services delivery system at the D.C. Jail and make recommendations for improvements in a report to be submitted to the Court and the parties by Nov. 1,1985 and implemented by March 1, 1986, unless good cause is shown by either party why they should not be.
(14) Defendants agree that in consideration of this stipulation, they will withdraw the Motion to Alter or Amend the Judgment in these cases, and will not appeal or contest the Findings of Fact and Conclusions of Law contained in the Memorandum and Order dated July 13, 1985. Should the Order dated July 13, 1985 be reinstated pursuant to Paragraph (2) of this Stipulation, the defendants reserve the right to seek a stay of the Order as reinstated, and to appeal from any denial of such stay request.
(15) Defendants will file with the Court every two weeks beginning August 26, 1985, a report detailing their implementation of this Stipulation. Defendants will notify the Court and counsel within 48 hours of any non-compliance with the

c.

- 7-
provisions of this Stipulation, other than Paragraph (2) Any non-compliance with Paragraph (2) shall be reported within 24 hours.

Date: August 22, 1985

DISTRICT OF COLUMBIA

J. JO0N H. MORE, DOUGLAS SHAW, PITTMAN, POTTS &
TROWBRIDGE 1800 M Street, N.W. Washington, D.C. 20036 (202) 822-100
Counsel for Plaintiffs in Campbell v. McGruder

fON BARRY Mayor
JOHN H. SUDA Acting Corporation Counsel, D.C.
Attorney for Defendants District Building, Room 329 1350 Pennsylvania Avenue, N.W. Washington, D.C. 20004 (202) 727-6248

STEVEN NEY, ESQ7. MARY E. McCLYMONT, ESQ. ALVIN J. BRONSTEIN, ESQ. ACLU NATIONAL PRISON PROTECT 1616 P Street, N.W. Washington, D.C. 20036 (202) 331-0500
Counsel for Plaintiffs in Inmates v. Jackson

SPECIAL EMPLOYMENT OUTREACH
The Director of the Department of Employment Services will intensify the Special Temporary Employment Program (STEP) initiated in January, 1984 through which 154 ex-offenders have already been placed in full-time employment. The program is designed to assist in meeting the work contingency required for parole.
Specialized approaches is to employment and employabiiity development for this population have included and will continue on an intensified basis:
Job developers were designated to develop jobs specifically for this target group. A concerted effort has taken place to identify employers willing to hire ex-offenders. Both large and small employers have been contacted in this endeavor. These contacts were as a result of both promotional telephone contacts and personal visits.
The OJT Program (ADP) is being used as a tool to encourage employers to participate in this on-the-job training program with a commitment to hire at a later date. Hopefully, this will encourage employers to hire by the government subsidizing one half of wages up to $3.00 per hour for a designated period of time depending on the occupation.
The Targeted Jobs Tax Credit (TJTC) Program is being used as a tool to encourage employers to hire. Employers would be eligible for a tax credit of up to $3,000 provided the employee earns wages of $6,000 or more. This is not considered a subsidy.
The Federal Bonding Program will be used as a tool to encourage employers to hire ex-offenders in positions which require bonds. The bonding program is a form of insurance provided by the Federal Government used to protect employers from loss of money or pr *perty sustained through the dishonest acts of their employees. This service is free to the employer and provides bonds for persons who would not usually qualify for bonding through private insurance companies.
Staff was designated from DOES and the Corrections System to serve as Counselors with emphasis being placed on followup activities on individuals participating in the program. The delineation of activities would require DOES to work in "choice-change counseling," which involves working with a person's barriers in order to place a person in a job. Department of Corrections counselors would work with those individuals who refuse to participate, calling them in for specialized counseling and determining the action to be taken.

-2-
Expanded Specialized Efforts
In order to work more intensively with this population, DOES has established a new .Unit under the Office of Job Service, Program Operations, to implement the STEP Program. This Unit will be responsible for all ptiases and activities of the program.
The Unit will be staffed with 6 DOES personnel (1 coordinator, 4 placement counselors, 1 clerk/secretary) and 2 Department of Corrections personnel (2 parole officers). The primary function of the Unit is the placement of offenders in unsubsidized jobs in the Washington Metropolitan Area. In addition, the Unit is responsible for assisting the participants through counseling to develop sound work habits, job skills, social adjustment to a working environment and a record of employabiiity through job per formance.
Each individual who had not yet been placed for the first time, will be contacted again and scheduled for a oneon-one interview with the probation officers and job placement counselor.
Job Search Workshops were conducted for all participants in the program in an effort to assist each ex-offender in their employment pursuit. The Job Search Workshops covered: Barriers to Employment, Motivation, Interviewing Techniques, Resume Preparation, and How To Keep Your Job Once Hired. It is felt that the Workshops were beneficial as ex-offenders were able to obtain employment through their own initiatives. Further, the information and knowledge obtained will assist those others placed by DOES.
DOES will contact contractors who have been awarded D.C. Government contracts requesting that special attention be given to placing individuals in the ex-offenders program.
D.C. Private Industry Council will be contacted to develop at least 15 on-the-job training slots in the private sector.
Personalized follow-up on each job referral will be made with each employer involved. It should also be done with the applicant within twenty-four hours to find out what the problems were if they did not receive the job. Depending on the employer and individual case, counselors may accompany applicants to job interviews.
Job development to match client profiles will be intensified, addressing specifically the barriers identified during the subsequent interviews.
Ongoing screening and assessment of ex-offender applicants at the penal institutions within 90 days of their parole or release to determine what jobs and/or training they would be ready to enter.

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al. , Plaintiffs,
V• ANDERSON McGRUDER, et al.,
Defendants.
INMATES OF D.C. JAIL, et al., Plaintiffs,
V.
DELBERT C. JACKSON, et a_l. , Defendants.

;

[

Civil Action No. 1462-71

. \

(Judge Bryant)

\

Fll-ED

:

:

JAMES E. DAVEY. Clerk

Civil Action No. 75-1668

:

(Judge Bryant)

:

ORDER
Whereas defendants have moved for a stay of the Order of the Court dat^d July 13, 1985, and the Court having considered the Stipulation of the Parties to Reduce the Population at the D.C. Jail ("Stipulation"), and the parties having requested in open Court the entry of this Order, and good cause having been shown, it is hereby
ORDERED: (1) The Court approves the Stipulation and incorporates it herein as if fully set forth below.

- 2-

(2) The Order of the Court dated July 13, 1985 is hereby stayed pursuant to the terms of the Stipulation.
(3) The Court maintains jurisdiction for such time as is necessary to enforce the terms of this Order and the Stipulation.

DATED: d** l*r Zj2jllll- ^ ^ - ^ 1 ^ /? /2.

*^

c— UNITED STATES DISTRICT JffDGE

 
 Campbell v. McGruder

JC-DC-001-058

FILED'

UNITED STATES DISTRICT COURT

I 0 1993

FOR THE DISTRICT OF COLUMBIA ^£^H,U.S.DIS

LEONARD CAMPBELL, et al., Plaintiffs,
v.

)
) ) Civil Action No. 1462-71
(WBB) )

ANDERSON McGRUDER, et al., )

Defendants. )

INMATES OF D.C. JAIL, et. a_l. , )

)

Plaintiffs, )

)

v.

)

)

DELBERT C. JACKSON, et al., )

) Defendants. )

Civil Action No. 75-1668 (WBB)

ORDER APPOINTING SPECIAL OFFICER
Hearings were held in these consolidated cases on April 6, April 8, and April 13, 1993 in esponse to plaintiffs' Motion for an Order to Show Cause Why Defendants Should not be Held in Contempt of Court. Based on the documents and deposition testimony received into evidence, the admissions contained in defendants' Memorandum in Opposition to Plaintiffs' Motion and in the Declarations of William Hall, M.D., Robert Morin, Psy.D. and Carolyn Groom, the arguments of counsel and the record as a whole, this Court finds that the plaintiffs have established by clear and

convincing evidence that the defendants were, until recently, in
substantial non-compliance with the June 9, 1980 and
August 22, 1985 Orders and that the defendants failed to comply
with portions of the March 5, 1993 Order.
The Court finds that, among other things, the defendants
have:
(1) failed to employ a full-time clinical psychologist on the mental health units at the Jail from January 1991 through April 5, 1993, although required to do so under the 1985 Order;
(2) failed to implement procedures to ensure that only correctional officers with specialized training in psychiatric care procedures worked on the mental health units, in contravention of the 1980 Order;
(3) dramatically reduced by one-third the hours of the mental health program on the mental health units in August 1990, in contravention of the 1985 Order;
(4) employed less than the fifteen required forensic psychiatric technicians (also known as mental health technicians) on the mental health units on several occasions over the last two years, including the period from July 11, 1992 through April 15, 1993, in contravention of the 1985 Order;
(5) employed only two psychiatric nurses on the mental health units at the Jail, rather than the three required, for a period of almost five months in 1992, in contravention of the 1985 Order;
(6) failed to provide sick call services to each housing unit each weekday from midDecember 1992 to mid-March 1993, in contravention of the 1985 Order;
-2-

(7) failed for a significant period of time to provide a full-time, on-site health administrator at the Jail, even though required to do so under the 1985 Order;
(8) failed to establish and implement a formal, functioning quality assurance program, in contravention of the 1985 Order; and
(9) discontinued chronic disease clinics until ordered by the Court to reinstate such clinics, even though the clinics were required to be maintained under the 1985 Order.
There appear to be serious deficiencies in medical and mental health care at the Jail associated with these violations. Indeed, thirteen years after defendants offered their initial plan for improving mental health services at the Jail, inmates on the mental health units appear to receive very little, if any, treatment for their illness beyond the prescription of psychiatric medication. See Declaration of Robert Morin, Psy.D. dated April 7, 1993.
Significantly, the Court finds that defendants concealed the
above-referenced violations of the 1985 Order from the Court by
not reporting them within 48 hours of their occurrence, as-
expressly required, and by not reporting them in the bi-weekly
reports to the Court which defendants continued to file. The
reporting requirement was developed precisely to inform plain-
tiffs and the Court of instances of non-compliance. The failure
to report in the required manner has unnecessarily prolonged the
discovery and proceedings in this case, and has hampered
-3-

plaintiffs' ability to seek to enforce the orders of this Court, to the detriment of the plaintiff class.
The Court also finds that the defendants initially failed to provide the certification expressly required by this Court's March 5, 1993 Order regarding the length and extent of any non-compliance with the 1980 Order, the 1985 Mental Health Plan and the recommendations of the medical experts. This failure to file the required certification demonstrates, once again, how difficult it is for even this Court to obtain from the defendants reliable information necessary to monitor compliance with its orders. In this regard, the Court also finds that the defendants failed to produce in a timely manner numerous documents requested in discovery which evidenced significant problems in the delivery of medical and mental health care at the Jail. This was so even though many of these documents were clearly responsive to plaintiffs' document requests and were ordered to be produced pursuant to this Court's August 7, 1992 discovery Order.
This is rot the first time that this Court has found that the defendants have failed to comply with its orders. See e.g. , Campbell v. McGruder, 416 F. Supp. 106, 108-09 (D.D.C. 1975); Memorandum Opinion (September 30, 1983)(finding defendants in contempt of Court). In light of the defendants' history of non-compliance, and given the complicated and factually intensive nature of the matters at issue, this Court determines that a
-4-

Special Officer is necessary to assist the Court in effecting future compliance with its orders. This step is not taken lightly, and is based on this Court's more than twenty years experience in this litigation. This Court also determines, based on the record presented, that the appointment of independent medical and mental health experts is necessary and appropriate.
Accordingly, it is by the Court this '2.0+i day of April, 1993
ORDERED that the Court shall, pursuant to its inherent authority to enforce its orders and Rule 53(b) of the Federal Rules of Civil Procedure, appoint Grace M. Lopes as Special Master (hereinafter "Special Officer") to monitor and ensure defendants' compliance with the Court orders and Consent Decrees in these consolidated cases (hereinafter "Orders"); and it is
ORDERED that the defendants shall, pursuant to Rule 53, pay the reasonable fees and expenses incurred by the Special Officer in carrying out her assigned duties. The Special Officer shall be paid a fee of $85.00 per hour, plus expenses, unless otherwise ordered by the Court. She shall be available to p rform her duties as the needs of the Court require; and it is
ORDERED that the duties of the Special Officer shall be to observe, monitor, submit proposed findings of fact, and make recommendations to the Court and to the parties concerning steps that should be taken to achieve compliance with the Orders of
-5-

this Court. The Special Officer should endeavor to assist the defendants in achieving compliance in whatever way possible, and should confer informally with the parties on matters affecting compliance with the Orders; and it is
ORDERED that the Special Officer shall assist the Court in monitoring defendants' compliance with the Orders by, among other things, reporting to the Court regularly, and no less than every ten months, concerning the state of defendants' compliance with the Orders of the Court; and it is
ORDERED that the Special Officer shall be granted access by the defendants to the D.C. Detention Facility and the records of the District of Columbia, to the extent necessary to permit the Special Officer to monitor and report fully on defendants' compliance with the Orders of this Court; and it is
ORDERED that the Special Officer shall have the power to require reports by tne defendants concerning matters affecting compliance with Orders of this Court; and it is
ORDERED that the Special Officer shall have the power to conduct hearings, to require the attendance of witnesses and the production of documents, and to examine witnesses under oath. The expenses of any reporter hired to transcribe such hearings before the Special Officer shall be paid for by the District of Columbia; and it is
-6-

ORDERED that the Special Officer shall be authorized to employ such experts and consultants, including but not limited to medical and mental health experts, as are reasonably necessary to assist the Special Officer in monitoring and reporting on defendants' compliance with the Orders. The Special Officer shall notify counsel for the parties at least two weeks in advance of her intention to employ an expert or consultant. The plaintiffs and defendants shall have the opportunity to raise with the Special Officer any objection they may have to the employment of such an expert or consultant, and make alternative recommendations for who should be employed as the expert or consultant. In the event of a continued disagreement between a party and the Special Officer concerning the employment of any expert or consultant, the party shall have the opportunity to file a motion with the Court to resolve the dispute. In the event that a party does not file a motion within two weeks of receipt of a notice from the Special Officer of the intent to employ an expert or consultant, the Special Officer shall be deemed authorized to employ such expert or consultant. The ees and expenses of any expert or consultant hired by the Special Officer pursuant to this paragraph shall be paid for by the District of Columbia, and any such expert or consultant shall be granted access to the D.C. Detention Facility and the records of the District of Columbia to the extent necessary to assist the Special Officer in monitoring defendants' compliance with the Orders of this Court; and it is
-7-

ORDERED that the Special Officer shall be authorized to employ an investigative assistant to assist the Special Officer in fact-finding and investigations concerning defendants' compliance. The investigative assistant shall be granted access to the D.C. Detention Facility and the records of the District of Columbia to the extent necessary to assist the Special Officer in monitoring the compliance of defendants with the Orders of this Court. The fees and expenses of the Special Officer's investigative assistant shall be paid for by the District of Columbia; and it is
ORDERED that the Special Officer, the investigative assistant, and any experts or consultants employed by the Special Officer shall have the right to conduct confidential interviews with officials and staff of the District of Columbia Department of Corrections. The Special Officer shall be authorized to confer and to correspond with either plaintiffs or defendants on an ex parte basis; and it is
ORDERED that the Special Of icer shall not be empowered to direct the defendants to take or refrain from taking any specific action to achieve compliance; and it is
ORDERED-that the Special Officer shall promptly select medical and mental health experts to evaluate the medical and mental health services being provided at the Jail, including those areas of concern identified in plaintiffs' Memorandum in Support of
-8-

Motion for Order to Show Cause Why Defendants Should Not be Held in Contempt. The experts shall issue reports and make specific recommendations for the improvement of medical and mental health services, including recommended staffing levels, as soon as possible but in no event later than 60 days from the date of this Order; and it is
ORDERED that the defendants shall file a detailed written report to the Court within 15 days after the issuance of an expert report responding to each recommendation contained in the report, indicating whether the defendants intend to implement the recommendation and the timeframe for implementation, and, if the defendants object to implementation, the basis for their objection; and it is
ORDERED that the Special Officer shall, within 30 days after the expert reports are issued, submit a report to the Court evaluating the state of defendants' compliance with the Orders respecting medical and mental health care and setting forth any additional concerns that the Special Officer might deem appropriate to bring to the attention of the Court; and it is
ORDERED that effective April 26, 1993, the bi-weekly reports filed by the-defendants with the Court shall be certified, in the manner set forth in 28 U.S.C. 1746, by an official (or officials) with personal knowledge and shall state, in addition to the information currently being provided, the following:
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1. The medical and mental health staff providing services at the Detention Facility during the two week period. The reports shall indicate the number of full-time equivalent employees, by job title (certified and licensed physician assistants shall be so designated) and shift, who actually worked during the time period. The defendants shall also state the number of overtime hours worked by individuals in each job category.
2. Whether sick leave was available on all housing units each weekday, without limitation on the number of prisoners who could be seen on any particular unit. The report shall list dates on which sick leave was not held on each housing unit, or on which sick leave was limited, and the housing unit or units which were effected.
3. Whether a chronic disease clinic was maintained by an appropriate health care provider, the type of health care provider or providers who delivered services at the clinic, and the number of inmates who attended the clinic in the reporting period.
4. The number of correctional officers assigned to each mental health cellblock during the reporting period, whether each officer employed on the unit had received specialized training in mental health issues and, if not, the dates and shifts on which untrained officers were used.
-10-

w

5. The number of psychiatric screening clinics held at the Jail during the reporting period,,the approximate length of each clinic and the number of inmates seen.

6. The number of the following during the reporting period: deaths, suicides, positive PPD tests for tuberculosis infection, cases of active tuberculosis diagnosed and positive tests for HIV infection; and it is

ORDERED that the parties shall negotiate in good faith and attempt to agree on a format for more detailed, certified," reporting to be used by the defendants in their reports to the Court, which shall include such information, in addition to that which is set forth above, as is necessary for the Court, the plaintiffs and the Special Officer to assess the defendants' compliance with Court Orders; and it is

ORDERED that if the parties are unable to agree by May 15,

1993 on a format for future reporting, the parties shall submit

proposed reporting forms to the Court, and the Court shall man-

date the form of reporting; and it is

.-

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FURTHER ORDERED that the defendants may, at any time, move to vacate the appointment of the Special Officer.
Wl11iam B. Bryant ^ United States District Judge
-12-

Copies to: David Flyer, Esq. Assistant Corporation Counsel Correctional Litigation Section Government of the District of Columbia Suite NLL-3 1923 Vermont Avenue, N.W. Washington, D.C. 20001 J. Patrick Hickey, Esq. Shaw, Pittman, Potts & Trowbridge 2300 N Street, N.W. Washington, D.C. 20036 Jonathan M. Smith, Esq. Executive Director D.C. Prisoners' Legal Services Project, Inc. 1400 20th Street, N.W. Suite 117 Washington, D.C. 20036 Edward I. Koren National Prison Project of the American Civil Liberties Union 1875 Connecticut Avenue, N.W. Suite 410 Washington, D.C. 20009
0222:089jhz.93
-13-

 
 ' '•'.,*

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al. . Plaintiffs, v.
ANDERSON McGRUDER, et al., Defendants.
INMATES OF D.C. JAIL, et al. . Plaintiffs, v.
DELBERT C. JACKSON, et al., Defendants.

C.A. No. 1462-71 (WBB)
C.A. No. 75-1668 (Cases consolidated before
Judge William B. Bryant)

INITIAL REMEDIAL PLAN FOR MENTAL HEALTH CARE, MEDICAL CARE AND COMPLIANCE MONITORING AT THE DISTRICT OF COLUMBIA JAIL
The Special Officer submits the following initial remedial plan pursuant to the March 3 6, 1994 Consent Order issued in the above-referenced matters.

I. BACKGROUND On March 16, 1994, this Court found the defendants in contempt based on the Special Officer's Report on Medical Care at
the D.C. Jail, the Special Officer's Outline of her Findings on Mental Health Care at the D.C. Jail, the Expert Reports on
Campbell v. McGruder

JC-DC-001-066

Medical and Mental Health Services at the D.C. Jail,1 the Court's findings in its Orders of March 5, 1993 and April 20, 1993, and the defendants' acknowledgement that they had been in non-compliance with numerous material provisions of the orders entered in these consolidated matters. Consent Order of March 16, 1994 at 1-2.
The March 16, 1994 Consent Order requires the Special Officer to submit a remedial plan designed to cure the defendants' contempt and to insure that inmates incarcerated at the Jail receive medical and mental health services that meet constitutional standards. Consent Order of March 16, 1994 at 2. The Consent Order mandates that the remedial plan address all issues raised in the Special Officer's reports and in the expert reports, as well as any other issues that come to the attention of the Special Officer or the Court that adversely impact on defendants' compliance with the Court's orders or adversely impact on the delivery of medical and mental health services in a manner consistent with constitutional standards. Jd. In addition, according to the terms of the Consent Order, the remedial plan must include an implementation schedule, graduated automatic fines2 for failure to meet implementation deadlines, and a compliance reporting procedure. Jd. at 2-3. The March 16,
The Special Officer's report on medical care was filed on February 2, 1994, the report on mental health care was filed on March 6, 1994, and the expert reports were filed on September 15, 1993.
2 The parties agree that the fines set forth in this plan constitute civil fines.
- 2-

1994 Consent Order also authorizes the Special Officer to file, and the defendants to implement, interim remedial plans to address conditions that should be remedied on an expedited basis.
id.3
The defendants are required to implement the remedial plan in accordance with the time-table established by the Special Officer unless either party can show good cause why the plan should not be implemented or should be modified. Id. at 3.
II. METHODOLOGY In accordance with the March 16, 1994 Consent Order, the Special Officer has consulted extensively with the defendants and their counsel, with counsel for the plaintiffs, and with her own medical and mental health experts4 in developing this remedial plan.5 In addition, with the consent of the parties, the Special Officer has also consulted with a nationally prominent expert in jail suicides, Lindsay Hayes. Mr. Hayes was retained in order to assist the Special Officer with fashioning a suicide prevention program for the Jail because of the substantial
The Specjil Officer filed an interim plan to address deficiencies in the defendants' tuberculosis isolation practices on May 4, 1994. The terms of this interim plan remain in full force and effect and are incorporated by reference herein.
The Special Officer's medical and mental health experts are Dr. Richard Belitsky (mental health), Dr. Robert Cohen (medical), and Dr. Goulda Downer (nutrition).
At her request, the parties provided the Special Officer with written proposals which have been considered by the Special Officer and her expert consultants. Copies of these submissions are attached hereto as Exs. 1A through 1G.
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increase in incidence of successful suicides and suicide attempts at the J a i l during the past 17 •onths.6
III. GENERAL PRINCIPLES
The purpose of this remedial plan is to bring the defendants into compliance with this Courtfs Orders regarding medical and
mental health care at the Jail as well as to ensure that the
delivery of these services meets minimal constitutional
requirements. In order to accoaplish these goals, four
principles have guided the development of this plan.
First, the non-compliance which this plan is designed to
address has been caused by pervasive deficiencies in the medical
and mental health delivery system which have been in evidence for
over two decades. These deficiencies have resulted in a
dysfunctional health care systen which cannot be fixed overnight.
Second, this remediation effort is predicated on a building-
block approach. This plan represents the first stage of a
remedial process. It addresses the most urgent problems and
6 Between May of 1993 and October 10, 1994 there were eight successful suicides at the D.C. Jail.
A redacted copy of Mr. Hayes1 report is attached hereto as Ex. 2. The parties have been provided with non-redacted copies of this report. At the request of the new Director of the Department of Corrections, Margaret Moore, both the Special Officer and Mr. Hayes met with Ms. Moore and many senior members of her staff to discuss the implementation of Mr. Hayes' recommendations. Ms. Moore endorsed virtually all of Mr. Hayes1 recommendations and has instructed various members of her staff to take curative action that is consistent with Mr. Hayes1 recommendations. The Special Officer is encouraged by the initiative the defendants have taken to address this problem before the issuance of an order.
-4 -

provides the foundation for the remedial effort in terms of basic
foundation elements such as staffing, the development and
implementation of policies and procedures, training, monitoring
and evaluation. Once this foundation has been established, the
Special Officer and her experts will conduct an evaluation of the
first stage of the remedial process. Thereafter, follow-up
remedial plans shall be developed in consultation with the
parties. The follow-up remedial plans will address the next
stage of the remedial process: building on the foundation, after
appropriate evaluation, in order to achieve and sustain
compliance with the Court's Orders.
Third, this plan establishes an implementation schedule
which is reasonable but firm. The plan contemplates close
collaboration between the defendants, the Special Officer and her
experts and plaintiffs' counsel. The plan will only succeed if
the defendants commit competent staff and appropriate resources
Ongoing monitoring of defendants' compliance with this Court's orders, as well as the provisions of this plan, will continue throughout this process.
8 There are many compliance violations which have not been addref ^ed in this initial remedial plan because they cannot be developed in the absence of appropriate staffing, the development of sound policies and procedures, and appropriate training of the correctional and health services staff.
9 Although this type of building block approach was not contemplated by the March 16, 1994 Consent Order, the parties have advised the Special Officer that they do not object to this approach. The defendants, however, have advised the Special Officer that although they consent to this building block approach, defendants reserve the right to object to the scope and/or content of this plan as well as the scope and/or content of any further plans that may be filed.
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to the remedial process. The defendants must monitor their own compliance with the plan and the DOC's leadership must hold staff members accountable for their work on the plan.
Fourth, the terms of this plan were negotiated with the parties. A series of substantial revisions were made in order to ensure that the defendants could meet the substantive requirements as well as the deadline requirements set forth herein.11
The Special Officer has substantial concerns about whether the DOC's central medical leadership will be able to work collaboratively within the deadline scheduled established by this plan. These concerns are based, at least in part, on the failure of the DOC's medical leadership to work within any of the deadlines that were established and extended by the Special Officer during the process of developing the tuberculosis protocol, the emergency response protrcol, and this remedial plan. For example, the Special Officer has waited for over six months for the defendants' infirmary space assessment. The defendants have allowed a succession of deadlines to lapse without providing any explanation for their dilatory conduct. Although this has not been the case with the DOC's mental health leadership, unless the medical leadership is held accountable by the DOC's executive staff, and required to perform the tasks set forth in this plan, the plan will fail.
11 Although this plan vas endorsed at the highest levels in the DOC, the Special Officer understands that the defendants may file some as yet unspecified objections to some aspects of this plan.
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IV. MENTAL HEALTH PLAN12
The initial remedial plan for mental health services focuses on three areas: suicide prevention and psychiatric emergencies, care of inmates with the most severe forms of mental illness, and basic services for the general population.
1. Organizational Structure and Staffing The mental health program at the D.C. Jail shall be restructured as set forth in this plan.13 A. Staffing14 All staff members hired pursuant to the staffing requirements set forth in this plan shall be hired under the exclusive budget authority and auspices of the D.C. Department of Corrections. Any staff member currently "detailed11 to provide mental health services at the Jail for the DOC by DHS shall become an employee of the DOC and assigned to mental health services at the Jail only if s/he meets the eligibility requirements set forth in this plan and is affirmatively selected
It is impossible to fully ,' aparate the mental health remedial plan from the medical remedial plan. In some instances, the mental health section of this plan addresses remediation efforts that are related to medical care and the converse is true with respect to the medical plan.
13 A copy of a revised organizational chart is attached as Ex. 3.
u The defendants provided the Special Officer and her expert consultant with two mental health staffing proposals. The proposals, which were helpful in fashioning the staffing requirements contained in this remedial plan, are attached hereto in Exs. 4A & 4B.
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by the DOC for one of the positions required herein. The
defendants shall, within 90 days, in consultation with the
Special Officer and her experts, develop a plan15 for
terminating within 90 days thereafter all DHS "details" to the
mental health units. 16
All persons employed in the positions that are required in
this staffing plan shall, unless indicated herein, work full-
time, in the mental health program at the District of Columbia
Jail. They shall not be subject to official or unofficial
"details".17
Within 21 days, the defendants shall identify any positions
required to be filled under this staffing plan which constitute
Because the remedial effort requires the development of written policies and procedures as a predicate for compliance, and because the defendants consistently have failed to meet Court ordered deadlines for drafting various protocols and policies, if the defendants fail to meet a drafting deadline that is set forth in this plan, the drafting of the policy, procedure, plan, or protocol at issue shall be completed by the Special Officer and imposed upon the defendants.
16 The defendants shall provide copies of all drafts of all plans, protocols, policies and procedures required under this remedial plan to plaintiffs' counsel who shall be provided with a meaningful opportunity to comment on the drafts. The policies and procedures that will be ieveloped pursuant to this remedial plan shall be filed with th'j Court. Defendants shall provide all drafts to the Special Officer, her experts, and plaintiffs' counsel sufficiently in advance of all deadlines so that all drafts can be finalized within the time-lines set forth in this plan.
17 This includes part-time and full-time details to positions inside the Jail, to positions in other DOC operated institutions, and to positions at other agencies operated by the government of the District of Columbia. Although the defendants
are not precluded from hiring part-time employees, all reasonable
efforts should be made to fill all full-time positions with fulltime staff.
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positions for which competent candidates are difficult to recruit
and shall prepare and implement a plan for recruiting candidates
to fill such positions. The plan shall include, if appropriate,
upward adjustments in pay grade in order to make salaries
competitive with other District of Columbia agencies as well as
18
other recruitment incentives.
If the defendants elect to fill any positions that are
mandated under this plan, including positions that are difficult
to recruit, with contract employees, the proposed employment
contracts shall be provided to the Special Officer and
plaintiffs' counsel for review and comment prior to the ratification of the contract.1
The failure to hire the staff required under the terms of this plan, within the time period set forth in this plan,20
shall result in fines of $200.00 per day per vacant position for
the first thirty day period of noncompliance followed by fines of
$250.00 per day per vacant position for each subsequent day of noncompliance.21 All vacancies which occur subsequent to the
18 T h e s e positions shall b e filled in accordance with t h e hiring deadlines set fo'th in this plan.
19 T h i s p l a n is n o t intended t o preclude t h e defendants from satisfying their obligations through the "privatization" of medical and mental health services if they elect to do so.
20 Defendants m a y petition t h e Court for a n additional 60 days to comply with a hiring deadline required under this plan upon a showing that the defendants have made a substantial good faith effort to fill the position within the currently imposed deadline schedule.
21 T h e total staffing required under this mental health plan is illustrated in the chart attached as Ex. 5.
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®
filing of this plan shall be filled within a maximum of 120 days. Failure to fill such vacancies within this time-line shall result in fines of $200.00 per day per vacant position for the first thirty day period of noncompliance followed by fines of $250.00 per day per vacant position for each subsequent day of noncompliance.
(i) Supervisory Staff Program Director: Effective immediately,22 the DOC shall hire a program director who shall oversee all aspects of mental health services at the Jail. The program director shall report directly to the DOC Chief Psychiatrist, Dr. Henry Edwards. The program director must have the following qualifications: an advanced professional degree in a mental health clinical profession, significant experience and training in program administration, and appropriate clinical experience. Unit Directors: Within 180 days, the DOC shall hire a unit director for each of the following units: South Two, South Three, and General Population/Intake. Each unit director shall be responsible for the oversight of unit programming and the clinical and administrative supervision of the clinical staff assigned to her/his unit. The duties of the unit director shall include, but shall not be limited to the following: the assignment of cases as well as the supervision of documentation,
22 The Special Officer understands that the DOC has "hired" a program director who has been "detailed" from the DHS. This detail must be abolished within the time-frame set forth in the preceding section of this plan.
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clinical work and direct clinical services. The unit directors must be licensed psychologists, psychiatrists, licensed master's level social workers or licensed master's level psychiatric nurses.
Head Nurses:23 Within 180 days, the DOC shall hire a head nurse for each mental health unit as well as for general population/intake. The head nurse shall supervise the nursing staff assigned to her/his unit, oversee scheduling and assign responsibilities. The head nurse must be a licensed Registered Nurse (R.N.) with significant psychiatric nursing experience.
(ii) Non—Supervisory Staff Psychiatric Nursing Staff: Within 180 days, the defendants shall hire 17.4 experienced psychiatric nurses with training in the administration of psychotropic medications. The mental health nursing staff shall be composed of a combination of licensed R.N.'s and licensed practical nurses (L.P.N.*s) and defendants shall ensure that there is an appropriate ratio of R.N.'s to L.P.N.'s in order for the L.P.N. 's to be properly supervised. Among other responsibilities, the nurses shall be responsible for providing nursing support for the psychiatric clinics in the mental health units and the general population as
23 The Special Officer has been advised that the DOC will continue to maintain centralized psychiatric nursing leadership.
This total includes the head nurses for each mental health unit and general population/intake.
25 The nurses must have at least one year of psychiatric nursing experience in either an in-patient or out-patient setting.
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well as for the distribution and administration of all psychotropic medications.
Clinicians: Within 180 days, the defendants shall hire 16 clinicians who shall be assigned to the mental health units, general population and intake screening. The clinical staff shall be comprised of licensed clinical psychologists, master's level social workers and master's level psychiatric nurses. Among other duties, the clinicians shall maintain an assigned caseload of patients, conduct group and individual counseling, and be responsible for charting.
Psychiatrists: Within 60 days, the defendants shall hire 2.5 licensed psychiatrists to provide psychiatric services for inmates housed on the mental health units and in the general population. Among other responsibilities, the psychiatrists shall conduct screening and medication clinics and shall be responsible for the psychiatric care of mental health patients housed in the infirmary, mental health units and general population. Four hours of on-site psychiatric coverage must be provided on weekends.
This total includes the unit directors for South Two, South Three, and General Population/Intake.
The defendants currently have 84 hours of psychiatric coverage at the Jail.
28 At least one of the psychiatrists hired pursuant to this plan shall be employed full-time at the Jail. The full-time psychiatrist may provide limited consultation regarding her/his patients who have been transferred to other DOC facilities. The other psychiatrists must be employed at the Jail for a minimum of 16 hours per week.
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Psychiatric On-Call Coverage: The defendants shall establish psychiatric on-call coverage in order to ensure that a psychiatrist is on-call during the hours when a psychiatrist is not working at the Jail. Within 10 business days, the defendants shall present an on-call staffing plan for consideration by the Special Officer and counsel for the plaintiffs. The on-call staffing shall supplement the psychiatric staffing required under the preceding paragraph. The on-call psychiatric staffing plan shall be implemented within 15 business days. The plan shall state the number of psychiatrists that the defendants submit are required to maintain on-call psychiatric coverage for the Jail during weekends, holidays, and shifts that are not staffed by the 2.5 psychiatrists required under this plan.
The defendants shall require the on-call psychiatrist to respond immediately by telephone to a page or a telephone call and to respond in-person if indicated to all psychiatric emergencies in the mental health units, the general population, and the infirmary. The failure to implement this on-call plan for psychiatric coverage shall result in fines of $200.00 per inci lent for each incident in which a psych atrist fails to respond appropriately under this on-call plan.
Quality Assurance Monitor; Within 120 days, the defendants shall hire a quality assurance monitor for mental health services at the Jail. The monitor shall be a licensed mental health provider with a clinical mental health background and previous training and experience in quality assurance. The monitor shall
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be responsible for quality assurance monitoring of mental health

services in both mental health units as well as in the general

population. Within 30 days of her/his employment, the Quality

Assurance Monitor shall develop an instrument for evaluating the

utilization of mental health clinicians in the intake screening

process.

Support Staff: Within 120 days, the defendants shall hire

one office assistant, two clerk typists, and one medical records

technician to support the mental health program at the Jail. One

clerk/typist shall be assigned to work full-time for the Quality

Assurance Monitor.

Correctional Staff: Effective immediately, the defendants

shall maintain the correctional officer staffing in each mental

health unit according to the following staffing plan:

Seven Day Nonsupervisorv Posts

Shift:

One

Two

Three

Posts:

3

4

4

Total: 11 posts per unit

Relief Factor: 11 x 1.74 = 19.14

Total Complement of Officers for Each Mental Health Unit: 19

All posts in the mental health units shall be deemed essential posts and shall not be vacated unless the assigned officer is relieved of her/his duties by an officer assigned to the unit for this purpose. Within 120 days, the defendants
shall, in consultation with the Special Officer and her expert
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consultants, develop post orders for all correctional posts in each mental health unit.
B. Mental Health (i) Intake Screening: Within 190 days, one mental health
clinician shall be assigned exclusively to the health services intake screening process during the evening shift, Monday through Friday, excluding holidays. This clinician shall provide assistance to the medical staff assigned to intake with the identification of inmates at risk for suicide and mental illness and shall facilitate further evaluation of inmates deemed to be at risk. The clinician shall directly participate in the mental health aspect of the screening process. In addition, the clinician shall periodically review intake screening forms and provide immediate feedback to the medical staff who have filled out the screening forms.
The failure to assign a mental health clinician to intake screening within the time period set forth in this plan shall result in fines of $200.00 per day for the first 30 day period of noncompliance followed by fines of $250.00 per day for each subsequent day of noncompliance.
(ii) Mental Health Units; Within 210 days, the mental health units shall be staffed 24 hours per day, seven days per week. Mental health staff in the mental health units shall be deployed in accordance with a
deployment plan that shall be developed by the defendants, in
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consultation with the Special Officer and her expert consultants, within 90 days. The failure to staff the mental health units on a 24 hour basis within 210 days shall result in fines of $250.00 for each uncovered shift.
Within 240 days, the mental health units shall provide the following services: the timely initial assessment of all new admissions to the units; the timely development of individualized treatment plans; the establishment of a reliable and competent system for the prescribing and dispensing of psychotropic medications, frequent and adequate follow-up of inmates prescribed psychotropic medications, crisis intervention, (including the ability to urgently assess inmates housed on the mental health units who are in need of emergency attention) , and an effective program of individual sessions, group sessions and case management services. The defendants shall, within 90 days, in consultation with the Special Officer and her experts, develop a plan for providing these basic services. The failure to implement this plan within 240 days shall result in fines of $200.00 per day for each day of noncompliance.
(iii) General Population: Within 240 days, the mental health program at the Jail shall provide the following services for inmates housed in the general population: mental health assessments for all referrals, including self-referrals; prescription of psychotropic medication; timely monitoring of inmates who are prescribed psychotropic medication; crisis intervention, including the availability of urgent assessment;
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an effective individual and group therapy program; follow-up services for inmates identified during intake screening to be at risk of mental illness but not in need of housing in the mental health units.
Within 90 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan for deployment of mental health staff in the general population as well as a plan for providing the above-specified basic mental health services to general population inmates. The failure to implement this plan within 240 days shall result in fines of $200.00 per day for each day of noncompliance.
(iv) At Risk High Acuity Services; Within 30 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan to provide at risk high acuity services for all inmates housed at the Jail. The plan shall identify the staff who will provide these services on an interim basis as well as the staff who will provide these services when the mental health program is staffed up to the levels required under this plan. The failure to substantially implement the plan within 60 days shall result in fines of $200.00 per day for the first 30 days of noncompliance followed by fines of $400.00 per day for each subsequent day of noncompliance.
29 Both the medical staff and the mental health staff should participate in the formulation of this plan.
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The plan for high acuity services shall include a procedure for rapid assessment and a protocol for the provision of acute psychiatric care. In addition, the plan shall take into account that designated rooms in the infirmary shall be used for housing and treatment of inmates who are considered to be at the highest level of risk, including inmates who are medically restrained pursuant to the requirements of the November 9, 1993 Order, inmates on constant observation status, inmates at imminent risk for suicide, inmates who are engaging in serious self-destructive behavior, and inmates who a psychiatrist determines, in the exercise of her/his clinical judgment, cannot be safely managed in the mental health unit. The plan shall include a protocol for appropriate documentation in the medical/mental health record of each patient housed in the infirmary.
2. Intake Screening A. Intake Form
Within 10 business days the defendants shall, in consultation with the Special Officer and her experts, revise the health services intake screening form. The form shall be revised in order to obtain more in-depth information regarding risk of
30 This latter category may include, but is not limited to, inmates undergoing some forms of psychotic decompensation and inmates diagnosed with complex medical/psychiatric problems that may compromise their safety.
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m
suicide, including but not limited to significant recent loss and
future outlook.
B. intake Policy and Procedure
Within 15 business days the defendants shall, in
consultation with the Special Officer and her experts, develop a
policy and procedure for the administration of the revised health
services intake screening form. The policy and procedure shall
include a protocol for obtaining, in a timely manner, the records
of prior hospitalizations and treatments of mentally ill
prisoners. In addition, among other requirements, the policy and
procedure shall contain the following: • The intake form shall only be administered by an appropriately trained physician or a trained, licensed and certified physicians1 assistant;
• At the time of intake, the physician or physicians' assistant who administers the form may only do so in an area specified in the procedure which ensures open discussion and confidentiality;
• At the time of intake, the physician or physicians' assistant who administers the form shall be obligated to review the inmate's prior DOC medical and mental health records in order to verify the accuracy of the information provided and in order to assist in the determination of whether tt A inmate is at risk for suicide and/or mental illness;
• At the time of intake, the physician or physicians' assistant who administers the form shall be obligated to review all available records from prior psychiatric
A description of the training requirement is addressed in the next section of this plan.
- 19 -

•i '
, ! !
i ' ; j
1
",

h o s p i t a l i z a t i o n s and a l l related discharge summaries;
• If there is evidence during the intake screening which suggests that the inmate is suffering from a severe for* of mental illness that would require kousing in the mental health unit, or vhicfe suggests s/he is at risk for suicide, or if the intake screener requires assistance in developing her/his clinical assessment, she/he must immediately contact a nenber of the mental health staff who is on-site at the Jail and has been designated to assist as needed;
• At the time of intake, the on-site mental health professional shall be contacted in order to ensure that « n returnees from psychiatric hospitals are boused in the mental health units pending a prompt evaluation by a psychiatrist;
• All inmates who enter the Jail shall receive a full health services intake screening, regardless offcheirprojected length of incarceration.
The intake policy and procedure shall be implemented within
75 days. The failure to comply with the policy, except those
provisions that are dependent on a new hire, will result in
fines of $250.00 per day for each day of noncompliance.

12 The policy and procedure must addresr the issue of coll Jaoration with a mental health professional pending the full staffing of the mental health program.
33 I n m a t e s c l a s s i f i e d a s "Lorton R e c o m m i t s " m u s t b e s u b j e c t to both a medical and a mental health screening upon admission to the Jail. Procedures for screening Larton Recommits shall be developed by the defendants, in consultation with the Special Officer and h e r experts, within 45 days.
34 T h e "new h i r e " i s t h e on-site mental h e a l t h professional. Once this staff member Is assigned to the unit, these fines shall apply to all aspects of the policy related to the on-site mental health professional.
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training. The monitoring form shall be used on an on-going basis and the raw data and analysis shall be maintained and made available to the Special Officer and counsel for the plaintiffs.
D. Participation bv Mental Health staff As set forth in Section IV.l.B.(i), above, within 190 days,
a mental health clinician (psychologist, social worker or psychiatric nurse) from the Jail*s mental health staff shall be assigned to intake screening on the weekday evening shift, excluding holidays. One clinician shall be assigned per shift and each clinician assigned to mental health services at the Jail shall rotate through this assignment.
The mental health clinician assigned to intake shall participate in the mental health portion of the intake screening. S/he shall supervise and train the non-nental health staff on all aspects of the mental health screening and shall conduct further evaluation of inmates at risk. The assignment of a mental health clinician to this position shall be evaluated by the defendants, in consultation with the Special Officer and her experts, six mox ths following the assignment of a mer.r* 1 health clinician to the intake process.
E. Quality Assurance (OR) /Intake Within 20 days intake forms shall be randomly reviewed
for thoroughness, completeness and accuracy and the results of these reviews, as well as all related back-up documentation,
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shall be filed and made available to the Special Officer and counsel for the plaintiffs. The defendants shall review the completeness and accuracy of all intake screening forms for inmates who have been referred for an assessment of their suicidality, have made a suicide attempt, or who have been placed on suicide watch. The failure to implement this aspect of mental health quality assurance activities at the Jail within 45 days shall result in fines of $200.00 per day for the first 30 days this requirement has not been implemented and $300.00 per day for each subsequent day of noncompliance.
Within 90 days the defendants shall develop a QA monitoring form which evaluates the use of mental health clinicians in the intake process. Following the assignment of a mental health clinician to the intake process, these forms shall be used on an on-going basis and the raw data and analysis shall be maintained and made available to the Special Officer and counsel for the plaintiffs. The failure to implement this aspect of mental health quality assurance activities at the Jail within 30 days following the assignment of a mental health clinician to the intake process shall result in fi es of $200.00 per day for the first 30 days this requirement has not been implemented and $300.00 per day for each subsequent day of noncompliance.
3. Mental Health Records and Medical Records Within 10 days the defendants shall form an interdisciplinary committee comprised of representatives from the
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Jail's medical records office as well as representatives from the
medical, mental health, and dental programs. Within 30 days
thereafter, the committee in consultation with the Special
Officer and her experts, shall develop a plan for the integration
of the medical, mental health and dental records into one single
record for each inmate.
The plan shall address both format-related and content-
related issues. The following requirements shall be included in
the plan:
• The single record shall be structured so that medications and treatments are rapidly accessible and inmate care is tracked in reverse chronological order;
• A procedure shall be included for the transfer of the record throughout the DOC system in a manner which ensures the confidentiality of the record; and
• A schedule for implementation of this requirement shall also be addressed in the plan. The schedule must be consistent with the requirement that the restructured medical record system shall be in use, and all medical records, clinical, and support staff appropriately trained, within 120 days following the filing of this remedial plan.
The failure to integrate the medical and mental health
records within 180 days shall result in fines of $100.00 per day
for each day of noncompliance.
Within 45 days the defendants shall, in consultation with
the Special Officer and her experts, develop a policy and
All staff members who have not been hired within this period shall be trained within 30 days following the commencement of their employment.
- 24 -

#
procedure governing the confidentiality of medical records. The policy and procedure must ensure that the correctional staff does not have access to confidential medical and/or mental health information, including but not limited to the actual medical/mental health record and the documents contained therein. The policy shall be implemented within 90 days and all breaches of confidentiality that constitute violations of the policy shall result in fines of $500.00 per infraction which shall be suspended. Following notice36 of a violation, the defendants shall be required to promptly investigate the reasons for the violation. Within 15 days thereafter, or such longer period as permitted by the Special Officer, the defendants shall report to plaintiffs' counsel and the Special Officer with regard to the results of the investigation. At that time the defendants shall also submit a proposed corrective action plan which shall include an implementation schedule. The corrective action plan shall be submitted by the defendants for comment by plaintiffs' counsel and for approval by the Special Officer. The failure to implement the corrective action plan, within the time-frame set forth in the plan, sha* i result in the imposition of the fine that was initially suspended.
The notice may be received from plaintiffs1 counsel, the Special Officer, or the following employees of the DOC: the compliance office staff, the warden or one of the deputy wardens of the Jail, the Assistant Director for Health Services, the Chief Medical Officer of the Jail, the Chief Psychiatrist of the DOC, the Director of the Ifantal Health Program at the Jail, the Jail's Chief Pharmacist, and the Executive Deputy Director of the DOC.
- 25 -

•;'^'
4. Mental Health Units A. Hours of Operation;
Within 10 business days the defendants, in consultation with the Special Officer and her experts, shall develop a plan to immediately increase the number of hours that the mental health units are staffed by members of the mental health staff in order to provide some expanded coverage on weekends and evenings pending the full staffing of the mental health units.37 The failure to implement this plan within 45 days shall result in fines of $200.00 per shift for each shift that is not staffed pursuant to the plan.
B. Policy and Procedure; Within 120 days the defendants shall, in consultation with
the Special Officer, her experts, and plaintiffs' counsel, develop written policies and procedures regarding the operation of the mental health units. All staff shall receive appropriate training related to the policy and a training plan, including a training schedule, shall be addressed in the policy and procedure.
The policy and procedure governing the operation of the mental health units shall include the following requirements:
(i) Admission Criteria;38
37 See also §IV.1.B. ( i i ) , above.
38 Like other aspects of this remedial plan, admission criteria for the mental health units may be subject to
(continued...) - 26 -

Only inmates in need of intermediate care services may be
housed in the mental health units. This includes, but is not
limited-to, inmates who fall under the following categories:
Inmates with persistent psychotic symptoms who would be at risk far exacerbation of their symptoms if they were housed in the general population;
Inmates with unstable mood disorders who are prone to marked mood lability or severe depression;
Inmates with severe foras of character disorders whose behavior would be significantly disruptive in the general population;
Inmates who require a higher level of supervision for their particular medication regimens;
Inmates who are identified as potential suicide risks;
Inmates for whom a court has ordered, based on a forensic screening, full competency and/or full criminal responsibility examinations;
(...continued) modification once mental health services for general population inmates are established and stabilized.
39 Following the forensic evaluation process, these inmates shall be assessed by a psychiatrist, in consultation with appropriate representatives from the Bureau of Forensic Psychiatry, in order to determine whether continued housing on a mental health unit is clinically appropriate. If a clinical determination is made that the inmate can be safely managed in the general population, s/he shall be promptly discharged from the mental health unit pursuant to all applicable discharge policies.
- 27 -

• Inmates who are returned to the Jail following psychiatric hospitalization.
(ii) adm-i gsion Form; Within 60 days, the defendants in consultation with the Special Officer and her experts, shall develop a mental health unit admission form. (iii) Initial Nursing Assessment; All inmates transferred to the mental health units shall receive an initial nursing assessment which shall be completed immediately upon entry into the mental health unit and which shall be documented on the admission form. (iv) Full Assessment; All newly admitted inmates, including returnees from psychiatric hospitals, shall receive a full assessment during the first shift that is staffed by clinical staff following their admission. The full assessment shall include completion of the admission form and evaluation of the inmate by a psychiatrist. (v) Discharge Procedure; An inmate shall not be discharged from the mental health unit until s/he is cleared for discharge by the Mental Health Program Director, or her/his designee, after a 5xnding that the inmate meets all discharge criteria. Once an inmate is cleared for discharge, s/he shall be transferred out of the mental health unit within 72 hours.
40 These inmates shall be housed on the mental health units pending prompt evaluation by a psychiatrist who shall, among other matters, fully assess the inmate's proper housing status.
- 28 -

I-

®

m

(vi) Special Status;

Except to ensure public safety or to address an emergency,

untrained personnel and other inmates shall not have access to inmates housed in the mental health units or the infirmary.41

(vii) Initial Processing Period; I

i

The processing period for new admittees to the mental health

unit shall not exceed one business day. Under no circumstances

may an inmate housed in the mental health unit be locked down for

more than one business day absent disciplinary justification,

protective custody status, or an appropriate clinical or

therapeutic reason.

(viii) Treatment Plans:

Treatment plans must be developed by the mental health

treatment team for each new admittee and filed in the inmate's

mental health record within one week of his/her admission to

the unit. They shall be reviewed by the mental health staff at

two week intervals and the reviews shall be documented in the

inmate's record. The treatment plan shall include the following:

diagnosis, treatment interventions, identity of staff assigned to

i rovide treatment, identification of spe ;ific problems being

treated, and treatment goals.

Treatment plans shall be evaluated quarterly for

appropriateness and timeliness through the quality assurance

Following the completion of the training cycle described in this remedial plan.

42 This shall become the integrated medical/mental health record.

- 29 -

process. All documentation, including raw data and analysis, shall be maintained and provided to the Special Officer, and plaintiffs' counsel.
(ix) Therapeutic Program: The therapeutic program provided in the mental health unit shall be described in the policy. The program will address, among other concerns, the special needs of the juveniles and women housed on the mental health units as well as a plan for providing all inmates housed on the units with regular access to outdoor recreation. The failure to implement the policy and procedure described above within 240 days shall result in fines of $200.00 per day for each day of noncompliance.
C. Physical Plant Within 45 days the defendants shall, in consultation with
the Special Officer and her experts, draft a plan for upgrading the physical plant in the mental health units. The plan shall include a housekeeping program, a preventative maintenance program, an extermination program, ar«d a schedule for reconfiguration of all office space in the unit in order to ensure that adequate space is provided for individual counseling, group counseling, team meetings, eating, recreation and other out-of-cell activity, and offices for the mental health staff.
The defendants shall steam clean and paint all ceilings and walls in all common areas, offices and cells located in the
- 30 -

®

m

mental health units within 75 days. The defendants shall abate

all deficiencies cited by the Department of Consumer and

Regulatory Affairs (DCRA) in all previous inspections within 60

days including deficiencies in the lighting of the cellblock

common areas as well as the lighting of individual cells. In

those situations where, despite a substantial good faith effort,

the defendants cannot abate a deficiency within 60 days, they

shall file on or before the conclusion of the 60 day period, a

corrective action plan which identifies those deficiencies that

have not been abated, the reasons why they have not been abated,

and a deadline within which each deficiency will be cured. The

corrective action plan shall also address those deficiencies for

which a waiver shall be sought from DCRA, the date the waiver

application has been or will be made, the basis for the waiver

application, and the anticipated date by which a final

determination will be made with respect to the waiver.

The failure to implement the plan to improve the physical plant

in the mental health units will result in fines of $150.00 per

day for each day of noncompliance.

5. General Population Within 190 days, three clinicians shall be exclusively assigned to provide mental health services for inmates in the general population. They shall provide coverage on both the day and evening shifts.

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Within 75 days, the defendants, in consultation with the
Special Officer and her experts, shall draft a plan for providing
reasonable and timely access to mental health services for
inmates in the general population. The plan must include the
following:
• A deployment schedule for the clinicians assigned to the general population;
• A procedure for self-referral and for referrals from the medical, correctional, or case management staff;
• A procedure for performing general mental health assessments which must be provided within 72 hours for a routine request or referral and which must be provided at the time of request or referral for emergencies;
• A procedure for the prescription of psychotropic medications and on-going monitoring of inmates who have been prescribed psychotropic medications;
• A procedure for instituting crisis intervention, including the availability of urgent assessment;
• A follow-up program for individuals identified during intake screening as at risk for mental illness; and
• A therapeutic program of individual counseling and group sessions, including eligibility and d scharge criteria.
The failure to implement the plan to provide mental health
services for inmates in the general population shall result in
fines of $200.00 per day for each day of noncompliance.
- 32 -

6. Medication*3
The defendants shall, within 75 days, in consultation with
the Special Officer and her experts, develop a policy and
procedure regarding medications, including medications used for
the treatment of mental disorders.
The policy shall include the following requirements which
shall be implemented as set forth below pending the development
of the full policy:
• Within 14 days, except in an emergency, medication for the treatment of mental disorders shall be prescribed only by a psychiatrist. The psychiatrist shall review the inmate's medical record, including current medical condition, prior to prescribing such medication.
• Within five days, the defendants shall maintain a log identifying all inmates who have been prescribed medication for the treatment of mental disorders by name and DCDC number, the date of the prescription, the actual prescription, ant the full name, title and provider nuaber at the prescriber.
• Within 14 days the defendants shall establish a policy and procedure for addressing emergency situations where a non-psychiatric physician prescribes medication for the treatment of mental disordexs. The policy and procedure must include a mechanism for prompt no ification, review and evaluation by a psychiatrist.
• Effective immediately, all Inmates who receive anti-psychotic medications must be informed of the risk of tardive dyskinesia. This shall be documented in the medical record.
Except where specifically noted, this section is intended to address all types of medication. It is not limited to medications used to treat mental disorders.
- 33 -

Within 60 days, a l l antipsjcaotic medication may only be prescribed vita an inmate' s informed consent. Appropriate documentation s h a l l be maintained in the medical record.

Within 10 business days, pnrfnr to the administration of antipsydmtic medication, a l l inmates shall be assessed for involuntary movements and appropriate tdiinical follow-up s h a l l be undertaken. Appropriate documentation shall be maissained in the medical record.

Within 45 days, the defendants shall evaluate, according to the fttmoxmal Involuntary Movement Scale* (UBS), a l l inmates who are receiving astipsychotic medication.

Within 55 days the defendants shall develop a system t o track a l l inmates receiving antipsychotic medication in order to ensure that AIMS evaluations are cmwfnrfprt at s i x month i n t e r v a l s for a l l ixmates who receive antipsychotic medication.

• Within f i v e days, the defendants shall u t i l i z e the computerized i-****ri™j system that they have developed to track a l l inmates who have been prescribed psychstropic medication.

• Within 10 days, inmates honed In the mental

health u n i t s who have been prescribed

medication for the treatment of a psychiatric

disorder s h a l l be seen and evaluated by a

p s y c h i a t r i s t at l e a s t once per week until

s t a b i l i z e d and thereafter a minimum of once

every two weeks for continued evaluation.

With: l 60 days, inmates hoased in the general

popuxation w i l l be seen ami evaluated

according to the identical schedule unless

the psychiatrist in the exercise of her/his

c l i n i c a l judgment determinesr in those s i t u a t i o n s where the inmate has been

stabilized for a significant period, that

evaluation every 30 days i s medically

appropriate. The medical record of a l l

|

inmates subject to these evaluations shall

1

include appropriate documentation of each

encounter. A schedule of appointments shall

be maintained and annotated in order to

document whether the appointment occurred.

- 34 -

1

The schedules shall be maintained and shall be made available to the Special Officer and counsel for the plainti£fs-
Within 30 days, the defentaits shall review the charts of a l l inmates afro receive psychotropic medications in order to ensure that appropriate biocheoicaL laboratory monitoring has been canfiustad.
Within 10 days, the defenfents shall develop a policy and procedure flttica establishes a system for tracking the laboratory monitoring of a l l inmates who receive psychotropic medication. Following implementation of the tracking system, the defendants shall develop a protocol which ensures tftafc a l l inmates whose laboratory findings are abnormal, including those with snfetiBBrapeutic medication l e v e l s , are evalbiated bj a psychiatrist and clinically appropriate action i s taken and docsmeoted in the medical record.
Effective immediately, as part of the mental health quality assurance program, the defendants shall commence monitoring a l l inmates on lithium in light of the following: prescribing practices, appropriateness and timeliness of laboratory sttndies, lithium l e v e l s , adjustment of dnsaijps, and monitoring of side e f f e c t s . Monthly sports that r e f l e c t findings in eacb of these areas shall be immediately incorporated into the monthly compliance report and the defendants shall maintain a l l raw data for xeviev by the Special Officer and plaintiffs1 connsel upon demand. Within 60 days the defendants shall expand t h i s effort in order to include a* 1 inmates on Tegretol.
Within 30 days, the defendants shall develop a plan establishing an effective system for procurement of a l l necessary medications in order to ensure that an appropriate inventory of medications i s always aiailable. The plan shall include an implementation schedule. Pending the implementation of this system, the defendants shall, within five days, demonstrate to the Special Officer, her experts and p l a i n t i f f s ' counsel that they have developed a workable system for
- 35 -

emergency procurement of out-of-stock medications in order to ensure that prescribed medications are promptly administered.
• Within 45 days, all medication for the treatment of mental disorders shall be administered by licensed nurses who have received training regarding the indications, effects and side effects of these medications. The training for these nurses shall include the methodology of watch-take administration. The defendants shall maintain records documenting the training of each nurse assigned to administer psychotropic medications. These records shall include the date of training, trainer, and curriculum.
• Within 10 days, all medication for the treatment of psychiatric conditions shall be administered on a watch-take basis and in liquid form. If there are medications which are not manufactured in liquid form, such medication shall be crushed and mixed with a liquid for administration. In situations where a medication cannot be effectively crushed (such as enteric coated medications), the medication shall be administered in the form in which it is manufactured on a watchtake basis.
The failure to implement the above-described policy
requirements within the time-lines specified above shall result
in fines of $200.00 for each violation pending the implementation
of the full policy. The full policy shall be implemented within
75 days and thereafter fines in the amount of $250.00 for each
violation of the policy shall be imposed.
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7 • Suicids Prevention A. Training;
(i) Suicide Prevention Training The defendants shall, within 45 days, in consultation with the Special Officer and her expert consultants, develop an eight hour Jail suicide prevention training program for all staff who come into contact with inmates. This training program must include instruction concerning the following: warning signs and symptoms; potential predisposing factors; high risk suicide periods; the reasons why jails are conducive to suicidal behavior; instruction in the identification of inmate behavior that may be indicative of mental illness and the procedure for reporting such behavior, liability issues, intervention techniques, and the requirements in the revised DOC suicide prevention policy described below. In addition, all staff must receive appropriate refresher training on an annual basis. The suicide prevention training must be conducted by individuals with appropriate credentials and experience. (ii) First Aid and CPR Training Effective within 30 days, the defendants shall develop a training program for both standard first aid and CPR training for all staff who come into contact with inmates. The training must
44 All training plans required under this section shall include a procedure and deadlines for training subsequently hired/assigned staff.
- 37 -

be conducted by certified instructors. All staff must receive recertification training as required.
(iii) Mental Health Training Within 60 days, the defendants, in consultation with the Special Officer and her experts, shall develop a mental health training program for all staff who come into contact with inmates. All staff assigned to the mental health units, one correctional officer per cellblock per shift, as well as all officers assigned to the infirmary post, shall receive the initial suicide prevention training, first aid training, CPR training and mental health training within 120 days. All remaining Jail staff who come into contact with inmates shall receive the initial suicide prevention training, first aid training, CPR training and aental health training within 120 days thereafter. In scheduling the training, priority must be given to staff assigned to the mental health units or other housing areas (i.e., the infirmary) in which suicidal inmates are housed. The defendants shall maintain a system for tracking suicide prevention training, CPR training ? ad first aid training, and mental health training which ensures that all staff members receive the initial, refresher and recertification training in a timely fashion. The tracking system, which shall be established within 45 days, must verify each employees1 status with respect to training.
- 38 -

*iV-'.f*
The defendants shall pay fines in the amount of $200.00 per staff member for every staff member who, absent good cause, fails to complete the suicide prevention, first aid, and CPR training within the above-stated deadline schedules. These fines shall be paid on a per diem basis for each day that each staff member has not completed the training.
B. Communication: Within 10 days, a team of correctional, medical and mental
health staff shall meet with supervisory and administrative staff in order to build a more effective working relationship. Follow-up meetings shall transpire on a regular basis. The schedule, agenda and minutes for these meetings shall be generated by the Warden in consultation with appropriate correctional, medical and mental health staff.
C. Policy and Procedure; The defendants shall, within 45 days, in consultation with
the Special Officer and her expert consultants, develop a revised suicide prevention policy. rme revised policy shall address the following areas: training; identification and screening; staff communication; housing; supervision; intervention; reporting; and follow-up/review. In addition, the revised policy shall incorporate the following requirements:
(i) Supervision: (a) Observation Levels for Inmates on Suicide Watch:
- 39 -

The current observation levels contained in DOP 6080.2 shall be discontinued and replaced with the following:45
Close Observation; This observation level shall be provided for the inmate who is not actively suicidal but expresses suicidal ideation and/or has a recent prior history of selfdestructive behavior. Inmates an close observation must be housed on the mental health units or the infirmary. They must be observed by correctional staff at staggered intervals that do not exceed every 15 minutes.
Constant observation: This observation level shall be provided for the inmate who is actively suicidal. Inmates on constant observation must be housed in the infirmary and shall be observed by a staff member on a continuous and uninterrupted basis. The staff member assigned to observe this inmate shall have no other responsibilities. If an inmate requires more than eight consecutive hours of constant observation, s/he shall be transferred to an appropriate psychiatric hospital under the terms of the Court's November 9, 1993 Order.
(b) Communication of Suicide Watch Status: Within 210 days a merger of the mental health staff shall meet with all correctional staff assigned to every housing unit within which there is an inmate housed on suicide watch at the beginning of each shift. The mental health staff member shall be
45 other observation aids, such as closed circuit television, may be used as a supplement to these observation levels. Under no circumstances may they be used as a substitute for close observation or constant observation.
- 40 -

@
required to brief the correctional staff about each inmate's suicide- watch status in order to ensure that the officers are fully aware of the inmate's status.
Within 10 business days the defendants shall provide the Special Officer and plaintiffs* counsel with a plan for the communication of an inmate's suicide watch status to members of the correctional staff on a shift-to-shift basis pending the full mental health staffing of the aental health units.
(c) Supervision of Inmates Who Are Not on 8nicide Watch;
All inmates housed in the mental health units must be physically observed by the correctional staff at 15 minute intervals. Staff must document the observation as the check occurs in each housing unit log.
All inmates housed in general population and segregation units shall be physically observed by correctional staff at regular 30 minute intervals. The correctional staff must document the observation as the check occurs in each housing unit log.
Under no circi -nstances shall inmates incarcerated at the Jail, including inmates on suicide watch, be permitted to append any materials to their cell doors which obstruct the view into the cell.
If the defendants fail to comply with the above-stated supervision and documentation requirements within 90 days, they shall be required to achieve compliance within 30 additional days. If the defendants remain in noncompliance at the
- 41 -

conclusion of this 30 day period they shall be required to develop within 30 additional days, in consultation with the Special Officer and her experts, a plan (including an implementation schedule) for the use and installation of electronic time clocks, or the functional equivalent, in the Jail's housing units. The time clocks shall be installed within 30 days after the plan is finalized.
(ii) Documentation for Close and Constant Observation: Staff members shall be required to document the physical observation of inmates under close observation as each check occurs. The physical observation of inmates under constant observation shall be documented at 15 minute intervals. This information must be recorded on the suicide watch flow sheet which shall be filed in the medical record at the conclusion of the suicide watch. Suicide watch flow sheets must be completed and signed by all correctional staff members who have made physical observations of an inmate on suicide watch on each shift. Each shift supervisor shall be held responsible for the security checks performed by correctional officers in order to ensure that thay are accurate and complete. The head psychiatric nurse assigned to oversee each housing unit, and or his/her designee, shall be responsible for ensuring that all forms related to the suicide prevention protocol that fall under the auspices of the medical and/or mental health staff are accurate and complete. (iii) Housing;
- 42 -

;'.:>•

@

The defendants shall, within 60 days, in consultation with

the Special Officer and her experts, develop a plan and

implementation schedule for the renovation of all cells in the

mental health units and the infiniary that shall house suicidal

inmates. The plan must incorporate tlie following requirements

which shall be implemented as specified below:

• Within 70 days all cells designated for the housing of suicidal immtes must be "suicide resistant" and free of all obvious protrusions. These cells most contain tamper-proof lighting fixtures, doors containing large panel heavy gauge lexan glass (pr equivalent gzade shatter-proof glass) and ceiling air vents that are protrusion-free. Cells that house suicidal inmates may not contain the following: electrical switches or outlets, bunks with open bottoms, towel racks on desks and sinks, radiator vents, or any other object that may constitute a readily accessible anchoring device.

• Within one year, all other cells within the Jail that are used for housing inmates, or as temporary holding cells, shall contain tamper-proof light fixtures and ceiling air vents that are protrusion free.

• Effective immediately the defendants shall cease housing or holding suicidal inmates in any of the holding areas located within the third floor medical area, including bit not limited to the locked valkway betweer the clinical side and the administrative side of the third floor, and the holding cells adjacent to the third floor control bubble.

(iv) Intervention:

Within 120 days, all housing unit officers shall be required

to respond immediately to all emergencies in the housing units

46 The panels must be large enough to permit staff a full unobstructed view of the entire cell.
- 43 -

and commence life-saving measures. Correctional staff shall not wait for the arrival of medical personnel before initiating lifesaving measures.
Within 10 business days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan which addresses the initial correctional response to emergencies in the housing units pending completion of the CPR and first aid training that is mandated under the terms of this plan.
Effective immediately, any staff member who discovers an inmate attempting suicide shall immediately respond, survey the scene to ensure the emergency is genuine, and alert other staff to contact the Medical Emergency Response Team (M.E.R.T) pursuant to the Emergency Response Protocol filed in this case on April 12, 1994. If the staff member has been certified in first aid and/or CPR, these measures should be initiated and maintained, if indicated, until the staff member is relieved by medical personnel.
Within 15 days, the defendants shall supply all officers assigned to the mental health units and the infirmary with handheld radios that shall be used to facilitate communication in the cellblocks and in the infirmary. All staff shall receive appropriate training in the use of the radios.
Within five business days the defendants shall survey the intercom system in each housing unit in order to determine whether the system is operational. In the event an intercom unit
- 44 -

in a housing unit is not operational, the defendants shall either cure the deficiency within 10 days or issue hand-held radios to the officers assigned to the housing unit pending the renovation of the intercom system. All housing unit intercoms shall be operational within 120 days.
Within five days, the defendants shall survey the first aid kits in each housing unit in order to ensure they are properly stocked and properly mounted. All first aid kits must contain an Addis Wonder Knife. An ambu bag shall be mounted in proximity to each housing unit first aid kit. All old first aid kits must be discarded.
Within 20 days, the defendants in consultation with the Special Officer and her experts, shall develop a protocol for regularly inventorying the contents of the first aid kits. The first aid kits shall be inventoried by an appropriately trained member of the medical staff. A log book of each inventory must be maintained by the Chief Medical Officer.
Within 20 days, all correctional staff who have contact with inmates shall receive instruction in the location of the first aid kit, the purpose and use of the wonder knife, and the purpose and use of the ambu bag. All trained staff shall be required to use the wonder knife, if indicated, to cut down hanging victims, and to use the ambu bag, if indicated, in order to provide respiratory resuscitation. Within 30 days the defendants shall provide documentation to the Special Officer and plaintiffs'
- 45 -

counsel which establishes that all staff have received the appropriate instruction.
Within 60 days, the defendants shall initiate training of all correctional, medical and mental health staff in the requirements of the Emergency Response Protocol filed with the Court on April 12, 1994. Records of the training shall be maintained in order to track the training status of all staff. The training program shall include the use of mock drills as well as initial and refresher training. Special consideration shall be given to the clinical training of medical personnel who shall be trained and tested on appropriate emergency medical techniques within 60 days. All training shall be completed within 75 days and the defendants shall develop a system for tracking the training status of all Jail staff. Within 90 days the defendants shall provide documentation to the Special Officer and plaintiffs' counsel which establishes that all staff have received appropriate training.
Within 30 days the defendants shall maintain a log of all medical emergencies. The log shall include a copy of Attachment A to the April 12, 1994 Emergency Response Protocol. The log shall be reviewed on a weekly basis by the Chief Medical Officer in order to determine whether there is any indication of deviations from the requirements of the protocol. All deviations shall be documented and a corrective action plan shall be instituted.
- 46 -

For the first 30 days following the training, deviations from the requirements of the Emergency Response Protocol shall be fined at the rate of $250.00 per violation. Thereafter, deviations shall be fined at the rate of $500.00 per violation.
Effective immediately, the issuance of a paper gown for a suicidal inmate should be accomplished only as a last resort for periods when the inmate is engaging in self destructive behavior. Cloth gowns with zippers shall not be issued to suicidal inmates.
(v) Reporting; The defendants shall, within 30 days, in consultation with the Special Officer and her experts, develop a protocol, implementation schedule, and a form for reporting all significant suicide attempts and successful suicides.
(vi) Follow-up/Review: The defendants shall, within 45 days, in consultation with the Special Officer and her experts, develop a protocol and implementation schedule for the follow-up and review of all serious suicide attempts and successful suicides. The protocol shall address, among other things, the operation of the Suicide Investigation Committee. The Suicide investigation Committee shall be governed by the following, among other, requirements:
• The Suicide Investigation Committee shall be required to commence a full investigation of all successful suicides within one business day of their occurrence.
• The investigation must include, but shall not be limited to the following: observation of the area where the suicide or significant attempt transpired; confidential interviews with staff, inmates, and eyewitnesses; and - 47 -

review of relevant documents, records and log books. The defendants shall promptly make all records and interviewees available to the Suicide Investigation Committee.
• The final report generated by the Suicide Investigation Committee shall be completed within 30 days of a Jail suicide or significant suicide attempt and shall contain recommendations which are considered by the DOC executive staff. In the event a particular recommendation is rejected, a written record must be developed citing the reasons why the recommendation has been rejected. The recommendations must be used to generate a corrective action plan and implementation schedule.
The defendants shall, within 60 days, in consultation with
the Special Officer and her experts, develop a plan establishing
a crisis intervention team for inmates and critical incident
stress debriefings for staff.
Failure to implement the above-stated suicide prevention
policy requirements, except those related to emergency response,
within the time-lines specified above shall result in fines of
$250.00 per infraction.
8. Restraints
Within 20 days, the defends cs shall, in consultation with
the Special Officer and her expert consultants, develop a policy
and procedure which implements the requirements contained in the
November 9, 1993 Order with respect to the use of medical
restraints. All medical, mental health and correctional staff
shall be trained in the policy within 30 days thereafter.
- 48 -

The defendants shall develop, within 30 days, a system for tracking the application of restraints. A restraint log shall be maintained and shall include the following information: the name and DCDC designator number of the inmate who has been restrained; the date and time that restraints were applied; the identity of the health care provider who ordered that restraints be applied and the reasons why the order was given; the precise restraint order; the terms of any modifications to the initial order; and the date and time when restraints were removed or the inmate was transferred to an appropriate psychiatric hospital facility.
Effective immediately, all violations of the November 9, 1993 Order regarding the use of restraints shall be fined at the rate of $500.00 per violation. After seven violations, all violations shall be fined at the rate of $1,000.00 per violation EXCEPT that effective immediately the defendants shall pay $3,000.00 for each instance in which an inmate is restrained in the absence of an order issued by a physician.
- 49 -

9. Hoaoitalization A. Transfers pursuant to the November 9, 1993 Order
Within 3 0 days the defendants shall, with the assistance of the Special Officer and her staff, provide to counsel for plaintiffs a list of all inmates who have been transferred pursuant to paragraph one and paragraph four of the November 9, 1993 Order. The list shall be accompanied by the following information: the date and time of the evaluation which precipitated the transfer, the date and time of the transfer, the name of the facility where the inmate was transferred, the date of return, the reason for the transfer (including the diagnosis and whether the inmate was transferred pursuant to paragraph one or paragraph four of the order), whether the inmate was on pretrial status, whether the inmate was under 18 years of age at the time of transfer, and the gender of the inmate.
Within 10 days the defendants shall maintain a log of all transfers conducted pursuant to either paragraph one or paragraph four of the November 9, 1993 Order. The log shall contain all of the categories of information listed in the preceding paragraph and shall be maintained by the Program Director of the Jail's mental health program or her/his designee. The log shall be producible to the Special Officer and plaintiffs1 counsel.
Within 30 days the defendants shall deliver to the Special Officer and plaintiffs' counsel a narrative statement, signed under penalty of perjury by a supervisory official in the DOC who has personal knowledge, which specifies all steps the defendants
- 50 -

have taken and plan to take to supplement their psychiatric hospitalization capacity, including but not limited to the identity of the DOC employee(s) assigned to this matter, the names and affiliations of the individual (s) who were contacted with regard to this matter, the dates of each contact, the content of each contact and the result of each contact. In addition, the defendants shall produce to the Special Officer and plaintiffs1 counsel all documents and records maintained by the DOC that are relevant to defendants' efforts to supplement the D O C s psychiatric hospitalization capacity.
Within 120 days, the defendants shall provide the Special Officer, her experts and plaintiffs' counsel with a detailed written assessment regarding the need to supplement the DOCs psychiatric hospital bed capacity for pre and post trial adult men and women as well as for pre and post trial juveniles who are held in the custody of the Department of Corrections.
Within 30 days following the issuance of the assessment described in the preceding paragraph, the defendants shall be required to demonstrate to the Special Officer and plaintiffs' counsel that chey have the actual capacity to provide for the psychiatric hospitalization of all inmates subject to hospitalization under the terms of the November 9, 1993 Order. Evidence of this capacity shall include but not be limited to contracts with appropriate psychiatric hospitals that provide psychiatric services and/or the establishment of an appropriate psychiatric hospital component in a facility operated by the
- 51 -

District of Columbia. The failure to develop an adequate
psychiatric hospitalization capacity within this time-frame shall
result in the imposition of fines in the amount of $3,500.00 per
day, per inmate, for each day an inmate who is in need of
psychiatric hospitalization pursuant to the November 9, 1993
Order is not hospitalized.
B. Policy and Procedure
Within 45 days, the defendants, in consultation with the
Special Officer and her experts, shall develop a policy and
procedure implementing the requirements of paragraphs one and
four of the November 9, 1993 Order. The policy shall include a
procedure for medical clearance of the inmate, as well as the
following requirements which shall be implemented as set forth
below:
Within 10 days, in consultation with the Special Officer and her expert consultants, the defendants shall develop a form that shall be used to assess an inmate's need for hospitalization under the provisions of both paragraph one and paragraph four of the Court's November 9, 1993 Order. The assessments shall commence immediately thereafter and with respect to inmates housed on the mental health units, the following schedr Xe shall apply:
• All inmates receiving psychotropic medications shall be assessed with regard to the need for hospitalization under either paragraph one or paragraph four of the November 9, 1993 Order at the time of their weekly or bi-weekly psychiatric evaluations. An assessment form shall be completed by the
47 This requirement is not intended to preclude the use of the psychiatric consult form.
- 52 -

psychiatrist conducting the evaluation and filed in the medical record.
• All inmates who are not receiving medication, but diagnosed as mentally ill and refusing medication, shall be assessed weekly and a copy of the assessment form shall be filed in the medical record.
• All inmates who have been diagnosed with a mental illness but medication has not been indicated, shall be assessed every two weeks. A copy of the assessment form shall be filed in the medical record.
Inmates who are not housed on the mental health units shall, within 60 days, also be subject to hospitalization assessments. An assessment form shall be completed by the psychiatrist conducting the evaluation and stored in the medical record. At the time of the assessment these inmates shall also be assessed with respect to the need for transfer into the mental health unit. These inmates shall be assessed according to the following schedule:
• All inmates receiving psychotropic medication shall be assessed with regard to the need for hospitalization under either paragraph one or paragraph four of the Hovember 9, 1993 Order at the time of their weekly, bi-weekly or monthly psychiatric evaluations.
• All inmates diagnosed with a mental illness shall be assessed every 30 days with regard to the need for hospitalization, the need for housing on the mental health unit, and the need for medication.
The defendants shall, in consultation /ith the Special
Officer and her experts, develop a system for scheduling all
psychiatric hospitalization assessments within 10 business days,
48 Inmates who are not receiving medication may be assessed by a mental health clinician who shall consult with a psychiatrist if appropriate.
49 See Section 6, above.
- 53 -

The defendants shall be fined $150.00 per occurrence for the failure to perform an assessment as set forth above. This fine shall be suspended. Following notice50 of a violation, the defendants shall be required to promptly investigate the reasons for the violation. Within 15 days thereafter, or such longer period as permitted by the Special Officer, the defendants shall report to plaintiffs' counsel and the special Officer with regard to the results of the investigation. At that time the defendants shall also submit a proposed corrective action plan which shall include an implementation schedule. The corrective action plan shall be submitted by the defendants for comment by plaintiffs' counsel and for approval by the Special Officer. The failure to implement the corrective action plan, within the time-frame set forth in the plan, shall result in the imposition of the fine that was initially suspended.
Within 45 days a master file of all assessments conducted shall be contemporaneously maintained. The master file shall include copies of all assessment forms that are completed pursuant to this plan. The file shall be made available to the ST ecial Officer and counsel for the plain -iffs.
C. Plan For Sentenced Prisoners Who Contest Non-Emerqencv Hospitalization
The notice may be received from plaintiffs' counsel, the Special Officer, or the following employees of the DOC: the compliance office staff, the warden or one of the deputy wardens of the Jail, the Assistant Director for Health Services, the Chief Medical Officer of the Jail, the Chief Psychiatrist of the DOC, the Director of the Mental Health Program at the Jail, the Jail's Chief Pharmacist, and the Executive Deputy Director of the DOC.
- 54 -

The defendants, in consultation with the Special Officer and her expert consultants shall develop, within 30 days, a plan for the care, treatment, and monitoring of any sentenced inmate who interposes an objection to his/her non-emergency hospitalization and requests a jury trial pursuant to Superior Court Mental Health Rule 9. The failure to implement the plan within 45 days shall result in fines of $500.00 per infraction.
Effective immediately, pending the development and implementation of the plan, such inmates shall be housed on the mental health unit and have daily documented contact with a mental health clinician as well as, at a minimum, a weekly assessment by a psychiatrist with respect to whether there is a need for emergency hospitalization. Within five business days, a treatment plan shall be developed and implemented in order to address the inmate's therapeutic needs while housed on the mental health unit pending the ultimate disposition of the petition for hospitalization. The failure to comply with this interim procedure within the time-frame specified herein shall result in fines of $1,000.00 per infraction.
10. Quality Assurance Within 30 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan for implementing paragraph 18 of the November 9, 1993 Order. The plan shall require implementation at the conclusion of the 30 day period. The failure to implement the plan within 10 days
- 55 -

thereafter shall result in fines of $200.00 per day for each day the plan is not implemented.
The mental health quality assurance monitor, in consultation with the Special Officer and her experts, shall develop a mental health quality assurance plan for the Jail within 60 days after the mental health quality assurance monitor commences employment. The plan shall include an implementation schedule. The mental health quality assurance plan shall be implemented in accordance with the implementation schedule set forth in. the plan. The failure to implement the mental health quality assurance plan within the time-frame specified in the plan shall result in fines of $250.00 per day for each day the plan has not been implemented.
V. MEDICAL CARE PLAN The initial remedial plan for medical care addresses staffing and other urgent compliance-related deficiencies such as deficiencies in pharmacy services, quality assurance, specialty clinic access, infirmary capacity, access to sick call, and care for inmates with HIV/AIDS. 0 ;her areas of non-compliance that are not the subject of this plan shall be addressed in subsequent remedial plans. 1. General Matters Related to Medical Staffing All persons employed in the positions that are required under this staffing plan shall, unless indicated herein, work full-time in the medical program at the District of Columbia
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#1
$200.00 per day for each day that an improperly credentialed provider works at the Jail.
All medical provider positions required under this plan, except the Chief Medical Officer, Chief Pharmacist, and Chief Nurse positions, should be considered positions that shall be filled as specified for each shift. Accordingly, within 45 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan for providing coverage on shifts where a provider may be absent due to circumstances that include but are not limited to annual leave, sick leave, and leave for continuing education.
The failure to hire the staff required under the terms of this plan, within the time period set forth in this plan, shall result in fines of $200.00 per day per vacant position for the first 30 day period of noncompliance followed by fines of $250.00 per day per vacant position for each subsequent day of noncompliance. All vacancies which occur subsequent to the filing of this plan shall be filled within 120 days. Failure to fill such vacancies wi *Jiin this time-line shall result in fines of $200.00 per day per vacant position for the first 30 day period of noncompliance followed by fines of $250.00 per day per vacant position for each subsequent day of noncompliance.
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2. Staffing Plan52

Within 180 days, the defendants shall hire the following

medical staff, who shall be deployed as indicated below:

A. Physicians

16.5 FTE's*

Deployment/ Week Days:

Days

Evenings

Fights

1 Chief 9 full-time

2 full-time 4 part-time

Deployment/ Weekends:

2 full-time

1.5 FTE's for physician coverage of at least one physician on each weekend shift.

B. Physicians' Assistants

17 FTE's

Deployment/ Week Days:

Days

Evenings

1 Chief 8 full-time

3 full-time

Deployment/ Weekends:

Nights 2 full-time

3.0 FTE's for 48 coverage deployed as 2 PA's per shift on each weekend shift.

For over six months, the Special Officer has repeatedly requested that the defendants work with her and her expert consultant on the development of this medical staffing plan. Unfortunately, although the defendants promised to provide the Special Officer wit)' staffing proposals on a number of occar ions, they failed to do so. The plan presented here was developed by the Special Officer's medical expert after consultation with various members of the Jail's medical staff. In large part, although not entirely, it is identical to "suggestions" regarding staffing that were made to the DOC executive staff by the DOC medical director. These "suggestions" are contained in a document which was forwarded to the Special Officer by plaintiffs' counsel who obtained it during the course of his participation on a task force related to correctional health care. It is noteworthy that at least one of the staffing "suggestions" directly contravenes this Court's orders regarding the deployment of the tuberculosis coordinator, k copy of the DOC medical director's "suggestions" is attached as Ex. 6.
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the services of a dental hygienist to inmates incarcerated at the Jail when such services are clinically indicated.
6. Pharmacy 1 Chief 5 Pharmacists 5 Pharmacy Technicians
H. Health Educator 1 full-time
I . jjursincr Assistants 4 full-time
J . Tliberculosis CoordiLnator53 1 full-time
K. Quality Assurance (OA) 1 full-time medical QA monitor 1 assistant
3. Pharmacy Effective immediately, the defendants shall take all appropriate steps to stabilize leadership in the Jail pharmacy. In this regard, the defendants shall, within 30 days, convert the
The tuberculosis coordinator shall receive adequate clerical support and support staff may be increased if the current staffing level proves inadequate.
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acting chief pharmacist position to a permanent chief pharmacist position.
The defendants shall, within 75 days, in consultation with the Special Officer and her experts, develop a plan to cure deficiencies in the pharmacy system in order to ensure, among other matters, that drug utilization reviews, patient profiles, daily one-on-one medication lists, and drug inventories can be obtained on a timely basis. The failure to substantially implement this plan within 150 days shall result in the imposition of fines in the amount of $200.00 per day for each day the plan has not been implemented.
Pending the implementation of the plan described in the preceding paragraph, the defendants shall, within 20 days, in consultation with the Special Officer and her experts, develop an interim system, that is not based on the Medication Administration Records (MAR's) prepared by the nursing staff, for tracking one-on-one medications, maintaining medication compliance information, and preparing the lists necessary for dispensing medications at each medication distribution time.
4. Quality Assurance (OA) The medical care quality assurance monitor, in consultation with the Special Officer and her experts, shall develop a medical care quality assurance plan for the Jail within 60 days after the medical care quality assurance monitor commences employment. The plan shall include an implementation schedule. The medical
- 62 -

quality assurance plan shall be implemented in accordance with the implementation schedule set forth in the plan. The failure to implement the QA plan in accordance with the implementation schedule set forth in the plan shall result in fines of $250.oo per day for each day of noncompliance.
5. Specialty Services Within 90 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan which incorporates in substantial part the recommendations made by Dr. Robert L. Cohen in his September 15, 1993 report on medical services at the Jail. The plan, which shall include an implementation schedule, must ensure that all inmates receive timely access to specialty medical services. Defendants shall pay fines of $1000.00 per day for each day that they are in noncompliance with the plan. Within 60 days, the defendants shall, in consultation with the Special Officer and her experts, develop a plan to renovate the holding cells at D.C. General Hospital In order to ensure that inmates do not remain shackled in the holding cells and/or shackled to the benches in the vestibule area while awaiting appointments in the clinics or in the emergency room. The plan shall include an implementation schedule and shall address the expansion of the holding area as well as the construction of security vestibules with handcuffs ports at the entrance to each of the holding cells. The failure to implement the renovation
- 63 -

plan within the time-line set forth therein shall result in fines of $500.00 per day for each day the plan is not implemented.
6. Infirmary Care Within 30 days the defendants shall provide to the Special Officer and plaintiffs1 counsel a full assessment of the DOC's infirmary space capability. The assessment shall include the average daily census of all infirmaries, including the handicapped unit at the Correctional Treatment Facility (CTF) , operated by the Department of Corrections since January l, 1992. The failure to provide this assessment within 30 days shall result in fines of $1,000.00 per day for each day the assessment is not provided.54 Within 75 days the defendants shall, in consultation with the Special Officer and her experts, develop a plan for the provision of infirmary care for inmates incarcerated at the Jail. The plan shall also address the use that shall be made of the current Jail infirmary facilities. The plan shall be implemented within 105 days. The failure to implement the infirmary care plan within 105 days shall result in f5 »es in the amount of
The Special Officer requested this assessment from the defendants in March of 1994. It has not yet been received. The assessment is necessary in order to evaluate whether defendants1 proposal for permanently closing the infirmary at the Jail should be endorsed. Pending the resolution of the infirmary issue, the Special Officer cannot meaningfully address through the remedial process the deficiencies in medical treatment and medical office space that continue to compromise the quality of care at the Jail.
- 64 -

©

m

$250.00 per inmate per day for each day an inmate is not admitted

into an infirmary when such admission is medically indicated.

7. Sic* call The defendants shall, within 30 days, in consultation with the Special Officer and her experts, develop a policy and procedure related to the operation of sick call at the Jail. The policy shall incorporate in substantial part the recommendations made by Dr. Robert L. Cohen in his September 15, 1993 report on medical services at the D.C. Jail. The policy shall be implemented within 45 days. The defendants shall pay fines in the amount of $250.00 per infraction for each violation of the sick call policy.

The defendants shall, within 75 days, in consultation with the Special Officer and her experts, develop a plan for the appropriate care and treatment of inmates with HIV/AIDS. The plan shall incorporate in substantial part the recommendations made by Dr. Robert L. Cohen in his September 15, 1993 report on medical services at the D.C. Jiil. The plan shall be implemented in accordance with an implementation schedule that is developed as part of the plan. The defendants shall pay fines in the amount of $250.00 per inmate per day that each inmate is not treated in accordance with the plan.

9. Intake screening

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Within 20 days the defendants shall, in consultation with the Special Officer and plaintiffs' counsel, develop a policy and procedure regarding the timely processing of inmates from the Reception and Diagnostic area at the Jail to the Medical Intake area at the Jail.
10. Therapeutic Diets Within 90 days the defendants shall, in consultation with the Special Officer and her experts, develop a therapeutic diet plan for the Jail. The plan shall address staffing and include an implementation schedule. The failure to substantially comply with the plan shall result in fines of $500.00 per day for each day of noncompliance. Within 20 days, the defendants shall develop a policy and procedure which ensures that inmates who are insulin-dependent receive their meals within 30 to 60 minutes after receiving their dosages of insulin. 11. Intake and sick call Procedures for
Inmates with Special Needs Within 75 days the defendants shall, in consultation with the Special Officer and her experts, develop a policy and procedure for facilitating the medical and mental health intake processing, as well as sick call care, of all inmates at the Jail who are not native english speakers, or who have speech and/or hearing impairments.
- 66 -

V I . COMPLIANCE MOKITOPTKG 8YBTOM
A. Btaffincr: Within 120 days the defendants shall hire an additional
compliance monitor who shall be assigned exclusively to monitoring and reporting on the defendants1 compliance with the Orders that have been issued in this case. The necessity for this additional compliance monitor assigned to this case on a full-time basis shall be evaluated by the parties, in consultation with the Special Officer, within 180 days from the date the second monitor commences her/his employment.
Within 90 days the defendants shall hire an office clerk/typist who shall provide support services to the compliance monitors.
B. office Space and Equipment: Within 30 days the defendants shall identify suitable office
space at the Jail for both compliance monitors and the office clerk/typist. The office space must include adequate filing space.
The compliance monitors shall be provided with such office equipment as is necessary for the proper performance of their duties, including but not limited to office furniture, telephones, offices supplies, appropriate computer hardware and
Indeed, as set forth in Ex. 7, the defendants have proposed the employment of an additional monitor for the Jail.
- 67 -

**».• software, and facsimile equipment. They shall also be provided with a £ull library of all applicable medical, mental health and environmental standards as well as a full library of the Orders, expert reports, DCRA reports, and the reports of the Special Officer that have been issued in this case. The compliance monitors shall be required to familiarize themselves with these documents within 60 days following the commencement of their employment.
C. Trainina: The defendants shall, within 90 days, in consultation with
the Special Officer and plaintiffs' counsel, develop a compliance training curriculum for the compliance monitors and their clerk. Both monitors and the clerk shall be trained within 30 days following the commencement of the employment of the second monitor. The training curriculum shall include the substantive legal requirements in this case, all applicable environmental, medical and mental health standards, as well as the methodologies for compliance ronitoring.
D. Job Descriptions: The defendants, in consultation with the Special officer and
plaintiffs' counsel, shall, within 20 days, finalize the job descriptions for the compliance monitor positions. The compliance monitors and their cleric shall not be subject to stigmatization or retaliatory action for properly performing
- 68 -

fe-
their duties and shall work directly under the authority and auspices of the Director of the Department of Corrections.
VII. REPORTING
The defendants shall continue to file monthly compliance reports and to report all violations of the Court's Orders within 48 hours and as required under the terms of the November 9, 1993 Order. The failure to comply with these reporting requirements shall be fined at the rate of $250.00 per violation except that the defendants shall be fined at the rate of $1,000.00 per violation for each instance of grossly negligent and knowingly false or misleading reporting. These fines shall be suspended. Following notice57 of a violation, the defendants shall be required to promptly investigate the reasons for the violation. Within 15 days thereafter, or such longer period as permitted by the Special Officer, the defendants shall report to plaintiffs' counsel and the Special Officer with regard to the results of the investigation. At that time the defendants shall also submit a proposed corrective action plan which shall include an implementation schedule. The corrective a c ion plan shall be
56 The reporting fines in the interim tuberculosis plan shall remain in full force and effect.
57 The notice may be received from plaintiffs' counsel, the Special Officer, or the following employees of the DOC: the compliance office staff, the warden or one of the deputy wardens of the Jail, the Assistant Director for Health Services, the Chief Medical Officer of the Jail, the Chief Psychiatrist of the DOC, the Director of the Mental Health Program at the Jail, the Jail's Chief Pharmacist, and the Executive Deputy Director of the DOC.
- 69 -

t
submitted by the defendants for comment by plaintiffs' counsel and for/ approval by the Special Officer. The failure to implement the corrective action plan, within the time-frame set forth in the plan, shall result in the imposition of the fine that was initially suspended.
Within 90 days, the defendants, in consultation with the Special Officer and plaintiffs' counsel, shall develop a written policy and procedure for the reporting of violations as well as for the monthly compliance reports.
Within 120 days, the defendants in consultation with the Special Officer and plaintiffs' counsel shall develop a revised monthly compliance report form. The revised report must be certified under penalty of perjury by each person designated to fill out each section of the report. The reports must be reviewed and their accuracy certified under penalty of perjury by the Warden and the compliance monitors.
* *** At the conclusion of a 10 month period, the Special Officer and her experts will fully audit the defendants1 compliance with the initial remedial plan and work with thf defendants on developing any appropriate modifications to the plan. Some adjustments in staffing, as well as adjustments in other areas, may be warranted. Given the fact that the defendants have been in noncompliance with this Court's orders for over two decades, and given the gravity of the deficiencies in medical and mental
- 70 -

health care at the Jail, if the defendants fail to implement the
terms of this remedial plan, and persist in their violations of
the interim tuberculosis isolation plan, the Special Officer
will be left with only one reasonable alternative to recommend to
the Court: the appointment of receiver to manage medical and
mental health care at the D.C. Jail. The Special Officer and her
experts will continue to work closely with the defendants in an
effort to avoid such an outcome.
Grace M. Lopes Bar No. 358650 Special Officer of the Court 1130 - 17th Street, N.W. Suite 400 Washington, D.C. 20036 (202) 778-1168
Certificate of Service
I hereby certify that a copy of the foregoing draft report was hand-delivered on the lHf\ day of OthJ^i/V. 1994 to the following:
Richard Love, Esq. Chief, Correctional Litigation 441 - 4th Street, NW Sixth Floor South
J. Patrick Hickey, Esq. Shaw, Pittman, Potts &
Trowbridge 2300 N Street, N.W. Washington, D.C. 20037
Jonathan Smith, Esq. D.C. Prisoners' Legal Services, Inc. 1400 - 20th Street, N.W. Suite 117 Washington, D.C. 20036

Exhibit l A 1 B 1 C 1 D 1 E 1 F 1 6 2
3 4 A
4 B 5 6 7

EXHIBIT LIST
Description
Plaintiffs' March 28, 1994 Letter Regarding Interim Mental Health Remedial Plan Plaintiffs' Proposed Remedial Plan Regarding Mental Health Care Plaintiffs' April 20, 1994 Letter Regarding Quality Assurance Plaintiffs' Proposed Remedial Plan Regarding Medical Care Defendants' Proposed Remedial Plan Regarding Medical and Mental Health Care Defendants' Second Submission Regarding Proposed Mental Health Remedial Plan Plaintiffs' Response to Defendants' Proposed Remedial Plan Regarding Mental Health Care Lindsay Hayes* Report Regarding Suicide Prevention at the Central Detention Facility - July 13, 1994 Organizational Chart for Mental Health Defendants' December 6, 1993 Letter Regarding Mental Health Staffing Defendants' Proposed Mental Health Staffing Plan Mental Health Staffing Requirements Defendants' Proposed Medical Staffing Plan Defendants' Draft Operational Plan Regarding Compliance Monitoring Remedial Plan

 
 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LEONARD CAMPBELL, et al.(

)

Plaintiffs,

)

v«

)

ANDERSON McGRUDER, et al., )

Defendants

)

) INMATES OF D.C. JAIL, et a_l. , )
Plaintiffs, )
v.
DELBERT C. JACKSON, et al..
Defendants

C.A. No. 1462-71 (WBB)
FILED /
OCT - 5 1995
Clerk, U.S. District Court District of Columbia
C.A. No. 75-1688 (Cases consolidated before
Judge William B. Bryant)

ORDER Upon consideration of the motion filed by the United States seeking review of the investigative file of this Court compiled by Special Officer Grace Lopes, it is this j!T^H day of October 1995, Ordered that Special Officer Grace Lopes make available the investigative file into the death of Richard C. Johnson to representatives of the United States Attorney's Office for the District of Columbia and the Department of Justice.

TTTLXIAM B. BRYANT UNITED STATES DISTRICT JUDGE
Campbell v. McGruder
JC-DC-001-077

 
 A, Street

(202)775-0323

Inmates D.C. Jail v. Jackson JC-DC-002-023

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

INMATES OF THE MODULAR FACILITY, RICKY BANNER, RONALD BATES, CLINTON HOWARD, DARREL PARKS, NATHANIEL POINSETTE, RODNEY RAINEY, RICHARD WINSTON,
Modular Facility Post Office Box 5100 D.C. Department of Corrections Lorton, VA 22079,
individually and on behalf of all other persons similarly situated,
Plaintiffs,
v.
DISTRICT OF COLUMBIA,
MARION S. BARRY, JR., Mayor, The District Building 1350 Pennsylvania Avenue, N.W. Washington, D.C. 20004
WALTER B. RIDLEY, Director, Department of Corrections 1923 Vermont Avenue, N.W. Washington, D.C. 20001
JOHN LATTIMORE, Administrator, Modular Facility Post Office Box 5100 D.C. Department of Corrections Lorton, VA 22079
Defendants.

) ) ) ) )

) ) ) )
) ) ) )

)

•••.-.-

)

'• ., .

) ) Civil Action ) No. )

) )

)

)

n q

)

) )

) ) )

)

) )

) ) )

)

)

)

COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF

- 2-
I. NATURE OF THE COMPLAINT 1. This is a class action brought by inmates at the Modular Facility of the District of Columbia Department of Corrections located at Lorton, Virginia (the "Modular Facility"). Defendants, the District of Columbia and named officials with responsibility for the District's prisons, have subjected plaintiffs to conditions of extreme overcrowding, and have failed to protect plaintiffs from the actual and threatened physical violence, dangerously unsafe and unsanitary living conditions, inadequate medical care and other conditions which result from and are exacerbated by the overcrowding. Defendants' actions and inactions violate plaintiffs' rights under the United States Constitution and the laws of the District of Columbia.
II. JURISDICTION 2. This is a civil action for declaratory and injunctive relief, arising under the Fifth and Eighth Amendments of the United States Constitution and 42 U.S.C. S 1983. Pendent claims are based on D.C. Code S 24-425, D.C. Code § 24-442, and regulations promulgated thereunder. 3. This case arises under the Constitution of the United States, and under 42 U.S.C. $ 1983. This Court has jurisdiction under 28 U.S.C. SS l33l(a), 1343(3) and 1361. Declaratory relief is sought pursuant to 28 U.S.C. $S 2201 and 2202.

III. VENUE 4. Venue is proper in this judicial district pursuant to 28 U.S.C. S§ l39l(b), (c) and (e).
IV. CLASS ACTION 5. This action is brought by the named plaintiffs on behalf of all inmates who are now or will be incarcerated at the Modular Facility, pursuant to Rule 23(a) and 23(b)(2) of the Federal Rules of Civil Procedure. 6. Members of the class on behalf of whom plaintiffs sue are so numerous that joinder of all members is impractical. The class members currently incarcerated at the Modular Facility number over 900. Over one hundred inmates are transferred to and from the Modular Facility per week. 7. There are common questions of law and fact affecting the right of inmates to be free from actual and threatened inmate violence and pervasive risk of harm. Common issues of fact include the existence and causes of violence throughout the Modular Facility, the existence and causes of dangerously unsanitary and unsafe conditions throughout the Modular Facility, and the existence of inadequate medical care. 8. Plaintiffs' claims are typical of the claims of the class, and plaintiffs fairly and adequately represent and protect the interests of the class. 9. Separate actions maintained by individual members of the class would create a risk of varying adjudications

- 4-
with respect to individual members of the class which would establish incompatible standards of conduct for the parties opposing the class, and adjudication regarding individual class members would, as a practical matter, be dispositive of or impair the interests of other members not parties to the adjudication.
10. Defendants have acted and/or refused to act on grounds generally applicable to the class plaintiffs represent.
11. Plaintiffs have brought this action for injunctive and declaratory relief on behalf of the class comprising . all inmates who are presently incarcerated at the Modular Facility at Lorton or who will be incarcerated at the Nodular Facility.
V. PARTIES
A. Plaintiffs 12. Plaintiff Winston Richards is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His District of Columbia Department of Corrections number ("D.C.D.C. number") is 242-201. He is confined in Cellblock 1. 13. Plaintiff Ronald Bates is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 204-685. He is confined in Cellblock 2.

- 5-
14. Plaintiff Nathaniel Poinsette is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 240-206. He is confined in Cellblock 2.
15. Plaintiff Rodney Rainey is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 187-515. He is confined in Cellblock 4.
16. Plaintiff Ricky Banner is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 201-660. He is confined in Dormitory 1 and a former resident of a program annex used for "overflow" housing in Cellblock 4,
17. Plaintiff Clinton Howard is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 163-495. He is confined in Dormitory 4.
18. Plaintiff Darrel Parks is a prisoner of the District of Columbia Department of Corrections presently confined in the Modular Facility. His D.C.D.C. number is 243-618. He has been confined in both the dormitories and cells in the facility.
B. Defendants 19. Defendant District of Columbia is a municipal corporation and is responsible for the supervision and

- 6-
operation of the District of Columbia Department of Corrections.
20. Defendant Marion S. Barry, Jr. is the Mayor of the District of Columbia and is responsible for the direction and control of the District of Columbia Department of Corrections.
21. Defendant Walter B. Ridley is the Director of the District of Columbia Department of Corrections. He is responsible for the overall operation of the District of Columbia Department of Corrections and each institution within its jurisdiction, including the Modular Facility.
22. Defendant John Lattimore is the Administrator of the Modular Facility and is responsible for its operation.
23. Defendants who are individuals are sued solely in their official capacity. In all of their actions complained of herein, defendants are acting and have acted under color of state law for purposes of 42 U.S.C. § 1983.
VI. THE MODULAR FACILITY 24. The Modular Facility is a correctional facility which has been operated by the District of Columbia since September 1986. Located in Lorton, Virginia, constructed within the fenced perimeter of the Central Facility, the Modular Facility was designed to house 400 male inmates. Defendants have incarcerated a large number of inmates in the facility, far in excess of the number that the facility can

- 7-
humanely accommodate. Currently, over 900 male inmates are housed at the Modular Facility, and the population has exceeded 960 in the weeks prior to the filing of this action. The majority of these inmates are awaiting trial on felony or misdemeanor charges; the remaining inmates are convicted felons and misdemeanants.
25. The principal housing areas at the Modular Facility consist of four dormitories and four cellblocks. The beds used in the dormitories and the cells are double bunk beds throughout the facility.
26. Additional rooms, originally intended to be used for prison programs, have also been filled with extra bunk beds and mattresses in order to squeeze more prisoners into the facility. These rooms are referred to as "annexes." Even with the addition of these makeshift sleeping quarters, some inmates must spend the night on the floor of the gymnasium or other spare rooms when more inmates arrive at the facility than can be accommodated in the existing bunks.
27. Each of the four dormitories at the Modular Facility has two wings which are used for bed space and a day room area which is shared by residents of the two wings. Although each wing is designed to house 26 inmates, the practice of double-bunking has increased the number of inmates to 52 in each wing and causes extreme crowding.
28. In some of the dormitories, in addition to the 104 inmates housed in the two wings, at least 16 additional

- 8-
inmates are housed on spare beds and mattresses placed in the adjoining "annexes."
29. The four cellblocks at the Modular Facility also hold more than twice the number of inmates for which these housing areas were built. Each cellblock was designed to house 48 prisoners in 48 individual cells, in a two-tiered U-shaped arrangement surrounding a dayroom area. Currently, two prisoners occupy each cell, bringing the number of prisoners in cells in each cellblock to 96.
30. Twenty additional men occupy ten extra doublebunked beds that have been installed in the open central dayroom area of each cellblock, where inmates from the cells also congregate when outside their cells.
31. As in the dormitories, program rooms adjoining several of the cellblocks have been converted to housing for groups of at least 16 inmates in a room.
32. The total number of occupants of a given cellblock, including the extra bunks in the center of the cellblock and in the program rooms, may be as high as 132, living in a space designed to house 48 prisoners.
33. Severe overcrowding is overwhelming all aspects of the correctional system at the Modular Facility and is causing serious and systemic deprivations of the minimum necessities of civilized life. The extreme overcrowding, in combination with other improper actions and failures to act by defendants, has caused, inter alia, (i) very high levels of

— Q _
violence and a deprivation of personal safety for the inmates; (ii) unsanitary and unhealthy conditions throughout the facility; (iii) a lack of necessary medical, dental and psychological care; and (iv) a grave lack of fire safety protection.
VII. PERVASIVE VIOLENCE AND THREATS TO INMATE SECURITY 34. Plaintiffs have been and continue to be
deprived of the basic human necessity of physical safety. Through their actions, defendants subject inmates to conditions of overcrowding and continual stress which result in a worsening cycle of heated arguments, threats, fights, and violent assaults.
35. Defendants have failed to protect inmates' rights not to be subjected to barbaric punishment in the form of inmate-on-inmate violence and the inmates' constant fear for their personal safety. Severe overcrowding of the facility both creates and exacerbates unsafe conditions when combined with other serious omissions, including: defendants' failure to perform classification to separate violent from nonviolent offenders, to separate convicted felons from pretrial misdemeants or to separate potential aggressors from potential victims of abuse; inadequate locks on cell doors; use of substandard bed frames, chairs and ventilation ducts which are known to be readily and frequently converted into deadly weapons; failure to employ correctional officers in sufficient numbers or with sufficient training to control the

- 10 -
facility; installation of additional bunk beds in the dormitories, cellblocks, and program room annexes in a way that prevents adequate monitoring; refusal to provide basic recreational, exercise or educational activities critically necessary to reduce inmate tension and idleness; and failure to address grossly unsanitary living conditions that further provoke and frustrate the inmates. These matters are set out more fully below.
36. Despite crowded and dangerous conditions, prison officials, overwhelmed with the influx of arriving inmates from the D.C. Jail, make minimal efforts to separate or classify the inmates according to their potential for violence or victimization. Accused misdemeanants are housed in the same areas with accused violent felons, and pre-trial detainees are housed with sentenced inmates. Rival gang members have on occasion been housed in the same housing unit. Young inmates are housed together with older inmates, and antagonisms between the two groups result in frequent fights.
37. Inmates who are likely to be victimized are housed with the general population. Weak or unpopular inmates are frequently threatened and abused and often subjected to being "burned out" — their mattresses and other belongings set on fire as a sign of dislike. Instead of protecting these weaker inmates in the first place, prison officials wait until trouble breaks out and then simply move victims and aggressors into different parts of the facility, where the same patterns of behavior operate.

- 11 -
38. For inmates who have been threatened or are otherwise vulnerable, protective custody is not available at the Modular Facility. Although protective custody cells are theoretically available, these units do not provide adequate protection, because the cellblock designated for protective custody must be shared during the day with 20 or more extra inmates who are not confined to cells. Even in cellblocks that are not intended for protective custody, the housing of inmates in double-bunked dormitory bunks in the dayroom areas of the cellblocks is a dangerous practice that causes an increase in violence.
39. Inmate security is further threatened by the fact that the cell doors in the cellblocks cannot be effectively locked. Inmates have learned that they can place a comb, pen or other object in the path of the door runner, which prevents the door from locking when shut, despite the sound of a "click" apparently indicating that the door is locked.
40. Thefts are very common at the Modular Facility. In both the cellblocks and the dormitories, inmates have no effective way to protect their personal belongings, short of carrying them everywhere. Fights concerning allegations of theft are commonplace at the Modular Facility. Although each inmate assigned to a dormitory bed is supposed to be provided with a locker for his possessions, not all inmates receive one. The lockers that are provided are not secure — some

- 12 -
have no locks at all, and are made of flimsy wood, while others have simple locks that can be picked open with a ballpoint pen or with the interchangeable keys to other lockers issued to many other inmates.
41. Personal safety for the inmates is impossible because of the abundance and availability of homemade knives ("shanks") and other weapons at the Modular Facility. These weapons, used in assaults, are manufactured by inmates from readily available materials.
42. The steel bunk beds that have been installed in all parts of the facility except the cells are among the most common sources of weapons. The bunks have many steel appendages which inmates twist or kick off the main frame and sharpen on the concrete floor to produce shanks.
43. In their haste to install more beds, defendants recently moved approximately 40 additional bunk beds into the dormitories and neglected to take the usual precaution of welding the bunk couplers (approximately 18-inch long steel pipes, four of which are used to join the top and bottom bunks together) to the bed frames. The result of this carelessness was to make 160 steel couplers readily available for inmate arsenals.
44. Other sources of weapons include the metal grates on the air vents in each cell and dormitory. The duct

- 13 -
outlets are covered with strips of metal, which are readily torn off and used as shanks.
45. In addition to the materials used for shanks, the Modular Facility contains a variety of movable chairs and lockers, which are easily converted into weapons. Rather than installing benches bolted to the floor and lockers attached to the walls, the prison provides inmates with free-standing metal and wooden chairs in the day rooms, as well as metal and wooden lockers in the dormitories, the latter small enough to be picked up. These objects are either used directly as clubs or pieces are broken off to create other weapons.
46. Because the chairs are poorly designed for prison use, they are frequently broken in fights or through hard use. The shortage of chairs in which to sit in the dayrooms, in combination with the overcrowding, produces another source of inmate-on-inmate antagonism and violence.
47. Searches or "shakedowns" conducted by the correctional officers fail to reduce significantly the quantities of weapons. In the cellblocks, these shakedowns are infrequent, and in the crowded dormitories, the searches are often ineffective. Illegal drugs are widely available within the institution as a result of poor security practices.
48. Correctional officers at the Modular Facility fail to provide adequate security for the inmates and struggle to maintain a semblance of control over the inmate population. The official "complement" of correctional officers is inade-

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quate to provide effective security, and many of the officers supposedly comprising the complement are frequently detailed to administrative and clerical tasks, rather than direct monitoring of inmates.
49. In the dormitories, only two or three correctional officers are on duty at a time and are expected to monitor up to 140 inmates in a given dormitory.
50. The dormitories, originally intended to hold 26 single beds in each wing, are now crowded with people, double bunk beds, lockers, and other clutter. Officer surveillance of the dormitories and cellblocks is dangerously compromised by the blockage of the officers' lines of sight. The correctional officers, who are normally stationed in the day room area of a dormitory, cannot see over the double bunks and into the middle and rear sections of the two long and narrow wings where inmates sleep. Tall lockers (approximately six feet high) also obstruct vision in some of the dormitories. Furthermore, neither the program rooms that adjoin several dormitories nor the bathrooms are visible from the usual officers' post.
51. The officers seldom venture into the annexes, wings, and bathrooms of the dormitories. As a result, violent or illicit acts are most likely to occur in these poorly monitored areas, which the inmates cannot avoid entering. Much inmate-on-inmate fighting occurs in the bathrooms, where it is not observed by or reported to the correctional officers.

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52. In the cellblocks, two or three correctional officers are assigned to each shift, with responsibility for well over 100 inmates, including inmates bunked in the center of the cellblock and in the annexes. The officers often remain inside an adjoining elevated observation area, separated from the inmates by a glass window.
53. From this observation bubble, officers have no view of the individual cells, including the cell used as a public toilet, nor can they see into the program-room annexes or behind the bunk beds in the cellblock's center. As in the dormitories, dangerous or violent activities tend to occur in . places hidden from the officers' view.
54. Even when the officers have been aware of violent incidents among inmates, they have on occasion failed to control the incidents. At current population levels, not only prisoners but also correctional officers fear for their own safety. The officers doubt their ability to control inmates and prevent violence. In such a climate of fear, some officers resort to excessive violence against inmates.
55. In each of the dormitories and the cellblocks, only two telephones are provided for the inmates to place outside telephone calls. Telephone calls are limited to five minutes per call. Disputes and fights regarding telephone usage are, accordingly, virtually constant. In many housing units, however, because of lack of staff, defendants have

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yielded the responsibility of controlling the telephones to inmates. This results in favoritism among inmates and additional antagonism and violence regarding telephone usage.
56. At times, the doors separating two dormitories are left open in order to give the inmates who work on the cleaning detail access to the cleaning supply room. This practice creates a risk of well over 200 inmates converging on one area and threatening the safety of correctional officers and inmates.
57. Facilities for the segregation and control of disruptive inmates are grossly deficient. On one occasion, a group of between 20 and 25 inmates banded together and created a serious disturbance in Dormitory 3. In retaliation, the correctional officers locked the entire group together inside a very small punishment cell, known as the "county jail," which is a former washroom from which the toilet and sink have been crudely removed, leaving the pipe stubs and drain flanges exposed. The men were confined in this cell for several hours.
58. Other prisoners are also routinely punished, individually or in groups, by being placed in the "county jail" for several hours. The smell of sewage is strong, but because the toilet has been removed, inmates are without access to a bathroom unless they can persuade an officer to escort them to a bathroom.

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59. Compounding the risks to inmates and officers is the high rate of turnover of the correctional staff. New and inexperienced guards known as probationary officers must perform a variety of functions normally reserved for more experienced officers. Although regulations prohibit these new officers from patrolling or acting outside the supervision of a senior officer, conditions often force these trainees into positions of responsibility for which they have not been adequately prepared.
60. Both the shortage of correctional officers and the use of officers with inadequate training directly and significantly reduce inmate security. The number of guards currently stationed in each unit is insufficient to control the volatile and overcrowded inmate population.
61. Opportunities for recreation, education or exercise are almost non-existent at the Modular Facility. At the most, inmates are allowed between thirty and sixty minutes of recreation time, three or four times a week. During those times, an entire housing unit (up to 140 people) is permitted access to half of the facility's gymnasium, which has a basketball court where one game at a time can be played. As a result, many inmates do not bother to attend these recreation sessions. When an entire dormitory is permitted to attend the gymnasium, only a very few inmates are able to exercise. Much recreational equipment has been removed from the gymna-

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sium because of a fear that the inmates would injure themselves or others in the crowded conditions.
62. Inmates are permitted very little access to outdoor recreation. Many inmates never set foot outdoors during their incarceration in the Modular Facility. At the most, inmates are allowed outside for recreation a few times each month. These recreation sessions, like those in the gymnasium, involve large numbers of inmates, from a cellblock or dormitory unit, crowded into a small recreation yard.
63. No other facilities for athletic activities are provided at the Modular Facility. Some inmates attempt to perform weight training with buckets filled with water, or do pushups in the limited floor space available. Even if more athletic recreation were available, however, the shortage of showers would deter inmates from taking advantage of what was offered.
64. For most inmates, the alternatives to idleness are playing cards or watching television, which is often inaudible above the noise of other prisoners. Fights over the choice of programs to be viewed on the one television in each unit are common, as are disputes over places close to the television where the sound is audible.
65. Neither technical training nor job skills programs are available for inmates at the Modular Facility. Educational opportunities are limited to an adult basic

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education program (there are very few inmates in this program) and Bible study groups.
66. A few inmates have jobs in the kitchen or on the cleaning detail, but not nearly enough jobs are available to provide opportunities to all those who are willing to work.
67. Rather than expending their energy on recreational or productive activities, the inmates remain idle in the greatly overcrowded housing areas. As a result, many inmates release their energy through fighting, arguing, making weapons, carrying out assaults and thefts, using illegal drugs, and abusing and intimidating others in their vicinity.
VII. DEPRIVATIONS OF BASIC SANITATION AND HEALTH NEEDS 68. As a result of the overcrowding, toilet and
shower facilities are severely overtaxed, causing frequent plumbing and sanitation problems that increase the risk of the spread of communicable diseases and add to the irritation and hostility among prisoners living in very close quarters.
69. Each dormitory wing has two toilets, two urinals, and two showers. These facilities are far from sufficient to service the current population adequately.
70. Heavy use causes toilets to overflow or stop up. Some showers are inoperable and have gone unrepaired for months, creating situations in which as many as 140 men in a dormitory, including those housed in the program-room "annexes," must share two or three working showers.

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71. Because of the heavy usage of the facilities and defendants' failure to provide prisoners with sufficient cleaning supplies such as disinfectant, it is impossible to maintain basic cleanliness and hygiene in the bathrooms.
72. Cracked or missing tiles, broken plumbing fixtures, leaks, corrosion and growth of mold and mildew are common in the dormitory bathrooms, and efforts by the prison administration to address these problems are insufficient or nonexistent.
73. Half-inch long black worms, living in a slimy area of chipped floor tile, infested the bathroom of one of the dormitories, until the inmates built a fire with toilet paper and newspaper to exterminate the worms. Although prison officials investigated the incident and promised to fix the floor, the broken tiles remain.
74. Toilet and shower facilities in the cellblocks are clearly inadequate under current conditions. Six showers, several of which may be broken at any one time, must be used by 116 residents in a cellblock and by the additional men housed in the adjoining "annex" rooms.
75. Each cell has a toilet, but this design leaves the 20 or more men bunked in the central day room area of each cellblock without access to a toilet. An unoccupied cell, containing one toilet is made available for general use by these men and by all the other inmates who leave their cells during the day. The toilets in these designated "public"

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cells are often stopped up or in foul condition, and inadequate provisions are made for cleaning these cells.
76. Because the existing ventilation system was designed to serve a population less than half the size of the current population, poor ventilation and inadequate air circulation are problems throughout the Modular Facility. The poorly designed ventilation system breaks down frequently, exposing inmates to extremes of heat, cold and humidity. The air is stuffy and stale with cigarette smoke, foul with smells from the bathrooms, humid and rank from the combined odors and exhalations of over 900 men in close quarters. Air ducts are full of dust, and mildew grows abundantly on the walls.
77. The ventilation system, which was inadequate for even the designed capacity of 400 inmates, constitutes a gross health hazard when the facility is packed with over 900 men. As a result of the inadequate ventilation system, respiratory problems and persistent colds are common among inmates. In some areas of the facility, blasts of very hot or very cold air from the air vents cause serious discomfort and compound the health risks, prompting inmates to create additional hazards by stopping up the vents with sheets or other available materials.
78. The overcrowding at the Modular Facility creates noise levels so extreme that in many areas, ordinary conversations can only be heard if the participants shout.

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The constant din, exaggerated by the concrete walls and floors and the lack of materials to absorb sound, heightens the tension among inmates. Noise levels remain high well into the late hours of the night, preventing many inmates from sleeping, particularly those who occupy extra beds that have been set up in the cellblocks.
79. Pressure on the kitchen facilities and staff to provide food for more than 900 inmates results in a lack of necessary precautions to ensure safe and sanitary food service operations. Meals are prepared and served almost around the clock because of the frequent movement of inmates in and out of the prison.
80. Pood is often undercooked, and eating implements are not always properly cleaned and sterilized. In addition, areas where food is prepared and eaten are infested with cockroaches and rodents. Dead cockroaches are sometimes served in the inmates1 food.
81. Inmate clothing, toilet paper, deodorant, soap, and other personal hygiene items are in short supply. Many indigent prisoners are deprived of the supplies necessary to maintain basic bodily hygiene.
82. Many inmates at the Modular Facility have only been issued one suit of clothes by defendants, and some inmates have no sheets for their beds. Often they must use

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the bathroom sinks or showers to wash out their clothes at night.
83. Irregular laundry service also forces some prisoners to wash out their own sheets and hang them to dry near the air vents or draped over their beds, adding to the dampness in the air and further blocking the correctional officers' lines of sight.
84. The failure to provide many inmates with a change of clothes or a change of sheets compounds the strain on the inadequate bathroom facilities and leaves prisoners with no alternative to makeshift washing arrangements that pose sanitation and health risks. The shortage of clothing, linens, and hygiene kits also provokes inmates to steal from each other. Accusations of stealing are a frequent source of inmate fights.
IX. INADEQUATE MEDICAL, DENTAL AND PSYCHOLOGICAL CARE 85. Shortages of appropriate medical staff and
shortages of space in which patients can be examined have the effect of denying care for the serious medical needs of prisoners. Such denial of care results from deliberate indifference on the part of the defendants.
86. Prisoners have opportunities to sign up for sick call only two or three times a week, and some prisoners must sign up repeatedly in order to receive attention for their complaints.

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87. When inmates succeed in getting medical attention, the treatment they receive is often inadequate. Few prisoners are treated by a physician, since the medical staff has only one doctor, and that doctor is not present at the Modular Facility more than two or three days a week. The majority of prisoners are seen by one of four staff members (three physician's assistants and one medical technical assistant) and are often given treatment not responsive to their specific illnesses and medical problems.
88. During the night and weekend hours, no medical staff are on duty at the Modular Facility. In emergencies at these times, inmates are supposed to be taken to the infirmary at the Central Facility, but the decision to provide emergency medical assistance is made by correctional officers with no medical training.
89. As a result of the inadequate medical staffing and the lack of emergency care, the urgent medical needs of many prisoners at the Modular Facility are ignored.
90. Prisoners with chronic illnesses such as diabetes are unable to obtain the regular care and monitoring that they require, and on occasion, prisoners known to be suffering from AIDS have been denied proper medical attention.
91. Defendants fail to provide needed information and education about HIV disease (AIDS) to the prisoners and staff at the Modular Facility, and thereby subject the inmates to life-threatening health risks.

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92. Although dental care is available through a small on-site clinic at the Modular Facility, prisoners must often wait for long periods to have urgent dental needs addressed by a part-time dentist.
93. The Modular Facility lacks adequate psychological and counselling services. Prisoners with obvious mental health problems are placed in the general population, where they do not receive needed special attention. Other prisoners become increasingly frustrated with the mentally ill inmates' disturbed behavior, until that behavior can no longer be ignored by the correctional officers or until other inmates attack the sick prisoner.
94. Although drug abuse is a readily apparent source of mental instability for many inmates, no drug or alcohol abuse treatment program operates at the facility. Inmates with drug problems remain in the general population, and in fact these inmates often sustain their drug habits through supplies available in prison.
X. FIRE HAZARDS 95. Lack of a working fire alarm system, as well as the absence of fire evacuation plans and little, if any, fire instruction for inmates or correctional officers, creates a dangerous risk of loss of life and property in the event of a serious fire at the Modular Facility. 96. The potential for a serious fire is apparent from the frequency with which inmates light mattresses,

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sheets, clothing and toilet paper on fire, in order to harass other inmates, or to fuel makeshift cooking arrangements. The clutter of wooden lockers, sheets and clothes hanging from the beds, as well as generally cramped conditions would both allow a fire to spread quickly and make evacuation of inmates difficult.
97. Even without the outbreak of a major fire, smoke and fumes from the frequent burning of plastic-covered mattresses are slow to clear in the poorly ventilated dormitories and cells, which are not evacuated when these fires occur. The building's automatic smoke purging system is broken, and manual operation of the system is not possible. The inadequacies of the smoke purging system threaten the inmates and staff with a major loss of life through smoke inhalation in the event of a major fire.
98. The lingering smoke from the frequent smaller fires exacerbates the respiratory problems experienced by many inmates and prevents correctional officers from maintaining complete control.
XI. DEFENDANTS' KNOWLEDGE OF THESE CONTINUING DEPRIVATIONS 99. Defendants are aware of the inhumane conditions
described in paragraphs 24 through 98 and nevertheless have failed to remedy the overcrowding, to improve deplorable sanitation, to address causes of violence among inmates, to provide needed medical care and to take precautions against the risk of fire. Such failure and refusal constitute

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deliberate indifference to the basic needs of the inmates at the Modular Facility.
FIRST CAUSE OF ACTION 100. Paragraphs 1 through 99 are incorporated herein by reference and realleged. 101. Defendants' failure to provide plaintiffs with a humane environment in which their basic human needs are met and their fundamental right to personal security is protected violates the rights of plaintiffs already convicted and serving sentences to be free from cruel and unusual punishment, under the Eighth Amendment to the United States Constitution, and 42 ü.S.C. S 1983.
SECOND CAUSE OF ACTION 102. Paragraphs 1 through 99 are incorporated herein by reference and realleged. 103. Defendants' failure to provide plaintiffs with a humane environment in which their basic human needs are met and their fundamental right to personal security is protected violates the rights of pre-trial detainees to due process of law under the Fifth Amendment to the United States Constitution and to freedom from cruel and unusual punishment under the Eighth Amendment to the United States Constitution, and 42 U.S.C. S 1983.

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THIRD CAUSE OF ACTION 104. Paragraphs 1 through 99 are incorporated herein by reference and realleged. 105. Defendants' failure to provide plaintiffs with a humane environment in which their basic human needs are met and their fundamental right to personal security is protected violates their duties under District of Columbia Code, SS 24442 and 24-425, which require defendants to provide plaintiffs with safekeeping, care, protection and instruction in a suitable and appropriate institution.
REQUEST FOR RELIEF WHEREFORE, plaintiffs request this Court to grant the following relief:
a. Declare that the actions and inactions of the defendants described herein have violated and continue to violate the plaintiffs' rights under the Fifth and Eighth Amendments to the United States Constitution, 42 U.S.C. S 1983, and the District of Columbia Code SS 24-425 and 24-442;
b. Enjoin the defendants from engaging in any action or conduct, or from failing to act in any way, that violates the plaintiffs' above-mentioned rights;
c. Order the defendants to take all actions necessary in order to remedy the violations of the plaintiffs' rights;

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d. Award plaintiffs the cost of this suit, and reasonable attorneys' fees; and
e. Award plaintiffs all further relief which this Court deems just and proper.
Respectfully submitted,

Peter J. M/ckles (# 53447) Alan A. Pèmberton (# 367108)

COVINGTON & BURLING 1201 Pennsylvania Avenue,
N.W. Post Office Box 7566 Washington, D.C. 20044 (202) 662-6000

Of Counsel;

Attorneys for Plaintiffs

Grace M. Lopes (« 358650) Jonathan Smith (# 396598) D.C. Prisoners' Legal
Services Project, Inc. 1400 20th Street, N.W. Suite 117 Washington, D.C. 20036 (202) 775-0323

March 28, 1990

 
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U.S. District Court District of Columbia (Washington, DC) CIVIL DOCKET FOR CASE #: 1:75-cv-01668-WBB

APPEAL

INMATES DC JAIL v. JACKSON Assigned to: Judge William B. Bryant Demand: $0 Cause: 42:1983 Prisoner Civil Rights
Special Master GRACE M. LOPES TERMINATED: 11/12/1997
Special Master KAREN M. SCHNEIDER Special Officer of the Court
Plaintiff INMATES DC JAIL

Date Filed: 10/07/1975 Jury Demand: None Nature of Suit: 550 Prisoner: Civil Rights Jurisdiction: Federal Question
represented by Alvin J. Bronstein NATIONAL PRISON PROJECT OF THE ACLU FOUNDATION 733 15th Street, NW Suite 340 Washington, DC 20005 (202) 331-0500 LEAD ATTORNEY ATTORNEY TO BE NOTICED
Edward I. Koren NATIONAL PRISON PROJECT OF THE ACLU FOUNDATION 733 15th Street, NW Suite 410 Washington, DC 20005 (202) 234-4830 TERMINATED: 04/05/1994 LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jere Krokoff NATIONAL PRISON PROJECT OF THE ACLU FOUNDATION 733 15th Street, NW Suite 340 Washington, DC 20005

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V. Defendant DELBERT C. JACKSON

(202) 331-0500 LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Grace Michele Lopes OFFICE OF THE SPECIAL ARBITER
1875 Connecticut Avenue, NW Suite 510 Washington, DC 20009 (202) 232-8311 Fax: (202)724-7743 Email: gmlopes@sparb.org LEAD ATTORNEY ATTORNEY TO BE NOTICED
Richard Stuart Love OFFICE OF CORPORATION COUNSEL, D.C. 441 Fourth Street, NW 6th Floor Washington, DC 20001-4600 (202) 727-6295 Email: richard.love@dc.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED
Robert C. Utiger Office of the Corporation Counsel 441 Fourth Street, NW Suite 600S Washington, DC 20001 (202) 724-6532 Fax: (202) 727-0431 Email: robert.utiger@dc.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED

Date Filed 05/12/1989
02/28/1990

#

Docket Text

ALL DOCKET ENTRIES PRIOR TO 5/12/89 WILL BE FOUND ON THE PAPER DOCKET (cjp) (Entered: 05/12/1989)

MOTION HEARING before Judge William B. Bryant : motion of defendants to modify Court order setting population limits at DC Jail heard, argument and taken under advisement (cjp) (Entered: 03/01/1990)

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04/05/1990 04/11/1990 04/11/1990 08/16/1990 08/16/1990 09/13/1990
09/26/1990
10/16/1990 10/30/1990 11/01/1990 10/10/1991
05/08/1992
07/20/1992 08/05/1992 08/06/1992

1 NOTICE OF FILING by plaintiff INMATES DC JAIL a copy of recent decision of the District of Columbia Circuit; attachment (cjp) (Entered: 04/06/1990)
2 ANSWER by defendant DELBERT C. JACKSON to interrogatories (cjp) (Entered: 04/12/1990)
3 RESPONSE by defendant DELBERT C. JACKSON to request for production of documents; attachments (cjp) (Entered: 04/12/1990)
4 ORDER by Judge William B. Bryant : granting plaintiffs' oral motion for expedited discovery (N) (cjp) (Entered: 08/16/1990)
5 ORDER by Judge William B. Bryant : granting motion of plaintiff's for inspection (N) (cjp) (Entered: 08/16/1990)
6 NOTICE OF FILING by plaintiff INMATES DC JAIL of address change RE: Edward I. Koren, National Prison Project, 1875 Connecticut Ave., NW, Suite 410, Washington, DC 20009 (202) 331-0500 (cjp) (Entered: 09/14/1990)
7 ORDER by Judge William B. Bryant : directing defendants to submit certain report to the Court by 10/12/90 ; setting hearing for 10:00 10/17/90; directing defendants to produce certain documents by 10/12/90 (N) (cjp) (Entered: 10/01/1990)
8 MOTION by plaintiff INMATES DC JAIL for order regarding medical services ; exhibits (5) (cjp) (Entered: 10/18/1990)
9 STATUS REPORT (copy) by plaintiff INMATES DC JAIL (cjp) Modified on 10/31/1990 (Entered: 10/31/1990)
10 MOTION by plaintiff INMATES DC JAIL to consolidate cases with 1462-71 (cjp) (Entered: 11/05/1990)
11 CONSENT ORDER by Judge William B. Bryant : Ordered that DC shall pay the National Prison Project the sum of Thirty one Thousand eight hundred dollars ($31,800.00); and that payment shall be in full settlement of any claims by plaintiffs for attorneys' fees or costs, exclusive of expert fees, that may be asserted in this matter for the time period from 11/6/86 through 9/13/91 (N) (ks) (Entered: 10/22/1991)
12 INTERROGATORIES and request to produce documents filed by plaintiffs INMATES DC JAIL to defendant DELBERT C. JACKSON regarding defendants' compliance with stipulation of 8/22/85 (ajr) (Entered: 05/11/1992)
13 MOTION filed by plaintiff(s) INMATES DC JAIL to compel defendant's response to discovery ; Exhibits (6) (ks) (Entered: 07/21/1992)
14 RESPONSE by defendant DELBERT C. JACKSON in opposition to motion to compel defendant's response to discovery [13-1] by INMATES DC JAIL (ajr) (Entered: 08/06/1992)
15 REPLY by plaintiffs INMATES DC JAIL to response to motion to

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02/25/1993 03/02/1993 03/05/1993 04/06/1993 04/08/1993 04/13/1993 05/14/1993
08/05/1993 08/16/1993 08/27/1993
10/12/1993 10/25/1993

compel defendant's response to discovery [13-1] by INMATES DC JAIL. Exhibits (3) (ajr) (Entered: 08/07/1992)
16 MOTION filed by defendant DELBERT C. JACKSON to extend time to 4/1/93 to respond to plaintiffs' motion for an order to show cause why defendants should not be held in contempt of court (filed in CA 71-1462) (ajr) (Entered: 02/26/1993)
STATUS HEARING before Judge William B. Bryant : Reporter: C. Gansle (lin) (Entered: 03/02/1993)
17 ORDER by Judge William B. Bryant : that defendants shall file their response to plaintiffs' motion for order to show cause and Report to the Court due 4/1/93; Original filed in CA 71-1462 (N) (ks) (Entered: 03/08/1993)
MOTION HEARING before Judge William B. Bryant begun and continued to 4/8/93 at 10:00 a.m. Reporter: W. McAllister (lin) (Entered: 04/06/1993)
MOTION HEARING before Judge William B. Bryant; motion of plaintiffs for appointment of Special Master heard and granted; parties to submit proposed orders by 4/13/93 at 3:00 Reporter: W. McAllister (lin) (Entered: 04/08/1993)
STATUS HEARING before Judge William B. Bryant : Reporter: C. Gansle (lin) (Entered: 04/14/1993)
18 CONSENT AGREEMENT by defendant DELBERT C. JACKSON, plaintiff INMATES DC JAIL; parties agree to extend the timeframe for negotiations regarding the enhanced reporting format until 7/27/93 to enable counsel an opportunity to review the reports, or by 7/27/93 parties to submit proposed reporting forms to the Court, APPROVED (fiat) JUDGE WILLIAM B. BRYANT (N) (ks) (Entered: 05/19/1993)
19 STIPULATEDCONSENT AGREEMENT by Judge William B. Bryant : (original filed in CA 71-1462) (N) (ks) (Entered: 08/05/1993)
20 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent Order regarding attorneys' fees (ks) (Entered: 08/17/1993)
21 ORDER by Judge William B. Bryant : that the DC shall pay DC Prisoners' Legal Services Project, inc. the sum of seventy five thousand ($75,000.00) in full settlement of fees and costs incurred through 4/30/93, asscoiated with bringing the contempt motion filed on or about 2/17/93 and with monitoring compliance with the Court's Orders entered in this civil action (N) (ks) (Entered: 08/30/1993)
22 MOTION filed by Special Master for compensation , Exhibit (6) (lpp) (Entered: 10/13/1993)
23 ORDER by Judge June L. Green: The Clerk of the Court shall pay Grace M. Lopes the sum of $16,943.16 for her services and expenses and Dr. Downer's services and expenses; this payment shall be drawn from the

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11/08/1993 11/09/1993
11/09/1993 11/17/1993 11/18/1993 11/18/1993 11/23/1993 12/09/1993 12/15/1993 12/15/1993

$20,000.00 fund account; the District of Columbia shall pay $16,943.16 to the Clerk of the Court in order to replenish the $20,000.00 fund account by 10/22/93; the Clerk of the Court shall pay Grace M. Lopes the sum of $35,767.75 for the services and expenses of Ms. Lee Ware Coykendall, Mr. Timothy Roche, Dr. Robert L. Cohen and Dr. Richard Belitshy; this payment shall be drawn from the Crestar Savings Account established by previous orders of this Court; the District of Columbia shall pay $35,767.75 to the Clerk of the Court in order to replenish the Crestar Savings Account by the 10/22/93 (N) (lpp) (Entered: 10/25/1993)
24 MOTION filed Special Master Grace M. Lopes for Compensation , Exhibits (2) (lpp) Modified on 11/10/1993 (Entered: 11/09/1993)
25 ORDER by Judge William B. Bryant : granting motion for compensation [24-1]; directing Clerk of Court to pay Grace M. Lopes the sum of $18,687.90 from the $20,000.00 fund account, established by previous orders, for services and expenses; directing D.C. to pay $18,687.90 to Clerk of Court by 11/19/93; directing Clerk of Court to pay Grace M. Lopes the sum of $13,502.97 from the Crestar Savings Account, established by previous orders, for services and expenses of Ms. Coykendall and Mr. Roche; directing D.C. to pay $13,502.97 to Clerk of Court by 11/19/93 (N) (ab) (Entered: 11/10/1993)
27 ORDER granting motion of plaintiff for interim relief by Judge William B. Bryant : (N) (lin) (Entered: 11/19/1993)
26 ORDER granting motion of Special Officer for extension of time to file report to 12/23/93 by Judge William B. Bryant : (N) (lin) (Entered: 11/19/1993)
28 MOTION filed by defendant DELBERT C. JACKSON to amend order [27-1] (lin) (Entered: 11/19/1993)
HEARING before Judge William B. Bryant; parties to report to Court within 24 hours re: completion of discovery : Reporter: V. Marshall (lin) (Entered: 11/19/1993)
29 MOTION filed by defendant DELBERT C. JACKSON to extend time to 12/3/93 for the defendant to transfer the three remaining inmates identified by Dr. Edwards as in need of hospital care. (bm) (Entered: 11/24/1993)
30 NOTICE OF APPEAL by defendant DELBERT C. JACKSON from order [25-1] , entered on: 11/10/93; Government-No Fee; Copies mailed to Edward I. Koren, Alvin J. Bronstein and Charles Reischel (ks) (Entered: 12/15/1993)
TRANSMITTED PRELIMINARY RECORD on appeal [30-1] by DELBERT C. JACKSON to U.S. Court of Appeals (ks) (Entered: 12/15/1993)
31 MOTION filed by Special Officer for compensation (pm) (Entered: 12/17/1993)

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12/15/1993 12/15/1993
12/16/1993 12/17/1993 12/21/1993 12/28/1993 01/05/1994 01/05/1994 01/11/1994
01/14/1994 01/19/1994 01/19/1994

Text not available. (Entered: 12/17/1993)
32 ORDER by Judge William B. Bryant : granting motion by Special Officer for compensation [31-1], directing that the Clerk of Court pay Grace Lopen $15,491.21 for services and expenses and DC shall pay $15,491.21 to Clerk of Court to replensih the fund account. The Clerk of Court shall pay Grace Lopez $12,941.00 for services and expensed of Ms. Coykendal, Ms Schneider, Dr. Cohen, Dr. Downer and Mr. Roche and DC shall pay $12,941.00 to the Clerk of Court to replenish the Crestar Savings Account by 12/31/93. (N) (pm) (Entered: 12/17/1993)
33 CONSENT by defendant, plaintiff(s) to file redacted copies of certain documents filed as part of 217th Bi-weekly report to court; APPROVED (lin) (Entered: 12/20/1993)
34 ORDER CLARIFYING COUNSEL AND MEDICAL OFFICER ACCESS TO MEDICAL AND MENTAL HEALTH RECORDS by Judge William B. Bryant : (N) (lin) (Entered: 12/21/1993)
35 MOTION filed by defendant DELBERT C. JACKSON to extend time for a period of 21 days within which the defendants must implement paragraphs 12 and 14 of the Court Order of 11/9/93. (bm) (Entered: 12/22/1993)
USCA # 93-7239 assigned for appeal [30-1] by DELBERT C. JACKSON (ks) (Entered: 12/30/1993)
36 RESPONSE by plaintiff(s) in opposition to motion of defendants for protective order. (lin) (Entered: 01/05/1994)
37 ORDER by Judge William B. Bryant : granting motion to extend time for a period of 21 days within which the defendants must implement paragraphs 12 and 14 of the Court Order of 11/9/93. [35-1] by DELBERT C. JACKSON (N) (lin) (Entered: 01/05/1994)
38 ORDER (copy) by Judge William B. Bryant, and June J. Green : that the Clerk of Court pay Grace M. Lopes the sum of $14,618.30 for her services and expenses and Dr. Robert L. Cohen's services and expenses; that DC shall pay $14,618.30 to the Clerk of Court in order to replenish the $20,000.00 fund account by 1/25/94; that the Clerk of Court pay Grace M. Lopes the sum of $10,820.50 for the services and expenses of Ms. Schneider and Mr. Roche; and that DC shall pay $10,820.50 to the Clerk of the Court in order to replenish the Crestar Savings Account by 1/25/94 (N) (Original filed in CA 71-1462) (ks) (Entered: 01/11/1994)
39 CONSENT AGREEMENT by defendant, plaintiff(s) to extend time frame for negotiations regarding enhanced reporting format to 4/15/94 (lin) (Entered: 01/14/1994)
40 MOTION filed by plaintiffs INMATES DC JAIL for Tara M. Flynn to appear pro hac vice ; affidavit of Tara M. Flynn (bm) (Entered: 01/21/1994)
41 MOTION filed by plaintiffs INMATES DC JAIL for Teresa L. Diaz to

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01/25/1994 01/25/1994 02/02/1994
02/02/1994
02/02/1994 02/15/1994 02/16/1994 03/01/1994 03/02/1994
03/08/1994 03/15/1994
03/16/1994 03/16/1994

appear pro hac vice ; affidavit of Teresa L. Diaz. (bm) (Entered: 01/21/1994)
42 ORDER by Judge William B. Bryant : granting motion for Tara M. Flynn to appear pro hac vice [40-1] by INMATES DC JAIL (N) (lin) (Entered: 01/26/1994)
43 ORDER by Judge William B. Bryant : granting motion for Teresa L. Diaz to appear pro hac vice [41-1] by INMATES DC JAIL (N) (lin) (Entered: 01/26/1994)
44 ORDER by Judge William B. Bryant : granting the Special Officer's motion to extend time to 2/3/94 to file their report on medical care; and to 2/28/94 to file their report on mental health care (N) (ks) (Entered: 02/03/1994)
45 ORDER by Judge William B. Bryant : granting motion to extend time to 1/31/94 in which the defendants must transfer the two inmates identified on 1/14/94, to be in need of hospitalization pursuant to paragraph 4 of this Court's 11/9/93 Order (N) (ks) (Entered: 02/03/1994)
ORDER by Judge William B. Bryant; Approving consent agreement by all parties to file redacted copies (fiat) (N) (ks) (Entered: 02/03/1994)
46 MOTION filed by Special Officer Grace M. Lopes for compensation ; Exhibits (3) (ks) (Entered: 02/16/1994)
47 ORDER by Judge William B. Bryant, and June L. Green : granting motion for compensation [46-1] (see Order for details) (Original filed in CA 71-1462) (N) (ks) Modified on 02/22/1994 (Entered: 02/22/1994)
48 CONSENT ORDER by Judge William B. Bryant : motion hearing set for 10:00 3/16/94 ; (N) (lin) (Entered: 03/01/1994)
49 ORDER by Judge William B. Bryant : granting motion to extend time to 3/4/94 for defendants to implement paragraphs 12 and 14 of the Court Order of 11/9/93. [35-1] by DELBERT C. JACKSON (N) (ks) (Entered: 03/04/1994)
50 TRANSCRIPT filed for date of 3/2/93. Reporter: Carrie L. Gansle (Filed only in 71-1462) (bm) (Entered: 03/09/1994)
53 COPY OF ORDER by Judge William B. Bryant and Judge June L. Green : granting the motion for Compensation by the Special Officer; Ordered that the Clerk of Court pay Grace M. Lopes the sum of $17,747.00 for her services and expenses, and that the Clerk of Court pay Grace M. Lopes the sum of $16,320.44 for the services and expenses of Mr. Roche, Ms. Schneider, and Dr. Robert L. Cohen (N) (Original filed in CA 71-1462) (ks) (Entered: 03/21/1994)
STATUS HEARING before Judge William B. Bryant; order to be presented : Reporter: G. Williams (lin) (Entered: 03/16/1994)
51 CONSENT ORDER re: implementation of remedial plan by Judge

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03/17/1994 03/31/1994 04/05/1994 04/12/1994
04/21/1994 05/09/1994 05/16/1994 05/17/1994 05/19/1994
07/06/1994
07/07/1994

William B. Bryant : (N) (lin) (Entered: 03/16/1994)
52 MOTION filed by plaintiff INMATES DC JAIL to withdraw Edward I. Koren as attorney for INMATES DC JAIL (ks) (Entered: 03/18/1994)
54 MOTION filed by plaintiff INMATES DC JAIL to withdraw Edward I. Koren as attorney for INMATES DC JAIL (ks) (Entered: 04/01/1994)
55 ORDER by Judge William B. Bryant : granting motion to withdraw Edward I. Koren as attorney for INMATES DC JAIL [54-1] by INMATES DC JAIL attorney Edward I. Koren for INMATES DC JAIL (N) (lin) (Entered: 04/06/1994)
56 ORDER (Copy) by Judge William B. Bryant, and Judge June L. Green : granting motion for compensation [22-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $18,840.33 for her services and expenses, and that the District of Columbia shall pay $18,840.33 to the Clerk of the Court in order to replenish the $20,000.00 fund account by 4/26/94; and that the Clerk of the Court pay Grace M. Lopes the sum of $17,090.91 for the services and expenses of Mr. Roche, Ms. Schneider, and Mr. James Henderson, and that the District of Columbia shall pay $17,090.91 to the Clerk of the Court in order to replenish the Crestar Savings Account by 4/26/94 (Original filed in CA 71-1462) (N) (ks) (Entered: 04/13/1994)
Text not available. (Entered: 04/21/1994)
57 ORDER by Judge William B. Bryant : granting motion to enlarge time to 5/2/94 in which the defendants must hire a tuberculosis coordinator (N) (ks) (Entered: 05/12/1994)
58 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent Order regarding attorneys' fees (ks) (Entered: 05/17/1994)
59 ORDER by Judge William B. Bryant : granting motion for adoption of consent Order regarding attorneys' fees [58-1] by DELBERT C. JACKSON (N) (lin) (Entered: 05/18/1994)
60 ORDER (Copy) by Judge William B. Bryant, and Judge June L. Green : that the Clerk of the Court pay Grace M. Lopes the sum of $16,357.43 for her services and expenses; that the Clerk of the Court pay Grace M. Lopes the sum of $19,760.28 for the services and expenses of Mr. Roche, Ms. Schneider, and Dr. Robert L. Cohen (Original filed in CA 71-1462) (N) (ks) (Entered: 05/20/1994)
62 ORDER by Judge William B. Bryant and Judge June L. Green : that the Clerk of the Court pay Grace M. Lopes the sum of $18,407.63 for her services and expenses as well as Dr. Downer's services and expenses; and that the Clerk of Court pay Grace M. Lopes the sum of $27,315.26 for the services and expenses of Mr. Roche, Ms. Schneider, Dr. Belitsky, and Dr. Cohen (Original filed in CA 71-1462) (N) (ks) (Entered: 07/15/1994)
61 ORDER (copy) by Judge William B. Bryant: granting motion of the Special Officer for extending the time to 8/31/94 to file a remedial plan

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08/09/1994
08/09/1994 09/13/1994
10/18/1994 10/20/1994
11/01/1994 11/14/1994 11/16/1994
12/12/1994 12/13/1994

(N) (Original filed in 71-1462) (bm) (Entered: 07/08/1994)
63 ORDER (copy) by Judge William B. Bryant and Judge June L. Green : that the Clerk of the Court pay Grace M. Lopes the sum of $19,511.02 for her services and expenses as well as Ms. Schneider's services and expenses; and that the Clerk of the Court pay Grace M. Lopes the sum of $21,880.43 for the services and expenses of Mr. Roche, Mr. Hayes and Mr. Henderson (Original filed in CA 79-1726) (N) (ks) (Entered: 08/19/1994)
64 MOTION filed by Special Master Grace M. Lopes for compensation, Exhibits (5) (lpp) (Entered: 09/07/1994)
66 COPY OF ORDER by Judge William B. Bryant and Judge June L. Green : granting motion for compensation, [64-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $17,030.13 for the services and expenses of Mr. Roche, Ms. Schneider, and Mr. Hayes; and that the Clerk of the Court pay Grace M. Lopes the sum of $29,844.38 for the services and expenses of Ms. Lopes and Dr. Robert l. Cohen (Original filed in CA 79-1726) (N) (ks) (Entered: 10/24/1994)
65 MOTION filed by Special Master Grace M. Lopes for compensation , Exhibit (7) (lpp) (Entered: 10/19/1994)
67 COPY OF ORDER by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [65-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $19,265.15 for her services and expenses; and that the Clerk of the Court pay Grace M. Lopes the sum of $32,408.21 for the services and expenses of Mr. Roche, Ms. Schneider, Mr. Hayes, Dr. Belitsky, Mr. Balsamo and Mr. Henderson (Original filed in CA 71-1462) (N) (ks) (Entered: 10/24/1994)
STATUS HEARING before Judge William B. Bryant : Reporter: Carrie Gansle (mon) (Entered: 11/01/1994)
68 MOTION filed by Grace M. Lopes, Special Master, for Compensation , Affidavit (1), Exhibit (6) (lpp) (Entered: 11/15/1994)
69 COPY OF ORDER by Judge William B. Bryant and Judge June L. Green : granting motion by Special Master Grace M. Lopes for compensation; that the Clerk of the Court pay Grace M. Lopes the sum of $10,725.23 for her services and expenses as well as the services and expenses of Mr. Hayes and Mr. Henderson; and that the Clerk of the Court pay Grace M. Lopes the sum of $13,508.01 for the services and expenses of Mr. Roche and Ms. Schneider (Original filed in CA 79-1726) (N) (ks) (Entered: 11/17/1994)
70 MOTION filed by the Special Officer Grace M. Lopes for compensation ; Exhibits (ks) (Entered: 12/14/1994)
71 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [70-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $19,671.13 for her services and expenses as

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12/16/1994 12/21/1994
01/17/1995 01/19/1995
01/27/1995 02/10/1995 02/14/1995 02/14/1995
02/16/1995

well as for the services and expenses of Mr. Roche, Mr. Henderson and Mr. Balsamo; and that the District of Columbia shall pay $19,671.13 to the Clerk of the Court in order to replenish the $20,000.00 fund account by 12/27/94; that the Clerk of the Court pay Grace M. Lopes the sum of $21,711.86 for the services and expenses of Ms. Schneider, Mr. Hayes and the law firm of Zuckerman, Spaeder, Goldstein, Taylor and Kolker and that the District of Columbia shall pay $21,711.86 to the Clerk of the Court in order to replenish the Crestar Savings account by 12/27/94 (Original filed in CA 71-1462) (N) (ks) (Entered: 12/14/1994)
72 NOTICE OF FILING by Special Master Grace Lopes; environmental health and safety survey. (Original filed in 71-1462.) (bm) (Entered: 12/20/1994)
73 ORDER by Judge William B. Bryant: granting the Special Officer's motion for leave to file expert reports under seal; directing the Clerk of Court shall take all steps necessary to ensure that the 1994 reports prepared by James D. Henderson that are related to correctional officer staffing and security at the D.C. Jail are filed under seal. (N) (bm) (Entered: 12/22/1994)
74 MOTION filed Special Master Grace M. Lopes for Compensation, Exhibit (5) (lpp) (Entered: 01/19/1995)
75 ORDER (copy) by Judge William B. Bryant and Judge June L. Green : granting motion for Compensation [74-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $18,936.67 for her services and expenses as well as the services and expenses of Mr. Roche and Ms. Schneider; and that the Clerk of the Court pay Grace M. Lopes the sum of $4,427.91 for the services and expenses of Mr. Hayes and Dr. Shansky (See Order for details) (original filed in CA 71-1462) (N) (ks) (Entered: 01/27/1995)
76 ORDER by Judge William B. Bryant : that the defendants shall implement the Special Officer's Initial Remedial Plan. (N) (dot) (Entered: 01/27/1995)
77 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent order regarding attorneys' fees (ks) (Entered: 02/13/1995)
78 MOTION filed Grace M. Lopes, Special Master for compensation , Exhibits: (6) (lpp) (Entered: 02/15/1995)
81 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [78-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $17,590.90 for her services and expenses as well as the services and expenses of Mr. Lindsay Hayes, and that the Clerk of the Court pay Grace M. Lopes the sum of $27,768.40 for the services and expenses of Mr. Roche, Ms. Schneider, Mr. Henderson, and the law firm of Zuckerman, Spaeder, Goldstein, Taylor and Kolker (Original Order filed in CA 79-1726) (N) (ks) (Entered: 03/13/1995)
79 ORDER by Judge William B. Bryant : that the District of Columbia shall pay D.C. Prisoners' Legal Services Project, Inc. within sixty (60) days of

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02/22/1995 02/27/1995 03/03/1995 03/07/1995 06/14/1995 06/14/1995
06/20/1995 06/27/1995
07/11/1995
07/18/1995 07/18/1995

the date of this Order the sum of sixty three thousand ($63,000.00) in full settlement of fees and costs incurred from April 16, 1994 through December 31, 1994, associated with monitoring compliance with the Court's orders entered in the above-referenced civil action. (N) (dot) (Entered: 02/16/1995)
82 CERTIFIED COPY of order filed in USCA dated 2/13/95, on appeal [301] , dismissing appeal . USCA # 93-7239 (cjp) (Entered: 04/24/1995)
80 NOTICE OF APPEAL by defendant DELBERT C. JACKSON from order [76-1] , entered on: 1/27/95; Government-no fee; Copies mailed to Jonathan M. Smith, J. Patrick Hickey and Grace Lopes (ks) (Entered: 03/03/1995)
TRANSMITTED PRELIMINARY RECORD on appeal [80-1] by DELBERT C. JACKSON to U.S. Court of Appeals (ks) (Entered: 03/03/1995)
USCA # 95-7048 assigned for appeal [80-1] by DELBERT C. JACKSON (ks) (Entered: 03/08/1995)
84 MOTION filed by the Special Master Grace Lopes for order for compensation ; Exhibits (4) (ks) (Entered: 06/23/1995)
86 ORDER (copy) by Judge William B. Bryant and Judge June L. Green : granting motion for order for compensation [84-1]; that the Clerk of the Court pay Grace M. Lopes the sum of $54,738.97 which represents compensation for the services and expenses of Special Officer Lopes, Mr. Roche, Ms. Schneider, and Dr. Shansky (N) (ks) (Entered: 07/14/1995)
83 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent Order regarding attorneys' fees (ks) (Entered: 06/21/1995)
85 ORDER by Judge William B. Bryant : that the District of Columbia shall pay D.C. Prisoners' Legal Services Project, Inc. the sum of THIRTY ONE THOUSAND ($31,000.00) in full settlement of fees and costs incurred from January 1, 1995 through April 30, 1995, associated with monitoring compliance with the Court's orders entered in the above referenced civil action. This amount shall bear interest at the rate established by 28 USC 1961 from the forty-fifth (45th) day following the entry of this Order; said amount to be paid no later than October 31, 1995. (N) (dot) (Entered: 06/27/1995)
87 FINDINGS AND ORDER by Judge William B. Bryant : granting plaintiffs' motion for the appointment of a reciver; and that the Court adopts the findings contained in the Special Officer's Report on defendants' compliance with the Initial Remedial Plan and the 11/9/93 Order as its own (See Findings and Order for details) (N) (ks) (Entered: 07/19/1995)
88 MOTION filed by the Special Officer for compensation ; Exhibits(4) (ted) (Entered: 07/20/1995)
89 ORDER (copy) by Judge William B. Bryant and Judge June L. Green :

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08/02/1995 08/02/1995 08/03/1995 08/03/1995 08/03/1995 08/11/1995
08/14/1995

granting motion for compensation [88-1]; that the Clerk of Court pay Grace M. Lopes the sum of $32,649.63 which represents compensation for the Sepcial Officer's fee and Ms. Schneider's fee and expenses; and that the Clerk of the Court pay Grace M. Lopes the sum of $17,377.90 which represents compensation for Mr. Roche's fee and expenses and the Special Officer's expenses; and that the Clerk of Court pay Grace M. Lopes the sum of $15,356.51 which represents compensation for Dr. Shansky's fee and expenses (Original filed in CA79-1726) (N) (ks) (Entered: 07/21/1995)
90 MEMORANDUM AND ORDER by Judge William B. Bryant :that Ronald M. Shansky, M.D., is appointed Receiver, effective August 21, 1995. The Receiver shall be paid at the rate of $175 per hour with a monthly ceiling of $16,500. (N) (dot) (Entered: 08/02/1995)
91 NOTICE OF FILING by Grace M. Lopes, Special Officer to the Court and to counsel for the parties the attached correspondence; attachments. (dot) (Entered: 08/04/1995)
92 ORDER by Judge William B. Bryant : granting motion to compel defendant's response to discovery [13-1] by INMATES DC JAIL; the defendants shall respond to the plaintifffs' outstanding request for production of documents within 10 days. (N) (dot) (Entered: 08/04/1995)
93 ORDER by Judge William B. Bryant : that the Special Officer's findings concerning security and officer staffing at the District of Columbia Detention Facility that are contained in her 2/16/94 Notice of Filing are, pursuant to FRCP 53(e)(2), adopted as the findings of this Court. (N) (dot) (Entered: 08/04/1995)
94 ORDER by Judge William B. Bryant : that the findings of the Special Officer, which incorporate the report of James Balsamo on environmental health and safety at the District of Columbia Detention Facility are, pursuant to FRCP 53(e)(2), adopted as the findings of this Court; defendants to show cause on or before 8/28/95 as to why they should not be held in contempt of this Court. (N) (dot) (Entered: 08/04/1995)
95 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation; and that the Clerk of the Court pay Grace M. Lopes the sum of $17,027.35 which represents compensation for the services and expenses of Special Officer Lopes and Ms. LaMarre; and that the Clerk shall pay Grace M. Lopes the sum of $32,449.82 which represents compensation for the services and expenses of Mr. Roche, Ms. Schneider, Mr. Hayes, Dr. Cohen and Dr. Shansky (N) (Original filed in CA 71-1462) (ks) (Entered: 09/21/1995)
96 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion to modify the Court's 8/11/95; and that the Clerk of the Court shall pay Grace M. Lopes the sum of $49,477.17 which represents compensation for the services and expenses of the Special Officer, Mr. Roche, Ms. Schneider, Mr. Hayes, Dr. Cohen, Ms. LaMarre, and Dr. Shansky; and that the Court's 8/11/95 Order is Vacated in lieu of this

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09/07/1995 09/13/1995
09/26/1995 10/05/1995 10/19/1995 10/30/1995 11/14/1995
11/14/1995
01/17/1996

Order. (Original filed in CA 71-1462) (N) (ks) (Entered: 09/21/1995)
98 ORDER by Judge William B. Bryant : granting motion by the Speical Officer to extend time to 9/15/95 to file the Receiver's plan for the exercise of his powers (N) (ks) (Entered: 09/28/1995)
99 ORDER (Copy) by Judge William B. Bryant and June L. Green : that the Clerk of the Court pay Grace M. Lopes the sum of $31,387.72 which represents compensation for the services and expenses of Special Officer Lopes and Mr. Roche; and that the Clerk of the Court pay Grace M. Lopes the sum of $17,126.69 which represents compensation for the services and expenses of Ms. Schneider, Dr. Belitsky and Mr. Hayes (Original filed in CA 79-1726) (N) (ks) (Entered: 09/28/1995)
97 ORDER by Judge William B. Bryant : regarding procedures for the receiver to exercise powers. (see order for details) (N) (dot) (Entered: 09/26/1995)
100 CERTIFIED COPY of order filed in USCA dated 10/3/95, on appeal [801] , dismissing appeal . USCA # 95-7048 (cjp) (Entered: 10/16/1995)
102 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : that the Clerk of the Court pay Grace M. Lopes the sum of $38,890.19 which represents compensation for the services and expenses of Special Officer Lopes, Mr. Roche, Ms. Schneder, and Dr. Cohen. (Original filed in CA 79-1726) (N) (ks) (Entered: 11/01/1995)
101 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent order regarding attorneys' fees (blj) (Entered: 10/31/1995)
103 ORDER by Judge William B. Bryant : that the District of Columbia shall pay D.C. Prisoners' Legal Services Project, Inc. the sum of thirty three thousand, one hundred and thirty two dollars and fifty six cents ($33,132.56) in full settlement of fees and costs incurred from 5/1/95 through 8/31/95, associated with monitoring compliance with the Court's ordrs entered in the above-referenced civil actioni; this amount sahoo bear interest at the established by 28 U.S.C. 1961 1961 from the fortyfifth (45th) day following entry of this Order. (N) (dot) (Entered: 11/15/1995)
104 ORDER (Copy) by Judge William B. Bryant and June L. Green :granting motion for compensation; that the Clerk of the Court pay Grace M. Lopes the sum of $29,112.66 which represents compensation for the services and expenses of Special Officer Lopes, Mr. Roche, and Ms. Schneider; and that the Clerk of the Court pay Grace M. Lopes the sum of $9,473.02 which represents compensation for the services and expenses of Ms. Fisher and Mr. Henderson (Original filed in CA 71-1462) (N) (ks) (Entered: 11/21/1995)
105 ORDER (copy) by Judge William B. Bryant and Judge June L. Green : granting Special Officer's motion to increase compensation Rate for Special Assistant; that Ms. Schneider's compensation rate shall be increased to $60.00 per hour (Original filed in CA 71-1462) (N) (ks)

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01/17/1996 01/30/1996
01/30/1996 02/07/1996 02/21/1996
02/22/1996

(Entered: 01/23/1996)
106 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting Special Officer's motion for Compensation; that the Clerk of the Court pay Grace M. Lopes the sum of $29,979.04 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, and Ms. Lytle (Original filed in CA 71-1462) (N) (ks) (Entered: 01/23/1996)
107 ORDER by Judge William B. Bryant : that by 2/5/96, defendant DC will issue checks made payable to the Receiver, Ronald Shansky, M.D. for the purposes and amounts listed: bi-weekly payrool $237,629.30, bi-weekly payroll $237,629.30, equipment, medications and supplies $233,020.00, receiver's office $31,413.23; that the parties shall attempt to reach, by 2/9/96, an agreement to facilitate payment of the Receiver's March 1996 costs and expenses pending finalization and approval of his annual budget; failing which the parties may apply to the Court for an order resolving this issue; that the above-referenced funds shall be subject to audit as referenced in this Court's order of 9/26/95. (N) (dot) (Entered: 01/31/1996)
108 ORDER by Judge William B. Bryant : that the time for the Receiver to submit the budget for his office as well as the operating budget for medical and mental health services is extended up to and including 3/7/96. (N) (dot) (Entered: 01/31/1996)
109 ORDER by Judge William B. Bryant : that the time to make available to the Receiver the funds needed to cover costs and expenses expected to be incurred during the first half of February 1996 ($385,552.53) is extended up to and including 2/6/96; that the time to make available to the Receiver the funds needed to cover costs and expenses expected to be incurred during the second half of February 1996 ($354,139.30) is extended up to and including 2/16/96. (N) (dot) (Entered: 02/07/1996)
110 ORDER by Judge William B. Bryant: the Clerk of the Court pay Grace M. Lopes the sum of $18,921.87 which represents compensation for the services and expenses of Special Officer Lopes; this check shall be drawn from the $20,000 Fund established by previous orders of the Court; the District of Columbia shall pay $18,921.87 to the Clerk of the Court in order to replenish the $20,000 Fund by 3/5/96; the Clerk of the Court pay Grace M. Lopes the sum of $25,330.50 which represents compensation for the services and expenses of Ms. Schneider, Ms. Fisher, Ms. Lytle, Mr. Roche and Dr. Belitsky; this check shall be drawn from the Inmates of Modular account established by previous orders of the Court; the District of Columbia shall pay $25,330.50 to the Clerk of the Court in order to replenish the Inmates of Modular account by 3/5/96. (N) (bm) (Entered: 02/21/1996)
111 ORDER by Judge William B. Bryant : granting motion to extend time to 2/20/96 in which to make available to the Receiver funds to facilitate payment of costs and expenses expected to be incurred during the second half of February 1996. (N) (dot) (Entered: 02/22/1996)

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02/22/1996
03/07/1996 03/13/1996
03/18/1996 03/20/1996 03/20/1996

112 ORDER by Judge William B. Bryant : granting the consent motion for an Order to Facilitate the Payment of the Receiver's March 1996 Costs and Expenses; that by 3/4/96, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of three hundred thirty four thousand, forty two dollars and fifty three cents ($334,042.53); that by 3/12/96, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of three hundred and two thousand, six hundred and twenty nine dollars and thirty cents ($302,629.30); that by 3/22/96, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of two hundred and thirty seven thousand, six hundred and twenty nine dollars and thirty cents ($302,629.30); that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/26/96. (N) (dot) (Entered: 02/22/1996)
113 ORDER by Judge William B. Bryant : granting the motion for the Receiver to submit the budget for his office as well as the operating budget for medical and mental health services is extended up to and including 3/15/96. (N) (dot) (Entered: 03/07/1996)
114 ORDER by Judge William B. Bryant : granting consent motion for enlargement of time; that the time for the District to make available to the Receiver the funds previously required by the Court's 2/22/96, Order is extended and modified as set forth herein; that by 3/18/96, defendant DC shall make available to the Receiver, ronald Shansky, M.D., funds in the amount of three hundred and two thousand, six hundred and twenty nine dollars and thirty cents ($302,629.30); that by 4/1/96, defendant DC shall make available to the Receiver, Ronald Shansky, M.D., funds in the amount of two hundred and thirty seven thousand, six hundred and twenty nine dollars and thirty cents ($237,629.30); that the abovereferenced funds shall be subject to audit as referenced in this Court's Order of 9/26/95. (N) (dot) (Entered: 03/14/1996)
115 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent Order regarding attorneys' fees (ks) (Entered: 03/19/1996)
116 ORDER by Judge William B. Bryant : that the District of Columbia shall pay D.C. Prisoners' Legal Services Project, Inc. the sum of forty five thousand, one hundred and forty three dollars and forty cents ($45,143.40) in full settlement of fees and costs incurred from 9/1/95 through 2/29/96, associated with monitoring compliance with the Court's orders entered in the above referenced civil action. This amount shall bear interest at the rate established by 28 USC 1961 from the forty-fifth (45th) day following enry of this Order. (N) (dot) (Entered: 03/20/1996)
117 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion by Special Officer Lopes for compensation; and that the Clerk of the Court pay Grace M. Lopes the sum of $22,098.03 which represents compensation for the services and expenses of Special Officer Lopes, Mr. Roche and Mr. Brown; and that the Clerk of he Court pay Grace m. Lopes the sum of $33,686.64 which represents compensation for the services and expenses of Ms. Schneider, Ms. Fisher , Ms. Lytle,

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03/28/1996 03/28/1996 04/01/1996 04/04/1996 04/09/1996
04/22/1996 04/23/1996
05/02/1996 05/07/1996

and Mr. Henderson. (Original filed in CA 79-1726) (See Order for details) (N) (ks) (Entered: 03/22/1996)
STATUS HEARING before Judge William B. Bryant : show cause hearing set for 4/1/96 at 10:00 a.m.; Reporter: Kay Moomey (dot) (Entered: 03/28/1996)
118 ORDER by Judge William B. Bryant : to show cause why William Plaut should not be held in civil contempt of this Court's Orders issued in this case, in connection with the establishment and operation of the SouthOne housing unit at the District of Columbia Jail from approximately February 23, 1996 to date [118-1]; that William Plaut to appear on 4/1/96 at 10:00 a.m. (N) (dot) (Entered: 03/29/1996)
SHOW CAUSE HEARING before Judge William B. Bryant, begun and continued to 4/9/96 at 10:00 a.m.; reporter: William McAllister (dot) (Entered: 04/01/1996)
119 ORDER by Judge William B. Bryant : that the time for the District to file objections to the Receiver's proposed budget is extended up to and including 4/12/96. (N) (dot) (Entered: 04/04/1996)
120 ORDER by Judge William B. Bryant : granting consent motion for an Order to Facilitate the Payment of the Receiver's April 1996 Costs and Expenses; that by 4/12/96, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of three hundred fifty thousand dollars ($350,000.00) or will wire said amount to the Receiver's bank account no later than 4/15/96; that by 4/26/96, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of four hundred fifty four thousand, nine hundred and seventy one dollars ($454,971.00) or will wire said amount to the Receiver's bank account no later that 4/29/96; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/26/95. (N) (dot) (Entered: 04/09/1996)
121 MOTION filed by special master GRACE M. LOPES for compensation (JMF) (Entered: 04/23/1996)
122 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : Ordered that the Clerk of the Court pay Grace M. Lopes the sum of $32,827.30 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Fisher, Mr. Roche and Ms. Lytle (Delaney, Siegel and Zorn; and that the Clerk of the Court pay Grace M. Lopes the sum of $23,266.01 which represents compensation for the services and expenses of Ms. Schneider and Mr. Henderson (N) (Original filed in CA 71-1462) (ks) (Entered: 04/26/1996)
MOTION HEARING before Judge William B. Bryant Reporter: William McAllister (dot) (Entered: 05/02/1996)
123 ORDER by Judge William B. Bryant : that the Receiver's request that defendants provide him with additional funding for fiscal year 1996 in the total amount of $5,065,927.00, as needed to facilitate the delivery of

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05/20/1996 05/21/1996
06/03/1996 06/14/1996
06/19/1996 06/20/1996 06/20/1996

medical and mental health services at the D.C. Detention Facility in compliance with the Unites States constitution and this Court's orders be and hereby is granted; the amount is to be provided to the Receiver, Ronald Shansky, M.D., in five monthly payments, with the first payment of $1,013,185.04 (1/5 of the total amount) to be made available by check no later than Friday, May 10, 1996 or by a wire transfer no lager than Tuesday, May 14, 1996. The four subsequent payments shall be for $1,013,185.04 less the difference between the sum of the immediately preceeding two bi-weekly payrolls and $552,000.00. The four subsequent payments to the Receiver are to be made by check on June 7 or by wire transfer on June 10, 1996; by check on July 5 or by wire transfer on July 8, 1996; by check on August 2 or by wire transfer on August 5, 1996; by check on August 30 or by wire transfer on September 2, 1996; that no sooner than 60 days but no later than 75 days from the date of this Order, the Receiver shall be available to meet with defendants in order to determine whether there are any funds budgeted for non-personal services which are not likely to be spent prior to the end of the fiscal year and which can, therefore, be credited to reduce the amount of defendants remaining payments; that the funds shall be subject to audit as referenced in this Court's Order of September 26, 1995. (N) (dot) (Entered: 05/08/1996)
124 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (4) (JMF) (Entered: 05/24/1996)
125 ORDER by Judges William B. Bryant and June L. Green : granting motion for compensation [124-1] by GRACE M. LOPES; directing the Clerk of the Court to pay Grace M. Lopes the sum of $42,171.74 for services of Special Officer Lopes, Ms. Schneider, Ms. Fisher and Ms. Lytle; directing that the check be drawn from the Crestar savings account established by previous orders; directing the District of Columbia pay $42,1717.74 to the Clerk of the Court to replenish the Crestar savings account by June 3, 1996. (N) (bjl) (Entered: 05/29/1996)
126 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (7) (JMF) (Entered: 06/06/1996)
127 ORDER by Judge William B. Bryant : evidentiary hearing set for 11:00 6/20/96; that the Director of the D.C. Department of Corrections, Margaret Moore, and the Deputy Dirctor of the D.C. Department of Corrections, John Thomas, also appear before the Court on that date and at that time. (N) (dot) (Entered: 06/14/1996)
129 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (5) (JMF) (Entered: 06/25/1996)
EVIDENTIARY HEARING before Judge William B. Bryant : Reporter: Ben Leesman (dot) (Entered: 06/20/1996)
130 ORDER (COPY) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [129-1] by GRACE M. LOPES; Ordered that the Clerk of the Court pay Grace M. Lopes the sum of

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06/21/1996
06/27/1996 06/27/1996 08/08/1996 08/08/1996
09/10/1996 09/11/1996
10/03/1996

$41,946.70 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Dr. Cohen and Mr. Henderson. (Original filed in CA 71-1462) (N) (ks) (Entered: 06/28/1996)
128 ORDER by Judge William B. Bryant : that the Special Officer of the Court shall review the main entry logs for the D.C. Jail for the period October 1, 1995 through the present; that the Special Officer shall report to the Court all instances of the appearances in the main entry log of the Director of the D.C. Department of Corrections, Margaret Moore, and the Executive Deputy Director of the Department, John Thomas. (N) (dot) (Entered: 06/21/1996)
131 ORDER (COPY) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation by Special Officer; Ordered that the Clerk of the Court pay Grace M. Lopes the sum of $44,033.90 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Ms. Lytle and Dr. Belitsky. (Original filed in CA 71-1462) (N) (ks) (Entered: 06/28/1996)
132 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (5) (JMF) (Entered: 06/28/1996)
133 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (4) (JMF) (Entered: 08/08/1996)
134 ORDER by Judge June L. Green and William B. Bryant : granting motion for compensation [133-1] by GRACE M. LOPES; directing the Clerk of the Court to pay Grace M. Lopes the sum of $36,938.29 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Mr. Roche, and Ms. Lytle; directing that this check shall be drawn from the Crestar savings account established by previous orders of the Court; directing the District of Columbia pay $36,938.29 to the Clerk of the Court in order to replenish the Crestar savings account by 8/22/96. (N) (jeb) (Entered: 08/08/1996)
136 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (5) (JMF) (Entered: 09/12/1996)
135 ORDER by Judge William B. Bryant : directing the Clerk of the Court to pay the sum of $40,622.03 to Grace Lopes which represents compensation and expenses of Special Officer, Ms. Schneider, Ms. Fisher, Ms. Lytle and Mr. Roche; this check shall be drawn from the Inmates of Modular account; directing the District of Columbia to pay $40,622.03 to the Clerk of the Court to replenish the Inmates of Modular account by 9/26/96. (N) (bjl) (Entered: 09/11/1996)
137 ORDER by Judge William B. Bryant : granting motion for an Order to Facilitate the Payment of the Receiver's October 1996 Costs and Expenses; that by October 15, 1996, defendant DISTRICT OF COLUMBIA will issue a check made payable to Ronald Shansky, M.D. in the amount of $1,063,915.08; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of September 26,

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10/16/1996 10/16/1996 10/22/1996 11/06/1996 11/06/1996 11/07/1996
11/07/1996
12/05/1996

1995. (N) (dot) (Entered: 10/04/1996)
138 MOTION filed by Special Officer for compensation; Exhibits A-E. (bjl) (Entered: 10/17/1996)
139 ORDER by Judge William B. Bryant : granting motion for compensation; [138-1] (N) (bjl) (Entered: 10/17/1996)
SCHEDULING NOTICE: motion hearing set for 10:00 11/6/96; before Judge William B. Bryant. (dot) (Entered: 10/22/1996)
142 MOTION filed by special master GRACE M. LOPES for compensaion ; exhibits (4) (JMF) (Entered: 11/14/1996)
STATUS HEARING before Judge William B. Bryant : Reporter: Chris Bitsko (dot) (Entered: 11/27/1996)
140 ORDER by Judge William B. Bryant : granting amended motion of the Receivership for Approval of the Receivership Budget for Fiscal Year 1997, the Fiscal Year 1997 Receivership budget of sixteen million, two hundred and twenty three thousand, four hundred and fifteen dollars ($16,223,415) be and hereby is approved; the money already paid to the Receivership in Fiscal Year 1997 ($1,063,915.08) and those costs in the receivership budget which are paid directly by the District of Columbia Department of Corrections ($2,056,434) are credited against the total approved budget referenced above; that the remaining amount ($13,103,065.91) is to be paid to Ronald Shansky, M.D. in eleven monthly payments of $1,191,187.81; the first payment to be issued by 11/18/96, the remaining payments to follow every thirty days; that prior to the preparation of the amount due in August 1997, the Receiver shall be available to meet with defendants in order to determine wheter there are any budgeted funds which are not likely to be spent prior to the end of the fiscal year and which can, therefore, be credited to reduce the amount of defendants' remaining payments; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/26/95. (N) (dot) (Entered: 11/07/1996)
141 ORDER by Judge William B. Bryant directing the Clerk of the Court to pay $51.675.11 to Grace Lopes which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher and Dr. Belitsky; directing that the check be drawn from the Crestar savings account; directing the District of Columbia to pay $51,675.11 to the Clerk of the Court in order to replenish the Crestar account. : (N) (bjl) (Entered: 11/08/1996)
143 ORDER by Judge William B. Bryant : granting motion of Grace Lopes for compensation; directing the Clerk of the Court to pay Grace Lopes the sum of $42,663.39 for services and expenses of Special Officer Lopes, Ms. Schneider and Ms. Fisher; directing that this check be drawn from the Crestar Savings Account; directing the District of Columbia to pay $42,663.39 to the Clerk of the Court in order to replenish the Crestar Savings Account. (N) (bjl) (Entered: 12/06/1996)

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01/07/1997 01/08/1997
02/06/1997 02/10/1997
03/05/1997 03/07/1997
04/07/1997 04/08/1997
05/06/1997

144 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (1) (JMF) (Entered: 01/08/1997)
145 ORDER by Judge William B. Bryant : for compensation [144-1]; Clerk of Court shall pay Graces M. Lopes the sum of $34,240.39 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher and Delaney, Siegel, Zorn and Associates, Inc.; check shall be drawn from the Inmates of Modular account; District of Columbia shall pay $34,240.39 to the Clerk of Court in order to replenish the Inmates of Modular account by 1/22/97 (N) (dbw) Modified on 01/09/1997 (Entered: 01/09/1997)
146 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (6) (JMF) (Entered: 02/10/1997)
147 ORDER by Judge June L. Green for Judge William B. Bryant : Clerk of Court shall pay Grace M. Lopes the sum of $54,530.83 which represents compensation for services and expenses of Special Officer Lopes, Ms. Schneider, Js. Fisher, Mr. Roche, Mr. Henderson and Dr. Downer [1461]; check shall be drawn from Crestar savings account established by previous orders of the Court; District of Columbia shall pay $54,530.83 to the Clerk of Court in order to replenish Crestar savings account by 2/25/97 (N) (dbw) (Entered: 02/10/1997)
148 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (3) (JMF) (Entered: 03/06/1997)
149 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion for compensation [148-1] by GRACE M. LOPES; directing the Clerk of the Court pay Grace M. Lopes the sum of $28,819.33 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, and Ms. Fisher; directing the District of Columbia pay $28,819.33 to the Clerk of the Court in order to replenish the Crestar savings account due by 3/20/97. (N) (jeb) (Entered: 03/07/1997)
150 MOTION filed by special master GRACE M. LOPES for compensation exhibits (4) (JMF) (Entered: 04/08/1997)
151 ORDER by Judge June L. Green and Judge William B. Bryant : [150-1] directing Clerk of Court to pay Grace M. Lopes the sum of $44,689.82 which represents compensation for services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, and Dr. Belitsky; check shall be drawn from the Inmates of Modular account established by previous order of the Court; DC shall pay $44,689.82 to Clerk of Court in order to repenish Inmates of Modular account by 4/23/97 (N) (dbw) (Entered: 04/08/1997)
152 ORDER by Judge June L. Green and Judge William B. Bryant : directing Clerk of Court to pay Grace M. Lopes the sum of $45,947.95 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Mr. Roche, Dr. Cohen and Dr. Downer; check shall be drawn from Crestar savings account established by previous orders of the Court; District of Columbia shall pay

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05/06/1997 05/09/1997 05/13/1997
06/02/1997 06/03/1997
07/08/1997 07/09/1997

$45,947.95 to Clerk of Court in order to replenish the Crestar savings account by 5/23/97 (N) (dbw) (Entered: 05/07/1997)
153 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (4) (JMF) (Entered: 05/07/1997)
154 MOTION filed by special master GRACE M. LOPES to substitute order for compensation filed May 06, 1997 , and to vacate order filed May 06, 1997 (JMF) (Entered: 05/12/1997)
155 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion to substitute order for compensation filed May 06, 1997 by GRACE M. LOPES, granting motion to vacate order filed 06, 1997 [1542] by GRACE M. LOPES; directing the Clerk of the Court pay Grace M. Lopes the sum of $45,947.95 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Dr. Cohen, and Dr. Downer; directing that this check be drawn from the Crestar savings account established by previous orders of the Court; directing the District of Columbia to pay $45,947.95 to the Clerk of the court in order to replenish the Crestar savings account by 5/23/97. (N) (jeb) (Entered: 05/13/1997)
156 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (3) (JMF) (Entered: 06/02/1997)
157 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion for compensation [156-1] by GRACE M. LOPES; directing the Clerk of the Court pay Grace M. Lopes the sum of $37,641.67 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, and Ms. Fisher; directing that this check be drawn from the Inmates of Modular Account established by previous orders of this Court; directing the defendant DC pay $37,641.67 to the Clerk of the Court in order to replenish the Inmates of Modular Account by 6/18/97. (N) (jeb) (Entered: 06/03/1997)
159 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (5) (JMF) Modified on 07/10/1997 (Entered: 07/10/1997)
158 ORDER by Judge William B. Bryant and Judge June L. Green: granting motion for compensation [136-1] by GRACE M. LOPES, granting motion for compensation [132-1] by GRACE M. LOPES, granting motion for compensation [126-1] by GRACE M. LOPES, granting motion for compensation [121-1] by GRACE M. LOPES; directing the Clerk of the Court to pay Grace M. Lopes the sum of $19,125.66 which represents compensation for the services and expenses of Special Officer Lopes; this check shall be drawn from the Crestar savings account established by previous orders of the Court; directing the Clerk of the Court to pay Grace M. Lopes the sum of $19,264.10 which represents compensation for the services and expenses of Ms. Schneider, Ms. Fisher, Dr. Downer and Mr. Henderson; this check shall be drawn from the Twenty-Thousand Dollar Fund established by previous orders of the Court; directing the District of Columbia to pay $19,125.66 to the Clerk

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07/10/1997 08/11/1997 08/11/1997
08/19/1997 09/03/1997 09/04/1997
10/06/1997
10/08/1997

of the Court in order to replenish the Crestar savings account and pay $19,264.10 to the Clerk of the Court in order to replenish the TwentyThousand Dollar Fund, by the 25th of July, 1997. (N) (mlp) Modified on 07/10/1997 (Entered: 07/09/1997)
160 ORDER by Judge William B. Bryant : granting plaintiff's motion for leave to file the Report of Special Officer concerning the Murder of Quan Harris under seal. (Originial filed in CA 71-1462) (N) (ks) (Entered: 07/10/1997)
161 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (6) (JMF) (Entered: 08/12/1997)
162 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation; that the Clerk of the Court pay Grace M. Lopes the sum of $46,084.76 which representys compensation for the services and expenses of Special Officer Lopes, Ms. Schneider, Ms. Fisher, Dr. Cohen, Dr. Belitsky, and Mr. Henderson; and that the District of Columbia shall pay $46,084.76 to the Clerk of the Court in order to replenish the Crestar savings account 9/2/97. (Original Order filed in CA 79-1726) (N) (ks) (Entered: 08/14/1997)
163 ORDER (Copy) by Judge William B. Bryant : granting plaintiff's motion that the Special Officer be requested to investigate violations of security related orders at the D.C. Jail and to make a report with recommendations for remedial action. (Original filed in CA 71-1462) (See Order for details) (N) (ks) (Entered: 08/20/1997)
164 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (4) (JMF) (Entered: 09/04/1997)
165 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion for compensation [164-1] by GRACE M. LOPES; directing the Clerk of the Court to pay Grace M. Lopes the sum of $37,212.70 which represents compensation for the services and expenses of Special Officer Lopes, Ms. Schneider,Ms. Fisher, and Mr. Roche; directing that this check be drawn from the Inmates of Modular Facility savings account established by previous orders of the Court; directing the defendant DC pay $37,212.70 to the Clerk of the Court in order to replenish the Inmates of Modular Facility savings account due by 9/18/97. (N) (jeb) (Entered: 09/08/1997)
166 ORDER by Judge William B. Bryant : granting motion of the Receiver for an Order to Facilitate the Payment of his October 1997 Costs and Expenses; that by 10/20/97, defendant DISTRICT OF COLUMBIA will issue a check made payable to Ronald Shansky, M.D. in the amount of $1,245,832.83; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/25/95. (N) (dot) (Entered: 10/06/1997)
167 MOTION filed by special master GRACE M. LOPES for compensation ; exhibits (3) (JMF) (Entered: 10/09/1997)

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10/16/1997
10/29/1997 10/29/1997 10/29/1997
10/31/1997 11/05/1997 11/06/1997
11/06/1997 11/12/1997 11/13/1997

168 ORDER by Judge William B. Bryant : granting motion to Release Report to Kathryn Monaco and Alan Henry; that the Special Officer is authorized to release James D. Henderson's 1994 staffing report directly to Kathryn Monaco and Alan Henry; that Ms. Monaco and Mr. Henry shall not release the report to non-parties to the above-captioned cases. (N) (dot) (Entered: 10/16/1997)
169 MEMORANDUM by Judge William B. Bryant (N) (dot) (Entered: 10/29/1997)
170 ORDER by Judge William B. Bryant : granting plaintiffs' motion for attorneys' fees and expenses filed on 5/9/97; that the plaintiffs are awarded attorneys' fees and expenses in the amount of $101,567.26. (N) (dot) (Entered: 10/29/1997)
171 ORDER by Judge William B. Bryant : granting motion of the Receiver for an Order to Facilitate the Payment of his November 1997 Costs and Expenses; that by 11/18/97, defendant DC will issue a check made payable to Ronald Shansky, M.D. in the amount of $1,245,832.83; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/25/95. (N) (dot) (Entered: 10/29/1997)
172 JOINT MOTION by defendant DELBERT C. JACKSON, plaintiff INMATES DC JAIL for entry of consent Orders modifying appointment of Specal Officer (ks) (Entered: 11/04/1997)
175 NOTICE OF FILING by special master GRACE M. LOPES of final accounting; exhibits (4) (JMF) (Entered: 11/07/1997)
173 ORDER by Judge William B. Bryant : granting joint motion for entry of consent Orders modifying appointment of Specal Officer [172-1] by INMATES DC JAIL, DELBERT C. JACKSON, that effective 11/1/97, the Court's Order Appointing Special Officer of 11/20/93, is modified to provide that the duties previously assigned to Grace M. Lopes are assigned to Karen M. Schneider. The foregoing Order otherwise shall continue in full force and effect. Ms. Schneider is authorized to consult with and seek assistance from Ms. Lopes with regard to any matter within the scope of the Special Officer's duties. (N) (dot) (Entered: 11/06/1997)
174 ORDER by Judge William B. Bryant : granting attorney's fees and expenses filed on 8/6/97; that the plaintiffs are awarded attorneys' fees and expenses in the amount of $132,592.00. (N) (dot) (Entered: 11/07/1997)
176 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (5) (JMF) (Entered: 11/13/1997)
177 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [176-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $39,652.04 which represents compensation for the services and expenses of Ms. Lopes, Ms. Schneider and Mr. Roche; and that the Clerk of the Court pay Special Officer karen M. Schneider the sum of

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12/03/1997
12/05/1997 12/08/1997
12/17/1997 12/17/1997 12/17/1997 12/30/1997 01/06/1998
01/08/1998 01/12/1998

$5,931.24 which represents underpayment by the defendants in prior motions for compensation. (Original filed in CA79-1726) (N) (ks) (Entered: 11/17/1997)
178 ORDER by Judge William B. Bryant : granting the motion of the Receiver for an Order to facilitate the Payment of this December 1997 costs and Expenses; by 12/18/97, defendant DISTRICT OF COLUMBIA will issue a check made payable to Ronald Shansky, M.D. in the amount of $1,245,832.83; the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/25/95.(N) (dot) (Entered: 12/03/1997)
179 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (5) (JMF) (Entered: 12/08/1997)
182 ORDER (COPY) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [179-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $42,988.11 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Roche, Mr. Henderson, and Dr. Downer. (N) (ks) (Entered: 12/18/1997)
180 ORDER by Judge William B. Bryant : granting motion to extend time for filing an appeal; the time for defendants to file an appeal from the order filed in this case on 10/29/97, is extended for thirty (30) days or until ten (10) days from the date of this Order, whichever is later. (N) (dot) (Entered: 12/17/1997)
181 NOTICE OF APPEAL by defendant DELBERT C. JACKSON from order [174-1], order [170-1] , entered on: 10/29/97 and 11/7/97; No fees paid; Copies mailed to counsel of Record. (ks) (Entered: 12/17/1997)
TRANSMITTED PRELIMINARY RECORD on appeal [181-1] by DELBERT C. JACKSON to U.S. Court of Appeals (ks) (Entered: 12/17/1997)
USCA # 97-7234 assigned for appeal [181-1] by DELBERT C. JACKSON (ks) (Entered: 12/31/1997)
183 ORDER by Judge William B. Bryant : granting motion of the Receiver for an order to Facilitate the Payment of his January 1998 Costs and Expenses; that by 1/20/98, defendant District of Columbia will issue a check made payable to Ronald Shansky, M.D. in the amount of $1,245,832.83; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/25/95. (N) (dot) (Entered: 01/06/1998)
184 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (9) (JMF) (Entered: 01/09/1998)
185 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [184-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the

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02/06/1998 02/11/1998 02/18/1998 02/24/1998
03/10/1998 03/12/1998

sum of $57,271.81 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Roche, Mr. Czerniak, Dr. Cohen, Mr. Phillips, Mr. O'Brien and Mr. Henderson; and that the District of Columbia shall pay $57,271.81 to the Clerk of the Court in order to replenish the Inmates of Modular account by 2/6/98. (Original filed in CA 79-1726) (N) (ks) (Entered: 01/13/1998)
186 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (11) (JMF) (Entered: 02/09/1998)
187 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [186-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $75,058.19 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Roche, Mr. Sandalow, Dr. Downer, Dr. Belitsky, Mr. Henderson, Mr. O'Brien, Mr. Phillips, Mr. Maupin and Mr. Hackle. (N) (ks) (Entered: 02/23/1998)
SCHEDULING NOTICE: motion hearing set for 2:30 2/19/98; before Judge William B. Bryant Courtroom 16, Sixth Floor. (dot) (Entered: 02/18/1998)
188 ORDER by Judge William B. Bryant : granting motion of the Receivership for the Fiscal Year 1998 Receivership budget of fourteen million, eight hundred and twenty seven thousand, two hundred and forty three dollars ($14,827,243) ; the money already paid to the Receivership in Fiscal Year 1998 ($4,983,331.32) and those costs in the Receivership budget which are paid directly by the District of Columbia Department of Corrections ($405,579) are credited against the total approved budget referenced above; that the remaining amount ($9,438,332.68) is to be paid to Ronald Shansky, M.D. in eight monthly payments of $1,179,791.59; the first payment (for February 1998) to be issued by March 12, 1998, the second payment to be made by March 26, 1998, and the remaining payments for April through September 1998 to be made by the eighteenth day of the month; that prior to the preparation of the amount due in August 1998, the Receiver shall be available to meet with defendants in order to determine whether there are any budgeted funds which are not likely to be spent prior to the end of the fiscal year and which can, therefore, be credited to reduce the amount of defendants' remaining payments; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of September 26, 1995. for Fiscal Year 1998(N) (dot) (Entered: 02/25/1998)
189 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (10) (JMF) (Entered: 03/11/1998)
190 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [189-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $44,151.12 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Roche, Ms. Sandalow and Ms. Banks; and that the Clerk of the Court pay Special Officer Karen M.

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09/03/1998

Schneider the sum of $53,086.66 which represents compensation for the services and expenses of Mr. Henderson, Mr. O'Brien, Mr. Phillips and Mr. Maupin. (Original filed in CA 79-1726) (N) (ks) (Entered: 03/18/1998)
191 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (8) (JMF) (Entered: 04/03/1998)
192 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (7) (JMF) (Entered: 05/08/1998)
194 ORDER by Judge Aubrey E. Robinson, Jr. for Judges June L. Green and William B. Bryant : granting motion for compensation [193-1] by KAREN M. SCHNEIDER; directing the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $62,717.28 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow, Mr. Maupin, KPMG, Peat Marwick; directing the defendant DC pay $62,717.28 to the Clerk of the Court in order to replenish the Crestar Savings Account due by 6/26/98. (N) (jeb) (Entered: 06/10/1998)
193 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (7) (JMF) (Entered: 06/09/1998)
195 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (8) (JMF) (Entered: 07/06/1998)
197 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [195-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $52,049.61 which pepresents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow, Dr. Belitsky, and Mr. Maupin; and that the District of Columbia shall pay $52,049.61 to the Clerk of the Court in order to replenish the Crestar Savings Account by 7/20/98. (Original filed in CA 79-1726) (N) (ks) (Entered: 08/21/1998)
196 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (7) (JMF) (Entered: 08/10/1998)
198 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [196-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $52,685.03 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow, Mr. Henderson and Mr. Maupin; and that the District of Columbia shall pay $52,685.03 to the Clerk of the Court in order to replenish the Crestar Savings Account by 8/25/98. (Original filed in CA 79-1726) (N) (ks) (Entered: 08/21/1998)
200 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (7) (JMF) (Entered: 09/09/1998)

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199 ORDER by Judge William B. Bryant : granting motion of the Receiver for Order re Collective Bargaining Agreement; Setting directives for the Receiver and the D.C. Department of Corrections. (See Order for details) (N) (ks) (Entered: 09/08/1998)
203 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [200-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $38,455.70 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow, Mr. O'Brien and Mr. Maupin; and that the DC shall pay $38,455.70 to the Clerk of the Court in order to replenish the Crestar Savings account by 9/23/98. (Original Order filed in CA 79-1726) (N) (ks) (Entered: 09/21/1998)
201 ORDER by Judge William B. Bryant : the Court's Order of 2/24/98 is amended defendant DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,551,739 by 9/25/98; the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/26/95. (N) (dot) (Entered: 09/10/1998)
202 ORDER by Judge William B. Bryant : that by 10/9/98, defendant DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225; that the above-referenced funds shall be subject to audit as referenced in this Court's Order of 9/26/95. (N) (dot) (Entered: 09/10/1998)
204 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (6) (JMF) (Entered: 10/07/1998)
206 ORDER (copy) by Judge William B. Bryant and June L. Green : granting motion for compensation [204-1] by KAREN M. SCHNEIDER; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $54,905.77 which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow, Mr. Maupin and KPMG Peat Marwick, LLP. (Original filed in CA79-1726) (N) (zz) (Entered: 11/04/1998)
205 ORDER by Judge William B. Bryant : directing that by 11/16/98, deft DC shall issue a check payable to Ronald Shansky, M.D. in the amount of $1,071,225 ; and these funds shall be subject to audit an referenced in this court's order of 9/26/95 (N) (jaw) (Entered: 10/30/1998)
207 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (6) (jf) (Entered: 11/05/1998)
208 ORDER (copy) by Judges William B. Bryant and June L. Green: granting motion for compensation [207-1] by KAREN M. SCHNEIDER; directing the Clerk of the Court to pay Special Officer Karen M. Schneider the sum of $40,495.45; this check shall be drawn from the Crestar Savings account; D.C. shall pay $40,495.45 to the Clerk of the Court in order to replenish the Crestar Savings account by 11/24/98. (N)

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02/11/1999

(Original Order filed in C.A. 80-2136) (mlp) (Entered: 11/06/1998)
209 CERTIFIED COPY of judgment filed in USCA dated 10/30/98, on appeal [181-1] , reversing the judgment of USDC , and remanding for further proceedings. OPINION (originally filed in 71-1462) USCA # 977235 (cjp) Modified on 12/04/1998 (Entered: 12/04/1998)
210 ORDER by Judge William B. Bryant : directing that by 12/18/98 deft DISTRICT OF COLUMBIA shall issue a check payable to Ronald Shansky, MD in the amount of $1,071,225.00 ; and these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 12/07/1998)
211 ORDER by Judges William B. Bryant and June L. Green: granting 12/7/98 motion for compensation; Clerk of Court is to pay Special Officer Karen M. Schneider the sum of $39,726.72 for compensation; check is to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $39,726.72 to Clerk of Court in order to replenish the Crestar Savings account. (N) (mlp) (Entered: 12/09/1998)
212 ORDER by Judge William B. Bryant : directing that by 01/22/99, the defendant District of Columbia shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225.00; directing that the $1,071,225.00 shall be subject to audit as referenced in this Court's Order of September 26, 1995. (N) (gew) (Entered: 01/06/1999)
214 MOTION filed by special master KAREN M. SCHNEIDER for compensaiton (jf) (Entered: 01/14/1999)
213 ORDER by Judges William B. Bryant and June L. Green: granting motion by compensation by Special Officer Karen M. Schneider; directing the Clerk of the Court to pay Ms. Schneider the sum of $56,400.99; this check shall be drawn from the Crestar Savings account; D.C. shall pay $56,400.99 to the Clerk of the Court in order to replenish the Crestar Savings account. (N) (mlp) (Entered: 01/12/1999)
215 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (6) (jf) (Entered: 02/03/1999)
216 ORDER by Judges June L. Green and William B. Bryant: granting motion for compensation [215-1] by KAREN M. SCHNEIDER; directing the Clerk of Court to pay Ms. Schneider the sum of $34,563.11 for compensation; the check is to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $34,563.11 to the Clerk of Court in order to replenish the Crestar Savings account by 2/19/99. (N) (mlp) (Entered: 02/05/1999)
217 ORDER by Judge William B. Bryant : directing that by 2/26/99, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,222; and these funds shall be subject to audit as referenced in this Court's order of 9/25/95 (N) (jaw) (Entered: 02/12/1999)

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06/02/1999

218 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (8) (jf) (Entered: 03/03/1999)
219 ORDER by Judge June L. Green and Judge June L. Green for Judge William B. Bryant : granting motion for compensation [218-1] by KAREN M. SCHNEIDER; Clerk of the Court is to pay Ms. Schneider the sum of $51,455.80 as compensation for services and expenses; this check shall be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $51,455.80 to the Clerk of the Court in order to replenish the Crestar Savings accounts by 3/22/99. (N) (mlp) (Entered: 03/05/1999)
220 ORDER by Judge William B. Bryant : directing that by 3/26/99, deft DC shall issue a check made payable to Ronald Ransky, MD in the amount of $1,071,225 ; and that these funds shall be subject to audit as references in this Court's order of 9/26/95 (N) (jaw) (Entered: 03/15/1999)
222 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (6) (jf) (Entered: 04/06/1999)
221 ORDER by Judge William B. Bryant for Judge June L. Green :that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $42,232.77, which represents compensation for the services and expenses of Ms. Schneider, Ms. Lopes, Mr. Wiley, Ms. Sandalow and Mr. Maupin; that this check shall be drawn from the Crestar Savings account established by previous orders of the Court; that the District of Columbia shall pay $42,232.77, to the Clerk of the Court in order to replenish the Crestar Savings account by the 21st day of April, 1999 (N) (lkn) (Entered: 04/06/1999)
223 ORDER by Judge William B. Bryant : directing that by 4/26/99, deft. DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225; and these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 04/07/1999)
224 ORDER by Judge William B. Bryant : directing that by 5/26/99, deft DC shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225; and these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 05/07/1999)
225 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (8) (jf) (Entered: 05/07/1999)
226 ORDER by Judge William B. Bryant and by Judge William B. Bryant for Judge June L. Green: granting motion for compensation [225-1] by KAREN M. SCHNEIDER; Clerk is to pay Ms. Schneider $59,180.00 for services and expenses, this check is to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $59,180.00 to the Clerk of the Court in order to replenish the Crestar Savings account by 5/25/99. (N) (mlp) (Entered: 05/11/1999)
227 MOTION filed by special master KAREN M. SCHNEIDER for

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06/03/1999 06/08/1999
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08/03/1999 09/02/1999

compensation ; exhibits (7) (jf) (Entered: 06/03/1999)
228 ORDER by Judges William B. Bryant and June L. Green: granting motion for compensation [227-1] by KAREN M. SCHNEIDER; the Clerk of the Court is to pay Special Officer Schneider the sum of $41,830.61 which represents compensation for the services and expenses; this check is to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $41,830.61 to the Clerk of the Court in order to replenish the Crestar Savings account by 6/17/99. (N) (mlp) (Entered: 06/03/1999)
229 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent order regarding attorney's fees (lkn) (Entered: 06/04/1999)
230 ORDER by Judge William B. Bryant : granting motion for adoption of consent order regarding attorney's fees [229-1] by DELBERT C. JACKSON; directing that DISTRICT OF COLUMBIA pay DC PRISONERS' LEGAL SERVICES PROJECT, INC., the sum of $50,630.63 in settlement of the undisputed portion of pltfs' claim for fees and costs associated with this case from 4/26/96 through 6/30/97 (N) (jaw) (Entered: 06/08/1999)
231 ORDER by Judge William B. Bryant : directing that by 6/28/99, deft. DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225; and that these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 06/09/1999)
232 ORDER by Judges William B. Bryant and June L. Green: directing the Clerk of the Court to pay Special Officer Karen M. Schneider the sum of $36,731.99 as compensation for services and expenses; this check is to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $36,731.99 to the Clerk of the Court in order to replenish the Crestar Savings account by 7/22/99. (N) (mlp) (Entered: 07/08/1999)
233 ORDER by Judge William B. Bryant : directing that by 8/6/99, deft DC shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,071,225; and that these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 07/27/1999)
234 ORDER by Judges William B. Bryant and June L. Green: granting motion for compensation; Clerk of the Court is to pay Special Officer Karen M. Schneider the sum of $29,598.98 as compensation for services and expenses; this check shall be drawn from the Crestar Savings account established by previous orders of the Court; D.C. shall pay $29,598.98 to the Clerk in order to replenish the Crestar Savings account by 8/19/99. (N) (mlp) Modified on 08/04/1999 (Entered: 08/04/1999)
235 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (5) (jf) (Entered: 08/04/1999)
238 MOTION filed by special master KAREN M. SCHNEIDER for

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compensation ; exhibits (5) (jf) (Entered: 09/13/1999)
236 ORDER by Judge William B. Bryant and Judge June L. Green : granting motion for compensation [235-1] by KAREN M. SCHNEIDER; directing the Clerk of Court to pay special master the sum of $31,827.22 (N) (jf) (Entered: 09/08/1999)
237 ORDER by Judge William B. Bryant : directing that by 9/27/99, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,938,213.70; and these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 09/09/1999)
239 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (5) (jf) (Entered: 10/06/1999)
240 ORDER by Judges William B. Bryant and June L. Green: granting motions for compensation [239-1] [238-1] by KAREN M. SCHNEIDER; directing Clerk of the Court to pay Special Officer Schneider the sum of $44,769.98 as compensation for services and expenses; this check shall be drawn from the Crestar Savings account established by previous orders of the Court; D.C. is to pay $44,769.98 to the Clerk of the Court in order to replenish the Crestar Savings account by 10/22/99. (N) (mlp) (Entered: 10/07/1999)
241 ORDER by Judge William B. Bryant : directing that by 11/1/99, deft. DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $982,725; and directing that these funds shall be subject to the audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 10/25/1999)
242 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (4) (jf) (Entered: 11/03/1999)
243 ORDER by Judges William B. Bryant and June L. Green: granting motion for compensation [242-1] by KAREN M. SCHNEIDER; directing Clerk of the Court to pay Special Officer Schneider the sum of $33,768.04 for compensation; this check shall be drawn from the Crestar Savings account established by previous orders of the Court; D.C. shall pay $33,768.04 to the Clerk of the Court in order to replenish the Crestar Savings account by 11/23/99. (N) (mlp) (Entered: 11/03/1999)
244 MOTION filed by plaintiff to reduce time for defendants to respond to plaintiffs' request for production of documents ; exhibits (4) (jf) (Entered: 11/09/1999)
245 MOTION filed by defendant DELBERT C. JACKSON for protective order ; (original filed in 71-1462) (tb) (Entered: 11/10/1999)
246 RESPONSE by defendant DELBERT C. JACKSON in opposition to motion to reduce time for defendants to respond to plaintiffs' request for production of documents [244-1] by INMATES DC JAIL .; (original filed in 71-1462) (tb) (Entered: 11/10/1999)

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247 RESPONSE by plaintiff INMATES DC JAIL in opposition to motion for protective order [245-1] by DELBERT C. JACKSON . (lkn) (Entered: 11/15/1999)
248 ORDER by Judge William B. Bryant : denying motion for protective order [245-1] by DELBERT C. JACKSON (N) (jaw) (Entered: 11/16/1999)
249 ORDER by Judge William B. Bryant: upon being informed that the Receiver has proposed a budget payment for fiscal year 2000 (FY 00) of $11,792,700.00, the Court directs that by 11/30/99, deft. D.C. shall issue a check made payable to Ronald Shansky, M.D. in the amount of $982,725.00; the above-referenced funds shall be subject to audit as referenced in this Court's 9/26/95 Order. (N) (mlp) (Entered: 11/18/1999)
250 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; exhibits (4) (jf) (Entered: 12/05/1999)
251 ORDER by Judges William B. Bryant and June L. Green: granting motion for compensation [250-1] by KAREN M. SCHNEIDER; directing the Clerk of the Court to pay Special Officer Schneider the sum of $33,148.35 which represents compensation for services and expenses; check shall be drawn from the Crestar Savings account established by previous orders of the Court; D.C. shall pay $33,148.35 to the Clerk of the Court in order to replenish the Crestar Savings account by 12/21/99. (N) (mlp) (Entered: 12/08/1999)
252 ORDER by Judge William B. Bryant : directing that by 12/30/99, the deft. DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $982,725; and that these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 12/16/1999)
253 ORDER by Judge June L. Green and Judge June L. Green for Judge William B. Bryant: granting motion by Special Officer Karen M. Schneider for compensation in the amount of $29,500.40; directing Clerk of Court to pay Ms. Schneider $29,500.40 for services and expenses; check to be drawn from the Crestar Savings account established by previous orders of the Court; D.C. to pay $29,500.40 to the Clerk of the Court to replenish the Crestar Savings account by 1/20/00. (N) (mlp) (Entered: 01/10/2000)
254 ORDER by Judge William B. Bryant : directing that by 1/31/00, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $982,725; and these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 01/18/2000)
255 ORDER by Judge June L. Green and William B. Bryant :granting the motion of Karen M. Schneider for compensation. (N) (jeb) (Entered: 02/07/2000)
256 ORDER by Judge William B. Bryant : directing that by 2/25/00, the deft

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03/06/2000
03/16/2000 03/30/2000
04/06/2000 04/10/2000 04/11/2000 04/12/2000 05/03/2000 05/05/2000 05/11/2000

DISTRICT OF COLUMBIA shall issue a check payable to Ronald Shansky, M.D. in the amount of $982,725; and these funds shall be subject to audit as referenced in this Court's order of 9/26,95 (N) (jaw) (Entered: 02/10/2000)
257 ORDER by Judge William B. Bryant : granting motion in CA 80-2136 for compensation to Karen Schneider ; directing the Clerk of the Court to pay Special Officer Karen Schneider the sum of $33,73.69 for compensation & services of Ms. Schneider, Mr. Wiley, and Ms. Julianelle; directing that the check be drawn from the Crestar Savings account established by previous orders; and directing that DISTRICT OF COLUMBIA pay the Clerk of the Court the sum of $33,793.69 to replenish the Crestar Savings account by 3/21/00 (N) (jaw) (Entered: 03/07/2000)
258 ORDER by Judge William B. Bryant : directing that by 3/27/00, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,043,740.44; and that these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 03/17/2000)
259 NOTICE OF FILING by defendant DELBERT C. JACKSON submitting a memorandum from the Warden at the D.C. Jail that informed undersigned counsel that the Jail has not been in complaince with the Court's August 22, 1985 Order from Sunday morning, March 26, 2000 through Thursday, March 30, 2000; Attachment (1). (tth) (Entered: 04/03/2000)
260 ORDER by June L. Green & Judge William B. Bryant: granting motion for compensation by KAREN M. SCHNEIDER. (N) (jeb) (Entered: 04/06/2000)
261 ORDER by Judge William B. Bryant : directing that by 4/21/00, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,046,856.50; and that the above referenced funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 04/11/2000)
262 MOTION filed by defendant DELBERT C. JACKSON to modify order of 08/22/85 (jf) (Entered: 04/12/2000)
263 ORDER by Judge William B. Bryant : granting motion to modify order of 08/22/85 [262-1] by DELBERT C. JACKSON (N) (jaw) (Entered: 04/13/2000)
264 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; Exhibits (4) (tth) (Entered: 05/05/2000)
265 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion for compensation [264-1] by KAREN M. SCHNEIDER (N) (jeb) (Entered: 05/05/2000)
266 ORDER by Judge William B. Bryant : directing that by 5/22/00, deft

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06/05/2000 06/06/2000
06/09/2000 06/12/2000
06/14/2000 06/14/2000
07/07/2000 07/12/2000 07/17/2000
08/03/2000

DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,046,856.50; and directing that the above referenced funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 05/12/2000)
268 MOTION filed by special master KAREN M. SCHNEIDER for compensation ; Exhibits (4) (tth) (Entered: 06/08/2000)
267 ORDER by Judge William B. Bryant : granting motion for compensation ; directing Clerk of the Court to pay Special Officer Karen M. Schneider the sum of $32,477.15 for compensation of services for Karen Schneider, Ed Wiley, II, and Patricia Julianelle; and directing the DC shall pay $32,477.15 to Clerk of the Court by 6/21/00 to replenish the account (N) (jaw) (Entered: 06/08/2000)
269 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent order regarding attorney's fees (jf) (Entered: 06/12/2000)
270 ORDER by Judge William B. Bryant : granting motion for adoption of consent order regarding attorney's fees [269-1] by DELBERT C. JACKSON; directing DISTRICT OF COLUMBIA to pay DC PRISONERS' LEGAL SERVICES PROJECT, INC. the sum of $48,465 in settlement of pltf's claims for fees and costs associated with this action from 3/1/96 to 4/25/96, and 7/1/97 to 12/31/99 (N) (jaw) (Entered: 06/12/2000)
271 ORDER by Judge William B. Bryant : granting motion of the Receiver to incur certain costs (N) (jaw) (Entered: 06/19/2000)
272 ORDER by Judge William B. Bryant : directing that by 6/23/00, deft DISTRICT OF COLUMBIA issue a check made payable to Ronald Shansky, M.D. in the amount of $1,046,856.50; and that these funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 06/19/2000)
273 ORDER by Judge William B. Bryant : granting motion for compensation for Special Master Karen Schneider ; and directing that by 7/24/00, the District of Columbia shall pay $38,004.99 to Clerk of the Court to replenish the Crestar Savings account (N) (jaw) (Entered: 07/13/2000)
274 MOTION filed by special master KAREN M. SCHNEIDER for compensation for services, and expenses of Ms. Schneider, Mr. Wiley and Ms. Julianelle ; Exhibits (4) (tth) (Entered: 07/13/2000)
275 ORDER by Judge William B. Bryant : directing that by 7/24/00, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,046,856.50 ; and directing that the above-referenced funds shall be subject to audit as referenced in this Court's order of 9/26/95 (N) (jaw) (Entered: 07/17/2000)
276 ORDER by Judge William B. Bryant : directing that by 8/21/00, deft DISTRICT OF COLUMBIA shall issue a check made payable to Ronald Shansky, M.D. in the amount of $1,046,856.50 ; and that the above-

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08/04/2000 08/04/2000 08/07/2000 08/09/2000 08/22/2000 09/01/2000 09/07/2000
09/18/2000
09/18/2000
09/27/2000

referenced funds shall be subject to audit as reference in this Court's order of 9/26/95 (N) (jaw) (Entered: 08/04/2000)
277 MOTION filed by defendant to terminate the receivership and the underlying order entered relative to medical and mental health services ; exhibits (2) (jf) (Entered: 08/08/2000)
278 ATTORNEY APPEARANCE for defendant DELBERT C. JACKSON by Robert Utiger (jf) (Entered: 08/08/2000)
SCHEDULING NOTICE: motion hearing on motion of deft to terminate receivership set for 2:30 9/18/00 ; before Judge William B. Bryant in courtroom 16 on 6th floor. (jaw) (Entered: 08/07/2000)
279 ORDER by Judge June L. Green and Judge William B. Bryant : granting motion for compensation (N) (jaw) (Entered: 08/11/2000)
280 ORDER by Judge William B. Bryant : granting consent motion of the parties for extension of time to file response by pltfs to motion of deft to terminate the receivership ; response due 9/5/00 (N) (jaw) (Entered: 08/23/2000)
281 ORDER by Judge William B. Bryant : directing that by 09/15/00, deft DISTRICT OF COLUMIBA, shall issue a check made payable to Ronald Shansky, M.D. in the amount o f$1,046,856.50 ; and directing that the above referenced funds shall be subject to audit as referenced in this Court's order of 09/26/95 (N) (tb) (Entered: 09/05/2000)
282 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $42,358.67 which represents compensation for the services and expenses of Ms. Schneider, Mr. Wiley, Ms. Julianelle and Dr. Greifinger; and that the District of Columbia shall pay $42,358.67 to the Clerk of the Court in order to replenish the Crestar Savings account by 9/22/00. (Original filed in CA 80-2136) (N) (ks) Modified on 09/07/2000 (Entered: 09/07/2000)
MOTION HEARING before Judge William B. Bryant taken under advisement by DELBERT C. JACKSON motion to terminate the receivership and the underlying order entered relative to medical and mental health services [277-1]; oral motion to admit Benjamin M. Dean pro hac vice, heard and granted; Reporter: Bill MacAllister (tb) (Entered: 09/18/2000)
283 ORDER by Judge William B. Bryant : granting motion to terminate the receivership and the underlying order entered relative to medical and mental health services [277-1] by DELBERT C. JACKSON; terminating the findings and order appointment receiver on 07/11/95; terminating requirements relative to medical and mental health services set for in previously order entered (N) (tb) (Entered: 09/19/2000)
285 MOTION (CONSENT) filed by defendant DELBERT C. JACKSON, plaintiff INMATES DC JAIL to enter proposed consent order (tth)

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09/28/2000
10/11/2000 11/06/2000
01/03/2001 01/09/2001 01/10/2001 02/01/2001 08/02/2001 08/06/2001 12/20/2001

(Entered: 09/29/2000)
284 ORDER by Judge William B. Bryant : That the remaining balance in the Receiver's accounts be transferred to the Special Officer of the Court, Karen Schneider; that the Special Officer sill deposit these funds into a construction account and use these funds soley for construction, architectural, construction management or other expenses that have been approved by the defendants for the completion of this renovation project; and that the Special Officer will return any funds not expended to the defendants; that after the renovation project is completed, the Special Officer will file with the Court a final accounting of the funds transferred from the Receiver's accounts and the expenditures made. (N) (ks) (Entered: 09/29/2000)
286 TRANSCRIPT filed for date(s) of 09/18/00. Reporter: William D. McAllister (jf) (Entered: 10/17/2000)
287 ORDER (Copy) by Judge William B. Bryant and Judge June L. Green : granting motion for compensation; that the Clerk of the Court pay Special Officer Karen M. Schneider the sum of $43,472.36 which represents compensation for the services and expenses of Ms. Schneider, Mr. Wiley and Ms. Julianelle; and that the District of Columbia shall pay $43,472.36 to the Clerk of the Court in order to replenish the Crestar Savings account by 11/22/00. (Original Order filed in CA 80-2136) (N) (ks) (Entered: 11/09/2000)
288 MOTION filed by special master KAREN M. SCHNEIDER for compensation for the services, and expenses of Ms. Schneider, Mr. Wiley and Ms. Julianelle ; Exhibits (4). (tth) (Entered: 01/08/2001)
290 MOTION (CONSENT) filed by defendant DELBERT C. JACKSON for adoption , for order regarding attorney's fees (cas) (Entered: 01/11/2001)
289 ORDER by Judge William B. Bryant directing the District of Columbia to pay D.C. Prisoners' Legal Services Project, Inc. the sum of twelve thousand, seven hundred and forty-two dollars (12,742) in settlement of plaintiff's claims for fees and costs association for period of January 1, 2000 through December 31, 2000 : (N) (tb) (Entered: 01/10/2001)
291 MOTION filed by special master KAREN M. SCHNEIDER for compensation for services, and expenses of Ms. Schneider, Mr. Wiley, Ms. Julianelle and Dr. Shansky ; Exhibits (5) (tth) (Entered: 02/14/2001)
292 MOTION filed by special master KAREN M. SCHNEIDER for compensation for the services and expenses of Ms. Schneider and Mr. Wiley ; Exhibits (3) (tth) (Entered: 08/03/2001)
293 ORDER by Judge William B. Bryant : granting motion for compensation for the services and expenses of Ms. Schneider and Mr. Wiley [292-1] by KAREN M. SCHNEIDER (N) (lin) (Entered: 08/07/2001)
294 MOTION filed by defendant DELBERT C. JACKSON for adoption of order regarding attorney's fees (nmr) (Entered: 12/21/2001)

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12/21/2001 06/13/2002 06/21/2002 03/21/2003
04/16/2003 04/24/2003 04/24/2003 05/15/2003 05/19/2003
07/15/2003 07/30/2003 08/08/2003 08/11/2003

295 ORDER re payment of attorney fees by Judge Paul L. Friedman : (N) (lin) (Entered: 12/21/2001)
296 ORDER by Judge William B. Bryant: the population limitation imposed by this Courts Orders be and hereby is stayed until further order of the court. (N) (dam) (Entered: 06/13/2002)
297 RESPONSE by plaintiff INMATES DC JAIL to motion to terminate the population limitation. (COPY) (mpt) (Entered: 06/24/2002)
298 ORDER by Judge William B. Bryant : granting motion to terminate the Orders by ANDERSON MCGRUDER, DELBERT C. JACKSON; final request for compensation due no later than 5/30/03; plaintiffs' may file remaining claim for attorney's fees and costs with the Court no later than 5/15/03; upon the filing and approval of the Special Officer's final accounting and compensation request these cases shall be dismissed with prejudice. (N) (ks) (Entered: 04/21/2003)
299 NOTICE OF APPEAL by plaintiff INMATES DC JAIL from order [2981] , entered on: 4/21/03. Fees paid. Copies sent. (aet) (Entered: 04/24/2003)
TRANSMITTED PRELIMINARY RECORD on appeal [299-1] by INMATES DC JAIL to U.S. Court of Appeals (aet) (Entered: 04/24/2003)
USCA # 03-7048 assigned for appeal [299-1] by INMATES DC JAIL (td) (Entered: 05/08/2003)
300 MOTION filed by defendant DELBERT C. JACKSON for adoption of consent order regarding attorney's fees. (td) (Entered: 05/19/2003)
301 ORDER by Judge William B. Bryant : granting motion for adoption of consent order regarding attorney's fees [300-1] by DELBERT C. JACKSON; the District of Columbia shall pay D.C. Prisoners' Legal Services Project, Inc. in the sum of $25,00 (N) (adc) (Entered: 05/23/2003)
302 MOTION filed by defendant DELBERT C. JACKSON for order of dismissal of cases with prejudice (71-1462 & 75-1668 ; original document is located in case jacket; CA 71-1462. (jf) (Entered: 07/16/2003)
303 NOTICE OF APPEAL by plaintiff INMATES DC JAIL from order entered in 71 cv 1462 on on: 7/22/03. Copies sent to parties in case. Notice of appeals fee paid $105.00. (bjsp) (Entered: 08/08/2003)
TRANSMITTED PRELIMINARY RECORD on appeal [303-1] by INMATES DC JAIL to U.S. Court of Appeals (bjsp) (Entered: 08/08/2003)
USCA # 03 7103 assigned for appeal [303-1] by INMATES DC JAIL (bjsp) (Entered: 08/12/2003)

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03/09/2004

304 MANDATE of USCA affirming the decisions of the District Court as to [303] Notice of Appeal filed by INMATES DC JAIL, [299] Notice of Appeal filed by INMATES DC JAIL ; USCA #'S 03-7048 & 03-7103 (cp, ) (Entered: 03/11/2004)

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 BEYOND COMMUNITY STANDARDS AND A CONSTITUTIONAL LEVEL OF CARE? A REVIEW OF SERVICES, COSTS, AND STAFFING LEVELS AT THE CORRECTIONS MEDICAL RECEIVER FOR THE DISTRICT OF COLUMBIA JAIL

HEARING
BEFORE THE
SUBCOMMITTEE ON THE DISTRICT OF COLUMBIA
OF THE
COMMITTEE ON GOVERNMENT REFORM HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTH CONGRESS
SECOND SESSION
JUNE 30, 2000
Serial No. 106–229
Printed for the use of the Committee on Government Reform
(

Available via the World Wide Web: http://www.gpo.gov/congress/house http://www.house.gov/reform

72–581 DTP

U.S. GOVERNMENT PRINTING OFFICE WASHINGTON : 2001

For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001

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COMMITTEE ON GOVERNMENT REFORM

DAN BURTON, Indiana, Chairman

BENJAMIN A. GILMAN, New York CONSTANCE A. MORELLA, Maryland CHRISTOPHER SHAYS, Connecticut ILEANA ROS-LEHTINEN, Florida JOHN M. MCHUGH, New York STEPHEN HORN, California JOHN L. MICA, Florida THOMAS M. DAVIS, Virginia DAVID M. MCINTOSH, Indiana MARK E. SOUDER, Indiana JOE SCARBOROUGH, Florida STEVEN C. LATOURETTE, Ohio MARSHALL ‘‘MARK’’ SANFORD, South
Carolina BOB BARR, Georgia DAN MILLER, Florida ASA HUTCHINSON, Arkansas LEE TERRY, Nebraska JUDY BIGGERT, Illinois GREG WALDEN, Oregon DOUG OSE, California PAUL RYAN, Wisconsin HELEN CHENOWETH-HAGE, Idaho DAVID VITTER, Louisiana

HENRY A. WAXMAN, California TOM LANTOS, California ROBERT E. WISE, JR., West Virginia MAJOR R. OWENS, New York EDOLPHUS TOWNS, New York PAUL E. KANJORSKI, Pennsylvania PATSY T. MINK, Hawaii CAROLYN B. MALONEY, New York ELEANOR HOLMES NORTON, Washington,
DC CHAKA FATTAH, Pennsylvania ELIJAH E. CUMMINGS, Maryland DENNIS J. KUCINICH, Ohio ROD R. BLAGOJEVICH, Illinois DANNY K. DAVIS, Illinois JOHN F. TIERNEY, Massachusetts JIM TURNER, Texas THOMAS H. ALLEN, Maine HAROLD E. FORD, JR., Tennessee JANICE D. SCHAKOWSKY, Illinois
——— BERNARD SANDERS, Vermont
(Independent)

KEVIN BINGER, Staff Director DANIEL R. MOLL, Deputy Staff Director DAVID A. KASS, Deputy Counsel and Parliamentarian
ROBERT A. BRIGGS, Clerk PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON THE DISTRICT OF COLUMBIA

THOMAS M. DAVIS, Virginia, Chairman

CONSTANCE A. MORELLA, Maryland STEPHEN HORN, California JOE SCARBOROUGH, Florida

ELEANOR HOLMES NORTON, Washington, DC
CAROLYN B. MALONEY, New York EDOLPHUS TOWNS, New York

EX OFFICIO

DAN BURTON, Indiana

HENRY A. WAXMAN, California

MELISSA WOJCIAK, Staff Director HOWIE DENIS, Professional Staff Member VICTORIA PROCTOR, Professional Staff Member
JENNY MAYER, Clerk JON BOUKER, Minority Counsel

(II)

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C O N T E N T S
Page
Hearing held on Juen 30, 2000 ............................................................................... 1 Statement of:
Ekstrand, Laurie, Director of Administration of Justice Issues, General Government Division, U.S. General Accounting Office; Ronald Shansky, M.D., corrections medical receiver; Karen Schneider, special officer for the U.S. District Court for the District of Columbia; Erik Christian, deputy mayor for public health and justice; and John Clark, District of Columbia Corrections trustee, accompanied by Odie Washington, director, District of Columbia Department of Corrections ........................ 20
Letters, statements, etc., submitted for the record by: Christian, Erik, deputy mayor for public health and justice, prepared statement of ................................................................................................... 120 Clark, John, District of Columbia Corrections trustee, prepared statement of ..................................................................................................................... 128 Davis, Hon. Thomas M., a Representative in Congress from the State of Virginia, prepared statement of .............................................................. 4 Ekstrand, Laurie, Director of Administration of Justice Issues, General Government Division, U.S. General Accounting Office, prepared statement of ........................................................................................................... 23 Morella, Hon. Constance A., a Representative in Congress from the State of Maryland, prepared statement of ............................................................ 15 Norton, Hon. Eleanor Holmes, a Delegate in Congress from the District of Columbia, prepared statement of ............................................................ 11 Schneider, Karen, special officer for the U.S. District Court for the District of Columbia, prepared statement of .................................................... 45 Shansky, Ronald, M.D., corrections medical receiver, prepared statement of ..................................................................................................................... 35
(III)
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BEYOND COMMUNITY STANDARDS AND A CONSTITUTIONAL LEVEL OF CARE? A REVIEW OF SERVICES, COSTS, AND STAFFING LEVELS AT THE CORRECTIONS MEDICAL RECEIVER FOR THE DISTRICT OF COLUMBIA JAIL
FRIDAY, JUNE 30, 2000
HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON THE DISTRICT OF COLUMBIA,
COMMITTEE ON GOVERNMENT REFORM, Washington, DC.
The subcommittee met, pursuant to notice, at 10:05 a.m., in room 2154, Rayburn House Office Building, Hon. Thomas M. Davis III (chairman of the subcommittee) presiding.
Present: Representatives Davis, Morella, Horn, and Norton. Staff present: Melissa Wojciak, staff director; Howie Denis and Victoria Procter, professional staff members; David Marin, communications director/counsel; Jenny Mayer, clerk; Jon Bouker, minority counsel; and Jean Gosa, minority assistant clerk. Mr. DAVIS. Good morning and welcome. Today’s hearing is the second in a series of oversight hearings examining the status of the D.C. agencies overseen by the court-appointed receivers. Currently, there are three agencies that are still in receivership, the Commission on Mental Health Services, the Corrections Medical Receiver for the District of Columbia Jail, and the Child and Family Services. Concerns about the delivery of services and managerial and financial practices in these agencies persists. The fourth agency in receivership is the District of Columbia Housing Authority, which has successfully recovered from mismanagement and is ready to be returned to the D.C. government’s administration. Today the subcommittee is focused on the corrections medical receiver in the D.C. jail. The receiver was appointed 5 years ago by the U.S. district court in order to address Constitutional violations in the delivery of health care at the jail. It is scheduled to end in September 2000. The subcommittee wants to examine the status of D.C.’s progress in meeting its court-ordered obligations so the jail may be returned to the city’s jurisdiction. Rampant problems in the D.C. jail were enumerated in two class action lawsuits filed in the city in the early 1970’s, in Campbell v.
(1)
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2
McGruder and Inmates of D.C. Jail v. Jackson were filed on behalf of pretrial detainees and sentenced inmates.
The plaintiffs’ charged that the conditions and treatment of inmates in jail were unconstitutional. The two suits were consolidated and senior U.S. Judge William B. Bryant presided over them for nearly 30 years.
The time line highlights key court actions and events concerning the D.C. jail. Through the years, Judge Bryant has issued orders requiring the D.C. government to rectify problems with the jail’s medical services. Despite assurances from the city that the necessary changes would be implemented, nothing materialized. Instead, the D.C. jail left the medical services program to languish at below-Constitutional levels.
In April 1993, finding the D.C. government in persistent noncompliance with his orders, Judge Bryant appointed a special officer to monitor and report on the city’s progress on meeting its court-ordered obligations. The city, however, continued to ignore the orders and the deficiencies in the jail’s medical services delivery persisted.
The jail’s suicide rate was out of control. In addition, the jail lacked an effective program to prevent the spread of infectious tuberculosis.
On January 5, 1995, the court ordered the implementation of the initial remedial plan. It was designed by the special officer after extensive consultation with the plaintiffs and the defendants and the special officer’s own medical and mental health experts. The plan addressed the most immediate and egregious problems with the delivery of medical services at the jail. It also provided the framework for major long-term changes to policies and procedures, staffing, and organizational structure. The initial remedial plan was never implemented. In fact, on June 5, 1995, 5 months to the day after the District was ordered to implement the remedial plan, inmate Richard C. Johnson died. Mr. Johnson was an aged patient in the jail’s infirmary who had been neglected for several days by the medical staff. His death highlighted the city’s failure to address the severe deficiencies in the delivery of medical services at the jail.
Citing the physical danger that the D.C. government’s continued blatant violation of the court’s previous order was tragically causing, Judge Bryant placed the jail’s medical and mental health services under court-supervised receivership. The receiver was ordered to implement the initial remedial plan.
The D.C. jail medical services have improved significantly under the receiver, Dr. Ronald Shansky. Dr. Shansky’s tenure has brought the jail remedial changes to increase the level of medical and mental health services to a Constitutionally acceptable level.
In addition, the D.C. jail’s tuberculosis epidemic has been controlled, HIV/AIDS cases are identified and treated, and qualified medical staff have been hired to improve the delivery of care.
The receiver has successfully implemented a suicide prevention program to identify potentially suicidal inmates and provide them with the necessary prevention treatment.
Despite these improvements in the delivery of health care, it is disturbing that the receiver is leaving the D.C. jail with exorbitant
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3
medical costs per inmate and high staffing levels. In both cases, the figures far exceed the national average.
The court order creating the receivership essentially gives the receiver carte blanche to spend the District’s money freely, without regard to sound financial practices and accountability to the D.C. government. Of course, it is important to provide a Constitutional level of medical and mental health services to D.C. jail inmates, but should the D.C. jail receivership accomplish this by spending at least two to three times the national average per inmate per day? Can a city emerging from bankruptcy really sustain this kind of expenditure?
In addition, the receiver issued a request for proposal for a 1year contract to manage the medical services at the jail once the receivership ends in September 2000. The contract was awarded to individuals who were employed by the receiver at the time the proposal was submitted, raising the specter of impropriety in the receiver’s procurement process. The benefit of the RFP is questionable, since it requests bids that would maintain the same services at the jail and therefore the same cost, thereby perpetuating the already high costs that were expended under the receivership.
D.C. government can’t afford these inflated costs and D.C. taxpayers shouldn’t be forced to foot the bill if there are other costeffective alternatives.
Today we will be looking at what reforms, if any, still need to be enacted to comply with the judge’s order. Additionally, the hearing will focus on what resources are needed to maintain the reforms which have already been instituted and to enact any additional reforms required for compliance with the court order so that the jail may return to the city’s jurisdiction.
We will hear from GAO. We will hear from Dr. Shansky; the receiver, John Clark; the corrections trustee; Erik Christian, the deputy mayor for public safety and justice. Karen Schneider, the special officer appointed by the U.S. district court, who refused to testify, requiring this subcommittee to issue its first ever subpoena mandating her appearance.
I would now yield to Delegate Norton for any opening statement she wishes to make, and then we will move right on to the witnesses.
[The prepared statement of Hon. Thomas M. Davis follows:]
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Ms. NORTON. Thank you, Mr. Chairman. I very much appreciate your initiative in calling this hearing and the way in which you have worked with me on this matter, in particular.
Over a period of many years, the District of Columbia lost control over four agencies, but only after the courts had seen their orders violated for years. Judicial patience had justifiably run out. Medical services at the D.C. jail before us today were replete with violations and with inhumane conditions. Respect for even minimal levels of Constitutional rights compelled the action Judge William B. Bryant, a distinguished judge of the U.S. district court here, took to relieve the District of control of the medical function at the jail in 1995.
Chairman Tom Davis and I, and the subcommittee, began our oversight of receiverships only in the wake of a precipitating event in one of the receiverships for which none of the actors, including the receiver, had any explanation or took responsibility, the death of an infant, Brianna Blackmond, committed to the care of the Child and Family Services Agency, under a receivership of the U.S. district court.
Shortly after the infant died, Chairman Davis asked me to join him in requesting GAO investigations of all the outstanding receiverships in order to assure that accountability problems had not developed in the absence of regular public oversight to which city agencies in the District are subjected today.
The Chair then commenced this series of hearings on the three receiverships that are still active, all of which have been subject to serious criticisms. Our own preliminary investigation has not been reassuring. We could not find evidence of significant use by our receivers of best practices of the kind required of District and Federal agencies, such as management and fiscal audits; procurement practices that foster fair and open competition; cost controls that reflect generally acceptable national or regional standards; or even Antideficiency Act requirements universally applicable to government agencies to prevent overspending of funds that are not authorized and available.
With the chairman, I then introduced H.R. 3995, the District of Columbia Receivership Accountability Act. The House passed H.R. 3995 unanimously, and the bill will be marked up by the Senate Governmental Affairs committee shortly.
Even before the GAO reports were in, it is clear that, at a minimum, receivers, their court monitors, and special officers who stand in the shoes of agency heads and their supervisors must operate at least at the standards required of those who have been ousted from control of the agencies involved. The agencies were removed from District control to achieve improvements and higher levels of accountability, beginning with the receivers and their supervisors, who, by definition, are setting the example for the District as to how the agencies are to be run in the future.
All of the receivership agencies originally had severe operational and service problems, but the concerns that remain differ. The jail medical receivership now before us has shown sufficient operational improvements to be scheduled to expire in August 2000, at the end of 5 years, pursuant to the court order establishing the receivership. However, the cost associated with these improvements
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would be astonishing to taxpayers and to any public official charged with responsibility for taxpayer funds.
The GAO investigation Chairman Davis and I have requested is ongoing and unfinished, but three outside experts who looked at the results have raised serious questions concerning cost and procurement practices.
First, and most recently, the D.C. Board of Contract Appeals found that challengers to the receivers’ RFP had not met the heavy burden necessary to divest the contract under D.C. law, even though the receivers’ own employees, while still employed by the receiver, had been awarded the contract to provide future services.
What was significant was the unusually strong language of the board, which wrote, ‘‘While the receiver asserts that he took steps that no offer was unfairly advantaged or disadvantaged, and, in particular, the procurement was designed to encourage outside companies, as well as employee-formed groups to participate, such actions are not apparent.’’
Second, the corrections trustee, a former assistant director for community corrections of the U.S. Bureau of Prisons, the largest in the country, has been charged by this subcommittee with assisting the entire corrections system with systemic management and financial reforms prior to the expiration of his tenure.
In meetings with the receiver and the special officer, the corrections trustee repeatedly objected to the costs of the receivership and the RFP but was successful only in getting the cost lowered from $16 million to $12.5 million, a cost nearly three times the national average for medical services at jails in this country.
Third, Faiver, Campau and Associates, reputable experts in the area of corrections health care, were commissioned by the corrections trustee to analyze the potential cost resulting from the RFP and winning bid. These experts found that the RFP issued by the receiver ‘‘incorporates an administrative structure akin to that often found in a fairly large State corrections system rather than in a moderately sized jail.’’
These experts concluded that ‘‘Nowhere in the country are we aware of a facility of comparable size that has such a top echelon of staff who are not significantly involved in direct patient care.’’
Confronted with cost figures so substantially above those found nationally and in similarly situated regional jurisdictions, and with sharply critical evaluations by outside experts, an explanation is necessary. This hearing is being held to give the receiver and the special officer the opportunity to respond and other witnesses the opportunity to elaborate and be questioned. Thus far, the only response regarding these costs we are aware of from the receivership are a letter from the special officer sent after I wrote to her about our concern, followed by a visit by the special officers receiver, and District correctional officials to my office for a meeting.
In her letter, the special officer justifiably and appropriately warns of the difficulty of doing cost comparisons, but even so concedes that, using the available data, the costs of the contract issued by the receiver is almost twice the national average cited in the applicable surveys.
She then cites the high administrative service cost which she asserts would not be found in the budgets of other jurisdictions. She
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10 also cites modifications that would reduce these costs to $12.92 per inmate per day, although that amount is still nearly twice the national average.
I am in full agreement concerning all the problems associated with analyzing the data involved; however, today local governments and especially the District of Columbia, fresh from insolvency, no longer authorize the expenditure of taxpayer funds without even an attempt to justify costs in comparison to others with similar responsibilities.
In the District, health care, in particular, requires our best effort at such attempts because more than 60,000 D.C. residents have no health insurance. Their health care continues to impose an enormous price on them, personally, on the health care indicators of residents, and on the D.C. government. A D.C. resident should not have to go to jail to get adequate health care and jail should not afford health care that far exceeds what is available to the average resident with and without insurance.
The District government, which stands to inherit the costs of the jail medical receivership, has the task of meeting both Constitutional standards for the health care of people charged with crime and the health needs of ordinary citizens, most of whom are from families who work every day but must look to the District to design a way for them to meet basic health care needs.
Ultimately, the District must take its responsibilities for both these sets of its residents more seriously than the city has in the past.
I look forward to hearing today’s witnesses and to approaching the issues before us as problems that can be solved with sufficient satisfaction to all concerned.
Thank you, Mr. Chairman. Mr. DAVIS. Thank you very much. [The prepared statement of Hon. Eleanor Holmes Norton follows:]
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Mr. DAVIS. Thank you very much. We have been joined by the vice chairman of this committee, Mrs. Morella, who will make a brief statement, as well. Mrs. MORELLA. Thank you, Chairman Davis. I appreciate Ranking Member Norton for calling this very important hearing today to examine the status of the receivership of the District of Columbia’s jail’s medical and mental health services. I am hopeful that this examination will help to enlighten us about how best to deliver this service out of receivership and return it to the control of the D.C. government. Since Dr. Ronald Shansky was appointed the corrections medical receiver for the D.C. jail 5 years ago, much of the crisis has been averted. I am encouraged that many of the problems that were faced by the receiver have been successfully addressed. When the receivership ends in September, the goal will have been met for attaining for the inmates a Constitutional level of health care. Recognition and treatment of depressed and unstable inmates has turned around a dismal situation in the rates of suicide in the jail, the tuberculosis epidemic has been brought under control, and HIV and AIDS cases are identified and treated. Dr. Shansky has brought in qualified medical staff and the level of care provided to the inmates has been greatly improved. I am obviously very concerned, though, that the solution to the dire issues that face the jail can be sustained by the District. Are there alternative staffing solutions and resources that can be applied to this situation to sustain the improvements that have been made under the receiver’s care? This level of care has been accomplished with medical costs and staffing levels that far exceed the national average. The receiver has not been held to sound financial practices and has not been accountable to the District government for its budget. I am further concerned that the request for proposal, the RFP, for a 1-year contract to manage the medical services at the jail once the receiver ends in September 2000, has resulted in a contract being awarded that maintains the staffing levels and medical costs endured under the receivership. If there is a more cost-effective solution, then that needs to be further explored. And so I hope this hearing today addresses these concerns and that, from what we learn, a suitable long-term solution may be received. Though the manner of care has improved over the past 5 years in the D.C. jail, it is imperative that the jail be able to sustain a Constitutional level of services to the inmate. I thank you, Mr. Chairman, and yield back. Mr. DAVIS. Thank you very much. [The prepared statement of Hon. Constance A. Morella follows:]
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Mr. DAVIS. I want to call now our panel of witnesses and supporting witnesses to testify: Ms. Laurie Ekstrand, the Director of Administration of Justice Issues of the U.S. General Accounting Office; Ronald Shansky, M.D., the receiver; Ms. Karen Schneider, the Special Officer for the U.S. District Court for the District of Columbia; Erik Christian, the deputy mayor for public safety and justice; and Mr. Odie Washington, director, District of Columbia Department of Corrections as a supporting witness; and, of course, John Clark, District of Columbia Corrections trustee.
As you know, it is the policy of our committee that all witnesses and supporting witnesses be sworn before they can testify, so if you would rise and raise your right hands.
[Witnesses sworn.] Mr. DAVIS. Thank you very much. To afford sufficient time for questions, if you’d try to limit yourself, we’ve read the testimony that has been submitted. We were here until 3 a.m., so we didn’t have anything else to do. It doesn’t always get read, but in this case it did. All written statements are going to be made part of the permanent record, so if you would try to dwell on the highlights that will give us time for questions and we can get you out of here earlier, as well. I’ll begin starting with Ms. Ekstrand and then move to Dr. Shansky, Ms. Schneider, Mr. Christian, and then Mr. Clark.
STATEMENTS OF LAURIE EKSTRAND, DIRECTOR OF ADMINISTRATION OF JUSTICE ISSUES, GENERAL GOVERNMENT DIVISION, U.S. GENERAL ACCOUNTING OFFICE; RONALD SHANSKY, M.D., CORRECTIONS MEDICAL RECEIVER; KAREN SCHNEIDER, SPECIAL OFFICER FOR THE U.S. DISTRICT COURT FOR THE DISTRICT OF COLUMBIA; ERIK CHRISTIAN, DEPUTY MAYOR FOR PUBLIC HEALTH AND JUSTICE; AND JOHN CLARK, DISTRICT OF COLUMBIA CORRECTIONS TRUSTEE, ACCOMPANIED BY ODIE WASHINGTON, DIRECTOR, DISTRICT OF COLUMBIA DEPARTMENT OF CORRECTIONS
Ms. EKSTRAND. Thank you, Mr. Chairman. I am very pleased to be here today to discuss several issues concerning the District of Columbia receivership contract for medical and mental health services at the D.C. jail. Without further ado, let me get right to the four issues that we were asked to review. The first one is cost. Our comparison of budget data for medical services at the D.C. jail and comparable facilities in Baltimore City and Prince George’s County indicated that D.C. jail’s per capita costs are higher. Indeed, the officials to whom we spoke during our review agreed that D.C. jail provided certain medical services and had staffing levels that exceed those of other facilities. Of course, this drives cost. In relationship to staffing, the inmate-to-staff ratios, as reported by the Office of the Corrections Trustee, is 13-to-1 at the D.C. jail, 74-to-1 in Baltimore, and 48-to–1 in Prince George’s County. The fact that the D.C. jail provides fully staffed pharmacy and both mental and dental services onsite, whereas Baltimore and
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Prince George’s County do not, provides some context for understanding some of the differences in the inmate-to-staff ratios.
Most of the officials to whom we spoke cited the court-ordered remedial plan as the primary reason why the D.C. jail provides enhanced medical services and has higher staffing levels than other jurisdictions. The trustee, however—and I’m sure he will address this himself—feels that adequate medical services could be provided with fewer staff and at lower cost.
The next issue you asked us to review concerned acceptable levels of care for jail inmates. We found that there is no single threshold that determines what an acceptable level of medical services is at the jail. According to experts, this is the case because the acceptable level is related to the medical circumstances and situations that need to be addressed. It can also be a function of specific constraints such as court orders placed on a specific jail facility.
Accreditation standards have been developed by several organizations, including the National Commission on Correctional Health Care. These standards define minimum recommended medical service requirements for jail to voluntarily obtain accreditation. When a facility seeks accreditation, experts review a broad range of factors related to the health of inmates and facility-related issues to make a decision concerning accreditation based on the application of standards to the specific jail setting. The standards then cannot be used as a simple check list to assess whether a facility provides an acceptable level of medical care.
You also asked us to look at the effects of the contracting process on medical service costs. As you know, the current contract maintains the level of medical services and staffing at the levels already in place at the D.C. jail, but the current contract can be modified at any time. In addition, it can be re-competed at its current or scaled-back levels of service and staffing when the base year ends in March 2001.
The solicitation that resulted in the current contract requested that offerors submit proposals that would maintain existing levels of service and staffing. These were referred to as comparison proposals.
According to officials we spoke to, the District sought to maintain existing levels of service to ensure that the receivership is successfully terminated in August 2000, and control of the jail is returned to the District. The solicitation also encouraged offerors to submit alternative proposals for providing health services differently or more economically than they were currently provided.
The Evaluation Committee rated all of the proposals and determined that none of the alternate proposals provided specific enough information to ensure that they would maintain the same level of medical services as would the comparison proposals; thus, the final recommendation of the committee was to endorse a comparison proposal. The committee’s recommendation was sent to the receiver, who selected the contractor.
Finally, let me turn to the issue of whether the failure of the receiver’s employees to resign from their positions prior to being awarded the contract violates D.C. law or regulations.
Under District personnel regulations, a District employee may make an offer on a contract, but generally cannot be awarded the
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22 contract while still in D.C. employment status. The firm that was awarded the contract to provide medical services at the D.C. jail was constituted of employees working for the receiver, not for the District government, thus they were not subject to these provisions of District law.
We would note that the D.C. Contract Appeals Board ruled in May 2000, on a protest by a losing offeror to this procurement. The protestor asserted that the receiver showed bias in favor of the awardee, which was a company formed by the incumbent medical director. The issue of employees’ failure to resign prior to the award was not raised in this protest. The Board denied the protest, finding that there was not proof of bias sufficient to challenge the award; however, the Board noted that certain of the receiver’s actions gave an appearance not conducive to confidence in the fairness of the procurement.
This concludes my oral statement, and I would be glad to answer any questions you may have.
[The prepared statement of Ms. Ekstrand follows:]
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Mr. DAVIS. Dr. Shansky. Dr. SHANSKY. I, too, would like to indicate I appreciate the opportunity to appear before you, and I will try to be brief. I have submitted my written statement to you, as you indicated. At the time the receivership was created, I was contacted, and only after several phone calls reluctantly agreed to accept the responsibility. One of the reasons I agreed was that the District wanted me to assume that responsibility. When I took over in September 1995, the jail was a very chaotic place. In fact, it was in some ways very frightening, not just to me but to the medical staff and to the officer staff, especially, and to the inmates. Numerous officers came to me indicating that they were concerned that if they got injured or something happened there would be no response. As a result of my concerns and my overwhelming sense of responsibility, I chose to stay in the jail. I took a cell and I stayed there in order to make sure that nobody died. Over the course of the next couple years, slowly but surely we were able to recruit a staff that was able to provide services consistent with my mandate, which was the previous court orders. The entire process that I have been involved in has been a collaborative one with the District. This has not been a receivership that has in any way forced anything down the throat of the District. Quite the opposite. The District wanted me to assume this responsibility. I took it. I never felt this was my program or the court’s program, it’s the District’s program. I am a temporary housekeeper trying to put things in order. The District indicated to me that it wanted to maintain services after I departed through a procurement process with a contractor. I agreed to do a procurement and drafted an RFP in complete collaboration with corporation counsel’s office, the Department of Corrections, plaintiffs, special officers, and with input from the trustee’s office. In fact, this RFP was about 6 months in the drafting, with comments included in it from probably a total of 10 or 12 different individuals, most of whom were lawyers. The procurement selection process we were very careful about. We wanted to make sure that the evaluation was a fair and objective one. As a result, a committee was put together completely independent of me. I had no say on who sat on that committee. I had no say in who they selected to assist them in their evaluation process. My only suggestion was that that committee, when it was created, have a majority of District Department of Corrections appointed people. The committee met. The RFP—the proposals were evaluated, and ultimately a not-for-profit group created by employees was selected. I did my own evaluation and I concurred. This was the lowest bidder. For many reasons we thought that this would guarantee the best value for the dollars spent. With regard to is the District getting its bang for its buck, which is a very legitimate question, the process is set up, first of all, so that, literally beginning now, the District can begin negotiating with the vendor on a second year, and if it chooses to reduce some services, eliminate some services, change how it wants the services staffed, it is able to do that.
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34 With a not-for-profit vendor, the unexpended moneys will be returned to the District, just as I returned them over the previous 5 years. We have always come in under budget, and I have every reason to believe that this contract will also come in under budget. With regard to the issue of employees being able to submit a proposal, that somehow it is unfair, every procurement that I am familiar with, once you are in the second round of procurements, has an incumbent, and that incumbent is never excluded from participating because they currently have the contract. That’s not the way contracting is done. This group, because it was a first time for them, was at certain disadvantages in terms of their skills at writing proposals, etc. The particular group that was selected partnered with an experienced for-profit company to handle fiscal management. I believe that the District and I believe the Department of Corrections believes that the District has gotten the best value it could out of its procurement process, and I look forward to the termination of my receivership, hopefully within the next 60 days, so I can get on to other things in my life, but also so that the District can then assume direct responsibility and make whatever modifications, changes it wishes to based on changes in disease, based on changes in responsibilities. For instance, the sentenced felons are supposed to be going to the Bureau of Prisons. When that happens one of the two mental health units will be able to close down and there will be a substantial savings of at least a half a million to $1 million. All of that is in process. When all of the prison inmates are ultimately sent to the Bureau of Prisons, there may be additional changes just based on that reality. So I have no doubt in my mind that over the next several years the budget and per capita costs of this particular contract are going to diminish significantly. I thank you for your time. Mr. DAVIS. Thank you very much. [The prepared statement of Dr. Shansky follows:]
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Mr. DAVIS. Ms. Schneider. Ms. SCHNEIDER. Mr. Chairman, Ranking Member Norton, and other Members, my name is Karen Schneider. I hold the position of the special officer, which is the special master, as that term is used in Federal rule of civil procedure 53. Judge William Bryant of the U.S. district court for the District of Columbia appointed my predecessor, Grace Lopes, to the position of special officer in 1993 for the purpose of assisting the court in the consolidated action captioned Campbell v. McGruder and Inmates of D.C. Jail v. Jackson. In Campbell, Judge Bryant had issued orders governing conditions and practices of confinement and care at the District of Columbia Jail. I was substituted as special officer in November 1997. Judge Bryant’s order appointing a special officer in Campbell found that the District of Columbia had a long history of noncompliance with court orders regarding medical and mental health care at the D.C. jail, and that a special officer was necessary in order to assist the court to assure future compliance. I ask that Judge Bryant’s order appointing a special officer be made part of the record. The responsibilities, powers, and limitations of the special officer in Campbell are detailed in this order. The special officer is a judicial officer whose principal responsibilities are to monitor and facilitate the District of Columbia’s compliance with the remedial orders of the court and to report and make recommendations to the court regarding compliance. The order authorizes the special officer to informally confer with the parties on compliance issues and to attempt to fashion compromises among the parties, much as a judge might seek to mediate or settle disputes among parties. The order authorizes the special officer to conduct hearings and to submit proposed findings of fact and recommendations to the court. Following her appointment in April 1993, the special officer, with the assistance of experts, evaluated the medical and mental health services at the D.C. jail, and in September 1993, issued a report regarding the compliance of those services with the court’s earlier orders. In March 1994, the court, relying on the special officer’s report, found the District in contempt. In January 1995, the court ordered the District to implement a remedial plan. On July 11, 1995, when the District continued in its state of noncompliance, the court ordered the appointment of a receiver to correct the deficiencies in the delivery of medical and mental health services at the jail. I ask that that order be made part of the record. Mr. DAVIS. Without objection, that will be made a part of the record. Ms. SCHNEIDER. The court’s order detailed the history of the District’s noncompliance and states that over the more than 20 years of this litigation the court has attempted all measures, short of the appointment of a receiver, to obtain the defendant’s compliance with its orders. The court finds that no other less-intrusive remedial measures will succeed in compelling the defendants to satisfy their court-ordered obligations. The July 11, 1995, order provides that the receivership shall expire 5 years from the date the receiver is appointed unless the
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court finds good cause to extend the appointment. The court also reserved the discretion to terminate the receivership at an earlier date if the special officer certified that the defendants are in compliance with all the orders of the court concerning medical and mental health services at the jail, and that management structures are in place to assure that there is no foreseeable risk of noncompliance.
In August 1995, Judge Bryant appointed Ronald Shansky, and in September Judge Bryant entered a detailed order regarding the procedures for the receivership’s exercise of power. I also ask that that order be included in the record. That order has governed the receivership over the last 5 years, and unless the receivership is extended by the court it will expire within 2 months of this hearing.
Since Dr. Shansky is a witness before this subcommittee, he is available to detail the specific activities in exercising the powers given by the court.
I understand that this subcommittee is interested in the contract awarded by the receiver to the Center for Correctional Health and Policy Studies for the provision of health care services at the D.C. jail.
My March 15, 2000, report to Judge Bryant regarding the receivership sets forth the process which led to the development of a request for proposal for that contract and the selection of the vendor for the award of that contract. I ask that that report be made part of the record.
I understand that the members of the subcommittee wish to ask me questions. I previously have informed the subcommittee that there are constraints on the comments I can make which are imposed by the Code of Judicial Conduct for U.S. Judges. That code very clearly states that it is applicable to special masters like me. Decisions of the U.S. court of Appeals for the District of Columbia circuit, the U.S. Supreme Court, and other courts also have determined that a special master is a judicial officer and that there are limits on what judicial officers can say about a pending case.
As I am sure this subcommittee knows, in most circumstances a judge would violate the ethical cannons of the Code of Conduct if she makes public comment about a case that is still pending before her. One of the reasons for that rule is that a judge’s comments might suggest some pre-judgment or the appearance of pre-judgment of an issue that may later come before the judge for decision in the case.
Since the Campbell case is still pending and I may be called upon to address issues in that case in the future, I may not be at liberty to answer all of the questions that are addressed to me. My counsel has submitted a letter to the subcommittee staff in which he elaborates on the legal authority imposing those restrictions on me. I ask that the letter be made part of the record.
However, I will try, to the best of my ability, within those legal constraints, to be responsive and answer the subcommittee’s questions.
Thank you. Mr. DAVIS. Thank you very much. [The prepared statement of Ms. Schneider follows:]
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Mr. DAVIS. Mr. Christian. Mr. CHRISTIAN. Thank you. Good morning. My name is Erik Christian, the Mayor’s deputy for public safety and justice. Good morning, Chairman Davis, Delegate Norton, Congresswoman Morella, and Congressman Horn. Thank you for the opportunity to testify before you today on the status of the current reform efforts undertaken by the D.C. Department of Corrections to improve medical and mental health services at the D.C. jail. In the first 15 months of the Williams administration, the District government has made great strides in instituting improvements to introduce accountability for each and every agency and employee in order to transform the government into one that is responsive to its citizens. This approach has already shown promising results in the first year and will continue to drive changes in years to come. When Mayor Williams took office, the management challenges the administrator inherited were daunting. Accountability for the District work force was rare, if not nonexistent. A deeply entrenched culture existed that was resistant to change, and, as we all know, there was infrastructure decimated by deferred maintenance and disinvestment and technology needs that were grossly inadequate. Now, the mental and medical health delivery system was no different. It was in need of repair. In fact, medical and mental health services, as well as other conditions at the D.C. jail, have been under court supervision for over 25 years. More recently, in 1993, a medical expert retained pursuant to court order to conduct an investigation and report on medical services at the D.C. jail concluded, ‘‘The quality of medical services is deplorable, the physical condition of the medical area horrible, and the infirmary is a disgrace.’’ At the same time, significant deficiencies were also found by a mental health expert retained pursuant to the court’s order to investigate and report on mental health services. These reports led to the development of a remedial plan the defendants were ordered to implement in January 1995. Unable to implement the remedial plan, U.S. District Judge Bryant, on July 11th, entered an order appointing a receiver to run medical and mental health services at the jail. In its order appointing a receiver, the court found that the District had violated the court’s order and, among other violations, they had failed to properly conduct sick call, failed to operate a chronic disease clinic, failed to implement a quality assurance program, failed to maintain a full-time health services administrator at the jail, failed to properly conduct intake, failed to properly provide meaningful access to specialty services, failed to appropriately and professionally respond to life-threatening emergencies, failed to properly provide medical guides, and failed to keep their own kitchen and medical clinic clean. Moreover, the population the District is serving at the jail has a high rate of HIV/AIDS, a high rate of tuberculosis and other infectious and chronic illnesses such as hypertension, heart disease, epilepsy, diabetes, and asthma, and a significant percentage of inmates requiring treatment for preexisting injuries such as prior
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gunshot wounds and chronic disabilities. Moreover, the jail had experienced a rash of suicides, and there is a high percentage of inmates who suffer a series of mental health problems.
But what is the solution for these problems? The solution is to instate the same solid management practices that this administration is applying to other troubled areas.
Throughout his campaign for Mayor, Mayor Anthony Williams repeated the mantra, ‘‘One government, good government, and self government.’’ These six simple words comprised his vision for the city. One government is a government where all functions that have been placed by the courts under the control of a receiver are returned to the control of this government under the Mayor’s leadership an with oversight of the District’s City Council. This administration is working to create one government and commit it to terminating court-imposed receiverships. Good government is an efficient and effective government. Good government facilitates the goal of one government and will ensure that the city can and does provide human and proper treatment to its jail population; that it complies with the law; and that a structure is instituted that not only makes sure that we end this receivership but assures that we do not in the future revert back into receiverships in the dictates of the court order.
This government is committed to exploring all ways to maximize efficiency and effectiveness. If this contract or any government contract of service is not efficient or effective, we will work to correct, modify, or replace it.
The District wants to work with the Congress, the GAO, and the court to identify ways to continue to reduce costs while maintaining the improved quality of health services required by the law and recommended by correctional health experts to address the unique medical and mental health needs of our population.
Ending receivership is a clear priority of this administration. As this administration continues to apply the principles of good government, we must be successful in our efforts to bring this receivership and all receiverships back under the authority of a Mayor with oversight from the District City Council.
The District is one city and our citizens deserve a unified government. This city deserves the democracy and home rule that receiverships prevent. We need to continue to perform at this high level so that we, as the District government, can demonstrate that we can provide all of our citizens, even those that are incarcerated, the highest and finest level of professional services at competitive rates.
Plain and simple, we need to return to one unified municipal government in the District under the leadership of officials that are accountable to our voters. By returning District agencies that are currently under receivership back to local control, democracy will be driving government here in the Nation’s capital.
Thank you, Mr. Davis and committee members. Mr. DAVIS. Thank you very much. [The prepared statement of Mr. Christian follows:]
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Mr. DAVIS. Mr. Clark. Mr. CLARK. Good morning. Thank you, Mr. Chairman, Ranking Member Norton, members of the committee. It is a privilege to appear before the committee today at this important hearing. Of course, I have submitted a detailed statement and I will try to just briefly summarize that here. It is not any secret that for 21⁄2 years I have been very concerned on behalf of the District about the exorbitant costs of the receiver’s operation. I’ve made my views known to all the appropriate parties and tried to work to resolve matters. I have not been particularly successful. So what are my concerns? To summarize, when I assumed this new position I was charged, Mr. Chairman, and directed by various authorities in the District and the Congress, including this committee, to take seriously my role of financial oversight in protecting the funds provided for corrections operations both by the District government and the Congress. I assure you I’ve taken that charge very seriously. Therefore, I was stunned when I first visited the jail and reviewed its budget in the fall of 1997 and compared it to my experience as a warden of a similar facility, a Federal facility in Miami about three-quarters the size, and also my experience as Assistant Director of the Federal Bureau of Prisons for 6 years, where I had policy oversight for all BOP urban jails. In short, the receiver had about 150 FTEs, compared to about 33 at my facility in Miami, and a $16 million budget compared to the equivalent of about a $4 million budget at my similar facility. Further, I was puzzled that when national averages for correctional health care are consistently reported at about $7.50 a day per inmate, it had cost in the District’s jail in excess of $20 a day. As I show in my testimony, in my written testimony, on the chart on page 6, if this contract runs its full length, the price to the District of the receiver’s tenure and the follow-on contract that he has awarded will be over $120 million versus the national average for that period of about $45 million. So the question now arises as to whether it is useful or fair to make comparisons of the receiver’s costs and staffing to other jails. Some have said that we cannot make such comparisons. I assert that of course we can, although certainly it is important to make proper allowances for unique variables. Every manager, whether in private business or public management, has to subject themselves to comparisons. We have to be held accountable to explain differences and discrepancies. That is particularly true in the face of such differences as we face here, which are not, Mr. Chairman, differences at the margins but are an order of magnitude problem. The District simply cannot afford such extravagance. I’m not here to question that the receiver has remedied the former crisis and has installed at the jail a Constitutional level of care for the prisoners, but at what cost to the District? Apart from the past 5 years, my other concerns, primary concerns, at least, are that the District is now stuck with an expensive contract in the amount of $68 million over the next 5 years unless some action is taken.
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The RFP, further, is not performance based, requiring the vendor to supply a certain level of service and care, giving only lip service to cost containment in certain narrative statements. But, where it counts, in the evaluation factors delineated in the RFP, de minimis value was given to cost containment.
I would refer the committee to table five on page 13 of my testimony, which is reproduced from the RFP. As one could see, the total weight of price is listed at 26 percent of the total score. Itself, a low weight but not unprecedented.
However, on closer inspection it is clear that element A, overall price, was only one of five elements scored in the price category, worth approximately 5 to 10 percent of the total score of the bid proposal, to be given little more weight than such vague elements as rational budget, salary structure, and fringe benefits or budget presentation. In other words, the lowest price could easily be more than counterbalanced by a much higher bid—just in this price category—which was simply more rational or showed a better package of benefits or was presented more attractively.
In my extensive experience overseeing Federal Government contracts, price is price. Here the issue was totally blurred.
Where it counted, the real message was that price is not that critical, and so the message went out. Everyone wanted to please the receiver, and to do that a rich staffing level was expected.
The message was heard by the bidders in the form of $12 to $14 million bids for a 1,650 bed operation. The well, indeed, had been poisoned against mainstream price and staffing bids.
In fact, to allow for a true comparison to contracts awarded by other jurisdictions, about $2.5 million should be added to the receiver’s contract cost to account for outside medical expenses covered by other contracts but here borne by the DOC. Therefore, making a true comparative cost figure for medical services at the jail, it’s about $15.2 million. But getting away from averages and rates to more recent comparable examples of actual contracts for medical services, I think Mrs. Morella would be interested to know that in Baltimore and in the Baltimore Detention Center—and several surrounding Maryland facilities, a contract was procured recently for all the services, all-inclusive services for those facilities, for 6,500 inmates, for $19 million. That’s $19 million for four times the number of prisoners that here in the District we are paying $15 million to provide services.
Again, this week in the clips I noticed in Delaware a contract was awarded for more than 6,000 prisoners for $14.2 million. Again, the same money for four times the number of prisoners.
A final example I’d give, in a recent report, another report by GAO in April noted that the Federal Bureau of Prisons, in its only private contract award in a facility—actually, several facilities together in Texas—awarded a contract for $10 million for 5,400 prisoners. That’s several million dollars less for three times the number of prisoners.
Compared with the jail, these are differences in the order of magnitude of three or four times, not at the margins.
I am not asserting that these jurisdictions are identical to the District’s needs or that we should be among the cheapest in the country, but we should be somewhere near the mainstream.
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127 Finally, everyone has to be concerned, in my estimation, that the receiver did not voluntarily recuse himself from being the sole procurement official in what turned out to be a $68 million award, particularly when it became clear that his professional associates and employees were forming a group to bid. Now, I’ve never objected that the employee group was bidding, but I did strongly suggest that the entire procurement be turned over to the D.C. Office of Contracts and Procurement. This was declined by the receiver and the special officer—in my estimation a violation of the most fundamental principles of public contracting, the perception of a fair and level playing field. In summary, a wonderful opportunity has been missed for the District over these past 5 years, as the receiver’s legacy leaves no appropriate or usable template for the future of medical services at the jail. I’m afraid that the city must start from scratch to rebuild this mishandled jail medical services operation. Since we cannot change the past, in my estimation the District must immediately, since the clock is ticking, begin the development of a new procurement process to replace the current contract at the first option date next March. Thank you, Mr. Chairman. I look forward to the committee’s questions. Mr. DAVIS. Thank you. [The prepared statement of Mr. Clark follows:]
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Mr. DAVIS. We’ll have a number of them. I’m going to start, I think, with Mr. Horn, who has another commitment. He has come in. We’ll start the questions with him.
Let me just make one comment. I think, Dr. Shansky, my impression, just sitting here and listening to everything, is you were brought into a very, very tough job and you turned the place around in terms of meeting the criteria and everything else. You are a doctor. I mean, you’re not a manager. That’s not your job, and so on. And when it came to the bid, you wanted to make sure you could get some people in place that knew how to do the job and they were bidding. If they got it, great. If they didn’t, at least you knew you had somebody competent. That’s my take on it, and that’s appropriate.
Now, I think you had some cost problems that go beyond what you perceived or what your expertise is, and that’s always the difficulty when courts take over these is that courts are not managers, they are not administrators, and as we get ready to transition we’ve got some tough questions to ask.
That’s my perspective on it, if it makes you feel better. Ms. NORTON. Would the gentleman yield on that point? Mr. DAVIS. I’d be happy to. Ms. NORTON. I think the chairman makes an important point. If we are showing concern—and this is before we get to our colleagues who are going to ask questions, because I want to simply make a point and not ask a question. In a real sense, we in the Congress are confronted with the same problem when it comes to HMO and managed care, and one of the reasons that doctors have lost control of medical services is that if, in fact, you turn over the bank to them, they will exercise the best of their professional judgment, and what has happened as a result is all of us who are not in jail are now in HMOs and managed care precisely because we are trying to press costs down, and we’ve taken these costs from medical judgment, alone, and that turns out apparently not to have been the case here. Mr. DAVIS. I’m going to yield to Mr. Horn for questions. Mr. HORN. Thank you, Mr. Chairman. I hope I haven’t disrupted the committee too much, but I have two questions, and I’d be particularly interested in all of your views on this. To what extent in the D.C. jail do we have literacy education? That’s one. To what extent do we have appropriate mental health services in the jail and when they are out of jail in the community? Can you just give me a thumbnail of what you experts have looked at there—literacy and mental health. Ms. EKSTRAND. Sir, I’m afraid I can’t answer the question about literacy because it was outside the scope of what we were asked to look at. In terms of mental health, they do have onsite facilities at the jail for mental health care. Mr. HORN. Well, how good it is? I think Dr. Shansky is probably the expert, isn’t he, on this? Ms. EKSTRAND. I’m sure that he is more expert than I am. Mr. HORN. Well, Dr. Shansky, I think you are the expert. What is the answer to it?
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Dr. SHANSKY. First of all, with regard to literacy, there are literacy problems, but I am—and we have a health educator who works with the inmates trying to teach them at different levels of literacy skills how to take responsibility for their own health.
I think the Director of Corrections would be better able to comment on literacy, overall.
With regard to mental health, the D.C. jail is a unique facility in the country. The D.C. system is a combined prison and jail system. There are only five jurisdictions that I am aware of that are combined prison and jails under one single Department of Corrections.
The District, long before I came, decided to put its only inpatient mental health services at the D.C. jail, so if you were an inmate and became unstable you got transferred to the inpatient unit at the D.C. jail, and when I came on board not only were there a lot of legitimately mentally ill people, but there are also individuals who would manipulate in seriously destructive ways, maybe to come from Lorton, VA, into the District.
We had to put together a program that identified mental illness at intake, and we’ve done that successfully. I am pleased to report we’ve had no successful suicides in over a year-and-a-half, compared to, before I took over, an average of a successful suicide every other month.
Mr. HORN. Can I ask how many unsuccessful suicides you had? Dr. SHANSKY. Actually, the number of serious attempts has been dramatically reduced. Those instances are pretty occasional now. The thing that you need to remember is—— Mr. DAVIS. Dr. Shansky, let me just stop you. Mr. Horn health as got to leave, but what we’d like you to do is provide this for the record, because I think he’d like to have this on the record and I think it is an important piece of information. Dr. SHANSKY. The thing that you need to be aware of is, as you are aware, the mental health program for the District is also under receivership. There are many people who are released from jail who, were they to be maintained adequately in an outpatient program in the community, would not, in all likelihood, come into the jurisdiction of the criminal justice system. In fact, my staff have participated with others in an effort to create a mental health court that will divert some of these individuals away from incarceration, provided that they maintain their therapeutic program that has been prescribed by the appropriate professionals. There is no question, because we service the prison system, also, that the number of mentally ill inmates, seriously mentally ill inmates at the jail is dramatically higher than anywhere else in the country. We know that when the Federal Bureau of Prisons ultimately takes responsibility for all of the sentenced felons the number of seriously mentally ill inmates in the jail is going to dramatically go down, because we have a substantial number of inmates who are in the mental health units at the jail who are sentenced felons. In fact, we proposed early on that if the chronically mentally ill who were stable and were sentenced felons were to be transferred to the Bureau of Prisons—and at one point they had agreed to take
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them 2 years ago—that would result in an immediate reduction in cost of between a half a million and $1 million.
We know that by the end of 2001 all of the sentenced felons will be the responsibility of the Federal Bureau of Prisons, and clearly the contract situation we’ve created allows the District to negotiate with its vendor literally at will to reduce staffing levels in services provided based on the population needs that it is responsible for at any given point in time.
Mr. DAVIS. Thank you. Does anyone else want to address that? [No response.] Mr. DAVIS. Let me ask Ms. Schneider a question. You received a letter inviting you to testify. You refused. You stated that to do so would be a violation to the Code of Judicial Conduct. After consultation with the U.S. House of Representatives Office of the General Counsel, the subcommittee concluded that you were not prohibited from testifying at this hearing. We made it abundantly clear to you that we really had no intention of influencing any judicial proceedings or discussing any quasijudicial functions you could exercise in your role as special officer. We repeatedly offered to meet with you to dispel any concerns you had about testifying. Finally, on Monday your attorneys came to this subcommittee for what we thought was to be a meeting in good faith. It turned out to be anything but that. Present at the meeting were the House general counsel, the majority and minority counsel for the Committee on Government Reform, subcommittee counsel, and majority and minority subcommittee staff. They agreed that your presence at this hearing was imperative. Your attorneys were uncooperative, and therefore this subcommittee issued its first subpoena in the 6-years that I have chaired this, mandating your appearance today. You know how hard it is to get Mr. Waxman and Mr. Burton to agree on a subpoena. Ms. Schneider, you’ve gone to incredible lengths to avoid this hearing, and yet it has come to my attention that during the 2weeks since you received the invitation letter you have been consulting with the media. From the subcommittee’s conversations with you, we couldn’t ascertain what your relationship to the receiver is, but in this article in the Post today you have been quoted as saying that Shansky has not been a Lone Ranger. How could you talk to the media and yet say you couldn’t talk to Congress? Ms. SCHNEIDER. Mr. Chairman, I first must say that my concerns about publicly commenting on this matter relate to my belief that I am bound as a judicial officer to the Code of Judicial Conduct. I did not talk to the press about that. That is apparently taken from a letter that I wrote to Mr. Odie Washington. I have made no comments to the press and have never spoken to the press about this matter due to my concerns about the Code of Judicial Conduct and my publicly speaking. I do not want to be in a position to compromise this litigation. This litigation is almost 30 years old. I may be called upon by the judge or by the parties to make recommendations to the judge. It
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will compromise my ability to do that to comment publicly about the merits of this case.
Mr. DAVIS. So you are testifying here under oath that you have not spoken to any Post reporters about this?
Ms. SCHNEIDER. I have not spoken to the Post reporter. I did not state that comment to the Post reporter. I was contacted by a Washington Post reporter and I informed him that I could not discuss the matter with him.
Mr. DAVIS. So let me just understand this. The only comment you made to the Post reporter was that you couldn’t discuss this matter with him?
Ms. SCHNEIDER. That’s correct. Mr. DAVIS. OK. Thank you. Ms. Norton. Ms. NORTON. Dr. Shansky, you have repeatedly noted that one of the problems with the—that you encountered in the D.C. jail necessitating greater expenditures is that there are problems relating to the medical condition of these inmates greater than in other jurisdictions. What is your evidence that the District jail inmates are sicker than inmates in New York, Baltimore, L.A., and other large cities in the United States? Dr. SHANSKY. Well, for instance, just to take one example, HIV’s seral prevalence. The District’s seral prevalence rate is about 10 percent, 9 to 10 percent at last survey. New York is similar—actually, a little higher. Baltimore’s I’m not familiar with. L.A. County is substantially lower. Ms. NORTON. What is it in Chicago? Dr. SHANSKY. Chicago, it is about 1 to 2 percent. Ms. NORTON. That’s HIV/AIDS? Dr. SHANSKY. That’s correct. That’s just one. Ms. NORTON. You know, we have a somewhat higher HIV/AIDS rate than some other cities, but your testimony is that you have evidence that the costs that were required in D.C. are so much greater because the inmates are substantially sicker than they are in other large American cities. Dr. SHANSKY. What my statement is that the reasons for the increase in cost are multifactorial. Epidemiology of disease and prevalence of disease is just one factor. Another factor is the decision by the District to house all of its acutely mentally ill, even from the prison system, at the D.C. jail. Had it chosen not to do that—— Ms. NORTON. If you took the acutely mentally ill out, what would be the cost of this contract? Dr. SHANSKY. The mental health program, as described, that would probably reduce the program by a couple million. Ms. NORTON. You have testified—well, let me ask you concerning your testimony. The contract that has been let, is a contract that could last as long as 5 years? Dr. SHANSKY. Well, it is a 1-year contract with a possibility of four option years, each of which is to be negotiated between the Department of Corrections, the city administration really, and the vendor. And, as I indicated, the city is the appropriate jurisdiction, I think, to determine what kinds of services, what types of services should be needed.
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As I indicated, we know that when the Bureau of Prisons takes all the sentenced felons the whole mental health program is going to be dramatically scaled down. Even if that is done in the middle of the year, the Department can renegotiate with a vendor and change in the middle of the year the staffing and other expenditures that are in the contract.
So we set it up flexibly enough so that the Department and the city administration will taper the services and expenditures to its perceived needs.
Ms. NORTON. Indeed, that is certainly the case. One of the reasons why collaboration with Mr. Clark was important—and you seem to have been willing to collaborate with the District, which seems to have been willing to do anything you said—but one of the reasons that collaboration with Mr. Clark was necessary is precisely the kind of transition that you speak of with respect to mental health.
For example, if you were to take the couple of million dollars out, you’d still be left with the cost of these services twice the national average, but if the point was to collaborate because we are in transition, I can’t understand why an objective observer who comes from the Bureau of Prisons would have been somebody you didn’t even want to hear nor did Ms. Schneider apparently want to hear, because it is hard to detect any oversight by her of you.
Dr. SHANSKY. Let me—— Ms. NORTON. So if there is no oversight by her, and Clark comes in as somebody charged by us and a Presidential appointee to look at management and financial reform, I cannot understand why the District of Columbia and Ms. Schneider and you, Dr. Shansky, wouldn’t have used that opportunity, an opportunity that comes precisely from the Congress, to try to collaborate and perhaps go back to the court with a revised notion of what might be necessary here. Dr. SHANSKY. Let me correct the record. Neither the District nor the special officer of the court have done everything that I wanted. That is not the way the process has worked. We have negotiated from day one how to implement, how to design services, how to create the proper program that the District wants. It has been a very fair and open and candid series of discussions we’ve had over 5 years. I did not get everything. Everything is not done exactly the way I wanted. I realized from the beginning this is not my program, it is the District’s program, and I have worked very closely—— Ms. NORTON. Dr. Shansky, you gave us no indication until you’ve just spoken of how those negotiations resulted in your getting less than you wanted. Would you care to give some examples? Dr. SHANSKY. Initially we talked about providing certain kinds of services in certain ways when we proposed the budget, based on what the remedial plan required. There were different interpretations. We participated with the corporation counsel’s office, and the budgets each year, in essence, were negotiated around what needed to be required. Each year the process took place. And, as you can see, each year the budget was scaled back, and each year we returned moneys to the District.
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Ms. NORTON. How did the budget go down from $16 million to $12 million? Was that a voluntary act on your part? Did you cut back on your part by yourself in your own judgment?
Dr. SHANSKY. It was a collaborative effort between myself, the corporation counsel’s office, the Department of Corrections, special officer, and plaintiffs.
Ms. NORTON. Mr. Clark, what role did you play in that process? Mr. CLARK. Well, as I mentioned, when I first came in I was quite stunned by this level, although I think, you know, to be fair to Dr. Shansky, the $16 million level in 1997 included $1.5 million or an extensive amount of a 1-year grant, I think, money from the Marshals for some equipment and some other factors there, so I think his true budget was somewhere in the $14.5 million range that year. But, on the other hand, there hadn’t been that much of a reduction, and I don’t know why he made decisions. But I know that when I came in and learned of this, I started to raise serious concerns with both him and particularly with Ms. Schneider and with the District, and I think that had some significant influence on lowering that budget. Ms. NORTON. Dr. Shansky and Ms. Schneider have indicated that the District can always contract for services for a lower amount. This receivership for 5 years was supposed to be returned to the District so that the District could take it off the shelf and run it, and if that is not the case then I don’t understand what a receivership is about. Dr. SHANSKY. Just to set the record straight, that is the case. Ms. NORTON. All right, but—— Dr. SHANSKY. At the end of August—— Ms. NORTON. But when this matter goes before the City Council of the District of Columbia I can guarantee you that it will be very hard to justify this level of cost, given the other pressures on the D.C. government. Both of you have indicated that the District is free to reduce the cost. This, of course, will take some considerable re-engineering to make sure that the new contract takes into account the very quality concerns that resulted in the District being ousted from jurisdiction, while at the same time meeting the District’s budget requirements. This is precisely the expertise that the D.C. government lacks, and I submit that Mr. Washington clearly lacks now when he says, ‘‘We’re getting all we paid for,’’ and clearly shows no indication that he wants to reduce these costs at all. He loves these costs. He loves this contract. So I don’t understand why, after 5 years, you are giving the District back a contract that almost surely will have to be re-engineered, unless the Mayor of the District of Columbia is willing to pay considerably more for jail costs than he has shown a willingness to pay above the national average for costs for other residents. I do not understand how you have spent your time, if it is to say, ‘‘You can take what I’ve done, throw it out, re-engineer it, and bring the cost down.’’ Why do we need you in the first place? Dr. SHANSKY. I believe that—— Ms. NORTON. That was your job, to——
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Dr. SHANSKY. Let me just indicate—— Ms. NORTON [continuing]. Give us back a cost-efficient—— Dr. SHANSKY. Let me just indicate I believe I was needed in order to save lives, and I tried to do that, and I believe I was successful. With regard to the competence of the city administration, I have every confidence that they have the expertise, the know-how, and the commitment to tailor a program based on their perception, the city’s perception of what needs and what services should be provided. I have every confidence in them, and I will so report that to the judge. Ms. NORTON. Well, of course you have confidence. One of the reasons I would have confidence in them is they’re getting a re-engineered program, a program that has been fixed. It is hard for us to understand how you can fix a program that leaves us this for out of the range of average services. Mr. Chairman, I will pass and come back. Mr. DAVIS. Thank you very much. Mrs. Morella. Mrs. MORELLA. Thank you. I’d like to first of all direct a question to Ms. Ekstrand—and this was picked up by Mr. Clark—the differences, the disparity with regard to Baltimore, Prince George’s County, and the District of Columbia. Could you tell me, from the GAO study, what are the differences in the kinds of medical services and problems that you found in Baltimore and Prince George’s County compared to the District? Ms. EKSTRAND. We do know that there is 24-hour-a-day pharmacy onsite at the D.C. jail and that is not the case in Baltimore City, not the case in Prince George’s County. We did also focus on mental health services, and again mental health services are enhanced in D.C. compared to Prince George’s County and Baltimore City. We did not have the opportunity in the time we had to do this review to go through item-by-item to make that comparison, but those are two of the larger items. Mrs. MORELLA. Are you kind of in that statement sort of justifying the fact that the District of Columbia costs that much more, the pharmacy and the mental health? Ms. EKSTRAND. Well, I’m just making the point that the enhanced services and enhanced staff means that it costs more money. We did not have the opportunity in the few weeks that we looked at this program to determine whether there were other aspects that affected costs, such as efficiency or salary levels. Those were outside the scope of what we could look at since the end of May. But at least we were able to identify some factors, and those factors had to do with enhanced services. Mrs. MORELLA. Thank you. Let me ask Mr. Clark to pick up on that. With all the experience that you have had with the Federal system and in Miami, do you see—I know the difference is, like, four times the difference in terms of price, and we know it is basically because it is staffing, but can you see an equation between the kinds of services provided and the cost? Does that make up for it?
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And then I’m curious. Has anybody looked at, like, recidivism rates? I mean, can you show something for this difference?
Mr. Clark, would you like to comment? And then if anyone else would like to comment?
Mr. CLARK. Well, two or three points. I think everybody would agree that one difference, one legitimate difference, is the service provided to the sentenced felons, which is a group which will go to the Federal Bureau of Prisons within the next year or so. I think Dr. Shansky, while he noted that the total mental health cost may be $2 million, I think he testified a couple of times that when the felons go that would reduce the cost by a half a million to possibly $1 million. I wouldn’t argue with that. Other than that, I don’t see any—the services that the inmates are being provided in Baltimore, whether it is pharmacy, mental health, or all the other services, meet Constitutional standards. They meet accreditation standards. They’ve all been accredited in those facilities. So the total package of services I don’t think is a problem in those facilities in Baltimore or in many other places around the country. And I’d like to make what I think is an important distinction. Higher staffing levels do not equate directly to improved services. At a certain point you reach a point of diminishing returns, and adding more staff members on the evening shift or adding additional nurses, pharmacists, or whatever, does not significantly improve the services. So once you’ve met a basic level, adding additional staff has marginal benefits, in my estimation. Mrs. MORELLA. I have kind of confirmation of what you are saying, and that is a quote from a company, Faiver, Campau and Associates, ‘‘Nowhere in the country are we aware of a facility of comparable size that has such a top echelon of staff who are not also significantly involved in direct patient care.’’ That’s quite a—— Dr. SHANSKY. Congresswoman Morella, could I respond to that? Mrs. MORELLA. Of course, Dr. Shansky. Dr. SHANSKY. That particular consultation, which was solicited by the trustee, was done purely by paper. There was no interviewing. In fact, that particular consultation was completely inaccurate. All of the staff, virtually all of the staff that he refers to as being 100 percent administrative are spending a significant percentage, 50 percent or more of their time, providing direct services. So it isn’t the case that these people are purely doing administrative functions. He never found that out because he never interviewed anybody. Mrs. MORELLA. Have you—recognizing all of that, do you feel— and knowing that you have made some reductions, putting this all together, do you feel you could reduce the number of staff? Dr. SHANSKY. It is my view—— Mrs. MORELLA. And enhance efficiency. Dr. SHANSKY. It is my view—right now we are in the process of completing the renovation, so efficiencies just physically are difficult. That should be finished by the end of October. And it is my view that, in fact, there can be some reductions, and we’ve already talked about it with the vendor. The District has talked about it. And I have every expectation that for the next contract there will be significant reductions in expenditures.
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But I believe those are the District’s decisions, and I have attempted to take, to a great extent, besides taking leadership from the court, also from the District because it is ultimately their program.
Mrs. MORELLA. We have a Government Performance and Results Act, you know, where we require our agencies and say, ‘‘OK, now what have you accomplished, not so much what your mission is and what your modus operandi are.’’ It seems to me that the system could certainly use a Performance and Results Act requirement.
Dr. SHANSKY. We have built exactly those performance measures into this request for proposal. It is the first one that I am aware of—and I was responsible for issuing request for proposals for 12 years for the Illinois State prison system, the first system ever to privatize. The reality is that we have put in performance measures, not just ensuring that certain processes are completed, like intake processing, but that the degree of control of chronic illnesses is such that morbidity and hospitalization are prevented. All of that is built into this RFP. It is unquestionably performance based.
Mrs. MORELLA. OK. I know my time has elapsed, and I thank you.
Mr. DAVIS. Let me try to put a perspective. I would much rather be here talking now about overstaffing and high salaries than I would a situation that we couldn’t correct. I just put that in perspective.
This looked like an impossible situation at the time you took it over and you turned that around, so that is understood and that is good.
But, for those of us that have to operate within the confines of government, which is transparent, which has limited salaries and everything else, you know, this violates all the rules, and it violates all of the traditional rules of government because we were not—you didn’t have political oversight. You had oversight from a judiciary branch. And that’s where you go back into the political spectrum and it goes back to the city that is not ready to transition, and that’s why we are asking these questions.
Dr. SHANSKY. I believe it is ready for transition. The contract is in the midst of its first year. The Department can, beginning to work right now with the vendor, restructure or shift or move or——
Mr. DAVIS. It’s a lot more ready to transition now than it was when you took it over. No question about it.
Dr. SHANSKY. There’s no question. Mr. DAVIS. So I’d put that in perspective. Dr. SHANSKY. There is no question about that. Mr. DAVIS. But I think you would concede and I think Mr. Clark and the GAO and others who have testified make it very clear that the payment for what were getting is very, very high by any normal governmental standard. Dr. SHANSKY. And the District has the opportunity to make decisions about what it wants to pay for and what value it is getting for the dollar. Mr. DAVIS. Of course. Dr. SHANSKY. And that’s why I think this is a perfect situation in terms of the closure of this receivership within the next——
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Mr. DAVIS. And that’s why we are holding the hearing. We need to understand that, and if the city had these costs in every part of its government and couldn’t afford it, it would be a lot better run city, but that’s a different issue.
I’m just trying to put it in perspective, and you don’t need to be overly defensive, but I just—and I can understand why you are that way. The main mission was accomplished, and it looked almost impossible when you took it over.
My wife is a doctor, too, so I understand. She’s tighter on finances than I am, but I just want to put that in perspective for you.
Now, let me ask a few questions here for Ms. Schneider. What are the major duties you perform on a regular basis as the special officer? Ms. SCHNEIDER. My duties as a special officer is to ensure the compliance of the court’s orders. That can be done through mediation with the parties on various issues, through observing and reporting to the court, and making recommendations. Mr. DAVIS. When you look at your priorities, cost has not been at the top in terms of trying to do it within the restrained budget. You’re really looking at turning this around and—— Ms. SCHNEIDER. Well, my mandate is precisely to ensure that the court orders that are in existence are followed, and that is by the order that appoints me. It requires me to ensure that those orders are followed. Mr. DAVIS. OK. So the court orders, no staffing levels are required? That’s a judgment call that you would make? Ms. SCHNEIDER. There were staffing levels required in the initial remedial plan, and there has been a process in this litigation where those staffing levels have been reduced each year through negotiations with the party and a budget that was submitted to Judge Bryant each year for consideration. Mr. DAVIS. But did you ever make any comparisons to other jurisdictions’ costs and services while the plan was being worked out among the parties, for example? Ms. SCHNEIDER. Well, my mandate was to ensure that the court order, as it existed, was followed. Mr. DAVIS. All right. Now, I think I understand how we got to where we are, and I don’t know that anybody is culpable or anything, I just want to try to understand that cost was really the kind of last thing you’d look at as you try to work your way through a very, very difficult situation when you took this over, and I can appreciate that. The corrections trustee reports that you appointed the receiver as the sole appeal authority on the procurement over his very own decision. Can you explain that decision? Ms. SCHNEIDER. Excuse me, that was not my decision to appoint the receiver as the sole—— Mr. DAVIS. Whose decision was that? Dr. SHANSKY. When we drafted the RFP, we had discussion with counsel on a variety of things. One of the issues that came up was to what extent we could parallel, if you will, D.C. procurement law. Now, the reality is D.C. procurement law refers to and is applicable to D.C. agencies. I was clearly not a D.C. agency head, so,
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strictly speaking, D.C. procurement law wasn’t applicable to a procurement that I was going to do, and I couldn’t, in my procurement, somehow require the chief of procurement to be responsible. I had to accept that responsibility myself.
Mr. DAVIS. And your argument now is, as the city transitions they can renegotiate.
Dr. SHANSKY. Yes. Exactly. Mr. DAVIS. Then that makes my next question for Mr. Christian and Mr. Washington. What mechanisms do you have in place to renegotiate the contract and control costs at this point? Mr. WASHINGTON. Thank you, Mr. Davis. First of all, I want to simply say that I, like many in the District, love the services that are currently being provided, but we all have a problem with cost, as has been the case for the last 5 years, but I have been impressed by the fact that the cost continues to go down every year and I am convinced that costs will continue to go down. The best way to do that is to return control of medical services and mental health services back to the District, where we will be able to negotiate specific services and further reduce the cost. I am confident the that District of Columbia will be able to do that. Mr. DAVIS. If you don’t do that, don’t come running to Congress. You’ll have to go somewhere else to find the money. I’ll let you make that argument with the Mayor, but I think that’s—and that’s really the bottom line at the end of the day. Mr. WASHINGTON. And clearly that is understood, Mr. Chairman. Mr. DAVIS. Do you have any mechanisms in place right now? Can you give us any idea where you might be headed on that, what cost controls you put in effect, what some of the services are being provided that you might not be able to provide, or anything? Mr. WASHINGTON. Well, one of the things that we will be doing is to hire our own medical expert to oversee the contract. That will be our person to evaluate the services that are being provided and to determine what services can be reduced. That is a position that will be established. Mr. DAVIS. I’ll tell you what. Instead of putting you on the spot today with that, maybe you can get back with the committee and talk to us as you transition about what some of your thoughts are with specificity. Would that be amenable? Mr. WASHINGTON. Yes. Mr. DAVIS. I think that would be helpful to us. Mr. Christian, do you have anything to add on that? Mr. CHRISTIAN. Again, Mr. Chairman and Council members, we are trying to maintain the quality of services that have already been provided at the most efficient and effective manner, so we would be looking at that contract during this period and when it expires. Mr. DAVIS. Why don’t you try, let’s say in the next—within 10 days could you get us back something in terms of your thoughts on transitioning this back to something that is affordable? I would just say one thing: the city—I mean, not you, personally—you weren’t probably with the city then—but the city had this thing really messed up. It has been fixed from a services point of view, but now we have to contain costs, and we are just eager to
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understand how you are going to do that, how you are going to get there, because if these costs continue it just doesn’t mesh with the culture of this city or any other city when you take a look at the other staffing ratios. So we want to see how we make this transition.
If I have to put an emphasis anywhere, it is on making sure the city isn’t sued again and that we are fulfilling our Constitutional obligations, so you have to do that. You can pick and choose, and I think you have a better system here than you have in Baltimore or you have in Prince George’s or the others, but you are paying a lot more for it, too, and what that balance is, we’re just eager to know what your thoughts are on that. That’s all I’m trying to get at.
Let me now yield to my ranking member, Ms. Norton, for a few more questions.
Ms. NORTON. Mr. Christian and Mr. Washington, you are aware that, as this hearing is going on, the Appropriation Committee is having a hearing in which it is looking precisely into whether or not the District is not only improving its services but is improving the management of those services. The Appropriation Committee is very much in sympathy with what this committee is doing and has made that known.
Are you prepared, when the appropriation comes before the Appropriation Committee next year, to come forward with a contract with these costs in it?
I ask that of you, Mr. Washington, because you said to the Washington Post, ‘‘I think we are getting what we are paying for,’’ therefore I don’t see any inclination on your part even to begin to reduce costs, and so must assume that when you go before next year’s appropriation you will not be recommending to the Mayor that any changes be made. Therefore it would be the Appropriation Committee or the Council that would have to do the oversight here.
Mr. WASHINGTON. Well, actually, Congresswoman Norton, I think it would be just the opposite. I think we will very much be prepared to discuss cost reductions.
One of my primary concerns, as a relatively new director of this department, is to ensure that the D.C. Department of Corrections does not revert back to 30 years of neglect in our department. We have a wonderful opportunity to get from under a 30-year court mandate and oversight of the D.C. Department of Corrections and return control to——
Ms. NORTON. When this program comes back, who will be the officer who has control over it?
Mr. WASHINGTON. Well, the Director of the Department of Corrections will be responsible for medical and mental health services.
Ms. NORTON. That’s you, isn’t it? Mr. WASHINGTON. That’s correct. Ms. NORTON. And you want control over this and you want it back from the receiver? Mr. WASHINGTON. Absolutely. Ms. NORTON. So you have been cooperating with the receiver in order to make sure that you, in fact, get this program back. Mr. WASHINGTON. Yes. I think the quickest way to reduce cost is to return control to the Department of Corrections and negotiate
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future contracts. I think we have a good level of services. That’s important to ensure that we do not have continued court oversight, and further reduce costs.
Ms. NORTON. Dr. Shansky and you have said the same thing. That’s a dangerous thing to say to this Congress. You know, the chairman and I have kept this matter before this committee. In doing so, we have made sure that we focus not on the courts. Neither of us believe it is inappropriate for courts to take over functions that are in the shape these functions are in, but there are many who disagree with us. To the extent that there is testimony before the Congress that courts don’t have any obligation to contain costs when trying to reform matters in receiverships, you endanger the whole notion of court receiverships and non-interference by the Congress of the United States. I think you should be told that.
This matter could just as easily be in the Judiciary Committee, and if it were there would be a very different kind of hearing. Indeed, the Congress has already intervened into receiverships. You do not help those of us who believe that the courts, particularly with respect to jails and to prisons, have done a service to the country in taking over such systems. You do not do a service when you say that it is quite all right for the receivers to rack up any costs they want to and then give it back to the people who couldn’t manage in the first place to bring down the cost, and that is what I am hearing from you, Mr. Washington, and that is what I’m hearing from the two receivership officers.
Dr. SHANSKY. Let me correct what may be a misperception on your part. My mandate was to put the program together and to save lives, but it was also to be fiscally responsible. We have been audited. We will be audited again at the end of the receivership. The audits were court mandated and arranged by the city. We negotiated and discussed each budget, literally at times every position and every service. We have returned money to the District each year that was unspent. I don’t think that is a record of someone who feels that a receiver has no responsibility to look at cost factors. Quite the contrary. We have been sensitive to the cost concerns, and I think the District has also been sensitive, as has the special officer.
Ms. NORTON. Dr. Shansky, it was precisely because there was no audit of the kind that D.C. agencies are required to engage in and only a two-page audit spreadsheet presented that this House unanimously passed a bill requiring that full-scale audits be done not after the receiver is through but on an annual basis while there is a receiver so that the receiver is not held to a standard less than the agency who has given up the function would be held.
Dr. SHANSKY. Once again let me correct the record. The audit that was to be performed was determined by the city it was supposed to be done under the existing city contract by a firm, Peat Marwick, which was doing all the city agencies. I had no say in determining how that audit was done, who was doing it, or what it consisted of.
Ms. NORTON. Just a moment. Did not the court require an audit? Dr. SHANSKY. Yes. That’s correct. Ms. NORTON. Ms. Schneider. Ms. SCHNEIDER. That’s correct.
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Ms. NORTON. Did you regard that as the kind of audit that was satisfactory?
Ms. SCHNEIDER. There was a court order requirement for the audit, and the audit was——
Ms. NORTON. Do you know what an audit is, Ms. Schneider? Do you know the kind of audit that District agencies, in fact, routinely have to go through?
Ms. SCHNEIDER. This was an audit that was done. It was organized by the city, by the agency that was doing the city audits.
Ms. NORTON. Mr. Washington, are you aware of the kind of audit—who organized it? Who was the officer? Was it Mr. Washington?
Dr. SHANSKY. I believe this preceded Mr. Washington. Ms. NORTON. Are you aware of the kind of audits that the new auditor requires when he does an audit of D.C. agencies? Dr. SHANSKY. I wasn’t made aware—— Ms. NORTON. Do you think that this is representative of the kind of audit that agencies should go through? Dr. SHANSKY. Let me indicate, after approximately 2 weeks of providing all financial records, all invoices, all bank statements, etc.—and, again, this was an audit arranged by the city by the contractor with a contract to audit city agencies—no one was more disappointed than we were to get, for the cost of that audit, which I’m told was about $40,000, that two-or three-page statement, believe me. Ms. NORTON. Again, I’m not sure what Ms. Schneider’s job is, but obviously the District wants to get out of the receivership. The District apparently felt it had no stake in the kind of audit these agencies have to go through. I repeat, I am concerned if the District now has to figure out how to reduce these costs, because the District is going to have to, in fact, design an RFP that meets quality concerns and also the cost concerns that the Council and the Mayor will raise. When I look at the number of physicians, no matter how we get into this contract, questions are raised that any public official— you, Mr. Christian; you, Mr. Washington; you, Ms. Schneider; you, Mr. Shansky; and certainly the GAO—should have wanted to question. For example, 15 doctors serving something over 1,600 inmates here, five serving something over 3,000 inmates in Baltimore—— Dr. SHANSKY. Those figures, by the way, are inaccurate. We do not have 15 physicians, and I’m not sure—— Ms. NORTON. How many do you now have? Dr. SHANSKY. We have—— Ms. NORTON. You obviously had it at one point. How many do you have now? Dr. SHANSKY. We have, I believe, nine. Ms. NORTON. Compared to five for more than twice as many in Baltimore, three times as many as these now—— Dr. SHANSKY. Again, you are quoting figures from a report in which the data was demonstrated to be inaccurate. Now, it is very hard to have a discussion—— Ms. NORTON. Give me the accurate data. I’m giving you the data you told me. It was nine. Prince George’s, same size as D.C.——
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Dr. SHANSKY. Again, inaccurate data. Ms. NORTON [continuing]. One M.D. for 78 compared with one for 15 here. What are your figures now? Dr. SHANSKY. When we talked with the officials at these agencies, they told us, first of all, in the Baltimore contract they said the numbers were part of an overall contract and it was very difficult for them to attribute the costs related to the jail part of that contract. Ms. NORTON. I’m just asking you about doctors now. Dr. SHANSKY. I don’t recall the specifics of the doctors, but—— Ms. NORTON. I’m just saying that Prince George’s, which is the same size as we are, the same kind of population, one doctor for 78 inmates compared with one for 15 inmates here, and we’re supposed to say, ‘‘That’s fine. The quality has improved, so don’t ask any more questions.’’ Mr. DAVIS. Let me recognize Mrs. Morella. Mrs. MORELLA. Picking up on our discussion today, I notice another difference probably among many of the correctional institutions in health care is the on-and offsite staffing, and I note in your testimony, Dr. Shansky, you mentioned that the offsite consists of, like, a physician and a nurse at D.C. hospital. Dr. SHANSKY. Yes. Mrs. MORELLA. I’m wondering whether this—and I’m going to get to you in a minute, Mr. Clark, whether this occurs in other hospitals, too. But it was interesting, as I was re-reading your statement, where you indicated that they are there also to make sure that they don’t stay there too long, to control. And I was thinking of the problems that patients have with HMOs, you know, where you’ve got a gatekeeper that says, ‘‘You can only stay 3 days,’’ or whatever it may be. That’s the same kind of thing you’re doing. Would you like to just comment on how effective you think it is having a—— Dr. SHANSKY. That’s a very legitimate concern. We added this, because when I came on board—and all of the Lorton facility, as well as the jail and the Correctional Treatment Facility use D.C. General as its main resource. One of the things that I found was corrections patients admitted to D.C. General were distributed among a variety of house officers, most of whom had their major focus on their non-incarcerated patients, and so the concern wasn’t that people were being sent out too quickly, as might be the case with an HMO, but they were literally forgotten or neglected and allowed to stay way, way too long. We talked to the District. The District felt that it would be a cost-effective investment to make sure that we had one doctor in control of all of the patients admitted to D.C. General from Lorton, from CTF, as well as the jail. There is no question we dramatically reduced the length of stay because our doctor focuses on those patients and gets them out in as timely a manner as possible. Now, when the prisons close down the city may decide, because there are fewer patients in the hospital, maybe it doesn’t want to support that service. But, given the number of admissions from all of the Department of Corrections facilities, it made sense to put a
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doctor in charge of that care, and therefore reduce the length of stay.
This was particularly important because the D.C. General Hospital became a public benefits corporation and began billing the Department of Corrections. Up until that time, which was roughly 1998, there was no transfer of funds, as far as I understood. But when they began doing that we talked with the Department, and the Department said, ‘‘Yes, we don’t want to be paying for unnecessary services, for people who are just laying around after they’ve received maximum hospital benefit.’’ It was on that basis that we instituted this program.
Mrs. MORELLA. Mr. Clark, would you like to comment on whether this is being done any other place and what you think about the efficiency? I mean, it is a pretty convincing case if you are reducing the time and you are watching them.
And then I would like to also ask you about this pharmacy. Have you found that there are other places where—I mean, is it common to have a pharmacy connected with a jail of that size? And then would it be better to—I mean, more cost effective to have a contract with a vendor for that kind of service? I don’t know much about it.
Mr. CLARK. Three issues, I guess, Mrs. Morella. The first one: I generally agree with Dr. Shansky on the advisability of having a physician or—well, principally a physician— whose loyalty or whose concern is primarily directed to the Department of Corrections providing some oversight to those cases at D.C. General or any of the other outside hospitals. On the other hand, I have a significant problem, as I mention in my written testimony, with the way the RFP, the second RFP was restructured to remove the responsibility for outside medical from the vendor so that the incentive, which had been built in and which is common in these contracts everywhere, as far as I can tell—and within the last few days we’ve contacted eight or nine States who contract out all or part of their services, and they all require the vendor who is providing the jail or prison health care to also be responsible for the outside medical care. If you don’t do that, you reduce the incentive or there is a reverse incentive in terms of providing the treatment in-house. And there is almost an incentive on marginal cases to move that case to the local hospital when then it becomes an expense to the Department of Corrections. That was our experience in the Federal system under contract facilities, and we went to total outside contracts, first with a catastrophic limit of $5,000 or $10,000, and then I know more recently they have removed that catastrophic limit. So I have, as I have testified in my written statement, a major concern that it was not in the economic interest of the District to remove that responsibility from the vendor. Your next question was about the pharmacy. It is not uncommon to have in-house pharmacy operations. I think in these contracts that is more of a market question. In other words, you ask to have a certain level of pharmacy services provided, and in some cases it is done more on an operation, in-house operation, sometimes more on a regional kind of a basis.
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Again, the problem that I have with the requirements in this contract are not that it is in-house; it is that they have, in my estimation, much exceeded the numbers of staff who are commonly needed to run a pharmacy in a correctional facility.
I forget your third question, ma’am. Dr. SHANSKY. Could I respond on the—I think it needs edification, the offsite service responsibility. The usual arrangement that I have seen is where you build in some sort of risk sharing, as alluded to by Mr. Clark, with the vendor. We had every intention of doing that, and we intended to negotiate with the selected vendor the conditions of that risk sharing. Some time in the fall of 1999 we were informed by corporation counsel’s office that, if we were to want this contract to be assigned to the District, we could not engage in those kinds of discussions with a vendor at the time of selection, so that we were locked into whatever was in the RFP if we’re going to leave this in, No. 1. No. 2, the vendors came up with per diem rates in their proposals that were, in fact, not as good as the per diem rate that the District had at that time, so we felt this was not in the district’s interest. The other thing is that the vendor’s proposals were very divergent. One vendor was very low on the outpatient side, very high on the inpatient side. Another vendor was very low on the inpatient side, very high on the outpatient side. None of them justified their numbers. We felt the wisest thing to do, particularly since we had a doctor in place and that doctor controls both admissions and discharges, so the risks that Mr. Clark is alluding to are taken care of by our having our person in control of those patients, which isn’t the case with most contracts with correctional facilities, and on that basis we felt the wise thing to do, the thing that was most prudent, was to take the offsite services out in the first year and then, for the second year, the Department of Corrections and the Mayor and the director of Corrections could, if they chose to, negotiate the kind of risk-sharing and offsite responsibilities that they felt were in the District’s best interest. That’s why we made those decisions. Mr. CLARK. I’d like to respond to that. One of the issues here is on this performance-based contracting and whether or not there was an incentive built into the contracting for the bidders to be innovative and creative. In this area, a couple of the bidders bid significantly below the District’s cost, one of them way below. I would call that innovation or creativity. In this case, Dr. Shansky chooses to say that the companies were confused and somehow didn’t understand. Well, these companies bid on these contracts all over the country. They understand. They knew what they were doing. And for some reason—again, I’ve got a chart, I think, that compares the bids on page 16 of my testimony that makes that point. Dr. SHANSKY. Let me respond that the numbers were not justified. There was no basis for the numbers. Mr. DAVIS. Dr. Shansky, let Mr. Clark finish before you interject, OK? Dr. SHANSKY. OK.
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Mr. CLARK. Again, I think this is another example where creativity and innovation were removed or not rewarded, and whether or not the receiver in his role as the procurement official, understood or felt that the background development of how these numbers came to be may have been justified, the company bid, in one case, was $1.3 million, which was about half the District’s estimated cost.
When you bid, if the bid is accepted, then you are going to have to live with that, and to me that’s innovation. It’s not confusion.
Dr. SHANSKY. Let me just indicate we selected the lowest bidder, No. 1. Within the finance category, lowest bid was considered the determining factor, and that was the largest single factor of any of the factors considered.
With regard to the offsite services, had we been able to negotiate with a vendor at the time of selection, we would have stuck with it. When we were told by corporation counsel contract lawyers that we could not do that, we felt it was potentially dangerous for the District to enter into a contract based on numbers that had no justification.
What we didn’t want was a vendor not hospitalizing people in order to meet the bottom line, which was inappropriate, that they had proposed and the District suffer the consequences of that sort of gatekeeping.
Mrs. MORELLA. Dr. Shansky, I just want to say that I think that this hearing has brought together a lot of the issues that have been smoldering, and I hope that what will happen is not only we will continue to be updated as we move along and get out of the receivership but that there will be some compromises worked out so that, you know, I think some of the things we’ve said and that we’ve listened to could be worked out, so I guess in that sense of moving ahead for the correction system and the accountability and all, this has been a great meeting.
I yield back the remainder of my nothing time. Mr. DAVIS. Mrs. Morella, thank you. Let me make a couple of comments, and then I’m going to—I mean, I think we get the gist of what has happened. I think everybody has had their say here and we understand. What concerns me now looking ahead is, is the city ready for prime time? Are they ready to take this over, because I’ve seen very little oversight from the city during this time except that they are eager to take back the control, and, frankly, I’m not sure I am comfortable with that. Mr. Clark, what is your judgment on that? Is the city—can they innovate these—have they shown the oversight initiatives and the like that show they have any understanding of how they can reduce these costs and maintain a level of service that will be acceptable Constitutionally? Mr. CLARK. Well, I know that Director Washington is working to step into the—to have the Department step into the role of oversight of the contract, but what I—and I guess this is partly why I got into the uncomfortable position that—— Mr. DAVIS. Let me just interject, obviously they can spend what they are spending and it will be fine, but that has other ramifications city-wide at this point.
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Mr. CLARK. Absolutely. I mean, this is money that could be spent for schools or police or pot holes.
Mr. DAVIS. Well, you have people that are working two jobs trying to support kids that have no medical care, and the people who are in jail are getting much, much better care, and if that is the city’s priority, but I don’t think it is.
Mr. CLARK. I think what I found when I came in almost 3 years ago was that the city felt impotent in the face of this receivership. This is what—this was the sense that I got from the Department of Corrections director and other officials there, and, frankly, from the corporation counsel. That in the face of this long suit and so on, which had many legitimate aspects, obviously, they didn’t feel that they could stand up to the receiver on these issues, and that’s, frankly, why I, in my independent position, felt that I had to.
Mr. DAVIS. Frankly, I don’t think they could have stood up to him. I don’t think they had the knowledge and I don’t think they had the background or they had the competence to do it, and if you look at what had happened, you know, to this previously when they had it and took a look at what was happening around the rest of the city and the priorities, the city had to develop it. I understand that. I mean, it cost a lot of money to turn this around, probably more than if we had been a little more cost conscious. We could have done this a little cheaper. But we are here where we are today and we have something we are not worried about in terms of meeting the Constitutionality test and the like.
The difficulty now is, from a budgetary point of view, making this transition, and I am, frankly, concerned about the city’s—I’ve asked them for some guidelines and they are going to send union something within 10 days, and the proof of the pudding is in the eating. I hope we see something of a substantive nature.
But that’s our concern. Let me just say that if you think this hearing is tough, you want to go see Mr. Istook and the appropriators. I guarantee you—Ms. Norton is not going to be there. She’s your friend. I think at the end of the day she wants this thing to work out. You just won’t get the money, and then we could be right back to where we were. We want to get this stuff solved here at the authorization level, and the way you do that is you show us a plan, you show us it is not going to be the same program you have today because you are not going to have the money, but we just want to see it. I just don’t get the sense here that we are ready to do that as a city.
Mr. CLARK. No. I think the focus—I mean, I think, unfortunately, you are right. The focus within the Department has been to be ready to take over the oversight of the contract, but I don’t know that there is—that anybody—again, and this feeling of sort of impotence, that anyone has felt that they were in a position to start trying to re-engineer this receivership’s operation.
Mr. DAVIS. Well, just for—— Ms. NORTON. Mr. Chairman, could I just comment on just that point? Mr. DAVIS. Sure. Ms. NORTON. The lost opportunity here, it seems to me, why the committee and the President and the Congress insinuated Mr. Clark into the matter was that there was a management and fi-
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nancial expert, so that you had, on the one hand, a doctor, and the doctor’s job is to deal with patients, you had a receiver, a monitor. She also isn’t in the management business, and we understood that. And we were clear, and I have been clear with Mr. Washington that the way to round this out was to take this expert who had the second-highest position in the BOP and make a synergy and it could all have worked.
What is most disturbing to me, Mr. Chairman, is that somehow or the other an adversarial relationship developed there and his suggestions were considered not to be relevant, and therefore your question as to whether the District prepared to do it is an important one because Mr. Clark’s tenure is running out and I’m not sure who then is to be the expert, except that the city is going to have to hire some experts. Mr. Washington has already said they’re going to have to hire a physician to help them monitor it, whereas I wanted something off the shelf, because we sure paid a lot for what we are getting back here.
Mr. DAVIS. And I don’t want to dwell on what we paid. I think we have been through that. We don’t need to beat a dead horse.
The bottom line is we took an agency here that was in awful shape, terrible shape, and that at least has turned around. Fundamentally, that’s what the task was. That’s what the court wanted to do. I just don’t think we need to go back on all the money that was spent and those kind of issues. I don’t think that serves any purpose except transitioning now. The city has to have a little bit more than just taking it over, and ‘‘we think we can do it.’’ They’ve got to show some vision. They need to show some accountability. That’s what we’re going to be waiting to see, and we’re going to watch it very closely.
Ms. Norton. Ms. NORTON. Well, I just want to be clear that what the chairman said about the appropriation hearing—and I mentioned it before—is a shot across the bow. There is no question that if the Council gets these costs there will be many questions raised, and the time to deal with them is now. Mr. Shansky, what is your current position? Dr. SHANSKY. With regard to the District? Ms. NORTON. No. Your full-time position? Dr. SHANSKY. I consult on correctional health care around the country, both—— Ms. NORTON. What was your professional position before that? Dr. SHANSKY. I was the Medical Director of the Illinois prison system. Ms. NORTON. I asked because I thought that was your position. I certainly regard you as an expert, and I certainly accept the notion that these services have been reformed and meet Constitutional standards. I would hate to think that they hadn’t at this point. Apparently, appropriate services or similar services are being provided in the State of Illinois Correction Department, at only 63 percent of the national average, $4.80, compared to $7.68. I can’t understand why some of that expertise, where in Illinois you are below the national average, wasn’t brought to bear here in the District of Columbia so that we not only got it fixed but got it fixed
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at costs comparable to what apparently you have contributed to in Illinois.
Dr. SHANSKY. The Illinois numbers you are referring to are our prison system. This is a jail. The services designed to be provided at this jail are unique in terms of certain responsibilities. We have brought the budget down and it is now in a position where the Department and the city administration will tailor it in any way it chooses. And the fact is that I had 12 years of opportunity to work with the Illinois Department of Corrections and create the system that I left there.
Ms. NORTON. And you had 5 years here. And if we took mental health services out, for example, we are still left with twice the national average.
The outside experts said, ‘‘Nowhere in the country are we aware of a facility of comparable size that has such a top echelon of staff who are not also significantly involved in direct patient care. With these salaries, with a medical director of $192,857, the Mayor should resign and take this job,’’ on down. And these salaries are very high.
Dr. SHANSKY. Those are not salaries. That’s salary plus fringe. Ms. NORTON. We say salary plus fringe. Dr. SHANSKY. You just said salaries. Ms. NORTON. Well, it says salary plus fringe. Dr. SHANSKY. OK. thank you. Ms. NORTON. The point is that they are compared, however, with facilities of comparable size. I point this out only to say, and certainly to say to Mr. Christian and Mr. Washington, if I’m pointing this out to the receiver, you can bet your bottom—I don’t know if you speak for the Mayor. Do you, Mr. Washington, when you say you are satisfied with this contract? Mr. WASHINGTON. I’m satisfied with the services that have been provided for the D.C. Department of Corrections to remediate a 30year court oversight. Ms. NORTON. Yes. I—— Mr. WASHINGTON. I’m confident that—— Ms. NORTON. This is not about that, sir. We’re not doing an oversight hearing on the services, and we haven’t questioned the quality of the services. The City Council is not going to be asking you about the services. They’re going to be asking you about the cost of the services. I’m asking if you are speaking for the Mayor when you say you are satisfied with the cost of the services, not the quality of the services. No question has been raised about the quality of the services. Mr. WASHINGTON. I’ve never said I was satisfied with the cost of the service. I’m satisfied with the services. I believe very strongly that the costs will continue to go down, and I also feel very strongly that—— Ms. NORTON. Are they automatically going to go down? What are you going to do to bring the cost down? Mr. WASHINGTON. We are going to evaluate all the services that have been provided. We will have staffing positions, and I will provide a plan to this committee to show exactly how the Department
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of Corrections will be prepared to take over this contract and further reduce costs.
Mr. DAVIS. Let me just say in the next 10 days you are going to give us an outline. It doesn’t need to be detailed, but just kind of a path.
Ms. NORTON. That would be very helpful. Mr. DAVIS. I don’t know how you want to do that. Ms. NORTON. That will be very helpful. Mr. DAVIS. And rather than try to sit here and go off the top of your head, we’d rather have you go back and do something that is a little reflective and send it back. Ms. NORTON. My concern, Mr. Chairman, is that these costs will go down. Costs never go down. You’ve got to make costs go down. Costs always go up, Mr. Washington. Making costs go down or maintaining quality is an art, and it is going to take real craftsmanship to do that, given the level of cost here. Mr. Shansky, I note that your own requirement will be that the contractor of these very same services you have designed now go forward and get accreditation. Why did you not get accreditation, since you’ve had them for 5 years? Dr. SHANSKY. First of all, I sit on the board of the National Commission on Correctional Health Care. Ms. NORTON. You can recuse yourself, just as you could have with respect to the procurement. Dr. SHANSKY. Would you like my answer? Ms. NORTON. Don’t tell me it is because you sit on the board. Is there a reason other than a reason that you could have easily been released from why you didn’t ask for accreditation to be—so that you could have handed us back fully accredited services. Dr. SHANSKY. Would you like an answer? Mr. DAVIS. Yes. Give us the reason why you didn’t get it. Dr. SHANSKY. The reason why we didn’t go for accreditation was very simple: the accreditation process, when we talked with the District, was something that the District wanted to do and to take responsibility for. An accreditation of a receiver program has nothing to do with whether the program run by the District is accredited, and we decided jointly with the District to wait for that accreditation process until the District had responsibility, and that’s why it was written into the contract as well as the RFP that by the end of the contract year the vendor would achieve accreditation. Am I confident that we could have achieved accreditation? Unquestionably. I have also been a surveyor for the Joint Commission on Accreditation of Health Care Organizations and have surveyed 20 of the Federal Bureau of Prison facilities. I know how to achieve accreditation. I don’t think it proves much when I achieve accreditation. Ms. NORTON. Well, one thing it might prove is that we really do have a level of services that anybody can have confidence in. I think you should be given the opportunity to reply to the way in which the Board of Contract Appeals regarded the procurement. Apparently the D.C. Contract Appeal Board says, ‘‘There appears to be little question that, in accordance with generally accepted government procurement practice, the initial late proposal of the
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bidder, the person who was successful, was improperly handled. The proper procedure would have been to hold the proposal unopened, apparently because it was late.’’
They also say that you restricted access by other bidders to your current employees, even though they had information that should have been made available to all offerors. That’s from the Appeals Board. They say you gave no basis for your statement that the proposal of your employees was dispatched in time, and they go on to say the record is clear that the proposal was not dispatched at a reasonable time.
‘‘Regardless of the correctness of the decision, the failure of the receiver to make a written finding supported by a record as to his reasons for considering a late proposal gives the appearance of impropriety.’’
I think it is only fair that you be allowed to respond to that. Dr. SHANSKY. Thank you. First of all, I put into the RFP a time deadline to ensure that no vendor would be advantaged by having more time to work on their proposal. When I was informed by my consultant that one proposal was received late, I asked the circumstances. I was told that the vendor had arranged to fly—deliver the proposal to Atlanta, where the proposals were to be received. The vendor’s roughly noon flight was canceled, was delayed, then the next one was canceled. They put the proposal on Delta Dash. The electrical storms in Atlanta then knocked out the computers, so Delta Dash couldn’t find it for 6 hours. To me that seemed like no situation in which any vendor was advantaged. The proposal was finished well in advance for delivery several hours in advance of the deadline. I also felt that it was in the District’s interest to have three proposals considered rather than two. I was advised later on that, according to CAB decisions, any deadline can be extended, even in the event of a late proposal, if it is for the purpose of expanding the scope of competition and especially where the number of proposals is small and where there is no unfair advantage. I felt all of those things obtained. The reality is we ended up, because we had to amend the contract because the offsite service situation was a problem and was not going to be in the District’s interest, we ended up amending the RFP anyway and sending out a new one. All vendors had a completely fair and open process. Look, the reality is one of the vendors, the vendor who protested, in fact, had my CFO working with them, so they had a person who knew more about my finances and salaries than any of the vendors. That’s No. 1. So, in terms of them being disadvantaged, it’s just not true. Second of all, all of the salaries and budgets were available. They’re filed with the court. Anyone had access to them. The third thing is some of the other vendors proposed leadership people that were similar to the or the same as the group who had actually ultimately won the contract. We provided more data with regard to services, types, utilization, costs, etc., than in any RFP I’ve ever seen. This was as open and competitive a process—and remember, the committee that did the evaluation and made the rec-
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ommendation was not created by me. I had no say in who was appointed and I had no contact with that committee during their deliberations. So the recommendation came completely independent of anything that I had to do with it.
Ms. NORTON. At bottom finally let me say I think the fact that the costs found in this contract are out of line with any comparisons that we have been able to come up with or anyone else has been able to come up with and no cost comparisons were made by you, if, in fact, even with the difficulty of making such comparisons, such attempts had been made, I believe that we probably would not be sitting here today, because we have fully accepted the notion that it is very, very difficult to make those comparisons. What we cannot accept is that no attempt should be made; that attempts have to be made by other agencies of the District of Columbia, but not by the Department of Corrections when it comes to the D.C. jail.
I was particularly interested to read in Mr. Clark’s testimony that he had offered to provide examples of RFPs from the BOP— and here I am looking at page 11 of his testimony—awarding a similar medical service contract for its four-prison complex in Beaumont, TX, at a rate of under $6 a day, and the offer was declined. You see, that is what we cannot understand. I don’t know why you, Mr. Shansky, or you, Ms. Schneider——
Dr. SHANSKY. I never received such an offer. Ms. NORTON. Well, it is in his testimony. Dr. SHANSKY. Well, he can testify, but I never—— Ms. NORTON. He said the offer was declined. Dr. SHANSKY [continuing]. Received such an offer. Ms. NORTON. What do you have to say to that, Mr. Clark? At bottom, this is my concern: that nobody looked to see what anybody else was doing, not necessarily that you cost more. Dr. SHANSKY. I have looked at prisons and jails in between 30 and 40 States, between 100 and 200 facilities. There is no one with more experience looking at facilities and issuing RFPs in the country than me. Ms. NORTON. And we haven’t found a single one at the cost you have left the District with. Now, Mr. Clark, you say the offer was declined. What does that mean? Mr. CLARK. This was an offer that I made in the course of meetings during the 6-months that was referred to in the preparation and detailing of the RFP, I think going back to some time in 1998, in meetings with a number of the parties in that process that was mentioned. Ms. NORTON. Clearly what we didn’t have here was the kind of collegial relationship you say you had with the District government. We needed it with you to do that. I really am tough, but I’m tough because it is better for me to be tough than the folks you all are going to meet next year, and because I think that this still can be done. I want to say first, as one whose former life was as a Constitutional lawyer, spent her early years doing nothing but writing briefs to Courts of Appeals and to the Supreme Court on cases not unlike the case before us, that I do not want to be misunderstood
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as to the job you had before you or the lack of respect I have for the District of Columbia for what it took to finally get this thing under control, and that they, themselves, did not get it under control and it took outside experts to do so.
I believe that the District is ready to receive this function back, but I don’t believe it because of anything I’ve heard from Mr. Washington or Mr. Christian here today. I believe it because I know the way the Mayor is right-sizing the rest of the government. I know that in some detail. I have seen what he has required of his department heads. I know that, in taking this back, he will put on the task experts that will, in fact, right-size this while keeping the quality necessary. I say that because there is precedent for his doing it.
At the same time, I must say that I regret that the city will have to spend money on the cost control, and cost efficiency aspects of the medical jail receivership. This should have been part and parcel of what the medical receiver gave us back. I hold not only Dr. Shansky responsible for that. It is hard to hold him entirely responsible because he acted the way that doctors always act. I hold Ms. Schneider responsible for that, since she was to mediate. When she saw that Mr. Clark, an outside expert who didn’t have a dime in this dollar except he was commissioned by us to make sure that this was cost efficient, it was your job as the mediator, a role you have defined for yourself, to bring Mr. Clark sufficiently into this so that there would be cost controls, to help Mr. Washington and Mr. Christian understand that this was not a stick-up, that they had to do whatever Shansky said or else they didn’t get it back, and to do for Dr. Shansky what managers are having to do for doctors all over the country. It is very painful, but unless we do it this way what we will say is that those who already have health care can eat up all the health care dollars and those such as the residents of the District that the Mayor is going to have to get health care for simply get left out in the cold.
Yes, I think you are ready, but I think you are ready largely because of the management structure of the D.C. government, not because of anything I’ve heard here today.
Thank you, Mr. Chairman. Mr. DAVIS. Thank you, Ms. Norton. We have 10 days to hear from you, Mr. Washington and Mr. Christian. Anyone want to add anything? I don’t want anybody to feel they didn’t get the last word, if they wanted to make a comment. [No response.] Mr. DAVIS. I’m going to enter into the record a briefing, a memo distributed to the subcommittee members. We’ll hold the record open for 2 weeks from this date, for those who might want to forward any other submissions for possible inclusion. I want to again thank all the witnesses for taking the time to come today and for your dedication to this. These proceedings are closed. [Whereupon, at 12:27 p.m., the subcommittee was adjourned.] [Additional information submitted for the hearing record follows:]
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 158 F.3d 1357 (1998)
INMATES OF D.C. JAIL, Appellees, v.
Delbert C. JACKSON, Appellant.
Nos. 97-7234 to 97-7236.
United States Court of Appeals, District of Columbia Circuit.
Argued September 28, 1998. Decided October 30, 1998.
1358 *1358 Lutz Alexander Prager, Assistant Deputy Corporation Counsel, argued the cause for appellant. With him on the briefs were John M. Ferren, Corporation Counsel, and Charles L. Reischel, Deputy Corporation Counsel.
Kimberly A. Jackson argued the cause for appellees. With her on the brief were J. Patrick Hickey and Jonathan Smith.
Before: EDWARDS, Chief Judge, WALD and SENTELLE, Circuit Judges.
Opinion for the court filed by Circuit Judge SENTELLE.
Dissenting opinion filed by Circuit Judge WALD.
SENTELLE, Circuit Judge:
In this suit brought on behalf of the inmates of the D.C. jail, the District of Columbia appeals the district court's award of attorney's fees at market rates for work performed after the passage of the Prison Litigation Reform Act ("PLRA"), Title VIII of the Omnibus Consolidated Rescissions and Appropriations Act of 1996, Pub.L. No. 104-134, 110 Stat. 1321 (1996), codified at 18 U.S.C. § 3626 and 42 U.S.C. § 1997e. We hold that the attorney's fees limitations in the PLRA apply to all work performed after the effective date of the Act, and reverse the district court for the reasons stated below.
I. Background
The Prison Litigation Reform Act was designed, inter alia, to stop frivolous prisoner lawsuits by placing some of the financial burden for litigation on parties and increasing financial and other burdens on prisoners found to have filed meritless cases. The Act also requires attorneys seeking fee awards to show that the hours they expend in successful suits are directly related to the problems they are trying to solve. Another provision, at issue here, places a statutory cap on the hourly fees that may be awarded to the attorneys who litigate prisoner lawsuits, even in cases which ultimately prove to have merit. Section 803(d) of the PLRA provides in relevant part:
(d) Attorney's fees
(1) In any action brought by a prisoner who is confined to any jail, prison, or other correctional facility, in which attorney's fees are authorized under section 1988 [Section 2 of the Revised Statutes of the United States (42 U.S.C. 1988)]....
...
(3) No award of attorney's fees ... shall be based on an hourly rate greater than 150 percent of the hourly rate established under section 3006A of Title 18, for payment of court-appointed counsel.
42 U.S.C. § 1997e(d). This appeal requires us to determine whether the cap on attorney's fees contained in the PLRA should be applied to work performed in these consolidated cases after the Act became effective, when the original fee award was determined a decade before.

The actions in this consolidated appeal, originally filed in 1971, challenged as unconstitutional the conditions at the D.C. jail. The plaintiffs in the two cases, Campbell v. McGruder and Inmates of the D.C. Jail v. Jackson, challenged the same conditions at the jails and requested the same relief. (The Campbell class comprised pretrial detainees, while the Inmates class comprised convicted prisoners.) In 1975, the district court found that the conditions did indeed violate the Constitution because of severe overcrowding, inadequate health care, unsanitary conditions, and unsafe facilities. The district court issued an injunction ordering the District of Columbia to improve the conditions for inmates. Since the original injunction issued, the district court has found a pattern of continuing violations and has repeatedly issued orders attempting to bring conditions at the D.C. jail into compliance with constitutional minimums. The D.C. jail has been so recalcitrant in complying with court1359 ordered *1359 reforms that the judge whose injunction the plaintiffs' attorneys are monitoring has said that the jail's lack of compliance borders on bad faith. Appellees' Brief at 5 (citing Transcript, Nov. 1, 1994 Hearing, Inmates of the D.C. Jail v. Jackson (No.75-1668) at 19-20 (statement of Judge Bryant)). After years of attempting to get D.C. to voluntarily comply, and appointing a Special Master to coordinate with D.C. in an attempt to alleviate conditions, the district court ordered that the jail's medical and mental health services be placed in receivership in 1995. Now, in addition to the attorneys for the plaintiffs, a court-appointed Special Master monitors compliance with existing orders, and the D.C. jail's medical and mental health services remain under the control of a receiver. This appeal involves the award of attorney's fees to plaintiffs' counsel for hours spent monitoring the D.C. jail, attempting to ensure that after twenty-seven years, the District of Columbia ends its continuing violations of the prisoners' civil rights.
II. Attorney's fees
The award of attorney's fees in this case comes against a complicated statutory backdrop. When the action was originally filed, the Campbell plaintiffs included a Section 1983 claim, but dropped it in light of District of Columbia v. Carter, 409 U.S. 418, 93 S.Ct. 602, 34 L.Ed.2d 613 (1973), which held that Section 1983 did not apply to the District of Columbia. The Inmates case was filed after the decision in Carter, and did not contain a Section 1983 claim. The attorneys litigated the case pro bono for a decade. It was not until Congress amended Section 1983 in 1979 to cover the District of Columbia (see Pub.L. No. 96-170, § 1, 93 Stat. 1284 (1979)) that the attorneys in this case became eligible for fees. Attorney's fees in civil rights actions had been made available by amendment in 1976. The relevant portion of the Civil Rights Attorney's Fees Award Act, Pub.L. No. 94-559, 62, 90 Stat. 2641 (1976) (codified at 42 U.S.C. § 1988(b)), provides that "[i]n any action or proceeding to enforce a provision of [section 1983] the court, in its discretion, may allow the prevailing party, other than the United States, a reasonable attorney's fee as part of the costs." The Supreme Court held that section 1988 applied retroactively to all civil rights cases pending at the time of its enactment. Hutto v. Finney, 437 U.S. 678, 694 n. 23, 98 S.Ct. 2565, 57 L.Ed.2d 522 (1978). In 1985, the plaintiffs in Campbell and Inmates moved to amend their complaints to include Section 1983 claims, and filed for attorney's fees under Section 1988.
In February, 1988, the district court awarded the plaintiffs "reasonable" attorney's fees and set the award at market rates. Multiple payments were made from the District to the plaintiffs' attorneys under that order. This appeal arises because the attorneys now seek a fee award for work performed after the passage of the PLRA. In 1997, the district court awarded attorney's fees for compliance-monitoring work done in 1996 and 1997 at market rates, pursuant to its 1988 order. The district court considered the existence of the PLRA in its order, but found it inapplicable. The district court reasoned that the plaintiffs' attorneys' right to fees vested in 1988 when its first fee award order was issued. In making its determination, the district court applied the test for retroactive application of statutes laid out by the Supreme Court in Landgraf v. USI Film Products, 511 U.S. 244, 280, 114 S.Ct. 1483, 128 L.Ed.2d 229 (1994):
When a case implicates a federal statute enacted after the events in suit, the court's first task is to determine whether Congress has expressly prescribed the statute's proper reach. If Congress has done so, of course, there is no need to resort to judicial default rules. When, however, the statute contains no such express command, the court must determine whether the new statute would have a retroactive effect, i.e., whether it would impair rights a party possessed when he acted, increase a party's liability for past conduct, or impose new duties with respect to transactions

already completed. If the statute would operate retroactively, our traditional presumption teaches that it does not govern absent clear congressional intent favoring such a result.
The district court determined that "[a]pplying the PLRA to Plaintiffs' motion for attorneys' fees would contravene 1360 the plain language *1360 of the statute as well as its legislative history and would result in manifest injustice to
the plaintiffs." Campbell v. McGruder, No. 71-1462, slip op. at 2-3 (D.D.C. filed Oct. 29, 1997) (mem.). The phrase "any action brought by a prisoner" in Section 802 means any action filed after the effective date of the Act, the district court reasoned. The court concluded in particular that applying the PLRA limitations retroactively to these cases, which have been litigated by the same groups of attorneys since 1971, would be "manifestly unjust." Id. at 6. The District appeals the fee award.
III. Retroactivity and the PLRA
The inmates urge us to adopt the district court's reasoning that the words "any action brought by a prisoner" mean any action brought after the enactment of the PLRA. That position was adopted by the Sixth Circuit in Hadix v. Johnson, 143 F.3d 246 (6th Cir.1998), and was cited with approval by the district court in its memorandum opinion. They point to the juxtaposition of Sections 802 and 803 of the PLRA, and argue that the explicit application of Section 802 to pending actions shows that when Congress intended a section of the Act to apply retroactively, it did so expressly. See Jensen v. Clarke, 94 F.3d 1191, 1203 (8th Cir.1996) (contrasting congressional treatment of Section 802 and 803 and finding no intent to create retroactive application of Section 803). They argue that taken together, the plain language, the negative inference to be drawn from the absence of retroactivity provisions, and the legislative history all show that the plain meaning of the statute is that it should apply only to actions arising after the passage of the Act.
At the very least, they argue, should the court find that there is some ambiguity, applying the three-part test of Landgraf and Lindh v. Murphy, 521 U.S. 320, 117 S.Ct. 2059, 138 L.Ed.2d 481 (1997), requires the court to find in their favor because to do otherwise would result in manifest injustice. The inmates cite Watson v. Secretary of Health, Education and Welfare, for the proposition that applying a statute that decreases, rather than increases, attorney's fees to work performed in pending litigation after the passage of the statute is impermissible. 562 F.2d 386 (6th Cir.1977) (interpreting potentially retroactive fee-capping regulation in black lung cases).
We are unpersuaded. We do not find in the statute the plain meaning urged by the prisoners. There is simply nothing in the phrase "any action" that implies, let alone compels, a holding that the statute applies only to actions brought after the passage of the Act. Nor does the language compel resort to legislative history in an attempt to clarify its meaning. We are also not convinced that there is a negative inference to be drawn from a comparison of Sections 802 and 803 of the PLRA. Section 802 of the PLRA amends an entirely different statutory section, 18 U.S.C. § 3626. It is unsurprising that Congress would use differing language to amend different statutory provisions, and the absence of the Section 803 language simply will not bear the burden urged by the inmates. If this case involved a genuine question of retroactivity, that is, if the District were seeking to apply the cap to hours worked before the effective date of the statute, we might find the omission more compelling. But the District advances no such argument, and we join the Eighth Circuit in holding that retroactivity concerns are not implicated when the statute is applied to work performed after April 26, 1996, the date of passage of the PLRA. See Williams v. Brimeyer, 122 F.3d 1093, 1094 (8th Cir.1997).
When it is applied to work performed after the effective date of the Act, the PLRA raises none of the retroactivity concerns that require the analysis used by the district court because the statute creates present and future effects on present and future conduct, and has no effect on past conduct. Compare Jensen, 94 F.3d at 1203 (holding that the PLRA did not apply to pre-Act work) with Williams, 122 F.3d at 1094 (holding that as applied to work performed after the passage of the Act, there is no retroactivity). The fees at issue were earned after the PLRA passed. The PLRA does not in this case upset vested interests because no right to a fee existed until the 1361 work was done. Because we find no retroactive effect, we need *1361 not consider the Supreme Court's extensive analysis of when to permit retroactive application. See Landgraf, 511 U.S. at 244, 114 S.Ct. 1483; Lindh v. Murphy, 521 U.S. 320, 117 S.Ct. 2059, 138 L.Ed.2d 481 (1997). As the Supreme Court stated in Landgraf, normally "`a court is to apply the law in effect at the time it renders its decision.'" 511 U.S. at 264, 114

S.Ct. 1483 (quoting Bradley v. School Bd. of Richmond, 416 U.S. 696, 711, 94 S.Ct. 2006, 40 L.Ed.2d 476 (1974) ).
In Landgraf, the Supreme Court noted that it has adopted a functional definition of retroactivity. See id. at 268-69 & n. 23, 114 S.Ct. 1483. In Miller v. Florida, it stated that "[a] law is retrospective if it `changes the legal consequences of acts completed before its effective date.'" 482 U.S. 423, 430, 107 S.Ct. 2446, 96 L.Ed.2d 351 (1987) (quoting Weaver v. Graham, 450 U.S. 24, 31, 101 S.Ct. 960, 67 L.Ed.2d 17 (1981)). To determine if a statute has retroactive effect, the court must decide "whether it would impair rights a party possessed when he acted, increase a party's liability for past conduct, or impose new duties with respect to transactions already completed." Landgraf, 511 U.S. at 280, 114 S.Ct. 1483. In determining whether the statute has retroactive effect, the court should consider "fair notice, reasonable reliance, and settled expectations." Id. at 270, 114 S.Ct. 1483. In this case, the work at issue was not done until after the passage of the Act. The attorneys did not possess a right to payment until they performed the work for which the fees were awarded, and thus had no settled expectations. Simply put, as applied in this case, the PLRA does not impair rights or upset expectations that did not exist prior to its passage, and could not exist after its passage. Because we hold only that the fee limitations apply to work performed after the passage of the Act, there is no need to continue the retroactivity analysis.
We stress now the limits of our holding. We do not subscribe to the Fourth Circuit's position that the Act applies to fees awarded after the passage of the Act, regardless of whether the work was performed before the statute was enacted. See Alexander S. v. Boyd, 113 F.3d 1373, 1386 (4th Cir.1997). We find persuasive those cases that have held that the PLRA would have retroactive effect if applied to work performed before the Act was passed. See Glover v. Johnson, 138 F.3d 229, 250 (6th Cir.1998) ("[A]pplication of the attorney-fee provisions to a fee motion that was pending at the time of the PLRA's passage and that pertained solely to work performed before the statute's passage would undeniably work an impermissible retroactive effect."); Blissett v. Casey 147 F.3d 218, 220-21 (2nd Cir.1998); Cooper v. Casey, 97 F.3d 914, 921 (7th Cir.1996); Jensen 94 F.3d at 1203. Even the District conceded before this court that under Landgraf, applying the PLRA to work performed before April 26, 1996 would upset settled expectations and result in manifest injustice. See Landgraf, 511 U.S. at 277, 114 S.Ct. 1483.
IV. Conclusion
We hold that applying the fee-capping provisions of Section 803 of the PLRA to work performed after April 26, 1996, does not implicate retroactivity concerns. The Act creates present and future effects on conduct performed after the passage of the Act. Section 803 caps attorney's fees earned after the effective date of the Act at 150% of the hourly rate established by 18 U.S.C. § 3006A, and that fee cap applies to the work performed by the attorneys for Inmates and Campbell which is at issue in this case. We vacate the order of the district court and remand for proceedings in accordance with this opinion.
WALD, Circuit Judge, dissenting:
I disagree with the panel that under Landgraf and Lindh because "the work at issue was not done until after passage" of section 803(d) of the Prison Litigation Reform Act ("PLRA"), 42 U.S.C. § 1997e(d), "[t]he attorneys did not possess a right to payment ... and thus had no settled expectations [of payment]," Majority Opinion ("Maj. Op.") at 1361. In the panel's view, the mere fact that the services in question had been performed after the fee cap went into effect meant that the lawyers would not be retroactively hurt even though these services were 1362 performed on a case initially undertaken long before the *1362 Act. While I agree with the majority that the statutory language is not "plain" as to whether Congress meant to apply section 1997e(d) to pending actions and that the legislative history is ambiguous as well, I do not believe under Landgraf's mandate the panel is entitled to ignore the presumption against retroactive application of a law when "manifest injustice" will result and adopt, as it did, an a priori reasoning that imposing the fee cap on any work performed after the Act's passage does not constitute a retroactive application.[1]

The Supreme Court in Landgraf v. USI Film Products, 511 U.S. 244, 114 S.Ct. 1483, 128 L.Ed.2d 229 (1994), cautioned against drawing cursory conclusions about retroactivity based solely on when the conduct immediately affected by the law in question occurred. As to conduct preceding the passage of the law, the Court admonished:
A statute does not operate "retrospectively" merely because it is applied in a case arising from conduct antedating the statute's enactment ... or upsets expectations based in prior law. Rather, the court must ask whether the new provision attaches new legal consequences to events completed before its enactment. The conclusions that a particular rule operates "retroactively" comes at the end of a process of judgment concerning the nature and extent of the change in the law and the degree of connection between the operation of the new rule and a relevant past event.
Id. at 269-70, 114 S.Ct. 1483 (citations omitted) (footnotes omitted), quoted in LaFontant v. Immigration & Naturalization Service, 135 F.3d 158, 161 (D.C.Cir.1998). This caution surely applies as well to conduct occurring temporally after the law is in effect but which is an inextricable part of a course of conduct initiated prior to the law. Acknowledgedly, whether section 1997e(d) "attaches new legal consequences to events completed before its enactment" depends in large part on the answer to the basic question of whether attorney's fee statutes regulate conduct that is merely secondary or ancillary to the parties' conduct, or whether such laws have real impact on the legal rights the parties. See Landgraf, 511 U.S. at 275 & n. 29, 114 S.Ct. 1483. This has been said to present a "close[] question." Id. at 289, 114 S.Ct. 1483 (Scalia, J., concurring). But I believe that the feeshifting provision under which this case has been litigated, 42 U.S.C. § 1988 0907 which is designed to facilitate the litigation of worthy civil rights violations0907gives rise to a strong argument that the triggering event for retroactivity purposes is when the lawyer undertakes to litigate the civil rights action on behalf of the client. Thus a subsequent radical change in the law as to the lawyer's eligibility, if successful, to collect fees computed in a particular manner for his services does indeed constitute "new legal consequences to events completed before ... enactment."
An important characteristic of the Court's retroactivity analysis is that it is capacious and flexible enough to account for the circumstances of each particular case. See Lindh v. Murphy, 521 U.S. 320, 117 S.Ct. 2059, 2063, 138 L.Ed.2d 481 (1997) ("In sum, if the application of a term would be retroactive as to Lindh, the term will not be applied, even if, in the absence of a retroactive effect, we might find the term applicable...."); United States v. Ortiz, 136 F.3d 161, 166 (D.C.Cir.1998) (circuits addressing potential retroactivity of AEDPA's amendments to section 2255 "share in their approaches [ ] the requirement that the new enactment be retroactive as applied to the particular claim before the court"). Equity and fairness are also to be considered in the analysis. The Court in 1363 Bradley v. School Board of Richmond, *1363 416 U.S. 696, 94 S.Ct. 2006, 40 L.Ed.2d 476 (1974), applied a new fee-shifting provision of the Education Amendments of 1972 to a pending school desegregation case based largely on these principles. The district court in Bradley had already exercised its equitable authority to award attorney's fees to the plaintiffs in that case, and "as [the Court's] opinion in Bradley made clear, it would be difficult to imagine a stronger equitable case for an attorney's fee award than a lawsuit in which the plaintiff parents would otherwise have to bear the costs of desegregating their children's public schools." Landgraf, 511 U.S. at 277, 114 S.Ct. 1483.
The plaintiffs make a strong case here that application of section 1997e(d) to work performed after April 24, 1996, is impermissibly retroactive. Section 1988 is a keystone in the enforcement scheme of our civil rights laws. Section 1988 "was no doubt intended to encourage litigation protecting civil rights." Kay v. Ehrler, 499 U.S. 432, 436, 111 S.Ct. 1435, 113 L.Ed.2d 486 (1991). As stated in the Senate Report accompanying passage of section 1988, "All of these civil rights laws depend heavily on private enforcement, and fee awards have proved an essential remedy if private citizens are to have a meaningful opportunity to vindicate the important Congressional policies which these laws contain." S.REP. No. 94-1011, at 2 (1976), reprinted in 1976 U.S.C.C.A.N. 5908, 5910. This surely calls for a closer examination of the effects wrought by section 1997e(d) on the prisoners' legal rights than the majority has undertaken. See also Hensley v. Eckerhart, 461 U.S. 424, 444, 103 S.Ct. 1933, 76 L.Ed.2d 40 (1989) (Brennan, J., concurring in part and dissenting in part) ("In enacting section 1988, Congress rejected the traditional assumption that private choices whether to litigate, compromise, or forgo a potential claim will yield a socially desirable level of enforcement as far as the enumerated civil rights statutes are concerned."); Copeland

v. Marshall, 641 F.2d 880, 895 (D.C.Cir.1980) (parallel fee provision in Title VII must be interpreted broadly because "the prospect of liability for an attorney's fee may help deter discrimination") (footnote omitted); Ortiz v. Regan, 980 F.2d 138, 140 (2d Cir.1992) (section 1988 "was designed to allow private individuals a meaningful opportunity to vindicate civil rights violations"); Seattle School Dist. No. 1 v. State of Washington, 633 F.2d 1338, 1348 (9th Cir.1980) ("The congressional purpose in providing attorney's fees in civil rights cases was to eliminate financial barriers to the vindication of constitutional rights and to stimulate voluntary compliance with the law.").
The two prisoners' cases before us now have been in litigation for a combined total of 50 years. The prisoners' lawyers became eligible for attorneys' fees when section 1988 was made applicable to the District of Columbia in 1979, and they have consistently received fee awards at market rates for work performed from 1983 onward. Much of this work has grown out of the lawyers' dogged efforts to monitor the District's compliance with a series of stipulated orders that the parties undertook beginning in 1984. The Rules of Professional Conduct, see D.C. RULES OF PROF. CONDUCT 1.16(b), preclude lawyers from withdrawing from a case in midstream except under extraordinary circumstances. It follows that once section 1988 was passed, a rational plaintiffs' lawyer anticipating a long and time-intensive case involving lengthy monitoring and compliance negotiations would have had to have expectations that if he prevailed for his clients he would be paid on the reasonable basis set out in that statute. Ethical high-grade representation of a class of civil rights plaintiffs, especially prisoners, does not consist of a series of discrete legal services that can be stopped and started again at any time, but rather a continuous responsibility to see the litigation through to its natural conclusion. In that very real sense, the PLRA has changed the rules of the game midstream and unsettled settled expectations of both lawyers and clients. Thus I agree with the learned district judge that in the absence of a clear congressional intent, the cap should not be applied to post-PLRA work undertaken to complete a legal obligation entered into prior to the law. In sum, 1364 application of the PLRA's limitations on attorneys' fees to legal services performed after the PLRA's enactment *1364 on a case undertaken prior to the Act does attach retroactively "new legal consequences to events completed before its enactment" 0907 both for the parties and the lawyers. I therefore respectfully dissent.
[1] My own reading of section 1997e(d), like the district court's, would confine it to cases brought after the passage of the Act. I note section 1997e(a) (dealing with exhaustion) speaks of an action which "shall be brought" and although the section most relevant here, 1997e(d)(1), uses "any action brought," I think it strained to conclude that (d)(1) is meant to apply to pending cases while (a) clearly is not. Section 1997e(d)(3) speaks of an award "in an action described in paragraph (1)," a limiting clause that would seem unnecessary if any post-Act award in a prisoner case were to be covered by the cap. In any case, I agree basically with Hadix v. Johnson, 143 F.3d 246 (6th Cir.1998), construing this section not to apply to cases already ongoing in the courts.
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 416 F.Supp. 119 (1976)
INMATES, D. C. JAIL, et al., Plaintiffs, v.
Delbert C. JACKSON et al., Defendants.
Civ. A. No. 75-1668.
United States District Court, District of Columbia.
May 24, 1976.
Nancy Crisman, National Prison Project, Washington, D. C., for plaintiffs.
Thomas R. Nedrich, Asst. Corp. Counsel, Washington, D. C., for defendants.
MEMORANDUM AND ORDER
BRYANT, District Judge.
120 This matter is now before the Court on plaintiffs' Motion For Partial Summary *120 Judgment and defendants' opposition thereto. In this class action suit, plaintiffs, who comprise a class consisting of all post-trial detainees at the D. C. Jail, seek to have the Court declare unconstitutional various conditions at the Jail and order defendants to remedy the deficiencies found.
This case is substantially identical to Campbell v. McGruder, 416 F.Supp. 100, CA No. 1462-71, decided by this Court November 5, 1975. The plaintiffs here challenge the same conditions and request the same relief. The sole material difference is the class itself: the plaintiff class consists of all those inmates not members of the plaintiff class in Campbell. Plaintiffs therefore ask for summary judgment as to all those issues which have been resolved in Campbell, invoking the doctrines of collateral estoppel and judicial notice.
The Court finds both doctrines applicable to the present situation. Collateral estoppel requires that the facts sought to be foreclosed from relitigation be the same as in the previous case. Hurley v. Beech Aircraft, 355 F.2d 517 (7th Cir., 1966). Those facts and issues must have been fully litigated in the prior action, so that the party against whom the estoppel is sought has had an adequate opportunity to contest the disputed facts. Hurley v. Beech Aircraft, supra. The facts subject to the estoppel must have been judicially determined, and must have been material to and in support of the holding. Hurley v. Beech Aircraft, supra. Finally, the party against whom the estoppel is sought must be the same party or in privity with the party against whom the original determination was rendered. Blonder-Tongue Laboratories, Inc. v. University Foundation, 402 U.S. 313, 91 S.Ct. 1434, 28 L.Ed.2d 788 (1971).
All of these tests are met here. There could hardly be a case more appropriate for application of collateral estoppel than this one, where all the issues have been fully litigated and resolved. The defendants have had every opportunity to contest the facts involved, and those facts can no longer be open to any dispute. Even in the absence of the requisite elements of collateral estoppel, the Court could judicially notice the record in Campbell to arrive at the same result. See, e. g., Shuttlesworth v. Birmingham, 394 U.S. 147, 89 S.Ct. 935, 22 L.Ed.2d 162 (1969); Dixon v. Jacobs, 138 U.S.App.D.C. 319, 427 F.2d 589 (1970).
The defendants' opposition to plaintiffs' motion raises no arguments which were not raised and decided in Campbell. The only legal distinction to be drawn between these two cases is that the plaintiff class in Campbell consists of persons not yet convicted of the crimes with which they are charged, while in the present case all class members have been convicted of such crimes. Whatever the force of that distinction in borderline circumstances, the reality of conditions at the D. C. Jail is so bad as to compel the Court to hold that they constitute cruel and unusual punishment for any human beings incarcerated there. In so holding, the Court is cognizant of the expanding meaning of the Eighth Amendment, which evolves from ". . . standards of decency

that mark the progress of a maturing society". Trop v. Dulles, 356 U.S. 86, 101, 78 S.Ct. 590, 598, 2 L.Ed.2d 630 (1950).
The current meaning of the Eighth Amendment is apparent in such cases as Holt v. Sarver, 309 F.Supp. 362 (1970) affirmed 442 F.2d 304 (1971); Jones v. Wittenburg, 323 F.Supp. 93 (1971), aff'd sub nom. Jones v. Metzger, 456 F.2d 854; James v. Wallace, 382 F.Supp. 1177 (1974); Costello v. Wainwright, 397 F.Supp. 20 (1975); Pugh v. Locke, 406 F.Supp. 318 (U. S. District Court M.D.Alabama N.D., 1976).
Holt consisted of eight class actions brought on behalf of inmates in the Arkansas prison system. Plaintiffs argued among other things that confinement under the conditions and practices of that system amounted to cruel and unusual punishment. The Court found that the conditions were indeed such that confinement of persons in the system amounted to cruel and unusual punishment. The significance of Holt lies in the Court's recognition that 121 conditions of *121 confinement themselves under certain circumstances can amount to cruel and unusual punishment. The Court found
". . . the concept of `cruel and unusual punishment' is not limited to instances in which a particular inmate is subjected to a punishment directed at him as an individual. In the Court's estimation confinement itself within a given institution may amount to a cruel and unusual punishment prohibited by the Constitution where the confinement is characterized by conditions and practices so bad as to be shocking to the conscience of reasonably civilized people even though a particular inmate may never personally be subject to any disciplinary action." Holt at 372-373.
While the Court believes that the conditions and practices at the District of Columbia Jail on their face are "so bad as to be shocking to the conscience of reasonably civilized people", Holt, supra, it finds further support for this position in the analogous cases of Jones, James, Costello, and Pugh. Each deals with the abridgment of constitutional rights of sentenced prisoners. Each deals with one or more of the factual issues before the Court in the instant case. Jones and Pugh (which was consolidated with James) are of particular significance in that the facts leading the Court in one to find cruel and unusual punishment are very similar to the facts of the other and of those in Campbell v. McGruder, supra, and therefore facts in the instant case.
Jones was a class action brought on behalf of all prisoners in the Lucas County (Ohio) Jail. The class included both sentenced inmates and pretrial detainees. Pugh was a consolidated class action brought on behalf of all inmates incarcerated in Alabama state penal institutions and subjected to conditions in violation of their Eighth and Fourteenth Amendment rights. Similarly, in the present case the Court has been asked to provide relief to all non-pretrial detainees at the District of Columbia Jail.
The Courts in both Jones and Pugh held that the conditions in the respective prisons or prison systems constituted cruel and unusual punishment. Both decisions base their determinations of law on findings of fact similar to those found by this Court in Campbell v. McGruder, 416 F.Supp. 100 (CA 1462-71) and judicially noted as the basis of this decision. These are overcrowded, unsafe and unsanitary conditions, lack of proper care for inmates with psychiatric problems, lack of recreation and overly restrictive visitation rights.
In Campbell this Court noted that overcrowding was the most flagrant and shocking encroachment on the constitutional rights of pretrial detainees at the D. C. Jail. The Jones and Pugh Courts similarly emphasized overcrowding. The Lucas County Jail in Jones was built in the last decade of the 19th century and was about 76 years old at the time of the decision. The Jail was designed to hold 150 prisoners, has held up to 272 and at the time of the opinion was holding 200. Inmates in the Lucas County Jail were held in two-man cells each 6 × 9 feet in floor area. The cells are equipped with two bunks, a toilet and sink with running cold water. The Alabama District Court was equally concerned with overcrowding in Pugh when it cited population statistics for the four principal institutions in the State prison system, showing actual capacity running one-third or more over maximum capacity.[1] Overcrowding in the D. C. Jail is equally bad, as the Campbell litigation has demonstrated. Indeed, the cells in the D. C. Jail are even smaller than those outlined in Jones (6' × 7' 10", compared to 6' × 9') and often house two men.
All three Courts have noted the unsafe and unsanitary conditions existing at each prison facility. In Jones the Court noted that when a prisoner enters the Lucas County Jail he is given a towel which is replaced once a week.

He is also given a blanket which may or may not have been washed before it was issued, and usually but not 122 always a mattress consisting of a *122 small piece of foam rubber. The Court in Pugh also notes the issuance of
old and filthy mattresses leading to the spread of contagious diseases and body lice. Similarly, inmates at the D. C. Jail are frequently issued old mattresses, not cleaned or sterilized and stained with urine and other excreta.
The Jones Court listed other health and safety hazards including a dishwasher unable to meet health standards, food storage not in accordance with health regulations, improper ventilation in the kitchen, and a kitchen crossed by leaking water and sewage pipes. The Pugh Court paints a similar picture of conditions in the Alabama system, i. e., broken windows, inadequate heating or ventilation, exposed wires, poor lighting, broken plumbing, roaches and other vermin, unsanitary food service conditions. In Campbell this Court noted the equally base conditions in the D. C. Jail. The Court pointed to the myriad violations of the District of Columbia Building Code, Housing Regulations, Health Regulations, Food Regulations and Fire Code. The Court also noted that there were rats, mice and roaches in abundance at the Jail.[2]
All three Courts found constitutionally inadequate health care in their respective institutions. In Jones the Court found the health facilities in general to be primitive. In Pugh the Court pointed out that 10% of its inmates were considered psychotic, while another 60% were disturbed enough to need treatment. The Court in Campbell found that the D. C. Jail was similarly unequipped to treat patients with psychiatric problems. In addition to the lack of treatment noted in the other cases, the Court found frequent use of ordinary handcuffs and leg irons to shackle some severely disturbed inmates to their beds.
Parallel findings also exist as to the lack of adequate recreation for the incarcerated. In Jones there were no recreation facilities, while the Court in Pugh found them inadequate. The Court in Campbell emphasized the lack of adequate recreation both in time and space. It pointed out that prisoners on deadlock receive no outdoor recreation time and only one-half hour daily of "tier" recreation.
Finally, both the Jones and Pugh Courts found that certain limitations on visiting privileges also constituted cruel and unusual punishment. In Jones the Court found that prisoners were only permitted visits on Saturday afternoons from 1 to 4 p. m. Visits had to be conducted through heavy screening. The Court in Pugh found that the irrational classification system in Alabama institutions prevented visitation for certain inmates. This Court in Campbell similarly found lacking any rational classification system at the D. C. Jail for allowing contact visits for inmates there.
Other cases also deal with individual issues in the instant one. See, e.g., Costello v. Wainwright, supra, where the Court issued a preliminary injunction to reduce inmate population in the Florida Corrections system after finding that overcrowding and the resulting deprivations in medical and psychiatric care amounted to unconstitutional cruel and unusual punishment. The Court has also been guided by cases specifically noting the rights of prisoners to adequate medical and psychiatric care. See Negron v. Preiser, 382 F.Supp. 535 (1974), Battle v. Anderson, 376 F.Supp. 402 (1974); Finney v. Arkansas Board of Correction, 505 F.2d 194 (1974).
The Court is also persuaded that the conditions and practices in the D. C. Jail are not rational means of advancing a valid state interest, and that the reality of conditions at the Jail subvert the legitimate purposes of incarceration. See Procunier v. Martinez, 416 U.S. 396, 94 S.Ct. 1800, 40 L.Ed.2d 224 (1974); Pell v. Procunier, 417 U.S. 817, 94 S.Ct. 2800, 41 L.Ed.2d 495 (1974).
It is apparent, therefore, that the conditions in which inmates are housed at the D. C. Jail constitute cruel and 123 unusual punishment *123 in the sense currently contemplated in American society. These conditions simply are
not to be tolerated in a civilized society, much less in our national capital. These are conditions which turn men into animals, conditions which degrade and dehumanize. In some senses the punishment they inflict is more painful and enduring than the stocks or the rack, long since discarded as barbaric or primitive. Imprisonment in conditions such as these absolutely guarantees that the inmates will never be able to return to civilized society, will never feel any stake in playing by its rules. For imprisonment under such conditions, where a man may be stuffed into a tiny cell with another, surrounded by the nocturnal moans or screams of mentally disturbed but untreated fellow inmates, plagued by rats and roaches, sweltering by summer and shivering by winter, unable to maintain significant contact with his family in the outside world, sometimes going for long periods without real exercise or recreation, can only have one message for him: society does not acknowledge your existence as a

fellow human being. And when that message is delivered in the D. C. Jail, whatever small chance may have existed that a person might act as though he were a member of a civilized society is obliterated, along with his decency and humanity.[3]
124 *124 Accordingly, it is by the Court this 24th day of May, 1976,
ORDERED:
1) That plaintiffs' motion for partial summary judgment be, and hereby is, granted; and
2) That defendant shall forthwith initiate action to correct all remaining violations reported to the Court in response to the Court's order of November 5, 1975 in Campbell v. McGruder, insofar as those violations relate to cell blocks 3 and 4, the dormitories, the food service area, and any other areas currently expected to continue in use beyond July 1, 1976. A report of the remedial action taken to correct each violation shall be submitted to the Court and to counsel in this case no later than July 15, 1976; and
3) That defendants shall provide at least one hour of out-door recreation daily for each resident of the Jail, except for medical patients and work crew; and
4) That defendants shall, no later than August 1, 1976, adopt a comprehensive policy with regard to "contact visits" at Department of Corrections facilities, taking into account the security of the institutions involved, differences among those institutions, the desirability of equal treatment of similarly situated inmates, and any other factors the Department considers relevant. Defendants shall submit such a policy statement to the Court upon completion, and shall accompany it with an expression of the rationale for the policy so adopted; and
5) That the defendants shall establish the following procedures at the Jail and the new detention facility: In the event an inmate displays unusual behavior suggestive of possible mental illness, such behavior shall be immediately reported to the medical staff. The inmate will be seen by a psychiatrist within twenty-four (24) hours. If the inmate is found to be mentally ill, he will be transferred within forty-eight (48) hours of such finding to a hospital having appropriate facilities for the care and treatment of the mentally ill; and
6) That defendants shall establish the following procedures governing use of restraints:
a) inmates requiring restraints will be housed only in a hospital setting, and not with the general population;
b) unpadded handcuffs and leg irons shall not be used under any circumstances. Medically appropriate restraints, padded or pliable to prevent injury to the inmate, may be utilized;
c) restraints may be imposed only on the specific written authorization of a medical doctor;
d) if required in an emergency situation when a doctor is not present, a Medical Technical Assistant (MTA) or a Registered Nurse may order the temporary use of restraints, subject to the receipt, by telephone or otherwise, of approval from a medical doctor within two (2) hours of the imposition of such restraints;
e) a log will be kept reflecting the use of restraints, and stating for each such use the name of the person restrained, the date and time he was placed in restraints, the name of the doctor approving the use of restraints, and the time of such approval;
f) orders by a doctor authorizing the use of restraints are valid for twenty-four (24) hours only, and if no further written order has been entered within that period, the inmate shall be released from restraints;
g) no restrained inmate shall be housed in such a manner as to permit access to him by non-restrained inmates, with the exception of inmates approved by the medical staff for employment in the hospital area; and
7) (a) that defendants, their agents, servants and employees are enjoined after June 1, 1976 from housing more 125 than 960 *125 persons at the New Detention Facility, and more than 215 persons in cell block 4, 161 persons in
cell block 3, 110 persons in dormitory 1 and 91 persons in dormitory 2 at the old Jail;
(b) that after July 1, 1976 no persons shall be housed in cell blocks 1 and 2 at the old Jail;

(c) that if compliance with this order requires a reduction in the inmate population at either facility, and other efforts to reduce the population are not successful within forty-eight (48) hours after compliance ceases, the Director of the Department of Corrections and the Superintendent of Detention Services are directed to release on their own recognizance, within forty-eight (48) hours of the admission to either facility of persons in excess of the numbers stated in paragraph 7a of this Order, those pre-trial detainees held in default of the lowest amount of bail, and among those detainees held in the same amount of bail those held for the longest time, until compliance with this Order is obtained; provided that if the Board of Judges of the Superior Court, or the Chief Judge thereof, specify a different method of selecting the persons to be released, the defendants shall be governed accordingly;
(d) that the defendants submit to the Court and serve on opposing counsel within forty-five (45) days their plan to reduce the population and/or increase the facilities available to house committed persons so that future overcrowding may be avoided; and
8) that there being no just reason for delay, the Clerk shall enter this order as a final judgment pursuant to F.R.C.P. 54(b).
[1] Fountain (maximum capacity of 632, actual capacity of 1,000); Holman (maximum of 540, actual 750); Draper (maximum 632, actual 1,000); Kilby (maximum of 700, actual 700).
[2] These findings were subsequently confirmed by the court-ordered inspections of the Jail, which found literally thousands of violations.
[3] The Court has confirmed the continuing nature of the conditions by a personal visit to the Jail on April 7, 1976, as well as by extensive hearings conducted on April 29th and 30th, 1976 with regard to the instant motion for summary judgment and pursuant to the remand directions of the Court of Appeals in Campbell. The specific findings made as a result of those hearings are also issued today by the Court. They indicate, in sum, that the conditions at the Jail continue to violate the constitutional rights of the inmates on a daily basis. There are however certain matters which, because of changes in the situation at the Jail since the Court's order of November 5, 1975 (including the partial opening of the new detention facility), require different treatment today than they did at that time.
In their report to the Court with respect to corrective action taken as a result of health, fire, safety, building and food inspections at the Jail (paragraph 1, Order of November 5, 1975), the defendants indicated that certain violations would not be remedied because the portions of the Jail involved were soon to be vacated. It now appears that cell blocks 3 and 4 and the dormitory area will remain in use for the indefinite future. The Court therefore orders remedial action in those portions of the Jail.
It appears to the Court that the defendants have complied with paragraph 2 of the November 5th order (clothing, linen, towels) and that no further action is required in that regard.
With respect to contact visits (paragraph 4 of the November 5th order), the latest hearings in this case and in Campbell indicated that the defendants plan to seal off the area at the Jail currently suitable for such visits, and that the new facility is prevented from affording contact visits by the presence of plexiglass barriers in the visiting area. The evidence in Campbell also shows, however, that contact visits are afforded to some prisoners at defendants' Lorton facility. There are obvious equal protection problems inherent in this situation, especially considering the fact that the convicted persons at Lorton are felons, whereas the convicted persons at the Jail are misdemeanants. The Court does, of course, realize that there may be valid security reasons for prohibiting contact visits in correctional institutions. Such a determination must, however, be the result of a reasoned analysis of the relevant factors, which the defendants' practice is clearly not. The Court nevertheless believes that it is the Department of Corrections which must make this analysis in the first instance, and therefore directs it to do so.
The Court believes that defendants are complying with paragraph 5 of the November 5th order (medical inspections of food handlers).

The overcrowding at the Jail is clearly the single most severe problem that the Court has faced in this case and in Campbell. Since the entry of the Court's original interim overcrowding order more than fourteen months ago, that situation has continued to plague the institution. As today's findings in Campbell indicate, a significant number of approaches remain available to defendants to alleviate this problem. Today's findings in Campbell also indicate, however, that there has been no substantial effort on the part of high level city and corrections officials to pursue these possibilities, which the Court believes 0907 taken together 0907 could virtually eliminate overcrowding. As the Court notes today in Campbell, apparently only pressure of a continuing and daily nature will suffice to motivate these officials to fully exhaust the possibilities open to them. The Court therefore today enters an order which, it expects, will create such pressure and will protect the constitutional rights of plaintiffs in this action. The Court is confident that no inmate in the custody of the Department of Corrections need ever be released under today's order unless the high city and corrections officials ultimately responsible for operating the corrections system feel that it is easier to continue their current inaction than to vigorously pursue their responsibility to the citizenry they serve.
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 Inmates of D.C. Jail v. Edwards, 527 U.S. 1035 (1999)
119 S.Ct. 2392 Supreme Court of the United States INMATES OF D.C. JAIL, petitioner,
v. Calvin EDWARDS, Director, District of Columbia
Department of Corrections, et al. No. 98-917. | June 24, 1999.
Case below, 158 F.3d 1357.

Opinion Petition for writ of certiorari to the United States Court of Appeals for the District of Columbia Circuit denied.
Parallel Citations 119 S.Ct. 2392 (Mem), 144 L.Ed.2d 793, 67 USLW 3780, 67 USLW 3784, 67 USLW 3419, 67 USLW 3394
	  

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 Campbell v. McGruder, Not Reported in F.Supp. (1987)
1987 WL 8724 Only the Westlaw citation is currently available. United States District Court, District of Columbia.
LEONARD CAMPBELL, et al., Plaintiffs, v.
ANDERSON McGRUDER, et al., Defendants. INMATES OF D.C. JAIL, et al., Plaintiffs, v. DELBERT C. JACKSON, et al., Defendants.
No. 1462–71. | March 11, 1987.
Opinion
ORDER
BRYANT, Senior District Judge.
*1 Upon consideration of plaintiffs’ Motion for Contempt, defendants’ response, and the evidence and testimony presented to this court on February 17, 1987, and all the evidence, reports and records in this case, it is hereby
ORDERED that:
1. Marion Barry, in his official capacity as Mayor of the District of Columbia, and Hallem Williams, in his official capacity as Director of the Department of Corrections, are in civil contempt for failure to comply with this court’s Orders of July 13 and August 22, 1985, and the Stipulation of the Parties to Reduce the Population at the D.C. Jail (‘Stipulation’), signed August 22, 1985. These defendants have violated paragraphs 5 (regarding the increase in Halfway House capacity), 8 (regarding classification), and 11 (regarding the reduction of minimum sentences) of the Stipulation. Defendants have admitted in a Supplemental Report filed with this court on November 14, 1986, to failure to report to the court vacancies in the staffing required by paragraph 12 of the Stipulation (relating to improvement of mental health services) and have admitted to substantial non-compliance with paragraph 4 of the Stipulation (relating to making a parole determination of parole eligible residents 10 days prior to their parole eligibility dates).
2. In consequence thereof, the above-named defendants are fined $50,000 to be paid in 60 days from the issuance of this Order, but if the defendants and their officers, agents, servants, employees and attorneys achieve and maintain compliance with the court’s Orders, produce

adequate documentation to verify their compliance, and implement the following procedures and perform the following actions designed to ensure their compliance, they will be purged of the contempt finding and will not have to pay the $50,000 fine imposed herein:
I. Halfway Houses On May 1, 1987, and July 1, 1987, defendants will file Special Reports to the court, and serve these reports on plaintiffs’ counsel, detailing defendants’ efforts to increase Halfway House capacity to 736, as is mandated by the Stipulation. These Special Reports are to be reviewed, certified and signed by either the Mayor or Deputy Mayor for City Administration of the District of Columbia. These Special Reports may, at the defendants’ discretion, be filed under seal.
II. Parole On April 1, 1987, and the first of each month thereafter, defendants will file sworn certifications by the Chairperson of the Board of Parole, the Administrator of the Jail, and the Director of the Department of Corrections, that procedures are in effect, fully implemented and monitored, to ensure that no resident of the District of Columbia Jail who is sentenced at least 45 days in advance of his parole eligibility (‘p.e.’) date is denied a parole determination at least 10 days in advance of his p.e. date. Residents will not be denied a parole determination at least 10 days before their parole eligibility date because a progress report or presentence investigative report is not at the Parole Board 45 days in advance of their p.e. dates or because the resident was transferred from one facility to another within the Department of Corrections system at the time of their hearing. *2 This court recognizes that some residents at the Jail cannot be heard 10 days in advance of their p.e. dates because, after receiving credit for time that they have already served at the Jail, their p.e. dates are already within 10 days of their sentencing dates. Defendants will file sworn certificates by the Chairperson of the Board of Parole that these residents have had a parole determination by the Board within 45 days of their sentencing date.
Defendants are ordered on three occasions to be selected by plaintiffs’ counsel to provide to plaintiffs’ counsel full access to all records, data and information, on 24 hours notice by telephone, to confirm that the procedures are operating to ensure compliance with paragraph four of the Stipulation.
Defendants will move expeditiously to automate the data essential to the parole process.
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Campbell v. McGruder, Not Reported in F.Supp. (1987)
III. Classification Defendants shall design, plan and implement an internal and institutional classification program, focusing on the pretrial detention population, the sentenced misdemeanor population and every other category of the sentenced prisoner population at the District of Columbia Jail that is not subject to the system-wide classification program now being devised by the Department. The design and plan shall be submitted to the court for approval by April 15, 1987. Implementation for the purposes of this Order shall be defined as actual assignment and placement of detainees and sentenced prisoners in housing facilities appropriate to their security and programmatic needs.
IV. Reductions in Minimum Sentences Within 30 days of this Order defendants must have the Chief Classification and Parole (‘C&P’) Officer at each of the institutions in the Department of Corrections certify under oath that the procedures outlined in the November 13, 1986 memorandum from Benny O. Hodges, Acting Assistant Director, to all the Administrators of the institutions within the Department of Corrections, have been implemented. Specifically, ‘Minimum Sentence Reduction Applications’ need to be placed in areas easily accessible to the residents; that is, in C&P offices, law libraries, dorm rooms, etc. As the forms are completed by the residents, conferences between the C&P officers and the residents should then be arranged. If the conference reveals that the resident is a good candidate for a reduction in minimum sentence, then the C&P officer will move expeditiously to take all steps necessary to recommend the resident for a minimum

sentence reduction. If the conference reveals that the resident is not, at that time, a good candidate, then the C&P officer should document and describe to the resident the steps the resident needs to take before he will be considered for a minimum sentence reduction. A future conference date should also be established by the C&P officer at that time. A monthly log similar to the one attached to the November 13, 1986 memorandum should be kept by each C&P officer, and be available for inspection by plaintiffs’ counsel.
*3 4. Defendants shall continue to file bi-weekly compliance reports with the court. These compliance reports will describe in detail defendants’ progress toward compliance with this Order and with this court’s Order issued August 22, 1985.
5. Upon finding that paragraph 8 of the Stipulation has not produced an effective system-wide classification program for the Department of Corrections, it is hereby ordered that further relief is granted to the plaintiffs and it is hereby further ordered that the defendants implement their system-wide classification program by September 15, 1987. The definition of implementation for the purposes of this Order is noted above in paragraph 2(III).
6. If defendants have failed to conform to one or more of the Orders expressed above, in the prescribed time period, a $50,000 fine will be automatically imposed.
7. Defendants shall pay plaintiffs’ counsel the costs associated with the prosecution of this contempt proceeding, including reasonable attorney’s fees.
	  

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