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Cruel and Unusual 

Report: Inmates at the Idaho State Correctional Institution denied human, constitutional rights

A 94-page independent review found non-urgent care to be "poor" and emergency care to be "troubling" in Idaho's prison system.

Idaho Department of Correction

A 94-page independent review found non-urgent care to be "poor" and emergency care to be "troubling" in Idaho's prison system.

The State of Idaho didn't want the public to read it, claiming a report on health care at an Idaho prison included "inflammatory and unsupported legal findings." But U.S. District Judge B. Lynn Winmill said the public's right to know about conditions at the Idaho State Correctional Institution outweighed concerns from the Idaho Attorney General's Office.

The 94-page jaw dropper, written by Dr. Marc Stern, a court-appointed health-care expert, pulled no punches, documenting "serious problems" that, according to Stern, violated "the right of inmates at ISCI to be protected from cruel and unusual punishment."

You can read the full report can be found here. Prison_Medical_Report_Part_1.pdf Prison_Medical_Report_Part_2.pdf Prison_Medical_Report_Part_3.pdf Prison_Medical_Report_Part_4.pdf

Few, if any, elements of health-care for inmates escaped Stern's wrath. Non-urgent care was poor and emergency care was "troubling," according to Stern. In one instance an inmate, whose X-rays discovered a lesion on his chest, was not informed of his condition for seven months thus denying him "his basic human right to participate in his care."

"It really gives you goose bumps," said Lea Cooper, American Civil Liberties Union of Idaho staff attorney. "The way we treat the least powerful members in our society says a lot about our society."

Attorneys representing the Idaho Department of Corrections wanted to keep Stern's report sealed, arguing the findings would cause "unjustified public scandal." But Winmill ruled otherwise.

"The [U.S.] Constitution provides human rights for all citizens," said Boise attorney Walt Sinclair. "We're not talking about providing nice living conditions for these inmates. We're trying to provide them with basic care and living conditions."

Sinclair represents inmates in a decades-old class-action federal suit that began with one prisoner, Walter Balla, who alleged overcrowding and poor access to medical care at ISCI. A wave of similar allegations from other prisoners followed Balla's suit, threatening to clog court dockets. The complaints were folded into one class-action lawsuit, now known as the "Balla Case."

Over the next three decades, several rulings against the State of Idaho were handed down, with different federal judges ordering a stop to prison overcrowding and violence. The case also prompted a federal court injunction tasking IDOC with improving mental health-care and medical conditions at the prison.

In 2011, Winmill pegged Stern, a physician from Washington State, to be a court-appointed watchdog to oversee IDOC compliance. Stern's scathing report outlined a litany of inadequacies, including the neglect of patients who were sometimes left unfed, in soiled bed linens and without medical treatment.

Stern also reported a host of shortfalls in mental-health treatment at the prison. In one case, a mentally ill prisoner had scored high on an intake assessment for suicide risk, and contrary to protocol, he was never referred to mental-health professionals. Eleven days later, fellow inmates found him hanging in his cell. He later died.

"We knew what the report was going to say," Cooper said. "We've been getting letters from prisoners for years about the inadequate medical treatment they've been receiving. And we also have been contacted by health-care providers who work at the prison who are really conflicted ethically. And then the care they are forced to provide is in direct conflict with their Hippocratic Oath."

Stern's report noted that it sometimes took as long as 15 days before prisoners' medical complaints were reviewed by a health care provider and that medical assessments, diagnoses and treatments were prescribed by licensed practical nurses in capacities that were beyond the scope of their training.

In yet another case, Stern noted that a patient, who later died, was left unattended by a nurse during cardiac arrest, and in at least one instance, care was provided by a nurse who was "indifferent and hostile" toward prisoners.

"Our primary concern has always been with providing our clients, the plaintiffs, access to the report," said Stoel Rives attorney Jason Prince, who, along with Sinclair and a third attorney, Allison Blackman, represent prison inmates in the case.

Prince said that Stern's report speaks for itself and is accurate. But IDOC officials challenged Stern's investigation, claiming he cherry-picked his findings.

State attorneys argued the report should stay under wraps, saying the findings were inaccurate and could cause potential embarrassment to IDOC.

Stern's report actually commended IDOC for its cooperation in the investigation, but prison officials withheld comment, issuing only written statements.

In a joint statement, IDOC and Corizon, the company contracted to provide health-care services at the prison, noted that, "while a few of the allegations raised in the report sent to the court report may be well founded but unfortunate anomalies, most of them have been or are being addressed."

IDOC did not respond to requests for information about health-care management plans that are currently in place or the review and accreditation findings of those plans.

Cooper said that prisoners who file complaints against IDOC for inadequate medical care face a host of challenges, not the least of which is legal expense.

"Most of these cases are out of reach for the average person unless they can find an attorney who is willing to cover the costs up front. And that's pretty rare," said Cooper. "At the end of the day, we have to go home and feed our family, too. So these are pretty hard cases to try and win. It's not that they're not winnable. It's just that the cost involved with them, especially the medical cases, are just so exorbitant."

While the inmates' attorneys said that Stern's report could help defend their clients' constitutional rights, Cooper said the report could help IDOC prisoners with other cases challenging inadequate medical care.

"It can be used as evidence," she said.

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