Expert Report on Health Care in Illinois Prisons Finds Many Challenges Ahead in Efforts for Reform

An initial report from an independent expert in a federal court case aimed at fixing long-standing problems in the delivery of health care in Illinois prisons identifies ongoing problems and new challenges to repair decades-old problems in the system. Dr. John Raba completed the report filed with the court one year after the Illinois Department of Corrections reached an agreement to oversee changes in its prison health care system and six months after the settlement was approved by a federal court.

“Clearly the problems of this system were so bad, they will take time to repair,” said Camille Bennett, Director of the Corrections Reform Project, ACLU of Illinois. “This is a system that was actually causing unnecessary deaths. What this first report shows is that the prison health care system in Illinois must be re-built from the ground up. We look forward to continuing to work on that process.”

Dr. Raba’s report identified a number of major issues and challenges for health care in IDOC, including:

• A complete lack of infrastructure within IDOC to collect and track information about patients and their conditions;
• A system of “collegial review” for offsite referrals used by the healthcare vendor, Wexford, that in the Monitor’s judgment serves as a barrier to patient care and puts patient health at risk, and should be abandoned;
• An ineffective process for mortality reviews that results in a lack of meaningful oversight and accountability, in which the death summaries are typically written by the physician who oversaw the care;
• Woeful lack of follow up on new protocols when they are adopted, including a new protocol around the treatment of Hepatitis C which has resulted in only 1% of those diagnosed with the disease being treated; and,
• An aging population and infirmaries “filled with patient-inmates who are confused, incontinent, and require assistance with the basic activities of daily living including dressing, feeding, bathing, and toileting,” that will soon overwhelm the system with needs for costlier and more long-term care.

“Illinois ended the death penalty in 2011, but the poor health care the state provides to prisoners often amounts to a slow-motion death penalty,” said Alan Mills, Executive Director of Uptown People’s Law Center. Also, the system is overflowing with elderly, disabled people who require intensive medical care—for them, the death is not so slow. Illinois needs to get them out of prison.”

“We are sorry that the new Governor has not expressed more interest in seeking a speedy resolution of these issues,” added Harold Hirshman of Dentons, also counsel in the case.

The report is the latest in Lippert v. Baldwin, a lawsuit challenging the abysmal system for providing health care in Illinois prisons. A 2018 examination of the system by an outside medical expert found 12 preventable deaths among a group of 33 IDOC deaths that were intensively examined. Another seven in that group were possibly preventable and the record-keeping in five cases was so poor that the expert and his team could not determine if the death was preventable. The expert identified a total of over 1,700 medical errors in the group of 33 mortalities.

The monitor in Lippert will continue to make regular reports to the court on developments in the system.