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State agrees to overhaul health care services at Baltimore jail

State officials agreed Wednesday to overhaul health care services and make improvements to the Baltimore jail system under the terms of a settlement in a decades-long dispute with advocates for prisoners.

Under the agreement, the latest in a federal case that dates to 1971, the state will allow three independent monitors to inspect the facility and report to a federal judge, who will enforce compliance.

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The previous agreement, made six years ago, was not enforceable by a judge.

Debra Gardner, legal director at the Public Justice Center, said the agreement would "at last ... provide adequate, timely medical care to detainees instead of abandoning those with injuries and illnesses."

"After years of litigation, the jail will meet its constitutional and ethical responsibilities to those inside its walls," she said.

A spokesman for the state prison system, which oversees pretrial detention for Baltimore, said the administration of Gov. Larry Hogan acted swiftly to address concerns and that the settlement "brings to a close an ugly chapter in the history of the state."

Advocates and state officials said Hogan's decision to close the Baltimore City Detention Center in August provided impetus for the agreement.

The facility, parts of which date to the Civil War era, had long been in disrepair, and officials and lawmakers had grappled with how to improve conditions. Hogan decided to shut it down and move detainees to other facilities.

"Closing the Baltimore City Detention Center resolved a significant number of issues immediately," said Robert B. Thomas, the chief spokesman for the Maryland Department of Public Safety and Correctional Services. "Secretary [Stephen] Moyer's belief was this: You do the right thing for the right reason. You don't wait for a federal court to order you to do something."

The agreement will be presented to U.S. District Judge Ellen L. Hollander for approval.

The ACLU case, now known as Duvall v. Hogan, led to a 1993 consent decree, which was reactivated in 2003 when the advocates filed a motion protesting extreme summer heat at the women's lockup. The state agreed to install air conditioning in the building, but dozens of health-related issues remained unresolved, leading to another agreement in 2009.

In June, with that agreement set to expire, advocates for prisoners renewed their complaints over conditions at the jail, including the lack of timely medical assessments, interruptions of medications to control diseases such as AIDS and diabetes, incomplete medical records, and shortages of supplies and fundamental equipment such as wheelchairs.

Advocates said some of the Baltimore buildings that make up Central Booking and the men's and women's jails had moldy showers, excessively hot and humid air, mattresses that could not be completely cleaned, and sometimes lacked working plumbing.

Moyer, who had been in the job for just a few months, asked for time to look into the problems. Within two months, he and Hogan announced that the facility was being shut down.

Pretrial detainees are now spread among two facilities within the jail complex. Officials said the closure was made possible because the number of people being arrested and held had dropped considerably, creating space to fit them into other buildings.

Six years ago, the facility had a daily population of about 4,000 detainees; officials say that number is now about 3,000.

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Closing the building "took a big headache off everyone's plate," Gardner said. But questions about medical treatment persisted. In the current system, advocates said, a detainee in critical need of care can go without attention for weeks.

The new agreement calls for several improvements, including accessible housing for detainees with disabilities and an agreement that correctional officers would not be able to deny inmates access to canes or crutches on the grounds that the aids are security risks.

Gardner said there would be "improved and clarified" standards for suicide and mental health risk upon entering the facility.

Outside monitors who specialize in correctional health care, mental health care and safety and sanitation would file reports every six months for the next two years. The state would pay for the monitors at a cost of about $100,000 over the next four years, Thomas said.

The state is working to implement an electronic medical records system, a project that could take years. Officials had previously said such a system was in place.

If the goals of the agreement are met within four years, the agreement would be terminated and the case would be dismissed.

David Fathi, director of the ACLU's National Prison Project, hailed the settlement.

"We can't undo the damage the jail has done to so many," he said. "But we can celebrate today's settlement for its commitment to better conditions and for establishing independent monitors who will ensure progress."

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