Magazine article Developments in Mental Health Law
Privatization by Puerto Rico of Prison Inmates' Medical and Mental Health Services Upheld for the Time Being; Ruling Not Disturbed
Since the 1970s, class action lawsuits have been brought against many states challenging the medical and mental health care provided in their correctional systems. In part because many of these lawsuits deeply enmeshed the federal courts in the supervision of prisons and jails for an extended period of time, Congress enacted the Prison Litigation Reform Act (PLRA) in 1996 to curb the involvement of the federal courts in day-to-day prison management.
One of the lengthiest ongoing lawsuits has focused on prison conditions in the Commonwealth of Puerto Rico. After roughly 20 years of litigation, prison conditions in general improved but medical and mental health care lagged behind. In 1997, the parties to the lawsuit agreed as part of a consent decree to privatize this care.
A non-profit entity, the Correctional Health Services Corporation (CHSC), was formed to provide these services. Although expected to be fully functional by the end of 1998, by 2003 the CHSC had not yet treated any patients, despite an infusion of $55 million.
In addition, a new administration representing a different political party took office in Puerto Rico in November of 2000. In October of 2003, the Commonwealth filed a motion under the PLRA to vacate the privatization component of the consent decree.
On appeal, the First Circuit rejected this motion. The court determined that (1) the health and mental health care provided remained constitutionally unacceptable, (2) the privatization remedy held promise of being able to correct this deficiency, and (3) this litigation, for the time being, was not in violation of PLRA. …