Cooper Brinson, Staff Attorney

Back in June, the US District Court for Oregon ruled that a lawsuit, filed by the Civil Liberties Defense Center on behalf of Angelo J. Fricano, should move forward to trial after successfully beating back the defendants attempts to have the case dismissed. The federal civil rights lawsuit alleges that Corizon Health Inc. (a private prison “healthcare” corporation), Lane County (OR), and one individual that worked at the jail, violated Mr. Fricano’s constitutional right to be free from cruel and unusual punishment as a result of the jail’s refusal to provide adequate mental health treatment while detained at the Lane County Adult Correctional (LCAC) facility in Eugene, Oregon. The court’s ruling denying defendants’ motion will allow a jury to decide whether defendants were deliberately indifferent to Mr. Fricano’s serious medical needs and whether such indifference was a result of established policies and customs of Corizon and Lane County. Trial is set for December 10, 2018 at the U.S. District Court in Eugene, OR.

The CLDC filed the lawsuit on behalf of Mr. Fricano in June of 2016 after hearing several reports of individuals that were arrested and taken to LCAC in the midst of a mental health crisis. These individuals were immediately placed in a segregation cell and left for weeks without any mental health treatment. In several cases, charges were dropped against these individuals affording the question:  why were they arrested and jailed in the first place, especially when police have the power (and obligation) to take people to the hospital for care instead?

Mr. Fricano served for 17 years in the Army National Guard. He had no history of mental health issues and no criminal record. In June of 2014 things started to get difficult for Angelo after he began to suffer from the onset of a psychotic episode shortly after a change in his prescription medications. He was eventually arrested in the midst of a complete psychosis. All of his charges were later dropped. Like others, Angelo was taken to jail and immediately placed in solitary confinement (segregation). He remained in solitary, as an innocent man, for 16 days until he was finally released and transported to the hospital where he received treatment.

While incarcerated, he was kept in his solitary cell for days at a time. Food, access to showers, and hygiene products/practices were regularly withheld. He was punished for actions clearly related to his psychosis, including being maced and beaten. His mattress was removed and he was not provided any of his vital prescription medications. Throughout his incarceration, Mr. Fricano’s family and people at the local Dept. of Veteran’s Affairs pleaded with the jail to transfer him to a hospital so he could be diagnosed and treated. Mr. Fricano never received mental or medical health care during his incarceration, including never having even his vitals checked, despite jail staff’s awareness that he was in need of immediate care and treatment. As the days wore on, his psychosis worsened and he lost over 30 pounds. Even 4 years after his release, Mr. Fricano is still haunted by the long-term effects of his solitary incarceration.

For defendants, this is not the first time that they have been embroiled in similar litigation. Corizon is a for-profit corporation that contracts with states and municipalities to provide medical and mental health care to jails and prisons at a significant profit for their shareholders. Estimates for Corizon’s net worth are hard to come by, but The Guardian estimates Corizon’s revenue in 2015 was $1.55 billion.

In 2012, Lane County entered into a contract with Corizon to provide care at LCAC after the CLDC sued Lane County on behalf of a seriously mentally ill person, who was also left in a jail segregation cell until he was found unconscious and critically ill. After three years, the County declined to renew its contract with Corizon. The County citedconcerns about actual cost savings and quality of care provided at the jail under Corizon. The County’s decision to sever ties with Corizon came just after Corizon settled a claim related to the death of Kelly Green(who was held at LCAC) for $7 million.

The Southern Poverty Law Center wroteextensively about Green’s case as well as several other cases around the country involving Corizon. The SPLC noted that what happened in Mr. Green’s case and elsewhere with Corizon, demonstrates what critics of private prison healthcare argue “is fundamentally wrong with a privatized prison health care system that, at its core, exists to generate profits for investors.” The report from the SPLC highlights the perverse incentive endemic to private prisons and private prison health care systems: In an effort to increase profits, private companies look for ways to cut costs and one way to decrease costs is to decrease services (or staff available for these services). As Oliver Hart, 2016 Nobel prize winner in Economics, and his co-authors have explained, the incentives for cutting costs at the expense of the quality of services are generally greater than the incentives to prioritize quality.

Counties and states across the country often cite cost-savings in their decisions to privatize jail and prison healthcare. However, the shift toward privatization in jail/prison healthcare appears more ideological than economic. Studies that have attempted to determine the actual cost-savings of governments using private prison contractors are inconclusive. A reportfrom the Hamilton Project of the Brookings Institution found that “existing studies that attempt to account for differences in the population show that private prisons do not offer clear cost savings or quality improvements.” Even the Justice Department under Obama recognized the need to phase out private prison prisons, with then Deputy Attorney General Sally Yates writingthat private prisons “simply do not provide the same level of correctional services, programs, and resources; they do not save substantially on costs; and…they do not maintain the same level of safety and security.” The Trump administration, predictably, rescinded the DOJ’s policy of phasing out private prisons. If, after decades of privatization in the nation’s jails and prisons, there is not a clear answer to this question, perhaps it is time, given the perverse incentives, to rethink whether privatizing is the right choice.

When the prior CLDC case settled, the County was supposed to change its policies to ensure that people who enter the jail in a psychotic state receive appropriate treatment and are never simply tossed into solitary confinement and left alone. It appears, though, that the County has not learned its lesson and thought they could avoid that responsibility by merely handing the burden off to a private corporation. This lawsuit illustrates that is not the case.

Even with Corizon out of the Lane County jail (they were replaced by another private corporation, California Forensics Medical Group), the problems seem to persist. Back in December of 2017, a young man named Jonathan Sliger went through a similar experienceas Mr. Fricano. Sliger, who suffered from multiple documented mental illnesses, was arrested for “menacing” (the same charge initially brought against Mr. Fricano) while in the midst of a mental health crisis. Sliger’s grandmother called 911 because she didn’t know what else to do and wanted to get him to a hospital for treatment. Instead, Sliger was arrested and taken to LCAC where he was held for 18 days. Sliger’s grandmother disputes that her grandson was ever “menacing.” “He was just out of control…And I wanted to get him help, to get him medically stabilized…I just don’t understand why he wasn’t taken to the hospital, where he needed to go. He didn’t need to go to jail,” she said. Law enforcement claimed they had no choice but to arrest Sliger.

The County is aware of the problem and difficulties treating people with mental health issues at the jail, but it has not been able to implement policies or procedures that would prevent the kind of horrific situation that Mr. Fricano and others have experienced. While, according to Capt. Dan Buckwald, a Lane County Jail commander, “[a] big portion of the folks who come in [the jail] are typically in some form of psychosis,” there is no indication that LCAC offers, or is capable of offering, any form of inpatient psychiatric care. An estimated 60%of individuals housed at LCAC suffer from some form of mental illness. Surely, some of them have emergency mental health issues that require inpatient levels of care. But, despite having no ability to offer inpatient psychiatric care at the jail, jail staff will not transfer anyone to the hospital or elsewhere for treatment absent two very narrow circumstances. First, a person may be transported to a hospital for psychiatric care if they are already about to be released from the jail. Second, jail staff will transfer someone to the hospital if that person is found unfit to proceed in their criminal case and a court issues an order to transfer the person to the Oregon State Hospital forensic unit. Outside of these two circumstances, those that need inpatient levels of care will not and cannot receive such care at LCAC. In other words, if someone is having an emergency mental health crisis (e.g., acute psychosis, as in the case of Mr. Fricano) and needs inpatient levels of care, there is nothing that staff will or can do to provide that level of care.

County Officials, including Sheriff Byron Trapp,have lamented that the jail has become the de-facto “treatment” center for people with mental health issues. As Sheriff Trapp has said, this is “not the right way to address our mentally ill in the community.” We agree. A large part of the problem, according to several county officials, is the lack of funding for treatment outside of the jail. Perhaps one simple action we could take in Lane County is to demand that county officials prioritize funding for mental health treatment. We could also urge county officials to refuse to outsource basic government responsibilities to corporations who don’t seem to care what happens to prisoners so long as the profits keep rolling in. Lastly, we need to start a discussion about the discretion of law enforcement in situations involving someone in the midst of a mental health crisis. This latter issue is extraordinarily complex, but if the position of law enforcement is that they have no choice but to take someone having an emergency mental health crisis directly to jail—even when that jail is incapable of providing treatment or transferring the person to the hospital, the alleged victim doesn’t want to press charges, and the probable cause determination is extremely weak—it is an issue that we must face.

No one, including law enforcement, seems pleased that the task of treating individuals with serious mental health issues rests primarily with the jail and law enforcement. But, as has often been the case with social problems, we cannot rely solely on law enforcement and the state to solve this problem. We must take an active role ourselves.

The CLDC looks forward to presenting Mr. Fricano’s case to a jury on December 10th. Please consider supporting or subsidizingour work in this case (include a note in your donation that you would like to support this case).

*People struggling with mental health issues or having a mental health emergency may find help by reaching out to these resources available in Lane County:

National Resources:

  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Veterans Crisis Line: 1-800-273-8255 (press 1 once you get through)
  • National Alliance on Mental Illness help line: 1-800-950-6264
  • National Youth Crisis Hotline: 1-800-442-4673
  • Trevor Lifeline(Crisis and Suicide Prevention help line for LGBTQ folks under 25): 1-866-488-7386