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Individual Advocacy Within the Prison

 

• Disability Rights Washington provided assistance to an inmate with diabetes regarding his need for a therapeutic diet. Through an investigation, the P&A discovered that though the inmate had requested a therapeutic diet, none had been approved and the prison kitchen staff had refused to provide appropriate diet choices, resulting in problems for the inmate with his insulin levels and ostomy care. The agency advocated with the prison’s dietician to review the inmate’s request for a proper diabetic diet and meal planning. After negotiation, the dietician's recommendations were developed, refined, and implemented by the kitchen staff.  Two years later, the inmate again contacted the P&A, reporting that the prison had determined his therapeutic diet was no longer “medically necessary.” The P&A contacted the prison system’s dietician and medical director regarding the inmate’s continued need for a special diet. The dietician thereafter met with the inmate and renewed the therapeutic diet.

 

• Disability Rights Wisconsin was contacted by an inmate with diabetes seeking assistance. The inmate suffered from diabetic neuropathy in the state issued shoes and had been refused the therapeutic shoes he needed for years. Disability Rights Wisconsin conducted an investigation and uncovered a confusing multi-level process for accommodation and a failure to adequately monitor the man’s condition. Thereafter, the organization advocated with the prison to develop an active treatment plan for the inmate that included orthotics and appropriate footwear. The facility also provided additional health services training on the prison’s footwear policy.

 

• An inmate with cerebral palsy contacted Disability Rights Vermont, seeking an accommodation in the prison’s dining hall. After meeting with the inmate, the P&A assisted him in requesting a spill-proof cup for meals as a reasonable accommodation for his disability. Within a month, the medical department had purchased and provided a spill-proof travel mug for the inmate to use.

 

• An inmate with a bowel disorder contacted Protection and Advocacy for People with Disabilities, the South Carolina P&A, for assistance in obtaining a “toilet paper pass” after her pass was revoked by the prison’s medical staff. The pass had allowed her to obtain additional toilet paper at no cost, due to her bowel related issues; the pass was removed after medical staff determined that her condition no longer warranted additional toilet paper. The P&A successfully negotiated with the facility’s ADA coordinator to have the pass renewed.

 

• An inmate contacted Disability Rights Washington regarding his ileostomy care in prison. Upon investigation, DRW discovered that the inmate had been instructed to conduct maintenance of his ostomy bag in the medical unit of the prison rather than in his living unit. This system often resulted in delay of care and bag leaks. The prison then instructed the inmate to empty and change the ostomy bag in the prison toilet, using the sink to wash out the bag; this created an unsanitary condition for himself and caused conflict with other inmates.  He was also prohibited from keeping bag maintenance supplies in his cell, thereby delaying care and putting him at risk of infection. The prison also refused to order needed supplies. After extensive negotiation with prison security and medical staff, the prison agreed to allow the inmate to conduct his ostomy care in his cell and keep his supplies on hand. The prison also agreed to provide needed supplies as well as additional nursing care and review.

 

• Disability Rights Mississippi met with a female inmate that used a catheter; the inmate reported that the prison was limiting the number of catheter bags she could have and preventing her from keeping cleaning supplies for her catheter in her cell. She reported that as a consequence, she was getting infections. Though the inmate had repeatedly raised these concerns with medical, staff were not responsive. The P&A contacted medical staff at the facility and advocated for increased access to both catheter bags and cleaning supplies. The inmate reports that the medical staff is now responsive to her needs.

 

• An inmate with paraplegia contacted Disability Rights Arkansas because he was denied medical care related to personal care and toileting. The inmate reported that he uses an enema to ensure that he does not develop any gastrointestinal issues resulting from his paralysis. While he had previously been allowed to do this in the medical area, he had been informed that he was taking too long and could no longer take care of his needs there, thus being forced to do this in the barracks. This deprived the inmate of needed privacy and caused severe anxiety, stress, and conflict with other inmates.  Following advocacy by the P&A, the state’s corrections department agreed to allow the inmate to go to the medical area to take care of his needs.

 

There is no "one-size-fits-all" approach to accommodations for inmates with disabilities.

 

• Disability Rights New York was contacted by an inmate with type 1 diabetes who was not permitted equipment for testing her blood glucose levels independently.  The prison administration believed the testing equipment presented a safety and security risk, and directed that the equipment be held in the prison’s medical unit.  The inmate was therefore required to visit the medical unit multiple times per day, which often delayed and/or prevented her from participating in prison programs. The P&A notified the prison and agency counsel that this practice presented an ADA violation, and advocated that she be permitted to keep her testing equipment safely in a locker on her housing unit.  The prison agreed to allow the woman to possess a glucometer, lancets, alcohol pads, and test strips in her locker. A medical plan was drafted for the inmate and she is now able to effectively participate in prison programs.

 

• An inmate with significant migraines contacted the Connecticut Office of Protection and Advocacy for Persons with Disabilities because the constant illumination in the medical unit where he resided exacerbated his migraines.  Because his migraines were so debilitating, he remained in bed with the blanket over his head for the majority of the day and night. The medical ward was a large room divided into four smaller rooms with one light switch that controlled all the lights.  Over the course of several months, the P&A was able to advocate for the state prison system to individually wire each room so the lights could be turned off or on in each room.

 

• An inmate with Post Traumatic Stress Disorder and Shy Bladder Syndrome contacted Disability Rights Vermont for assistance in obtaining an accommodation for his disabilities related to providing mandatory urine samples for random drug testing.  The inmate had received disciplinary reports for his inability to provide urine samples and though he had filed multiple grievances and ADA requests on his own, they had all been denied.  The P&A assisted the inmate in requesting a reasonable accommodation in the form of alternative drug testing methods and also asked that the most recent disciplinary reports be expunged. The accommodation was granted, with mouth swabs being offered instead of requiring urine samples, and the disciplinary report was expunged.

 

• Protection and Advocacy for People with Disabilities, the South Carolina P&A, received a letter from an inmate who reported that his cell was not wheelchair accessible.  Though the inmate had used a wheelchair for many years and had been in an accessible cell, he had recently been moved to a disciplinary unit that was not accessible.  The inmate reported the toilet was inaccessible, he could not maneuver to and from his bed from the wheelchair, there was no table for him to use in the cell or any ramp to the unit’s outdoor recreation area, there was no appropriate shower chair, and his wheelchair no longer met his needs.  After the P&A contacted the facility’s ADA coordinator, the inmate was transferred to a newer, more accessible facility and was approved for a more appropriate wheelchair. He was also provided with an accessible cell, trapeze bars, an aide to assist him in accessing the yard, a shower chair, and a lapboard.

 

• An inmate contacted Disability Law Colorado, reporting that her wheelchair, walker, and personal care assistant had been removed. The inmate reported that the removal had occurred after prison custody staff saw her engaged in light physical exercise that prison medical staff had suggested she do in order to gain strength. The P&A contacted the prison’s ADA Coordinator and advocated for the return of the inmate’s walker and personal care assistant, but not her wheelchair, which she no longer needed.  As a result of that advocacy, her personal care assistant and walker were returned.

 

• Disability Rights Mississippi received a letter from a female inmate who reported her wheelchair was so badly damaged she was unable to move herself, forcing her to pay other inmates to push her. She also reported that her prosthetic had not been serviced during the two years she had been incarcerated and that as a result, she had been unable to use it for over six months.  After the P&A contacted medical staff and a prison social worker, a new wheelchair was provided and the inmate’s prosthetic was serviced.

 

• An inmate contacted Disability Rights Washington for technical assistance, reporting that he had been in the segregation unit of the prison for almost two years without a wheelchair. As a result, the inmate reported dragging himself across the floor in order to conduct his daily activities. The inmate reported that he had been unable to access the yard or shower due to his inability to ambulate out of his cell. The P&A opened an individual investigation and found that while the inmate had been provided with a wheelchair for many years, it had been removed when he was placed in segregation. The records reflected that during that time, the inmate was noted by prison staff as being unable to ambulate in his cell due to his lack of a wheelchair. Upon the P&A commencing an investigation, the inmate’s wheelchair was returned and through negotiations with correctional administrative staff, the agency was able to facilitate the inmate’s transfer to a less secure setting.

 

• The designated P&A for South Carolina, Protection and Advocacy for People with Disabilities, received a letter from an elderly inmate that used a wheelchair, stating he was housed in the assisted living unit of the prison and he had fallen out of bed several times, with injuries. P&A staff contacted the prison and requested accommodations; the inmate now has a bed with side rails and inmate workers have been instructed to assist the inmate with transfers and remind him to have the rails up when he sleeps to prevent falling out.  In addition, prison staff agreed to a medical assessment to determine if the inmate needs any further accommodations or interventions.

 

• An inmate contacted the Connecticut Office of Protection and Advocacy for Persons with Disabilities, requesting a double mattress. The inmate had several back surgeries and needed more cushion between the metal bed frame and his back. He had received a double mattress in his previous facility but upon being transferred to a new facility, was not provided with the accommodation because each prison had its own mattress policy.  After contacting the ADA Coordinator for the corrections system, the P&A was able to get a new, thicker mattress for the inmate, a better accommodation then having a double mattress.  As a result of this advocacy, the ADA Coordinator is also working on developing a system- wide mattress policy.

 

• Disability Rights Iowa was contacted by an inmate diagnosed with glaucoma and vision loss.  His prescription eyeglasses were confiscated by prison officials as a result of the individual having altered the frames. Subsequently, he was denied access to a replacement pair of glasses and sought assistance from the P&A in obtaining them. The agency investigated the circumstances surrounding the seizure and destruction of the inmate’s glasses and prepared a demand letter, supporting the individual’s immediate right to the eyeglasses. The prison complied and made the individual an optometry appointment and ordered new glasses.

 

• Disability Rights Mississippi was contacted by an inmate who was an amputee with crutches that were the wrong size for him; the inmate also reported that he needed rubber grips for his crutches as his hands were calloused from use. P&A staff met with the inmate and he reported he had submitted kites and grievances regarding his need for new crutches for years but received no response from the prison. The agency contacted a social worker and medical staff at the prison and explained the inmate’s need for fitted crutches. The inmate was subsequently fitted for crutches and provided with rubber grips to protect his hands.

 

• An inmate with paraplegia contacted Disability Rights Arkansas because she was denied needed medical care and accommodations.  The inmate reported that the prison required her to fill out a sick call in order to get an enema and denied access to needed physical therapy and appropriate footwear.  The prison had also failed to ensure that the inmate had a special needs treatment plan or that she was admitted to the spinal cord chronic care clinic, in direct violation of their policy.  As a result of the P&A’s advocacy, the inmate was allowed to have ready access to enemas, fitted for the correct medical shoes, obtained a follow-up physical therapy evaluation, and admitted to the specialized clinic.

 

• An inmate contacted Disability Rights Washington reporting that his orthopedic shoes and cane had been removed when he was placed in segregation. The P&A conducted an investigation and advocated for the return of the inmate’s mobility devices and for a transfer to a less restrictive and more accessible setting. The inmate thereafter received medical shoes while in segregation and was transferred to a less restrictive setting, where his cane was returned. The state prison system is now in the process of identifying orthopedic shoes that are approved for use in segregation and has clarified that assistive devices will be assessed on a case-by-case basis before taking them from an inmate in segregation.

 

• Disability Rights Iowa was contacted by an inmate diagnosed with glaucoma, dementia, and a foot bone disorder who stated he was regularly denied access to his medications, and had been denied access to prescribed orthotic footwear. The P&A completed an investigation and found medical records supporting the need for orthotic footwear that had not been provided to the DOC. The agency provided the state prison system with that information and requested that the inmate be evaluated by a qualified physician for orthotic footwear.  As a result, the inmate was evaluated and given orthotic shoes. He was also provided consistent access to prescribed medications for glaucoma.

 

 

Systemic Advocacy with Corrections Officials

 

• During routine prison monitoring, Disability Rights New York found that a prison did not have hoses for inmates to take hand-showers, rendering the showers inaccessible to many inmates with disabilities. After the P&A raised this issue with the facility administration and corrections’ counsel during the visit, the prison ordered and installed hoses in the inmate shower stalls. The facility installed removable hoses in its mental health and segregation units due to concerns with suicide risk on the unit.

 

• During a monitoring visit, Disability Rights New York identified a rough and broken sidewalk at a facility.  The prison administration agreed to prioritize repair of the sidewalk to render a safe and accessible path of travel.

 

 

Administrative Advocacy and Litigation

 

• An inmate with injuries to his hands contacted Disability Rights New York because he was deprived of his adaptive eating and writing utensils when placed in disciplinary confinement.  The utensils had been removed from the inmate because they allegedly posed a threat to safety and security. The P&A wrote to lawyers for the prison and persuaded the prison administration to return the adaptive utensils to the inmate.

 

• Disability Rights Center – NH, the New Hampshire P&A, settled a case alleging violations of the ADA, Rehab Act, and the Eighth Amendment. In the case, the plaintiff inmate, who used a wheelchair and prosthetic arm, alleged that during his incarceration, his prosthesis was taken and he was permitted only a manual wheelchair, which he could not use with one arm. He also alleged he was held in a maximum security cell with no accessible toilet or shower and he suffered injuries as a result of attempting to transfer himself from his wheelchair to the toilet. Since settlement, the prison has installed an accessible cell in the maximum security unit, as well as an accessible shower.

 

• Following a year-long investigation and report, Alabama Disabilities Advocacy Program, the P&A for Alabama, along with co-counsel Southern Poverty Law Center, filed a federal lawsuit against the state’s department of corrections, alleging violations of the Eighth Amendment as well as violations of the ADA and Rehab Act. The lawsuit alleged, among other things, that facilities and programs in almost every prison in the state have architectural barriers to inmates with mobility impairments, creating an unsafe and inaccessible environment. In 2016 the parties reached settlement on the ADA and Rehab Act claims, wherein the state’s prison system agreed to remove all architectural barriers within the prisons, including in living units, bathrooms, and showers. The prison further agreed to implement a tracking system for identifying people with disabilities and their specific needs and to create an inclusive emergency preparedness plan. Extensive ADA training for agency personnel was also required in the settlement, as well as the creation of a separate grievance and appeals process for ADA compliance concerns. Finally, all 28 of the state’s prisons must have an ADA coordinator, overseen by an appointed statewide coordinator.

 

• Advocacy Center of Louisiana, the P&A for Louisiana, filed a lawsuit in federal court on behalf of a prisoner with vision impairments. The lawsuit alleged violations of the ADA and Rehab Act. The subsequent settlement directed that the prison assign the inmate to a bottom bunk with access to an electrical outlet for his assistive devices; it also directed that the prison provide protective padding for the bunk and situate it in an accessible area. The settlement further anticipated that medication and meals would be delivered to the inmate on his unit or, in the event of unusual circumstances, the prison would assign an individual to escort the inmate to pill call and meals. It also directed that the prison provide the inmate with a white cane as well as training in its use. Finally, the prison agreed to ensure shower chairs are available in the inmate’s living unit and that the shower drain is covered.

 

• The P&As from Connecticut, Vermont, and New York, along with other prisoner’s rights groups, filed an amicus brief supporting the federal lawsuit of an inmate challenging a New York prison’s refusal to allow him to use his motorized wheelchair in prison.  The correctional facility has a blanket ban on motorized wheelchairs because of alleged safety concerns. Instead of a motorized wheelchair, the inmate was forced to rely on other inmate "pushers" for access to meals, medical care, and basic hygiene, and often missed these essential services because his assigned pushers failed to show up or refused to assist him.  The P&As argued that the prison’s blanket ban violated the ADA. That case is pending.

 

• In 2016 Disability Rights Florida filed a federal lawsuit against the state’s department of corrections. Prior to filing, the P&A had conducted an investigation for almost two years, reviewing thousands of records and interviewing inmates across the system. The suit accuses the prison system of routinely violating the ADA and Rehab Act, as well as the Eighth Amendment and Due Process Clause of the Fourteenth Amendment. Among the claims presented are allegations that certain prisons are not fully wheelchair accessible, and that the prison system excludes prisoners from work programs and other services because of their disabilities, while retaliating against them for attempting to exercise their rights under these laws. The P&A is seeking an injunction requiring the state’s department of corrections to, among other things, comply with federal disability laws, provide prisoners with the aids and services they need, structurally modify prisons where necessary to ensure equal access, and train its staff to ensure ongoing compliance.

The AVID Prison Project is a collaboration between The Arizona Center for Disability Law, Disability Law Colorado, The Advocacy Center of Louisiana, Disability Rights New York, Protection and Advocacy for People with Disabilities of South Carolina, Disability Rights Texas, Disability Rights Washington and The National Disability Rights Network.