As described below, P&As and their partners have successfully advocated to limit or end the segregation of inmates with mental illness in various state and federal systems. These examples demonstrate the critical role P&As have played in providing independent external monitoring and advocacy in our nation’s prisons while also making clear that much still needs to be done to advance and protect the rights of inmates with mental illness in segregation.
➢ The Prison Law Office and the ACLU investigated prison conditions in Arizona; specifically those located at the Eyman, Florence, Tucson, Lewis, and Perryville complexes. The investigation revealed that inmates with mental illness were impacted by significant deficiencies in diagnosis, staffing, medication delivery, therapeutic treatment, and protocols for inmates with suicidal ideations. PLO, through the National Disabilities Rights Network, contacted Arizona Center for Disability Law regarding a potential partnership. In October 2011, PLO wrote a letter to the Director of the Arizona Department of Corrections demanding that the Department remedy the conditions described above on the grounds that the conditions violated the Eighth Amendment. When the Department did not timely remedy the conditions, PLO along with the National and Arizona chapters of the ACLU, Perkins Coie, and Jones Day, filed a class action lawsuit against the Department. The Arizona Center for Disability Law joined as an organizational plaintiff on the mental health care claim on behalf of the class of inmates with mental illness.
After two years of discovery and lengthy monitoring visits, the Department of Corrections and Plaintiffs settled the case. The settlement included provisions regarding the improvement of health care, mental health care, and conditions of isolation and confinement for inmates in maximum custody. The settlement provisions related to inmates in maximum custody included: requiring minimum levels of out-of-cell time; restrictions on length of stay in segregated housing; incentives for out-of-cell time, programs, and property; and restrictions on use of pepper spray and other chemical agents. The settlement also ensured ongoing monitoring of prison facilities by Plaintiffs, including the Department’s monthly submission of inmate health care records, 20 prison monitoring days per year, and substantial compliance in performance measures agreed upon by the parties, as well as attorneys fees.
The formal monitoring process for the settlement began in March 2015. After reviewing reports produced by the Department as well as other documents, and conducting monitoring visits during the first year of implementation of the settlement, Plaintiffs found that the Department of Corrections was substantially noncompliant with many performance measures and that prisoners were still experiencing lengthy delays in receiving care. Plaintiffs provided the Department with a Notice of Substantial Noncompliance in October 2015 and as required by the settlement the parties attended mediation and attempted to address the matter. Following the mediation several issues remained unresolved and Plaintiffs filed a Motion to Enforce the settlement in April 2016. In May 2016, the Court ordered the Department of Corrections to develop and submit to the Court for review a remedial plan to come into compliance with numerous performance measures in the settlement. The Department’s remedial plan was submitted to the Court in June 2016 and is currently under review.
➢ In 2012, Disability Law Colorado, formerly The Legal Center, joined in a class action lawsuit against the federal Bureau of Prisons to improve conditions that were alleged to violate the Eighth Amendment for confining inmates with severe mental illness for 23 hours per day, seven days per week in the United States Penitentiary, Administrative Maximum Facility (ADX).53 The United States District Court For the District of Colorado granted Disability Law Colorado’s motion for partial summary judgment on the issue of the P&A’s associational standing to pursue claims for declaratory and injunctive relief for all inmates with mental illness incarcerated at the ADX. As of the date of this report, the parties are in confidential settlement negotiations. However, the Bureau of Prisons has taken significant action to cure the alleged constitutional violations. Some of the significant actions taken by the BOP include; system-wide policy formulation and revisions concerning the care and treatment of inmates with serious mental illness, excluding inmates with serious mental illness from the ADX, screening inmates at the ADX for serious mental illness, and transfer of inmates from the ADX who have a serious mental illness to new programs at treatment facilities within the Bureau of Prisons system. As this case progresses to settlement or trial, Disability Law Colorado intends to monitor the Bureau of Prisons’ progress in correcting the identified areas of concern.
The Legal Center is not using federal grant money to fund this litigation since it involves a federal agency.
➢ Connecticut Office of Protection and Advocacy for Persons with Disabilities filed a lawsuit against the Department of Corrections on behalf of inmates with mental illness confined at the supermax prison in Connecticut in 2003. The action alleged that the prison system confined inmates under conditions of extreme isolation sufficient to exacerbate mental illness and failed to provide appropriate mental health treatment. The parties ultimately agreed to a settlement in 2006, which, among other things, required prison clinical staff to review an inmate’s mental health records to determine whether the behavior that led to a potential sanction was a manifestation of the inmate’s mental illness. If the inmate’s behavior was deemed to be a symptom of mental illness, sanctions were not to be imposed if clinically determined to cause harm to the inmate.
➢ In 2014 Disability Rights Florida began investigating the scalding death of an inmate in the inpatient mental health unit of a state prison. The P&A quickly discovered that this was not an isolated incident of abuse and that the correctional officers at the unit had a pattern of abusing inmates exhibiting behaviors that were the result of untreated or undertreated mental illness. Further investigation revealed the mental health care being provided to inmates on the unit was inadequate to the point of being almost nonexistent. With Disability Rights Florida serving as an organizational plaintiff, the P&A, along with private firm co-counsel, filed a federal lawsuit against the state’s department of corrections and its mental health contract provider, Wexford, for its failure to protect inmates in the unit from abusive correctional officers and for its failure to provide adequate mental health care on the unit. The lawsuit raises claims under the Eighth Amendment, the ADA, and the Rehab Act. Shortly after litigation was filed, the parties met regarding potential settlement and agreed that each side would retain a mental health expert and security expert to visit the unit, review records, and interview staff and inmates. The experts wrote reports identifying the issues that needed to be addressed in settlement, including provision of treatment interventions, individualized service plans, training of security and mental health staff, treatment team meetings, the use of restraints, and enhanced oversight to prevent inmate abuse. Based on the experts’ reports, the parties negotiated a settlement and a plan of compliance, which was finalized in early 2016. Under the terms of the agreement, the prison has six months to implement the plan, at which point the experts for both sides will return to evaluate whether the plan has been adequately implemented. If not, the case will be reopened in the federal court and litigation will resume. This case remains pending. More coverage on Florida prisons and segregation by the New Yorker.
➢ Equip for Equality, the Illinois P&A, investigated conditions at four Illinois prisons that contained residential treatment units for inmates with mental illness. The investigation revealed a lack of appropriate treatment and punitive approach to mental illness, including the overuse of isolation, including disciplinary segregation and “crisis” cells. The P&A subsequently joined a prisoners’ right organization, the Uptown People’s Law Center, and two private law firms, Dentons and Mayer Brown, to represent all prisoners with mental illness in a class action case challenging the conditions of confinement and lack of mental health treatment in the Illinois Department of Corrections. The case included claims brought under the ADA and the Rehab Act, as well as the Eighth Amendment.
In December 2015, after years of negotiations and litigation, the parties reached a settlement. The settlement agreement requires a complete overhaul of the prison mental health system, including mechanisms and timelines for appropriate treatment, as well the construction of a psychiatric hospital and additional residential treatment units at four facilities. Under the settlement, all prisoners with mental illness in long-term segregation (more than 60 days) will have both structured and unstructured out-of-cell time, starting with eight hours and increasing to 20 hours per week. The settlement requires other changes to the disciplinary procedures to prevent discipline for mental illness-related behaviors such as self-harm and to reduce the segregation of seriously mentally ill prisoners. Additionally, the settlement calls for increased training for all correctional and clinical staff, and contains enforcement measures that include ongoing monitoring and reporting, an independent monitor, the ability to return the case to litigation if the Department of Corrections does not substantially comply with the settlement terms, as well as attorneys’ fees and costs. The court held a fairness hearing on the proposed settlement agreement in May 2016 and approved the settlement agreement.
➢ In 2008, Indiana Disability Rights and the ACLU of Indiana filed a lawsuit against the Indiana Department of Correction on behalf of the P&A Commission and three individuals representing a class of inmates with serious mental illness. The lawsuit alleged that the Department was housing inmates with mental illness in segregated or excessively isolated and harsh conditions where they failed to receive adequate mental health care. After four years of litigation, the court found that the Department, which had been placing inmates with serious mental illness in isolation with little or no access to treatment, violated Eighth Amendment prohibitions against cruel and unusual punishment. Inmates subjected to these conditions faced significant worsening of symptoms and illness, including hallucinations, increased paranoia and depression, self-harm, and suicide. In an effort to resolve this action, the parties worked together to come to a settlement agreement to improve conditions for inmates with serious mental illness.
The agreement prohibits, with some exceptions, the confinement of inmates with serious mental illness in restrictive status housing or protective custody (segregation). The agreement also provides for “minimum adequate treatment” for these inmates, which includes: an individualized treatment plan created by a team consisting of mental health professionals and correctional staff who are familiar with the inmate, reviewed at least every 90 days; 10 hours each week of therapeutic programming, which includes individual and group therapy; recreation and showers; and additional therapy and out-of-cell time where possible and appropriate.
The agreement also stipulates that inmates in restrictive housing will receive frequent monitoring of their mental health status and needs by mental health personnel, including daily visits by correctional and medical staff. In addition, any inmate with a mental health diagnosis will be visited at least once a week by mental health personnel and offered monthly out-of-cell monitoring by a mental health professional.
➢ Disability Rights Maryland settled a case in which the federal district court asked the P&A to represent an inmate who had filed a lawsuit alleging brutality in prison. Sidley Austin LLP agreed to co-counsel the matter pro bono. The inmate had a history of mental illness and multiple adjudications of incompetency to stand trial. The P&A’s initial obligation, tasked by the federal court, was to determine if the inmate could proceed in person or needed a guardian. It was determined that the inmate was competent to engage counsel and the P&A began investigating the inmate’s brutality claims. Unfortunately, the events leading up to the inmate’s lawsuit were barred by the statute of limitation. However, while investigating, the P&A learned that the inmate had been held in segregation for over three years, which was harmful to his mental health.
Disability Rights Maryland and Sidley Austin negotiated a settlement agreement with the State Department of Public Safety and Correctional Services to address the following: the inmate’s transfer from the prison where he had been seriously injured and continued to feel that he was in danger to a prison closer to his family; agreement not to discipline the inmate for self-injurious behavior, and to avoid the use of administrative segregation whenever possible; continued assessment of the inmate’s mental health status if segregation is used in the future and consideration of alternatives to segregation, including recommendations for services and time out-of-cell; use of a multi-disciplinary team to address the inmate’s somatic and mental health needs; and, since the inmate uses a wheelchair, specific accessibility features in his cell unless no longer medically necessary.
The case gave the P&A insight into the Department’s use of segregation that will be useful as it continues to investigate use of segregation for inmates with mental illness. The P&A’s PAIMI Council and Board of Directors have voted to add a provision to the P&A’s Advocacy Services Plan to include advocacy work to reduce the use of segregation for prisoners with mental illness.
Subsequent to settling this case, Disability Rights Maryland has visited other Department facilities, reviewed records and state documents, and interviewed inmates with disabilities. The P&A also worked successfully with other groups to advocate for state legislation that will require the Department to collect and make available data on the use of segregation, disaggregated by various factors including “serious mental illness,” and to include such information as length of stay and attempts at self-harm.
➢ After receiving complaints of excessive restraint and seclusion at Bridgewater State Hospital, a hospital run as a correctional facility by the Massachusetts Department of Corrections, as opposed to a mental health hospital run by the Department of Mental Health, the Disability Law Center, the Massachusetts P&A, opened an investigation in the spring of 2014. The P&A conducted an intense investigation over three months, using five attorneys and additional assistance provided by law students. The P&A conducted tours on site, interviewed correctional and mental health staff, and did in-depth interviews of 75 patients and record reviews of 64 patients. At the conclusion of its investigation, the P&A issued a 24-page letter of findings to the Governor, identifying 11 critical problems with excessive use of restraint and seclusion and providing policy recommendations, including a need to restructure agency oversight, provide greater resources for staffing, and require more rigorous training.
After negotiations with Disability Law Center, the Commonwealth approved a series of systemic reforms at the hospital, including major improvements around restraint and seclusion practices. The P&A also contracted to monitor the hospital for a period of two years beginning at the end of 2014. Finally, the P&A also agreed to serve as court monitor to oversee an agreement reached by the Commonwealth with other parties in Superior Court litigation. Since that time, Disability Law Center attorneys have typically been on site three full days a week. This on-site review includes meeting with patients; touring units (especially the seclusion rooms); meeting with leadership and other correctional and mental health staff; troubleshooting; and identifying areas of noncompliance and issues for policy reform. The P&A has also worked with state agency leadership, representatives from the Governor’s office, legislators, families, other advocates, and representatives of the media to help explain the urgent need for restructuring and improvement at the facility.
There have been several positive developments at the hospital. Rates of restraint and seclusion have decreased considerably. The hospital is more closely following the legal standard governing the use of its Intensive Treatment Unit, or segregation unit. The Department of Corrections also established an Executive Committee to advocate for more hospital resources. Additionally, the hospital’s mental health contractor has been able to obtain some additional funds to improve staffing ratios and new leadership now administers the facility. The P&A continues to work with key stakeholders to place the hospital under the control of the Department of Mental Health, and to improve and restructure the facility. The P&A will continue intensive monitoring at least until the end of 2016.
Unfortunately, however, the modest progress at the hospital has also been accompanied by tragedy. In April 2016, a patient with mental illness committed suicide while in the isolation unit at the hospital. The Disability Law Center has opened an intensive investigation into this death due to its concerns that patients at the hospital will continue to be at risk of harm to themselves until the facility is transitioned from the Department of Corrections to the Department of Mental Health.
➢ The Disability Law Center, the Massachusetts P&A, in partnership with the Center for Public Representation, Prisoners’ Legal Services, and the private law firms of Bingham McCutcheon and Nelson Mullins, sued the Massachusetts Department of Corrections and several of its senior administrators alleging that housing inmates with serious mental illness in segregation violated their constitutional rights against cruel and unusual punishment and violated the ADA. The P&A filed suit in 2007 after 11 inmates committed suicide in segregation within 28 months. At least seven of the inmates had serious mental illness.
After five years of litigation, a settlement was approved and the Department of Corrections implemented significant systemic reforms, including a mental health classification system, a policy to exclude inmates with severe mental illness from long-term segregation, and the design and operation of two maximum security mental health treatment units as alternatives to segregation. These units have dramatically reduced the number of acts of self-harm and suicide attempts. They have also made the prisons safer for staff and other inmates by substantially reducing disruptive and assaultive behavior. Under the terms of the agreement, the Department must maintain the number of beds in the alternative secure treatment units and “strictly regulate” the amount of time that prisoners with severe mental illness are held in other segregation units. In addition, the Department also must provide expanded mental health services and out-of-cell time for prisoners with mental illness who are awaiting placement in treatment units or removal from segregation. Plaintiffs’ attorneys closely monitored the implementation of the agreement.
➢ After a year-long investigation, Disability Rights Montana signed on as organizational plaintiff in 2014 in a federal lawsuit challenging the policy and practices at Montana State Prison in treating and confining inmates with mental illness. The lawsuit raised claims under the Eighth and Fourteenth Amendments of the U.S. Constitution as well as the ADA, and alleged that the prison impermissibly imposed solitary confinement or behavior modification plans on inmates with mental illness, thereby depriving them of clothing, bedding, human contact, a working toilet, and proper food as punishment for behaviors caused by mental illness. This case is ongoing.
➢ The Nevada Disability Advocacy and Law Center, Nevada’s P&A, was contacted by the Ninth Circuit Administrator concerning a case filed on behalf of a female inmate with borderline personality disorder, mental illness, and intellectual disability who had been housed in segregation on the mental health unit at a men’s prison in excess of 13 months. The women’s prison in Las Vegas was not equipped to handle the inmate’s mental health condition and self-injurious behaviors.
Nevada Disability Advocacy and Law Center was appointed as counsel for the limited purpose of investigating the inmate’s claims and representation at an early settlement conference. The court also appointed a psychiatrist as guardian ad litem to assist with the investigation and early settlement. The matters at issue in this case were whether the Department of Corrections failed to protect the inmate from sexual harassment by male inmates; prolonged solitary confinement for a period in excess of 13 months; failed to provide meaningful mental health treatment; and deprived the inmate of outdoor recreation for a period in excess of 13 months, as a result of “deliberate indifference.” The facts of the case also highlighted the disparity in mental health treatment options for female and male inmates. Shortly after the complaint was filed, the inmate was transferred back to the women’s prison and the case was ultimately settled for a substantial sum of money. As part of the settlement, the Department of Corrections was to pay for a Dialectical Behavior Therapy specialist to consult with the inmate’s treatment team to develop an appropriate treatment plan, as well as develop a safe release plan. Subsequently, an intensive forensic mental health team from the state mental health division agreed to accept the inmate to is program and coordinate with the Department.
➢ In 2002, Disability Advocates, Inc., now Disability Rights New York, joined as co-counsel with Prisoners’ Legal Services of New York, the Legal Aid Society of New York’s Prisoners’ Rights Project, and Davis Polk & Wardwell in bringing systemic litigation to address what had become a cycle of misery for hundreds of prisoners housed in Special Housing Units (SHUs), or segregation (also discussed in the Non-Litigation section of this report). The P&A also appeared as plaintiff in the litigation on behalf of a constituency of prisoners with “significant mental illness or emotional impairment who reside in New York State prisons.” The complaint for injunctive, systemic relief was brought against the Department of Corrections and Community Supervision, the state Office of Mental Health responsible for providing mental health services in the prison system, as well as individual superintendents and Office of Mental Health officials. It alleged deliberate indifference to prisoners’ serious mental health needs, by failing to provide adequate mental health services and imposing punishments which aggravate mental illness, as well as violations of the ADA and the Rehab Act. The complaint described the systemic failure to provide necessary mental health care, the suffering and suicides of inmates with mental illness in SHU, and the knowledge by prison and mental health officials of these continuing harms. Finally, it outlined the remedies needed, including increased treatment resources and a prohibition against placement of prisoners with mental illness in solitary confinement.
After the complaint was filed, the parties embarked on years of discovery, culminating in a partial trial in 2006. During the trial in April 2006, following the testimony of experts and several inmate witnesses, the federal district court judge toured several prisons with the parties and informed the parties of the gravity of the conditions in solitary confinement that he had observed, particularly the withdrawal and idleness of so many inmates in isolation. Following this court conference, defendants offered to meet with plaintiff to discuss settlement, and the trial was adjourned for purposes of these discussions.
One year later, in April 2007, settlement was finally reached in the form of a private settlement agreement.54 As a result, SHU confinement for inmates was subject to increased levels of review and out-of-cell treatment and programming was required for inmates meeting criteria for “serious mental illness.” The settlement’s key components were: 1) a “heightened level of care” for inmates meeting criteria for “serious mental illness” and with SHU sanctions greater than 30 days, of two hours out-of-cell treatment five days a week; 2) criteria for serious mental illness, including psychotic disorders, bipolar disorders, schizophrenic disorders, major depressive disorders; other mental illness, organic disorders, and personality disorders included if rising to high levels of dysfunction; and serious, recent suicide attempt; 3) Suicide Prevention Screenings within 24 hours and Mental Health assessments within one working day of admission to SHU; 4) universal mental health screening at reception into the prison system; 5) increases in treatment bed capacity and residential mental health programming, including SHU diversion programs, with two programs offering up to four hours daily programming; 6) joint facility-based Department and Office of Mental Health case management committees reviewing all Office of Mental Health caseload inmates in SHU, as well as a central office administration committee rotating through the facility committees to oversee the reviews, and a one-time central office committee review of SHU sanctions for all inmates with serious mental illness; 7) monitoring of the agreement, consisting of semi-annual tours, with periodic reporting and document production to plaintiff; 8) and required mediation before the Court for pervasive non-compliance of a material provision of the settlement, following which the Court may recommend extension of the settlement or plaintiff may move to reinstate lawsuit.
Many of the settlement terms were incorporated into New York’s “SHU Exclusion Law” which passed both houses and was signed into law in July 2007. The SHU Exclusion provisions went into effect in July 2011, following the anticipated sunset of the lawsuit’s settlement agreement. (See discussion at pp. 13-14 under Non-Litigation Advocacy).
➢ Disability Rights Pennsylvania conducted a comprehensive monitoring of the Pennsylvania Department of Corrections’ solitary confinement units starting in 2007. Over the next six years, the P&A met with hundreds of prisoners, reviewed thousands of pages of documents, and consulted with mental health experts regarding the mental health treatment and housing that was provided to prisoners with mental illness. Monitoring and investigation revealed that approximately one-third of 2,400 prisoners in solitary confinement had serious mental illness which represented a significantly disproportionate share compared to the general prison population. Many prisoners with mental illness were also not receiving adequate mental health treatment. The P&A also had grave concerns regarding the Department of Corrections’ prevention of and responses to self-harming behaviors including completed suicides. The P&A attempted to work with officials at the Department, but when they failed to take any remedial action, Disability Rights Pennsylvania and outside legal counsel filed a federal lawsuit on March 11, 2013.
After nearly two years of negotiations, on January 9, 2015, Disability Rights Pennsylvania and the Department reached a comprehensive settlement agreement that reformed mental health screening, tracking, and treatment for all 52,000 state prisoners in Pennsylvania. The Department can no longer place prisoners with serious mental illness in solitary confinement. New prisoners receive timely mental health screening and classification for housing and treatment purposes. New mental health treatment units have been created and staffed, along with an expansion of spaces for counseling and recreation. Almost 100 new mental health staff have been hired by the Department with approximately 80 more to come over the next year. All Department staff have received Mental Health First Aid Training and hundreds more have been receiving Crisis Intervention Training. New out-of-cell programming provides opportunities for prisoners with mental illness to leave their cells, receive needed care, and socialize. Prisoners with mental illness are now entitled to significantly more access to mental health treatment which must be individualized to the prisoner and include his or her involvement. Prisoners’ mental health history must be considered by a hearing officer at disciplinary proceedings, including whether a particular housing placement would be harmful to the prisoners’ mental health. Prisoners can no longer be disciplined for self-harming behaviors. When possible, mental health staff must attempt to de-escalate a situation before force is used against a prisoner with mental illness. New suicide prevention measures have been developed and implemented.
Disability Rights Pennsylvania continues to monitor and enforce the Department’s compliance with the terms of the settlement agreement. The P&A conducts site visits to state prisons, tours a variety of housing units, meets confidentially with prisoners with mental illness, and reviews Department records including mental health and disciplinary records. The P&A continues to communicate with Department officials and legal counsel as well as expert monitors who track the Department’s compliance with the settlement agreement.
➢ In 2005, Protection and Advocacy for People with Disabilities, Inc., the South Carolina P&A, filed a class-action lawsuit on behalf of inmates with serious mental illness under the state constitution alleging inadequate mental health treatment for inmates held by the South Carolina Department of Corrections. The suit alleged that inmates endured multiple hours of restraint with no bathroom breaks; prolonged segregation; placement naked in shower stalls, interview booths, and holding cells for hours and days with no toilets; and routine and excessive use of pepper spray. The lawsuit asked the court to require the Department to design and maintain a program that provided adequate treatment to inmates with mental illness. In 2012, a five-week trial was held, and in 2014 the trial judge ordered the Department to remedy constitutional violations by submitting a remedial plan to include: the development of a mental health screening tool and treatment program to end inappropriate segregation of inmates in mental health crisis; the employment of sufficient mental health professionals; the maintenance of treatment records and administration of psychotropic medication with appropriate supervision and periodic evaluation; and a program to identify, treat, and supervise inmates at risk for suicide. The parties subsequently engaged in mediation and in 2016 reached an agreement to implement the remedial plan. The plan provides segregated inmates access to group and individualized therapy, access to higher levels of mental health services, more out-of-cell time, and improved cleanliness and temperature of segregation cells. It also calls for staff to collect and report data on the percentage of inmates in segregation with mental illness and their average lengths of stay, timely review treatment records, and implement a formal quality management program under which segregation practices and conditions are reviewed. The settlement is currently pending approval before the State Supreme Court. More case summaries and video from South Carolina.
➢ The Vermont Prisoners’ Rights Office referred Disability Rights Vermont to an inmate with mental illness in segregation. The inmate’s mental health had deteriorated such that he had become manic, delusional, and paranoid, refused his medications, pulled his hair out, sobbed uncontrollably, banged his head, and screamed. After conducting a record review, the P&A determined that the inmate had been identified many weeks earlier as requiring inpatient psychiatric care, but because no inpatient bed was available, the inmate remained in segregation where his condition worsened. Within a week of the P&A contacting the Department with its concern that the inmate’s rights to adequate treatment and freedom from unnecessary isolation were being violated, the inmate was transferred to an acute care facility where he received appropriate treatment and improved, and was furloughed directly home. Disability Rights Vermont filed a federal complaint asserting violations of the Eighth Amendment and the ADA regarding the inmate’s circumstances and the case remains in litigation at this time.
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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.