Lawyers representing people locked up at Louisiana State Penitentiary at Angola and those working for the prison offered dramatically different versions of healthcare and disability accommodations at the facility in a federal court hearing on Monday.

The hearing was the beginning of the “remedy phase” of a trial over healthcare at the prison, part of a seven-year-old federal class-action lawsuit filed by civil rights groups on behalf of all prisoners who are or will be incarcerated in the prison.

The two-week  trial follows a ruling against the state Department of Public Safety and Corrections last year by Judge Shelly Dick of the U.S, District Court for the Middle District of Louisiana in Baton Rouge. More than two years after the first phase of the trial — called the “liability phase,” during which plaintiffs made the case that conditions at the prison violated prisoners’ civil rights — Dick ruled in 2021 that the prison was in violation of the 8th Amendment of the U.S. Constitution and the rights of disabled prisoners guaranteed by the Americans with Disabilities Act and the Rehabilitation Act.

Now Dick will hear from the parties on how to fix the problems, though the state is arguing that it has already taken appropriate action. 

Mercedes Montagnes, executive director of Promise of Justice Initiative, representing  the prisoners, said on Monday that her clients were receiving the “​​“exact same pattern of grossly inadequate care” that Dick found unconstitutional last year. But Connell Archey, a lawyer contracted by the Department of Public Safety and Corrections, on the other hand said that it was a “new day” at Angola, and they had made “great strides” in addressing the issues.

The case, which was filed in 2015, initially went to trial in October of 2018, and lasted 11 days. Then in 2020 Dick herself toured Angola. When she finally issued her 124-page-ruling in March of last year, she found that the prison had been “deliberately indifferent” to the “serious medical needs” of prisoners at the prison. 

Physicians at the facility “focused on episodic complaints rather than the underlying state of disease” and “routinely fail to perform a meaningful physical examination, read and monitor testing, and monitor and manage medications, including educating patients regarding medications,” Dick wrote in the 2021 ruling.   

The clinical exam rooms, she found, had “serious hygiene deficiencies” including “a lack of usable handwashing facilities.” 

Montagnes on Monday said that “everything we saw in the liability period repeats itself.” Given the lack of progress the court would likely need to appoint outside monitors to supervise healthcare until it comes into compliance with federal law, she said.

One contributing issue she identified was personnel. She noted that Dr. Randy Lavespere, former medical director at Angola, who Dick found had “directly contributed to constitutionally infirm health care,” was now the medical director for the state department, overseeing healthcare at all Louisiana prisons.  

And Lavespere’s subordinantes, officials involved in the administration of healthcare at Angola, had not taken Dick’s ruling to heart, Montagnes said.  

“This is not a cast of characters who have internalized what has happened in this case,” she said. 

Archey, for the defendants, outlined improvements in coordination among the medical staff at Angola, including daily morning meetings, and increased number of nurse practitioners.  He stressed that the plaintiffs must show that the conditions at the prison are still unconstitutional. 

“It’s not good enough what happened then,” Archey said. “Are they persisting, and are they going to persist into the future?” 

‘Treated like numbers’

On Monday, the plaintiffs called Angola prisoner Dennis Mischler to testify regarding what he characterized as the “very poor” medical care he was receiving for several issues including diabetes, a deteriorating spine, and a urinary tract issue that causes him to frequently urinate on himself — which he said is getting worse.

Mischler, 70, was transported from Angola to Dick’s courtroom in Baton Rouge to testify. Confined to a wheelchair and dressed in an orange jumpsuit, handcuffs were only removed from his wrists when his lawyer asked the judge that they be removed, and Mischler testified that they were causing him pain. 

Since he arrived in Angola in 2018, Mischler said that the medical providers at the prison had not demonstrated any cohesive understanding of his conditions.

“They don’t really know what’s going on,” he said. “We’re sort of treated like numbers.”

Mischler said he would like more robust interventions for both his back pain and his urinary tract issues, but has not received them. A doctor who diagnosed deterioration of his spine, prior to his time at Angola, had said he may need an operation. But he said he hasn’t had any follow-up testing. 

In addition, he said he has never received a diagnosis for his urinary tract issues, and would like more tests for that as well to determine what is going on.

The management of his diabetes isn’t any better, Mischler said. Security staff provide him with insulin, but sometimes they don’t have test strips available so he can determine his blood sugar and take the correct amount. 

“So I could take the wrong amount of insulin,” Mischler said. “It’s very dangerous.”

He estimated that he is given insulin without testing his blood sugar once or twice every few weeks. 

“I have a great deal of concern for security giving me insulin,” he said. “They don’t know anything about my condition.”

When asked on cross-examination when exactly the issues with testing and insulin had been happening, Mischler said it had just happened the day before. 

“It’s continuing,” he said. “It occurred yesterday,” 

He added that he is not provided with an appropriate diet for his condition. 

“I’m on a diabetic diet, but it’s not a diabetic diet,” he said. “It’s pretty much the same food they give everybody else, but instead of giving me fried food they’ll give me baked foods.”

Mischler said that much of the food he is given he can’t eat, and he has brought it to the attention of several prison staff members

“One doctor even told me that he approached the administrators that he developed a diabetic menu that would be less costly,” he claimed.

But so far, that hasn’t happened. 

Partial settlement withdrawn by AG Landry

Prior to the remedy phase of the trial, lawyers for the plaintiffs and the prison appeared to have come to an agreement to resolve one portion of the suit. 

During the initial phase of trial, an expert had toured the prison and found 190 “architectural barriers” that impeded access for people with disabilities to “access to a range of programs, services, and activities, including housing, toilets, showers, phones, JPay stations, common areas, drinking fountains, recreation areas, transportation, the law library, visiting areas, medication administration, meals, medical services, and mail services.” 

According to Dick’s ruling, one prisoner in a wheelchair testified at trial in 2018 that he was unable to access a shower or bathtub, and “which caused him to give himself bed baths and shave and wash his hair in the sink.” But because the sink was above chest level

Dick found that the plaintiff’s expert’s findings of architectural barrier violations were “uncontroverted” by the DOC, and ruled that they contributed to the prisons violations of the ADA and RA. 

In March of this year, lawyers for the Department of Public Safety and Corrections and prisoners at the facility filed a preliminary agreement into the record that would have addressed the architectural barrier issues. In it, the prison agreed to work with an architectural expert to come up with a schedule for fixing the specific barriers, which would then be signed off on by the plaintiffs and approved by the judge. 

The changes would then be monitored by architectural consultants selected by the plaintiffs and the defense, who would report to the court every six months after conducting an audit. 

But the DOC is being represented by both private contract attorneys along with Louisiana Attorney General Jeff Landry’s Office. And despite the fact that lawyers with the AG’s office names were on the settlement agreement, the day after it was filed, the office withdrew the agreement, claiming it had not been involved in the negotiations. 

“The Office of the Attorney General was inadvertently not consulted in connection with the limited settlement agreement and has requested an opportunity to review the agreement,” lawyers for the office wrote. 

On Monday, Archey didn’t address the abandoned settlement agreement, but said that 150 of the 190 identified architectural barriers had been fixed. 

The remedy phase of the trial is scheduled to continue for 2 weeks. The plaintiffs, who are asking the court to order the prison to make specific changes in order to come into compliance with federal law, will present their case first, followed by the state defendants next week. 

After the trial, the judge will schedule another site visit to the prison.