AX 00:02

So, hello, my name is Alex Mark, and I'm a volunteer with the UCLA Law COVID-19 Behind Bars Data Project. I want to start by explaining how we plan to use this conversation that we're about to have. Our conversation is not legally privileged, and we will not keep what you say confidential. We plan to make transcripts and recordings of our interviews available for use by future researchers and the general public. And portions may be posted online or discussed and posted on our website or other published writing. I want our conversation to flow freely and I realize that you may discuss a sensitive topic or mention a piece of information that you later realized would like to be withheld. If you request it now, at the end of the interview, or later on after further reflection, we are happy for you to review the transcript of our conversation before it is made public and to redact any portions you deem necessary from the transcript and the recording. So, without further ado, please introduce yourself.

AM 00:53

Good morning. Thank you for ha- thank you for giving me this opportunity. My name is Alan Mills. I'm the Executive Director of the Uptown People's Law Center.

AX 01:02

Wonderful. So, I want to start by going back to last spring 2020, very beginning of the pandemic. How can you describe your personal experience, um, and more importantly, your experience as an advocate when the pandemic just started.

AM 01:21

Um so we had um for many years had a couple of class action lawsuits, um which were in settlement posture. Um one about mental health care and one about medical care, um both covering all prisoners in the Illinois Department of Corrections. Um o, we were in touch with a lot of prisoners um for many years. Uh Throughout the system, we got probably about 100 letters per week. And we're regularly visiting prisons. In fact, we just come back from a visit on March 10th, to one of the medium security prisons, which has a large segregation unit, as well as the general medium side. Um and uh then every, and, there was talk what during that visit, they you know, they might have to quarantine, they'd said that they'd actually emptied out a one cell house so they could use it to quarantine people and all that, but it was still um pretty vague what was going on as to March 10th. By March 20th, everything had closed down. Um they canceled all visits in the Illinois Department of Corrections and I have not yet been to a prison since March 10th of 2020. Um whereas before I've going, you know, once or twice a month to tour and uh visit with prisoners. Um in Illinois, uh the vast majority of the early cases were all at Stateville Correctional Center, which is the maximum security prison that is closest to Chicago. Um it went from no cases at all to about uh 100 cases very quickly within a couple of weeks. There were news articles about people being rushed to the local hospital being immediately put on ventilators. And there were five or six deaths within that first few weeks after COVID hit the prison system in general. Um it spread to a couple of other prisons early on, but only four or five cases each in those prisons, which was terrifying to the prisoners, but not so much, um wasn't, wasn't nearly as intrusive as Stateville was.Um and frankly, we weren't sure what we could do about this. You know, obviously there was no litigation about it at that point anywhere. Um it had not been part of our medical lawsuit, although it seemed to sort of be part of it cause this is obviously a medical crisis. Um and it quickly became clear that the medical system in Stateville was totally incapable of handling this, this crisis. Um local hospitals were saying that they were overwhelmed withum (the OC) patients so that there was no beds left for the community at large. Um they were holding news conferences about how the department had to get their act together or otherwise they, the whole system was going to crash. Um but again, I was like, okay, lawyers aren't very good about coming in and solving immediate crisis. They're much better at mopping things up afterwards than they are about intervening and I, I was trying to figure out, you know, what, what could we do, we had some conversations among us here at the Uptown People's Law Center. Although we were also trying to figure out how in the world you work remotely– um, going from an all intensely in-person operation to an all remote operation. So, it's not like we were concentrating on anything at all other than trying to figure out how we could stay alive for the next, what we thought was gonna be a few months. And then ah, I have a good friend, former student, Sarah Grady, who has uh, who's at Loevy & Loevy Here in Chicago, who also had a class action case about conditions in Stateville. And they were going through very much the same sort of conversations and late one night she called up and said, you know, we just have to do something we have clients that are dying, uh we can't sit on the sidelines and let this happen, we have to do something. Um so between us we recruited a whole bunch of other lawyers who had done some work in, in the prison field that we both worked with, uh put together a team of uh, I don’t know, probably uh 10 lawyers, and filed a lawsuit. ((AM laughs)) We found people who had, who were medically vulnerable, and who were at State– who I think they were all at Stateville at that point, um saying that the Department of Corrections had to do something. They had to let people out or, you know, figure out some other way to protect people. But letting people out was our first choice, um medically vulnerable people. And the hook we had was that there were a series of existing statutes in Illinois, which allowed for the early release of prisoners under certain circumstances, um including the um medical, medical, a medical furlough statute, which allowed, of course, people to be sent, normally would be sent to the hospital locally, if you broke your leg, you go to a hospital, you get a it set and you come back in. And our theory was that that statute allowed them to move anybody anywhere, for it for the healthcare needs and our theory was that staying in Stateville was contrary to what anybody needed for good health. And therefore they should be sent home on medical furlough until the COVID was under control in Stateville. Unsurprisingly, the Department of Corrections did not agree. We went through a series of negotiations with them before filing a lawsuit, um talking both the department and to the governor's office about what they might or might not do. I do have to give some credit to the governor, they did certainly ramp up the number of people that they released, going from, you know, a trickle of one or two people to ultimately about, I would say they got out maybe thousands people early. But our feeling was that this was not nearly enough, that they should be talking in the tens of thousands rather than in the hundreds. Um and they were just on the wrong, wrong order of magnitude to think about this problem. And, you know, throughout we had talked about the nightmare and what would happen– the advantage of Stateville is it's in a- a urban environment. It's a medium-sized city. So there is an actual medical infrastructure. Some of our downstate prisons are just as large and in tiny little communities. The whole county where our biggest maximum security prison is Menard Correctional Center has two ventilators. And like six ICU beds for the entire county um and a prison of 3000 people. So you know, if even 1% of that population needed to be hospitalized, the entire public health system would crash. The whole southern tier of Illinois, which includes the plurality of Illinois prisoners, um also is vastly under resourced in terms of ICUs and ventilators and that kind of thing. So, you know, that was what we were really worried about, is that this would not stay at Stateville, this would spread throughout the state. Um but luckily, um as our litigation went on, um things seemed to stabilize, it did not go out to the other prisons. Stateville remained a huge mess, they in fact, had to bring in the National Guard Medical Corps in order to do such basic things as take people's temperatures on a regular basis. Umm the doctors and nurses that were employed just didn't have the ability to do that. And, you know, the way we thought about this, stepping outside of the litigation COVID In particular, was that we'd settled the our medical class action case about a year before COVID hit. And that settlement really anticipated it would probably take a decade to bring the system into constitutional compliance. Obviously COVID did not give us a decade to get our act together and quickly show just how thinly stretched they were. Um Aside from the fact that it was a much higher demand for medical services and much more urgent demand for medical services, that people started getting sick as on staff. So they were both understaffed and overworked and over demanded. So the between those two it was just unworkable, people were not getting the kind of care they wanted. People were left in their cells with cellmates long after they had some very serious symptoms that are obvious to anybody and left in their cells far too long without any real treatment or any attempt to get them which is why so many people died at the very beginning.

AX 09:36

Yeah.

AM 09:39

But things didn't spread throughout the state uh immediately anyway. Pretty much for all summer. It stayed. There are a few cases scattered around the state, but basically it was the same three prisons that had been hit hard at the very beginning. And most prisons had one or two cases and it didn't explode anywhere. During that period, what we were really focused on was not so much just the litigation, although that continued on, but also working with community organizations, and some elected officials to do things like get soap to prisoners, so they could wash their hands regularly. Um and, and it took them a long time to get masks out to people. Um Eventually, they did all of that, although it was a real struggle, it wasn't till mid summer, I'd say that they really ramped it up so that they got soap, sanitizer and masks, well distributed throughout the prison system. Um, There were still problems, but they did a lot better than they did at the beginning. Then came August, and in mid-August, we began to see the second wave out here and the public in general. And we had a second wave very much in the prison system. At that point, every prison became infected. And the numbers went from a couple 100 up to first several 1000 And ultimately, 10,000 cases. Um we and the monitor in our federal class action lawsuit had been pushing, really beginning in August, for rapid testing of all staff. The University of Illinois in Champaign, Urbana, the main State campus in Illinois, had developed its own rapid test, which they were requiring all students and staff to take twice a week in order to open up the university. So we said well one state agency is using these rapid tests, and you ought to do it at the prison system. There's only one way the virus can get in the prison, is through staff, you're not allowing visits and prisoners aren't going anywhere, so it doesn't just jump over the walls, magically, it comes in with staff. So if you have a real testing procedure, where you test every guard at the front gate before they walk into the institution, and turn them around, if they test positive, um then you should be able to keep it out of most prisons. The Department of Corrections did not do that. Um so they, they never gave a good reason as to why they weren't doing it. But they basically said we can't do that.

AX 12:05

Mmm.

AM 12:06

And as a result, by December, they still weren't testing, and we had 10,000 People who had tested positive for COVID, and about 80 deaths.

AX 12:16

Yup.

AM 12:17

And our position has been all along that all of those deaths could have been prevented, um had they started testing, like they should have back in August. And it spread to literally every institution, it was not one that didn't have a couple 100 cases. Um Our litigation settled along there somewhere, not for a whole lot. They agree basically to set up a system where they did, they did give good time um to a lot of people who were eligible for it, and therefore they got out anywhere from a month or two early. Um

Some as many- as early as maybe three months early. So that, that a lot about 1200 people who otherwise had not been released already to get out. So, good victory 1200 people got sent home, but not nearly what we thought we needed. Um but the bigger victory was outside, was both in our, we then start pushing on our medical class action case as well, that they really had to do something more than they were doing. Initially, or pushing for testing in that lawsuit. They did start testing in mid December,

rolling out one prisoner at a time to see they sort of wanted to experiment with a prison to see if made a difference. And it did. What you saw when you started doing universal testing was a spike in cases. Um and initially, because of course, the more people you test, the more you're going to find cases that otherwise had been identified. So you saw a huge spike in number of cases, but then quickly, it dropped off. So you would see a rise in a crash. So it was clearly working. And they spread it out to all the prisons, quite quickly within a month. So by mid January, all of the prisons were being tested all the time. At that point the vaccine became either available or was about to be available. Um and then the question was what kind of priority prisoners will be given? We looked around the country and we saw some states that said, prisoners are gonna be last and other states that said prisoners are gonna be the first um and our position was prisoners should be first but an absolute minimum they should not be any different than guards are.

AX 14:29

Yeah.

AM 14:30

As it makes no sense to sort of immunize half the population in a prison.

AX 14:35

Yeah.

AM 14:35

Um if the other half is not inoculated and nothing changes. So and that, that really did involve a full court by press by us in court, but I think probably equally effectively, by a whole lot of other organizations, both other legal organizations and lots of grassroots organizations that care about prisoners.

We also developed an alliance with the warehouse workers who were also in that same fight. They had been deprioritized in a lot of states, including Illinois, and thought that since they're the ones that are out there, making sure there was food on everybody's table, they really should be a higher priority. So we joined forces really in and pushing for each, each other, to be highly vaccinated. And it also turns out that a large number of warehouse workers are formerly incarcerated people, it's one of those jobs that don't require public uh interaction. And therefore, warehouse employers tend to hire formerly incarcerated folks.

AX 15:36

Yeah. That’s interesting.

AM 15:38

So there was a much bigger overlap than I ever ever thought there was going to be. Um so but, eh, but and again, I have to give the department credit, somewhere around mid-January, they did review as a total 180 uh and said, we fought you all along for the last, you know, six months on this question, nine months on this question. Now we're going to vaccinate, we're gonna– we agree with you um they did put guards and prisoners at the same level and fairly early on in the process. Um and then they turned to us and said, alright, we're gonna vaccinate, we want to make sure as many people will take this vaccine as possible. And we know that we, the Department of Corrections, and our medical people are not the ones to give that message to prisoners. So would you help us?

AX 16:22

Yeah.

AM 16:23

Um and not just you, not just us, but the whole coalition of people that had fought for the vaccine. Um and basically, what the Department said is, you give us materials, either videos or written materials, we will reproduce them, and we will make sure every prisoner gets one of their hands. Anything you want to put in. So we did. ((AM laughs))

AX 16:40

Yeah.

AM 16:41

We got letters from both of the monitors in our two federal lawsuits, we had videos, and we is not the Uptown People's Law Center to be clear, it is this whole coalition of people.

We produced a video five or six videos, including a couple by former incarcerated people, either getting the shots themselves, or having a conversation in somebody's kitchen table, which was uh attempting to recreate the kind of conversations that happen inside sells, um sort of just informal back and forth about what you've heard and what you're gonna do, and that kind of stuff. Um because we think that's really where decision making is made among prisoners is talking among themselves, they don't care about authority.

AX 17:19

Absolutely.

AM 17:20

So they we got some former prisoners who had been vaccinated early, when they got out, um they sort of got lucky and that, you know, that there was a whole period of time where vaccines (had falled), and they need, they had extra doses at the end of the day. Um so both of them had gotten vaccinated to that, way, way above their priority um list. So they talked about how desperate they were to get vaccinated, and they were first in line, as soon as this opportunity came, they zipped down there, and they took the rest of the day off and drove a hundred miles in order to get vaccinated. ((AM laughs)) And yes, they had problems in advance.

AX 17:52

Yeah.

AM 17:53

But you know, they overcame those and decided it was absolutely the right thing to do and how much better they felt after they got vaccinated. So, you know, we had lots of those kinds of stories going on. And as a result, um 70% of the prisoners, in fact, accepted the vaccine. Um they continue to inch that up. But in the first round that they did, it was 70%, which I understand is significantly higher than a lot of states, which have read the averages about 40% of prisoners accepted.

AX 18:20

Hm.

AM 18:22

So um I take pride in the fact that first the department was willing to do it and second that we were able to pull this together um in order to make it happen.

AX 18:30

Yeah. So do you think there–

AM 18:33

And now, and just to close this, the loop.

AX 18:34

Sure.

AM 18:35

They’re now um it varies between five and ten but there's like less than a dozen cases throughout the Department of Corrections. And no, but no prison has more than two or three.

AX 18:44

Wow. Do you feel like Illinois’ response was better in some ways than than other states in terms of going in prisons?

AM 18:54

Um I would say, starting somewhere in mid December to late December? Yes. Before that. It was horrific.

AX 19:02

Hm.

AM 19:03

They missed so many opportunities. And it's not because they didn't know about it. And you know, they had a federal monitor on it. And the problem Illinois had is, is they were just so far behind in medical care.

AX 19:15

Yeah.

AM 19:15

The experts who are working on our medical case, um said that Illinois was among the worst states in the country in terms of their medical system for prisoners, in terms of just raw costs. When we started our lawsuit, Illinois was I believe, 48 of the 40– of the 50 states in terms of how much per prisoner they spent on medical care, which surprised me,

AX 19:36

Wow.

AM 19:36

Terrifically. You know, we're a nice blue state, relatively well off.

AX 19:40

Yeah.

AM 19:41

Unless we were really cheap and you're in California, the and it wasn't just by a little bit. I believe we spent about a seventh of what the California system spends on its doctors. It's, uh, you know, yes, the cost of the cost of living in California is a little higher than it is in Illinois, but not seven times higher.

AX 19:58

Yeah. ((participants laugh))

AM 20:00

And of course, the California system is the one that was so bad. The Supreme Court said you have to let people go because you can't fix the medical care system.

AX 20:07

Right. Right. I mean, I was gonna say a lot of those blue well off states did not handle COVID in prisons well, and I just think it goes to show that the political compass does not correlate with how states treat their prisoners.

AM 20:23

Right. I mean, yeah, yeah. I mean, many people have made this point that the prison industrial complex was the one really successful bipartisan action over the last 50 years. It's been supported completely by both parties.

AX 20:38

Completely. Um, so then, kind of switching gears. But you know, I know you've dealt with medical cases before, but do you think this was maybe the first case or set of cases where you're really dealing as a public health advocate, in addition to being a human rights advocate?

AM 21:02

Yes, absolutely. I mean, that was one of the points we made over and over again, is what happens in prison doesn't stay in prison. You know, every, every week, uh, I forget our exact number. But something like 10,000 people walk in and out of prisons, mostly staff would go home at night. Um but also just in an ordinary course, they let out 1000’s of prisoners every week, because their sentences are up, not early releases, nothing else just cause their sentences are up, and they come back to the community.

We weren't particularly involved in the Cook County Jail, but our good friends were and some of our co counsel were on both those cases, both that, there was a separate case about Cook County Jail.

And uh, you know, the at the jail, that was even more of an issue, was even of the public statements was public health. Somebody did a study showing that I think it was about 16% of all cases in Cook County, could be traced back to the Cook County Jail.

AX 21:59

Mm.

AM 22:00

And I don't know of any study like that, really into the state prisons, but it has to be a large number of people that interact just because,

AX 22:08

Yeah.

AM 22:08

South of in the southern third of Illinois, the department Corrections is the largest employer in the state.

So it's not surprising that what happens in the community goes into the prison gets magnified, and it goes back out in the community, it's very much a cycle, a self-reinforcing cycle. Um the bad news is, as of now, while prisoners have done quite well, there actually many more cases of guards that are positive, and guard acceptance rate was down about 30%. Not 70% for prisoners, but only about 30%.

AX 22:45

Accepting the vaccines?

AM 22:46

Yeah, accepting the vaccines, right. And then a couple of prisons, it's well below 10% which is just unbelievable to me.

AX 22:54

So you mentioned earlier that um the staff asked you, your team to make videos, because a lot of the prisoners don't trust authority. They don't trust the guards. But their acceptance rate was higher. So what do you think explains that? Um, if that question makes sense, where, you know, the prisoners clearly don't trust authority, and yet, they still eventually decided it was the right thing for them to do.

AM 23:20

I, and, our, it was our, I believe it was our educational materials. They weren't relying on authority. They were relying on us.

AX 23:27

Yeah. Um, and so do you think there's something with prison staff culture? And just I don't know. Do you have any, I'm not trying to just openly speculate, but what, what do you think explains that disparity? If you had to guess or,

AM 23:48

Disparity meaning the staff? ((Lowest timeframe?))

AX

Yeah, yeah.

AM 23:52

I mean, I think, and I have not studied this. So this is very much my impressionistic view of things.

AX 24:01

Yeah.

AM 24:02

You know, most guards live in counties that voted heavily for Trump.

AX 24:08

Okay.

AM 24:09

Uh and, you know, that's the statistics we see all over the country is that Trump voters tend to be much more vaccine resistant than Biden, Biden votes. And I just think that's where most guards live.

AX 24:21

Okay.

AM 24:22

So I don't think the guards are particularly adverse it’s just, you know, the, the general population that they come from. And that has a lot to do just where we choose to locate our prisons.

AX 24:46

That makes sense. Um, and also with where the prisons are located. Do you think the um just the public health effect of prison policy had a different effect in maybe the counties that like, just were more accepting of pandemic science pandemic guidelines in general? Um because they were, I guess, more holistically trying to respond, before, you know, for everyone.

AM 25:14

Maybe, I mean, the vast majority of our prisons are not in blue counties.

AX 25:16

Yeah.

AM 25:16

They're very much in red counties. I, so, you know, Cook County, obviously is in Cook County, which is heavily Democratic, overwhelmingly democratic. And it didn't do a great job at all. Uh early, I would say it turned things around quicker than the state did. So in that sense, maybe yes.

AX 25:38

Okay.

AM 25:39

Uh but, you know, in terms of the prison system, you know, Joliet the Stateville prison is in Joliet, which is a pretty democratic area. And it was the one that did the worst. So.

AX 25:50

Hm. (It’s still) in a more urban, concentrated area.

AM 25:56

Yeah right, that's the one that hit first where, yes, it's in an urban area. It's closest to Chicago. Um so yes.

AX 26:05

How much of uh, how much of Stateville’s response do you think just really had to do with the people in charge there? And how much of it do you think was systemic?

AM 26:14

Well Stateville’s response I think was, was simply a crisis, which exposed the weaknesses that we all know existed in the medical care system. I mean, just to give a very simple example, um Illinois Department of Corrections had never had a infectious disease expert on staff.

AX 26:33

Hm.

AM 26:33

The person who was the so-called infectious disease control person, had no training in infectious control, infectious disease control, there's just a nurse.

AX 26:43

Yeah.

AM 26:44

So, you know, that's kind of a crucial position have when you have a pandemic spreading. Uh so they really didn't know what they're doing. They just didn't have any idea what they're doing is, these are some medical staff that was barely meeting that man before the pandemic came along, simple things like the flu, and more complex things like diabetes and kidney disease, and all the problems that prisoners have, were not being properly treated. So it's not surprising at all, to me that they simply collapsed. Once, once uh the pandemic hit. (As already said), you know, our, our settlement agreement thought about 10 years, nature gave us nine months, unsurprisingly, we failed the nature's stress test on the system.

AX 27:26

Yeah.

AM 27:27

And dramatically, it didn't help that it was at the first beginning, so that nobody knew what they were going to what they should really be doing at the beginning. People on the outside, were fumbling around trying to figure out how to treat COVID patients, and what the right thing was, and you know, we went through all kinds of things as to whether or not touch was the way it was being transmitted, or aerosol or, you know, said we're trying to figure out the science on the outside. So you can't totally blame the administration. On the other hand, it was very clear that they were not identifying people anywhere near as quickly as they should have as deep potentially positive.

AX 28:00

Yeah. Do you think uh medical system’s going to adjust and try to prepare for the next time this could happen?

AM 28:08

I mean, yes, but (.) our federal court consent decree requires them to adjust.

AX 28:19

Okay.

AM 28:20

So you know, the idea was to build, build a constitutionally adequate medical care system, I think that they've learned some lessons. But it's still like every other case, it's a fight to get them to implement it, you know, it really changes the entire culture of the or, of the organization, those are always really hard things to do. Medical care has often been viewed as sort of a privilege rather than as a constitutional mandate.

AX 28:42

Yeah.

AM 28:43

You know, I talk all the time about how, you know, when, when there is uh something goes wrong medically um generally, the sort of shrugged it off, well, you know, these mistakes happen. If they took it really seriously, It would be like whether or not you locked the cell doors. You know, if, if one day, a third of the cell doors weren't locked, heads would roll on, you know, that would be like,

AX 29:08

Yeah.

AM 29:08

There would be arrests, the whole system would go up in arms and say, what the hell's going on. what happened, etc, etc. Whereas a third of the day, if one day, a third of the prisoners meet, miss their medical appointments, because something went wrong in the prison, it’s like eh we'll get to it. So. you have to view it's really a question of how you view this. And then it just the basic infrastructure. I mean, we don't have enough doctors and nurses. We don't even have the electronic medical record yet. Um

So we just the infrastructure just isn't there.

AX 29:35

Is that a cost problem? Is it a priorities problem?

AM 29:40

All of that.

AX 29:40

All of it? Yeah. Um wow. I mean, that's astonishing. Um (.) Yeah I want to ask if you foresee that changing anytime soon, but I guess you just answered it, but I mean, have you have you seen a change in the past, you know, from when you first started working on these types of cases to, I'll say, up until when, you know, right before COVID hit?

AM 30:10

Well, alright, so (I mean) this goes back a long ways,

AX 30:17

Yeah.

AM 30:17

Um you know, medical care in Illinois has never been great. I would say it got a lot worse when they privatized medical care here,

AX 30:24

Okay.

AM 30:24

Which was a good 20 years ago, maybe more 30 years ago, something like that

long time ago. And it really hasn't been hasn't changed much since. Um the medical care began to improve a little bit in that year between our settlement and the onset of COVID. But they were nowhere near meeting the deadlines that are in the consent decree. And we were going to go in and start enforcement proceedings, but then the whole world changed. So we haven't done that.

AX 30:55

Yeah.

AM 30:55

Just, Just I think yesterday, filed a motion to enforce all kinds of things. I mean, they haven't even done the very basic thing, uh a staffing analysis, how many staff do we actually need in order to carry out our duties that now had uh two years to do that. Uh and it hasn't yet been done. So they're recalcitrant and slow. Um they will tell you we've done more in the last three years than anybody any administration did in the previous 20. And they're probably right. Um but that, you know, going from zero to one is great, but you need to get to 100, uh.

AX 31:35

Yeah.

AM 31:35

So yes, zero to one is better than staying at zero. But you're still way down at the bottom, you really got to increase.

AX 31:41

Right.

AM 31:41

I will say the mental health side, which we settled, you know, five plus years ago,has dramatically improved, it's still got a long ways to go. But it's just head and shoulders above where it was before. Again, we had, we were sort of starting from zero. And I say we're now we're at 50, as compared to 100. So we've but again, it’s had longer, had more pressure from the courts.

AX 32:04

Right.

AM 32:05

And that was easy to achieve.

AX 32:06

In what ways do you think it improved the most?

AM 32:10

Oh, I mean, the mental health side is, as, as the expert who came in, the first thing we did in that case was (grew the ( ) is) we have an expert come in and look at the system and try to figure out how to fix it. And he said I was hired his sort of interaction in his report was, I was hired to evaluate a system. I couldn't do that, because you don't have a system.

AX 32:38

Hm.

AM 32:29

Essentially, every contact between a mental health professional and a prisoner is treated as if it was the very first time anybody ever seen them. So they make a diagnosis, they make some, give them some drugs, and there was very little ongoing, non psychotropic drug treatment happening. Nobody had treatment plans. There just was no continuity of care, there was no planning. And, and those people who had problematic behaviors related to their mental health, simply were put into solitary. And people would spend, you know, crisis watch was for people who are involved in self harm. And they just didn't have the capacity to figure out what to do about those folks. So people stayed on so called crisis, which, you know, usually should last a few hours. And generally should never last more than five or six days, people would spend five or six months on crisis. And sometimes more. We met some people who had spent several years in a crisis watch cell. Severely, mentally ill, psychotic, and just sitting in a cell, their only job was to keep them alive. It wasn't, there was no real thought that we could maybe make people better.

AX 33:41

Hm.

AM 33:42

Now, everybody has a (treatment) plan. As bad as some of them are. There are groups that that work all the time, although they were they were pretty much suspended during COVID. Um everybody has some continuity in their care now. So again, I'm not going to say that it's not a lot to do. Because again, we have lots of enforcement actions going on in that case, right now that COVID is over. There's lots of things that are not back to where they should be. So we still have a long ways to go, but compared to the mental, the medical care system, the mental health system has changed, has increased dramatically.

AX 34:17

Right.

AM 34:18

But again, from essentially a no system at all.

AX 34:20

Yeah.

AM 34:21

Big increases without actually solving the problem.

AX 34:24

But we're not at 100 yet.

AM 34:26

We're not even close to 100.

AX 34:28

No. Have you um have you interacted with any individual clients since you started these lawsuits that the most recent ones during COVID?

AM 34:38

Oh, yeah, I mean, we um because we have not visited the prison. So let me back up, under our mental health case, settlement we had the right to tour any prison that had any tier that had prisoners who were mentally on it, which turned out the all of them.

AM 34:55

Yeah.

AM 34:55

So we could tour, go cell to cell throughout the entire system where we wanted to, with notice and all those things, but we can do monitoring tours. Um so we got, and those are very efficient, see a lot of people at once. And then what we would do is spend one day touring, identify people we want to talk to, as well as some (free, identify) it and spend a second day in more confidential, individual interviews. So we had a lot of contact face to face and people. And as I think I mentioned earlier, we were getting about 100 letters a week from prisoners prior to COVID. Um after COVID hit um we did a couple of mass mailings to all prisoners in some senses, in some instances, and a lot of prisoners and others, as well as set up lots of legal calls. So, we were doing probably 10 to 15 legal calls per week to talk to individual people. And um we set up a-uh web portal, as did a couple other organizations for family members to log in and detail what, what they learned from their loved ones. Because they, they also had, one of the other things that DEP didn't do, there was a good thing was right at the beginning of the COVID-19 they allowed for extra video and telephone calls to all prisoners. So, family was at least, even though they weren't able to visit, they were at least able to stay in regular contact, generally, with the people inside so they were also family members became a good source of information as to what was going on inside. And the number of letters we got multiplied. So we're now probably getting 150 to 200 letters per week instead of 100 letters a week.

AX 36:37

Hm.

AM 36:37

So yeah, we're in contact with lots and lots of prisoners throughout this process.

AX 36:43

So your relationship with them definitely changed. But it expanded in some ways too, sounds like, yeah.

AM 36:49

Right yeah, we've heard from more prisoners. I mean, we've heard on a more, more thoughtful way for more prisoners, we haven't heard from nearly as many prisoners, because when you tour a cell house, you're can see 100 people in a day.

AX 36:59

Right.

AM 37:00

You can't duplicate that any other way.

AX 37:02

Yeah.

AM 37:04

((AM laughs)) So the amount of contact has definitely dropped. But the depth of the contact we have with those we have been able to talk to has increased.

AX 37:11

And how how has that affected your advocacy at all? Do you feel like, you know, what are you losing from not talking to as many way you're gaining from the depth increasing?

AM 37:21

Yeah, I mean, I think we're getting to know some people better. And therefore the level of trust is built up more than it was before. Met some new people we didn't know particularly well before. So all those are positive things. But the negatives vastly outweigh that. I mean, we just, you know, it's like, it's like the old story of five blind men trying to see an elephant, you get little pieces of it, and you don't get the overall picture as to what's really going on. And it's really hard to do that without being there in person. It's hard to visualize the layout, where are people at? When, how, where are they in relation to each other? You hear three different stories from different people? Are they in the next, are they three cells right together? Are they from three separate parts of the institution entirely? You know, are they describing very different things because they have different experiences, or just because they're in different units, and therefore they're going to have different experiences? There's no way to know that, at least not to figure it out well, without being there.

AX 38:19

So way earlier, you mentioned trust. Um, so I was wondering, you know, what, over the years, have you found the most effective in building trust with your clients?

AM 38:30

Persistence?

AX 38:32

Yeah. ((participants laugh))

AM 38:33

You know, we've been doing this work now for 35 years. And, you know, a number of prisoners have sort of pulled me aside during those tours saying, you know, you're not like the other lawyers. Most lawyers come in and do a case and then they're gone. And we never hear from them again. Um you just don't go away. ((AM laughs)) You're always here.

AX 38:53

Even after the cases?

AM 38:55

Well, I mean, I may not be doing it for them. But you know, I've got another case going on, or something. So I'm in the Department of Corrections’ face all of the time, and have been for the last 35 years.

AX 39:04

I see.

AM 39:05

I’m there doing something. And throughout that period, we've always had one class action or another going, uh we now have a lot more than we did, we used to concentrate mostly on individual cases. Um and now we're doing mostly class action work uh but from the beginning, we had the way I kind of really got into this as we did a class action case about access to the courts, beginning in 1982, um and that we lasted 20 years. So during that process, we met all the jailhouse lawyers, because of course, they're the ones trying to get into court, right.

AX 39:37

Mhm.

AM 39:37

So, if you want to sort of do advertising in prison, that's a great case to take on. Even though after 20 years of litigation, we completely got blown out of the water. The Court told me that we never had standing to bring the case in the first place and never should have been allowed to proceed past the complaint. But nonetheless, we learned a terrific amount and had contact with lots and lots of people, um all over the system. So you know, we had a really good introduction, a really good way to get started in a system.

AX 40:03

Yeah. So this isn't related to that, but I thought of it earlier. And I want to make sure I ask it. I know some of your cases dealt with the Eighth Amendment.

AM 40:14

Yeah.

AX 40:15

And was there any talk, not just with your litigation, but you know, any litigation around the country, if using the Eighth Amendment in a COVID litigation suit?

AM 40:25

I mean, there's been a lot of talk about it. It's really hard, because, you know, the Eighth Amendment requires a subjective, has a subjective component to it. So you have to prove that there was deliberate indifference to somebody's well being basically. And, you know, COVID, it's a good argument for the dependents to make is that everybody was trying to figure out what to do. We were trying really hard, you may have failed, but you can't say weren't trying. Um so you know, I don't know. And then the other question is causation. You know, even if they done it perfectly, some COVID cases would have been there. Um so how do you prove that this individual didn't get, got COVID? Because of their failures, compared to just he would have gotten anyway?

AX 41:09

Sure.

AM 41:09

So you know, I don't think anybody's successfully brought such a case. ButI guess the other answer is, the longer it goes on, the stronger such a case would be. Uh people have kind of figured out what to do now. I mean, if, if there are prison systems that are not giving the vaccine to prisoners, and could be, then that's a problem. Uh I believe that was that case in Oregon, which, which went on Equal Protection Eighth Amendment, but basically said that you can't–it's, it violates the Constitution to give it to guards, not prisoners, to vaccinate guards but not prisoners. So there's, and that's Equal Protection, but it's kind of also the Eighth Amendment because it's, again, deliberate indifference to their, their care compared to somebody else. And you clearly can do it, since you're doing it for all the guards. So,

AX 41:52

For sure.

AM 41:52

You know, the longer this goes on, and the, if people continue to get really ill or die, then I think those cases become stronger.

AX 42:03

So, in general, what lessons do you think were the strongest from your work in the past year?

AM 42:10

Oh, I mean, I think that, uh, the obvious one is, we have too many people in prison. But that's not like this. But that this just drove it home, you know, most people should not be there in the first place. And COVID just drove home how, how absurd it was. And you know, Illinois again, to its credit did reduce his prison population by about 10,000 people during COVID. So, at our peak, about 10 years ago, we had just a shade under 50,000 prisoners, under the, pri– prior to COVID, we had dropped that down to just under 40. And now we're just under 30. Um so, you know, the good news is that we had dropped it that first 10,000, before COVID hit, if COVID had hit when we had 49,000 people in prison, it would have been much bigger disaster than it was because there was no room to move anybody anywhere. Literally, every bed, every basement was converted to the living area, every dormitory was packed full. Even some warehouse space had been converted into dormitories. So, um you know, there literally would have no way to isolate anybody, if it had hit when we were packed full. The good news is that it hit after we had reduced our prison population by 10,000. And therefore there was some empty spaces you could use to actually physically quarantine people once they figured out what to do about that, to do that.

AX 43:28

Right.

AM 43:29

Um and the fact that we're now down to just under 30 means they have some real creativity, and our hope is that they will use that and there are rumors around that they really are rethinking the whole question of how prisons, prisons are designated. To be able to move some people around and make much more creative use of the space that they've got now that they have more room to do so. So you know, that's our hope is that this will, they will take this, this crisis as an opportunity to keep the population where it is, rather than growing it back up again, first of all, and then the reduced population should allow them to do a lot more programming. And of course, when they can, cheaper to fix some of the problems they have, because they have fewer people.

AX 44:10

Yeah. Do you think it’s going to just take a change in public opinion, and how we view prisoners in our country to, you know, drastically decrease the population? Probably to the level it should be?

AM 44:27

Hopefully, yes. No question about it. But, but you know, we can make some progress getting there. And I view this as a symbiotic uh action, that is, the more the more we can reduce the population and show that there is no negative effect, uh the easier to just reduce the population further and to change the hearts and minds of people. So letting people out is a good way to to affect not only getting the population down, but also persuading the public that it's okay to reduce the prison population.

AX 44:57

It's a really good point. Well, before we end the meeting, any final thoughts? Wisdom?

AM 45:07

I mean, I, all I can say is I think that the battle here, nationwide is to um take the right lessons from COVID. Both that the medical system is, is vastly unprepared in the vast majority of states to deal with crises. And this is not the last crisis, there will ever be, you know, the flu comes around regularly. And there's no nothing to say that's not going to happen again, sometime in the future or some other virus is not going to come back or this one's not going to come back. So there should be a lesson learned that they need to beef up medical care systems that they need to really take infectious control very seriously. And they're not in most prison systems, they have not been. Uh and more importantly, that they really need to reduce the prison population so they have the flexibility to do things when crises hit. You can't run a prison system, um, barely adequately staffed. And that's the way too many prisons operate on a day to day basis. I mean, before COVID hit, Illinois was a perfect example. We were understaffed so that they're mandating overtime for the vast majority of guards. And that's not sustainable in the long run. And it certainly isn't sustainable When a crisis hits because then guards go out sick and you're totally, you have nothing to do.

AXFA 46:28

Absolutely. Well, on that note, thank you so much.

AM 46:33

You're very welcome. I hope this was helpful.