The Maryland Office of the Attorney General has ratcheted up a more defiant legal strategy in its defense of a still-dysfunctional Baltimore jail health care system, hiring an outside law firm and targeting the medical monitor who has been gauging the state’s compliance, or lack thereof, with the terms of its settlement.

In recent months, the Maryland AG hired attorney William Lunsford of the law firm Butler Snow LLP. Lunsford and his associates have gained notoriety in Alabama and other states for defending state prisons against a variety of allegations, and at a steep cost.

Lunsford recently served on the board of advisers for the health care provider in Maryland prisons and Baltimore jails: YesCare, a correctional health care giant formerly known as Corizon Health. The company entered into a controversial bankruptcy earlier this year before it split into two divisions, one of them rebranding as YesCare. Lunsford did not respond to a request for comment.

In a legal filing last week, attorneys for the ACLU’s National Prison Project, which continues to battle the state in federal court over health care and mental health treatment in the jails, pushed back against policy changes that have arisen as the state has retained Lunsford and his associates. The ACLU argued that the judge should order the parties to attend a status conference, which the state is resisting.

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ACLU’s prisoner rights lawyers said in their filing that the attorney general’s office has been “gratuitously attacking” the medical monitor and making “inflated and misleading claims about their [the state’s] compliance” with a 2016 settlement. That agreement laid out nine provisions that Baltimore jails must satisfy to exit court supervision. The state has so far been found to be in compliance with only one of them.

Among the charges by the ACLU is that the state is “inexplicably” claiming that certain COVID protocols are hindering their ability to comply with the settlement, despite not reporting any COVID infections among detainees in recent months. The prisoner rights attorneys also say the state is using “copy-and-paste” documents to detail their efforts to come into compliance with the settlement that are identical to ones submitted in July 2021, raising questions about the seriousness of their plans.

“Rather than acknowledge, and take responsibility for, their continuing noncompliance, defendants scapegoat Dr. Michael Puisis who, by agreement of the parties and approval of the court, has served as the independent medical monitor since the SA’s [settlement agreement’s] inception in 2016,” the ACLU wrote in its legal motion.

The state corrections department took control over Baltimore jails in 1991, after the decades-old litigation against the jails had been initiated. In aiming its legal arguments at the medical monitor, the state has recently accused Puisis of making unspecific recommendations that they are not obligated to comply with because they don’t fall under the “four corners of the settlement agreement.”

In their filing, attorneys for the ACLU also shared correspondence showing that an assistant attorney general recently told Puisis to stop communicating directly with YesCare doctors in Baltimore jails, and instead deal only with the Maryland Department of Public Safety and Correctional Services medical director, according to court records.

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David Fathi, director of the ACLU’s National Prison Project, said the restriction on who Puisis could communicate with is a “significant problem” and represented a sudden policy change that was made without notice given to his team or the federal judge.

“These are court-appointed monitors, they’re agents of the court,” Fathi said. “Their job is to be neutral investigators of compliance. It’s extremely troubling that the state’s lawyer unilaterally and covertly gave this instruction to Dr. Puisis without notifying the plaintiff or the court.”

The legal maneuvers come as the state is backsliding on its efforts to meet court-imposed deadlines to fix an array of issues with medical and mental health care in Baltimore jails. The state recently told a judge that such fixes were years away.

A spokesperson for the attorney general’s office confirmed that it had retained Lunsford and his firm, but declined to comment on the cost of the legal services, saying the office needed to research the budget and deferring the question to a public records request.

In a recent report to the Maryland Department of Legislative Services, the corrections department said it needed outside attorneys “to help bring this litigation to conclusion in the next 18 months.” The department said the law firm “will participate in all aspects” of representing the state in the lawsuit and “might have other responsibilities that may arise as litigation continues.”

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The cost of Lunsford’s legal services has drawn scrutiny from lawmakers in Alabama, with one Democratic state representative saying the nearly $15 million in corrections department contracts the attorney received means “Lunsford is basically a government agency at this point,” according to reporting by the Alabama Reflector.

Maryland hired its medical provider for prisons and Baltimore jails in 2018 to a five-year, $680 million contract. The company has been sued all over the country, including here, for a variety of issues with its health care services. Attorneys and prison health care experts, including the company’s former CEO, have described the restructuring and bankruptcy as a “two-step” ploy to escape certain liabilities.

The company has struggled to address continuing issues in Baltimore’s sprawling jail system, where those in severe mental health crises languish in solitary confinement, medical care is dysfunctional, and people with disabilities are still not being properly identified or accommodated, even after a deaf man was killed in his cell late last year while being housed with a man charged with murder, according to the medical monitor’s latest reports and tours of the facility by ACLU prisoner rights’ attorneys.

Ben Conarck is a criminal justice reporter for The Baltimore Banner. Previously, he covered healthcare and investigations for the Miami Herald and criminal justice for the Florida Times-Union.

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