Appeals Court Rules Against “Discharging and Dumping” People with Mental Health Needs from Immigration Detention

May 24, 2019

Charles v. Orange County, Health Justice, Immigrant Justice, News, Press Release

A man holding his head in his hands under a bridge

The Second Circuit Court of Appeals handed down a landmark decision today in a “case of first impression” that says government officials can be held accountable on constitutional grounds for failing to provide mental health discharge planning for people in immigration detention.

New York Lawyers for the Public Interest Director of Health Justice Laura F. Redman said: “We are delighted with the court’s ruling. It holds the government accountable for its continued attack on immigrant communities. The government grabbed our clients off the street, denied them vital medical treatment, and then discharged and dumped them back onto the streets to suffer horribly. Today’s decision lets us move forward to hold the government accountable for this injustice.”

Daniel Stujenske with Simpson Thacher & Bartlett LLP said: “We intend to prove that our clients’ constitutional rights were violated when they were not provided discharge planning as part of their treatment for serious mental health illnesses. We are gratified that the Second Circuit concluded that our clients could pursue their claims that the defendants were deliberately indifferent to our clients’ serious medical needs by failing to provide adequate care. “

The appeals court decided in favor of plaintiffs Michelet Charles and Carol Small, two people with serious mental illness who ultimately needed hospitalization after the government “discharged and dumped” them onto the street without medication or any connection to medical care.

Mr. Charles and Ms. Small are represented by New York Lawyers for the Public Interest (NYLPI) and co-counsel, Simpson Thacher & Bartlett LLP, in their case against Orange County.

The appeals court said the lower court erred when it dismissed the plaintiffs’ case by ruling that they had failed to satisfy grounds for a constitutional violation showing that the county was “deliberately indifferent” to their care.

The appeals court said that the plaintiffs can now move forward in holding the county accountable on 14th Amendment grounds for showing deliberate indifference to serious medical needs on the basis that the county “knew” or “should have known that failing to provide the omitted medical treatment would pose a substantial risk to the detainee’s health.”

Orange County sought to avoid responsibility by arguing that the plaintiffs’ problems flared up after they were discharged. The appeals court disagreed, saying: “If discharge planning is to occur at all, it must, by definition, occur prior to release from custody.”

Ms. Small, who had been diagnosed in detention with paranoid schizophrenia, was released from detention in January, in below-freezing temperatures, with no medication, or treatment plan. She ended up checking herself into an emergency room, desperate for help.

Mr. Charles, who had been diagnosed in the 1980s with bipolar and schizoaffective disorders, was simply dumped on the streets of lower Manhattan with nothing more than his identification. His subsequent decompensation led his family to call 911 for emergency help, police intervention, and two months of hospitalization to stabilize his condition.

The appeals court’s full ruling is available for download here.

Press coverage

The news was covered by the New York Law Journal:

Immigrant Detainees’ Lawsuit Over Mental Health Discharge Planning Revived by 2nd Circuit Rules

When both plaintiffs were released from jail after successfully avoiding deportation, neither was given their medication or any post-release treatment plan, the lawsuit claimed.

By Dan M. Clark| May 24, 2019 at 05:15 PM

The U.S. Court of Appeals for the Second Circuit and the U.S. District Court for the Southern District of New York. (Photo: Ken Lund)The U.S. Court of Appeals for the Second Circuit and the U.S. District Court for the Southern District of New York. Photo: Ken Lund

A lawsuit alleging that officials in upstate New York’s Orange County unconstitutionally failed to provide mental health discharge planning to two individuals in immigration detention will continue after a federal appellate court reversed a lower court ruling that dismissed the litigation.

The Second Circuit U.S. Court of Appeals said in a decision Friday that the plaintiffs could argue that such planning qualifies as legally mandated in-custody care and could therefore be evaluated through a constitutional lens.

“If discharge planning is to occur at all, it must, by definition, occur prior to release from custody,” said the court’s decision, which was written by U.S. Circuit Judge Gerard Lynch.

The litigation was brought against Orange County by two individuals who were detained by U.S. Immigration and Customs Enforcement. Both were jailed in Orange County, which has an agreement with the federal immigration agency to house civil immigration detainees while they await deportation proceedings, according to the decision.

They were held for several months in the Orange County Correctional Facility, where they received treatment for various mental health conditions. Both were also lawful, permanent residents of the U.S., the decision said.

When both plaintiffs were released from jail after successfully avoiding deportation, neither was given their medication or any post-release treatment plan, the lawsuit claimed.

One plaintiff, Michelet Charles, was released directly after his hearing in Manhattan without a plan or his medication. Without treatment Charles soon began “psychologically decompensating,” according to the decision. Charles was eventually hospitalized in an inpatient psychiatric unit, where he spent two months before he was deemed stable.

The other plaintiff, Carol Small, was ordered to be released from the jail by an immigration judge. She was given $80 in cash, which she used to take a train from Orange County to Manhattan, after which she stayed briefly with family members, according to the lawsuit.

Small eventually had to check herself into an emergency room in the Bronx, where she was able to be prescribed the medications she was taking while in jail, the decision said. She had made a list of the medications she was taking while detailed.

Small and Charles alleged that before they were released, they were not provided with details on their treatment while in jail, including what medications they were prescribed while incarcerated. They filed a lawsuit against Orange County in 2016 that claimed their due process rights had been violated because of the alleged lapse.

U.S. District Judge Nelson Roman of the Southern District of New York granted a motion by Orange County to dismiss the litigation in 2017. Roman wrote at the time that the county’s actions were not unconstitutionally unlawful, even if they were negligent.

Roman recognized that the Fourteenth Amendment would require that the jail provide medical care to detainees while they are in custody. But he interpreted the mental health discharge planning as post-release treatment, not in-custody care. Lynch disagreed with that interpretation in appellate court’s decision Friday.

“We find that Plaintiffs have plausibly alleged that discharge planning is an essential part of in-custody care,” Lynch wrote. “We conclude that despite the forward-looking nature of discharge planning, a claim for damages caused by the lack of it can be considered a claim for deprivation of in-custody care for purposes of the ‘special relationship’ exception.”

The decision was one of first impression, meaning that the appellate court had not previously considered the specific issue in the litigation.

The plaintiffs were represented in the litigation by New York Lawyers for the Public Interest and Simpson Thacher & Bartlett. Daniel Stujenske, counsel at Simpson Thacher, said they’re looking forward to going back to the district court to continue the litigation.

“We intend to prove that our clients’ constitutional rights were violated when they were not provided discharge planning as part of their treatment for serious mental health illnesses,” Stujenske said. “We are gratified that the Second Circuit concluded that our clients could pursue their claims that the defendants were deliberately indifferent to our clients’ serious medical needs by failing to provide adequate care.”

Langdon Chapman, the county attorney for Orange County, said the appellate court did not address other arguments they made previously to dismiss the litigation and that they may renew those defenses before the district court.

“The Second Circuit made a limited holding in which they assumed (as they are required to) that all of Plaintiffs’ allegations were true,” Chapman said. “The County has appropriate policies in place. The Court did not address a number of other dispositive defenses raised below, which we are considering renewing on remand.”

The case will now resume at the district court in White Plains, though future dates have not been set.

Politico also covered the news:

Federal appeals court overturns lower court decision on mental health care for immigrant detainees

By Amanda Eisenberg

May 24, 2019

A federal appeals court ruled Friday that the U.S. District Court in Manhattan did not properly interpret Fourteenth Amendment protections afforded to prisoners receiving mental health treatment when those prisoners were released without a plan for continued care.

The 37-page ruling, issued by the U.S. Second Circuit Court of Appeals, will allow lawyers to again plead the case that the Orange County Correctional Facility failed to provide two prisoners with discharge plans despite treating them for serious ongoing mental health problems. The district court dismissed the civil rights suit in September 2017.

“Plaintiffs have plausibly alleged that Defendants were fully aware of, and violated, both Orange County and ICE policies by failing to provide them with discharge planning as part of their care,” the three-judge panel wrote in its opinion. “Plaintiffs’ allegations, if proven true, are sufficient to establish that Defendants knew, or should have known, of the substantial risk that Plaintiffs would relapse and suffer serious adverse health consequences if they were not provided with necessary discharge planning.”

The ruling is seen by advocates and lawyers as “a landmark decision to hold government officials accountable for failing to provide mental health discharge planning for individuals held in immigration detention,” according to the firms representing the plaintiffs.

“We are delighted with the court’s ruling,” said Laura Redman, an attorney on the case and the director of the New York Lawyers for the Public Interest’s health justice program. “It holds the government accountable for its continued attack on immigrant communities. The government grabbed our clients off the street, denied them vital medical treatment, and then discharged and dumped them back onto the streets to suffer horribly.”

Michelet Charles and Carol Small, the two plaintiffs in the case, were detained on immigration charges, though the court described them as “lawful permanent residents” of the United States. When they were released, their lawyers allege they were not provided with discharge plans that identified the medication they are required to take and the type of medical and mental health care they received in custody.

Without that plan, Charles and Small were at high risk of hospitalization, Redman said, noting the correctional facility should have been aware of those risks.

The lawyers are now tasked with proving that Orange County, its health and sheriff’s departments and the correctional facility were reckless by discharging their clients without proper documentation. They are arguing that an improper discharge is a violation of the Fourteenth Amendment, as Charles and Small were denied services within an ICE-contracted facility, despite their citizenship status.

Findlaw covered the story:

Court: County Cannot ‘Discharge and Dump’ Mental Patients

By William Vogeler, Esq. on June 03, 2019 9:00 AM

Carol Small, diagnosed in a New York detention center as a paranoid schizophrenic, was released in below-freezing temperature with no medication or treatment plan. Michelet Charles fared no better. The immigration center diagnosed him as a bipolar schizoaffective, and then pushed him into the cold with nothing but the clothes on his back and identification.

They both wound up in emergency rooms. In Charles v. Orange County, State of New York, the U.S. Second Circuit Court of Appeals told the government you can’t just discharge and dump people like that on the street.

‘Discharged and Dumped’

The appeals court said the plaintiffs may proceed against Orange County under the Fourteenth Amendment for showing deliberate indifference to their medical needs. The judges said the county knew or should have known that “failing to provide the omitted medical treatment would pose a substantial risk to the detainee’s health.”

The plaintiffs were held for several months in the Orange County Correctional Facility, where they received some treatment for their conditions. But after findings they were lawfully in the United States, they were released with medication or treatment plans. Public interest lawyers sued on their behalf, but a trial judge dismissed their case. On appeal, the Second Circuit blasted the county for discharging and dumping the plaintiffs. Small checked herself into an emergency room, and Charles wound up in a psychiatric unit for two months. The appeals court said they deserved better.

“If discharge planning is to occur at all, it must, by definition, occur prior to release from custody,” Judge Gerard Lynch wrote for the panel.

Landmark Decision

The plaintiffs’ lawyers praised the appeals court for giving their clients another chance at trial. They called it a “landmark decision” because now government officials can be held accountable for failing to provide mental health plans for people discharged from immigration detention.

“The government grabbed our clients off the street, denied them vital medical treatment, and then discharged and dumped them back onto the streets to suffer horribly,” said Laura Redman, director of health services at New York Lawyers for the Public Interest. “Today’s decision lets us move forward to hold the government accountable for this injustice.”

Daniel Stujenske with Simpson Thatcher & Bartlett said he was gratified with the decision. “We intend to prove that our clients’ constitutional rights were violated when they were not provided discharge planning as part of their treatment for serious mental health illnesses,” he said.

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