Work

Court-Managed Policy Change: A Content Analysis of Prison Healthcare Consent Decrees and Settlement Agreements

Year: 2025

Type: article

Abstract: While most prison healthcare litigation seeks individual relief, some cases lead to broader structural reform via consent decrees—court-approved “legally binding performance improvement plans” designed to improve conditions. This study systematically analyzes 121 such settlements from 1970 to 2022 to assess their policy goals and implementation strategies. We identify the substantive areas targeted—general medical care, mental health, dental services, and treatment for specialized conditions like HIV, Hepatitis C, and COVID-19—and trace trends across time and geography. These agreements span 39 states and the federal system, with most states subject to multiple cases. They frequently mandate changes to budgets, staffing, facility infrastructure, training, and patient rights, alongside monitoring for quality improvement. Our findings suggest that consent decrees function not only as judicial remedies but as tools of policy development and institutional reform, shedding light on the role of courts in shaping correctional healthcare delivery. These findings also show how institutional responses to healthcare failures in prisons shape the conditions under which serious harm—and in some cases, preventable death—occur behind bars.

Source: Social Sciences

DOI: 10.3390/socsci15010013

Authors: Bryant J. Jackson-Green, Jihoon Yuhm, Johnny Vu

Institutions: Loyola University Chicago, University of California, Irvine

Language: English

Topic: Criminal Justice and Corrections Analysis

Subfield: Sociology and Political Science

Field: Social Sciences

Domain: Social Sciences

SDGs: Peace, justice, and strong institutions, Good health and well-being

Open Access status: gold

Estimated APC paid: $2,172