Assistant Attorney General Kristen Clarke Delivers Remarks on Agreement with Cumberland County Addressing Mental Health Care, Suicide Prevention and Medication-Assisted Treatment for Opiate Withdrawal at the Cumberland County Jail

Remarks as Prepared for Delivery

Good afternoon. I am joined by Philip R. Sellinger, U.S. Attorney for the District of New Jersey. We are here today to announce that the Department of Justice and Cumberland County, New Jersey, have agreed to a consent decree that outlines remedies to resolve our investigation of the Cumberland County Jail in Bridgeton.

The Civil Rights Division and the U.S. Attorney’s Office opened a pattern or practice investigation of the Cumberland County Jail, under the Civil Rights of Institutionalized Persons Act. We launched the investigation after a spate of six tragic suicides by incarcerated persons who had used opioids prior to their admission to the jail but who were denied medication-assisted treatment (MAT) when they came to the facility. Medication-assisted treatment is the use of medications, in combination with behavioral therapy and counseling, to treat opioid use disorder (OUD). It is an effective, evidence-based treatment that has become a best practice in prisons and jails across the country.

After a thorough investigation, the Justice Department issued a findings report in 2021 concluding that there was reasonable cause to believe that Cumberland County’s failure to provide MAT to incarcerated people with opioid use disorder, together with its failure to provide adequate mental health and suicide prevention measures, was a pattern or practice that violated the Eighth and Fourteenth Amendments to the Constitution. Failure to provide such treatment forces incarcerated people with opioid use disorder to suffer painful symptoms of withdrawal; discourages participation in other types of treatment; and increases mortality after discharge. MAT is not merely safe for use in prisons and jails – it is associated with a decline in illicit drug use and a reduction in disciplinary problems.

Since the release of our findings report, we have been engaged in discussions with Cumberland County about the remedies necessary to address these findings. The proposed consent decree is the product of those discussions. The consent decree resolves the department’s claims by ensuring that Cumberland County provides MAT, where clinically appropriate, to incarcerated people experiencing unmedicated opiate withdrawal, and that the County offers adequate mental health care and suicide prevention measures to those at risk of self-harm. The agreement requires the screening and assessment of opioid withdrawal and suicide risk, provision of MAT and mental health care under individualized treatment plans, and adequate supervision and suicide prevention methods.

The agreement stands as a model for other facilities across the county that are confronting high numbers of people with OUD. The agreement calls for an independent monitor, which the parties will jointly select and propose to the court. The independent monitor will assess compliance with the consent decree and issue public reports every six months.

Nearly two million people currently are confined in our nation’s prisons and jails. There are simply too many people incarcerated today who have mental illness and substance use disorders. The Civil Rights Division has long fought to protect the right of incarcerated people to receive treatment for their serious medical and mental health needs. Our work protects some of the most vulnerable people in society, who do not leave their rights at the jailhouse door. Our investigations have been successful at identifying not only systemic constitutional violations, but also the root causes of such violations – so that the causes can be fixed and the violations remedied.

This consent decree follows our work in Virginia, where we are enforcing an agreement that ensures medical and mental health care and appropriate housing for people with serious mental illness incarcerated at the Hampton Roads Regional Jail. In Massachusetts, our agreement with the State Department of Correction ensures that people experiencing mental health crisis are not simply locked away in restrictive housing, but instead receive the services they need.

The Cumberland County Jail consent decree also marks a significant milestone in furtherance of the division’s commitment to protect the civil rights of people with opioid use disorders. The Civil Rights Division, together with U.S. Attorneys’ Offices around the country, have prioritized efforts to combat discrimination against people with opioid use disorders under the Americans with Disabilities Act (ADA). The law is clear – people receiving treatment for opioid use disorders are generally considered to have a disability under the ADA. Cutting off treatment for such a disability may constitute discrimination against these individuals in violation of the ADA. Jails and prisons cannot have policies prohibiting the continuation of medications that individuals have already been prescribed to treat opioid use disorder. For example, the Civil Rights Division has worked with the U.S. Attorney’s Office in Massachusetts in a number of ADA enforcement matters that includes the Worchester County Jail, a review that resulted in the first agreement between the Department of Justice and a correctional facility regarding MAT in the entire country. The department also has enforced the ADA’s requirement to provide MAT to incarcerated people in matters in Rhode Island (Wyatt Detention Facility) and Kentucky (Fayette County Detention Center).

The Constitution safeguards the inherent dignity and recognizes the intrinsic worth of every human being. Individuals do not lose that protection in jails. All people are entitled to receive adequate medical and mental health care, and that includes those in jails and prisons. To be adequate, this care must include access to life-saving medications, treatment for opioid use disorder and protection from the risk of self-harm and suicide.

We recognize Cumberland County for working collaboratively with the Justice Department to ensure that the constitutional rights of people detained at the Cumberland County Jail are protected.

I will now turn it over to Philip R. Sellinger, U.S. Attorney for the District of New Jersey, who will discuss the specific details about the agreement for his remarks.

Speaker: Assistant Attorney General Kristen ClarkeTopic(s): Civil RightsComponent(s): Civil Rights Division

Updated May 17, 2023Original Article