Advocates Press Lawsuit Despite DOC Claims Of Improved Involuntary Addiction Treatment

It was earlier this year, at the height of the coronavirus pandemic, that Kim Agrella found herself not knowing where to turn to get help for her son.

Her son, Derek Rooney, was seriously injured after he took pills he bought off the street and fell from the third floor of his apartment building. The 33-year-old underwent surgery and a stay in the ICU. Agrella worried her son's addiction might affect his healing once he left the hospital.

"I knew he was going to be in a lot of pain when he got out of the hospital," Agrella explained, "and I wanted to try to figure out a way to get him the help he needed and not have to worry that he'd be out there trying to find street medications again."

To get help, Agrella asked the court to involuntarily commit her son to addiction treatment, hoping he would heal physically while getting support to combat his addiction. The court agreed, and a correctional van picked him up from the hospital.

"When they came to pick him up, they put handcuffs and shackles on him, threw him in the back of a van," Agrella said. "He says he was in the van for two or three hours when he had just been released from the hospital. They sent him to prison, of all places."

The court approved what's called a "Section 35" petition, which gets its name from the state law that allows judges to civilly commit someone to treatment if that person's substance use is considered dangerous. Massachusetts is one of only a few states that uses jails and prisons to house people who are civilly committed and haven't committed any crimes.

'They'd Rather Go To Prison'

Rooney was sent to the Massachusetts Alcohol and Substance Use Center (MASAC) in Plymouth, a former prison overseen by the state Department of Correction. During his nine-week stay, Rooney said he was put in a solitary cell, assaulted and penalized for not attending programs. Rooney also said he was humiliated when he was given only scant clothing to wear and transported to follow-up medical appointments in handcuffs and shackles.

"From what I heard, and I've never been to prison, but people are telling me that it's actually worse, that they'd rather go to prison," Rooney said. "The care was just terrible. Everything was ignored; the groups were s---; there were no activities to do; the food was terrible. Everyone in there says the same thing: that this place is completely out of control, it should not be allowed."

Since MASAC moved to the Plymouth prison in 2017, there have been dozens of complaints from those committed there about their treatment. Shortly before Rooney was committed in late May, state officials said that although MASAC is overseen by the DOC, its operations were largely turned over to Wellpath, the facility's medical provider.

In announcing the change, the state said MASAC had undergone a complete transformation to "reflect the facility's core mission to provide treatment." The Executive Office of Public Safety and Security said correction officers would be stationed only at the perimeter of the facility and clinically trained staff would be working inside in order to "move to a care-based model, rather than a correctional one." But a newly expanded lawsuit over Section 35 disputes that claim.

Attorney Bonnie Tenneriello, with Prisoners' Legal Services of Massachusetts, said those committed to MASAC since the change still report prison-like conditions.

"It's a restrictive and punitive environment," Tenneriello said. "They still use isolation cells, and we have some horrendous stories of people held in isolation. Culturally, a lot of what we're hearing is it's a culture of control and distrust, the kind of environment that's more stigmatizing and not at all therapeutic."

"Culturally, a lot of what we're hearing is it's a culture of control and distrust, the kind of environment that's more stigmatizing and not at all therapeutic."

Bonnie Tenneriello, with Prisoners' Legal Services of Massachusetts

Other men committed to MASAC since May described similar conditions. One man said he was locked in a cell without running water for five days. WBUR agreed not to use his name because he fears it could jeopardize his employment.

"When I was sectioned both my family and I were under the impression that this was going to help," he said. "They say they have meetings, programs and classes, and none of that is true. Immediately, you're treated like you committed a crime."

Wellpath said it does not comment on litigation, but emailed a statement saying:

"Wellpath’s business is grounded in providing excellent patient care, and in providing excellent service and value for our clients. Our core mission is always to ensure that all of our patients receive the highest standard of care."

The Ongoing Lawsuit

Tenneriello, the attorney, first filed suit over the Section 35 law last year, in part claiming gender discrimination in how civil commitments are handled. Massachusetts stopped sending civilly committed women to prison for treatment in 2016 after a similar lawsuit that applied only to women.

"Sending people through a prison door, no matter how you treat them inside, not only instills shame, it also sends the wrong signal to the community," Tenneriello said. "Governor [Charlie] Baker has said this is a 'state without stigma' — meaning that there should be no stigma around substance use. If we want to give meaning to that phrase, then we have to stop sending people to prison."

Recently, Tenneriello amended the litigation to include not only MASAC, but also the Hampden County Jail in Ludlow. It's the other state correctional facility that houses men civilly committed to addiction treatment.

One man — whose name WBUR agreed not to use because he is an unnamed plaintiff in the lawsuit — was involuntarily committed to the Hampden jail and discharged last month. He said he's been incarcerated before, and there is little difference between being a prisoner and being civilly committed.

"The place is run by COs [correction officers]," he said. "They do rounds every 16, or 15 minutes. If you say something wrong, or breathe the wrong way, they tell you to lock in, if you don't, there's a bunch of officers suited up who come running like they do if you're in jail. We get locked in for counts. We're literally in jail, and they say we're in treatment. That just boggled my mind."

Hampden County Sheriff Nick Cocchi said while he can't comment on pending litigation, he's proud of the treatment offered in his jail, saying that for many families involuntary treatment is an "option of last resort." In the past, the sheriff said his data show men stay more than 50 days on average, and the facility sees a low recommitment rate, which he said proves it is effective.

Cocchi has been defending the program since it became operational in 2018. Last year, he appeared before a state panel reviewing the state's Section 35 law and argued that, for some people, locked treatment is necessary and saves lives. Some parents also testified that being in a locked facility saved their child's life. After months of testimony, the panel recommended the state step away from sending civilly committed men to correctional facilities.

Commission member and state Rep. Ruth Balser filed legislation banning the use of prisons and jails for addiction treatment. Although her bill is currently stalled, Balser said she's hopeful it will be acted on this legislative session.

"Now more than ever with COVID-19 — and there's been an outbreak at MASAC — it's questionable whether that's a safe place to be under any circumstances," she said. "But certainly it's about time that Massachusetts recognized that addiction is an illness and not a crime."

Earlier this month, the Department of Correction temporarily stopped sending men to MASAC after 28 of the almost 100 men there tested positive for the coronavirus. The DOC said it conducted widespread testing after a man left MASAC and told them he tested positive shortly after his release. MASAC is still not taking new admissions.

Leo Beletsky, another Section 35 commission member and director of the Health in Justice Action Lab at Northeastern University, said the outbreak might have been prevented if the state had acted on the commission's recommendations.

"As a member of the Section 35 commission, it's incredibly frustrating to see our worst fears realized," Beletsky said. "Although we didn't foresee the advent of the COVID-19 pandemic, it's precisely the kind of issue that can arise when you put people in correctional, instead of health care, facilities."

For Kim Agrella, she said although dealing with a loved one's addiction is difficult, people in that situation should carefully consider all options before seeking an involuntary commitment.

"I asked the state for help with my son, and my son and I have been failed by this system," Agrella said. "He is more traumatized from this whole nightmare than by his own surgery and hospital stay. My son is not a criminal; he is an addict."

The DOC said it does not comment on pending litigation. It's now up to the court to schedule hearings on the new lawsuit.