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Charles v. Orange County

United States Court of Appeals, Second Circuit

May 24, 2019

Michelet Charles, Carol Small, Plaintiffs-Appellants,
Orange County, State of New York, Orange County Sheriff's Department, Orange County Department of Mental Health, Carmen Elizondo, Former Clinic Director, Orange County Correctional Facility, in her individual capacity, Defendants-Appellees, Nicole Kaye, Clinic Director, Orange County Correctional Facility, in her individual capacity, Defendant.

          Argued: September 25, 2018

         Plaintiffs-Appellants Michelet Charles and Carol Small were formerly civil immigration detainees at the Orange County Correctional Facility, where they were treated for serious mental illnesses. They instituted this civil rights action against Orange County and some of its agencies and officials under 42 U.S.C. § 1983, complaining that the failure to engage in discharge planning or to provide them with discharge plans upon release violated their substantive due process rights under the Fourteenth Amendment. The United States District Court for the Southern District of New York (Nelson S. Román, J.) granted the Defendants' motion to dismiss the complaint. We VACATE and REMAND for further proceedings.

          Daniel J. Stujenske, Simpson Thacher & Bartlett LLP, New York, NY (Thomas C. Rice, Simpson Thacher & Bartlett LLP, on the brief), Laura F. Redman, Antony P. F. Gemmell, New York Lawyers for the Public Interest, New York, NY for Plaintiffs-Appellants Michelet Charles and Carol Small.

          Anthony Cardoso, Orange County Attorney's Office, Goshen, NY, for Defendants-Appellees Orange County, State of New York, Orange County Sheriff's Department, Orange County Department of Mental Health and Carmen Elizondo, Former Clinic Director, Orange County Correctional Facility, in her individual capacity.

          Aaron M. Panner, Kellogg, Hansen, Todd, Figel & Frederick, P.L.L.C., Washington, DC (Ira A. Burnim, Judge David C. Bazelon Center for Mental Health Law, Washington, DC, on the brief), for Amici Curiae American Psychiatric Association, American Academy of Psychiatry and the Law, American Psychological Association, American Medical Association, National Association of Social Workers, American Public Health Association, and Judge David L. Bazelon Center for Mental Health Law, in support of Plaintiffs-Appellants.

          Jamie A. Levitt, Morrison & Foerster LLP, New York, NY, for Amici Curiae The Bronx Defenders, Brooklyn Defender Services, Community Initiatives for Visiting Immigrants in Confinement, Detention Watch Network, The Florida Justice Institute, Inc., Human Rights First, Immigrant Defense Project, The Immigrant Rights Clinic of Washington Square Legal Services, Inc., at NYU Law School, the Kathryn O. Greenberg Immigration Justice Clinic at the Benjamin N. Cardozo School of Law, The Legal Aid Society of New York, The Prison Law Office, Prisoners' Legal Services of New York, and the Urban Justice Center Mental Health Project, in support of Plaintiffs-Appellants.

          Alexander M. Wilson, New York State Sheriffs' Association, Albany, NY for Amicus Curiae New York State Sheriffs' Association, in support of Defendants-Appellees.

          Before Lynch and Hall, Circuit Judges, and Bolden, District Judge. [*]

          Gerard E. Lynch, Circuit Judge

         The question before us is whether the Plaintiffs-Appellants, Michelet Charles and Carol Small, have stated a plausible claim for relief under the Fourteenth Amendment for deliberate indifference to their serious medical needs. Plaintiffs were confined for many months as civil immigration detainees at the Orange County Correctional Facility, where they received treatment for their serious mental health disorders. Defendants-Appellees are Orange County, the municipality that oversees the Orange County Correctional Facility ("the Jail"); the Orange County Sheriff's Office, the specific entity that contracts with the Federal Government to house detainees in the Jail; the Orange County Department of Mental Health, the agency responsible for providing mental health services to people confined at the Jail; and Carmen Elizondo, the Clinical Director at the Jail.[1] Plaintiffs filed a complaint in the United States District Court for the Southern District of New York alleging that the Defendants, who were responsible for providing them with medical care while they were detained at the Jail, failed to provide them with mental health discharge planning before their release from custody, in violation of the Fourteenth Amendment's Due Process Clause. Plaintiffs seek relief under 42 U.S.C. § 1983.

         The district court (Nelson S. Román, J.) dismissed Plaintiffs' complaint for failure to state a claim. For the reasons that follow, we VACATE that judgment, and REMAND for further proceedings.


         Both Plaintiffs suffer from serious, ongoing mental illnesses.[2] Each Plaintiff was arrested by agents of the U.S. Immigration and Customs Enforcement ("ICE"), the federal law enforcement agency charged with the detention and removal of illegal immigrants. While awaiting their removal proceedings, Plaintiffs were detained at the Jail, a county detention facility that houses civil immigration detainees pursuant to an intergovernmental agreement between ICE and Orange County. During their detention, Plaintiffs were treated for their illnesses, receiving counseling and psychotropic medication. However, the treatment Plaintiffs received while they were in custody did not include discharge planning, which Plaintiffs allege is a routine and necessary component of institutional mental health treatment. Plaintiffs claim that as a result of Defendants' failure to provide them with discharge planning while they were in custody, they suffered serious mental health consequences shortly after their release.

         I. Michelet Charles

         Plaintiff Michelet Charles is a 55-year old lawful permanent resident who has lived in the United States for 34 years. Charles has suffered from bipolar and schizoaffective disorders since around 1984. For years, he managed his illness through regular mental health care. When Charles is not treated for his illnesses, he suffers from hallucinations, delusions, and periods of mania and depression.

         In July 2014, Charles was arrested by ICE officials and detained at the Jail for 363 days during the pendency of his immigration case.[3] When Charles entered the detention center, medical personnel at the facility diagnosed him with bipolar disorder with psychotic features. During his detention, Defendants provided Charles with psychiatric care, which included meeting with a psychiatrist every three weeks in order to monitor his condition, and daily psychotropic medication to keep him stable. Charles's treatment was documented by the Jail Clinic in an "Intervention/Care Plan" which listed his diagnosis, the types of counseling Charles received, the medication he required, and any suicidal or harmful tendencies he had.

         On July 22, 2015, Charles was brought from the Jail to New York City for an appearance at the Immigration Court in lower Manhattan. Prior to his immigration hearing, Defendants had not provided Charles with any plan for his continued mental health care after discharge, a list of his medications, a list of outside referrals, any other information about the medication and counseling he received while detained, or assistance or information relevant to his obtaining future treatment for his known medical condition. Nor were any such materials provided to Charles at or after his hearing. Charles succeeded at his immigration hearing[4] and was released directly from the court with his identification and nothing more. The ICE Deportation Officer who attended the hearing told Charles's attorney that ICE did not have any medication for Charles, and that he should return to the Jail if he needed to obtain a supply of his medication.

         The day after his release, Charles and his daughter drove over 65 miles from their home to the Jail to obtain Charles's psychiatric medication. When Charles's daughter asked an employee at the front desk of the Jail for her father's medication, the employee refused to provide it, claiming that the person who had transported Charles to the Immigration Court was responsible for providing him with a continuing supply of medication. The Orange County employee also informed Charles and his daughter that as a matter of institutional policy, after a person is released from the facility, the Jail can no longer provide him with medication.

         Charles's immigration attorney then contacted the ICE Deportation Officer again, requesting that Charles be provided with a supply of medication. The Officer did not respond to the inquiry. According to Charles's medical file from the Jail, on July 23, 2015, the day after his release, and the same day that he visited the facility with his daughter, a clinical social worker at the Jail signed a document entitled "Continuing Care Plan/Discharge Summary" ("Discharge Summary") for Charles. The Discharge Summary listed Charles' diagnosis and expressly anticipated that Charles would have future mental health needs including medication, psychiatric treatment, and substance abuse treatment. However, neither Charles nor his attorney was given a copy of the Discharge Summary.

         After his release, without immediate access to his prescription anti-psychotic and anti-depressant medications and counseling, Charles soon began psychologically decompensating. He exhibited bizarre behavior, was disorganized, and mumbled when he spoke. His family reported that he was manic, anxious, and paranoid.

         By August 4, 2015, Charles was experiencing symptoms of psychosis, and his ability to control his thoughts and emotions was so impaired that he lost contact with reality. On that date, Charles's family called 911 for emergency medical assistance. The police officers who responded to the call transported him to the emergency room at a nearby hospital. The next day, Charles was hospitalized in an inpatient psychiatric unit of North Shore LIJ South Oaks Hospital. His admission record states that he had worsening aggressive, disorganized, and bizarre behavior, and was preoccupied with paranoid ideas. It took two months in the hospital for Charles's condition to stabilize and for him to return to his baseline mental state.

         II. Carol Small

         Plaintiff Carol Small is a 45-year old lawful permanent resident of the United States. Before she was detained, Small lived on her own and supported herself as a hairdresser in the Bronx.

         Small was detained at the Jail in May 2015. After about a month of detention, Small began experiencing symptoms of severe mental illness, including visual and auditory hallucinations. She became extremely paranoid and delusional, believing that she was being monitored by the government through a chip implanted in her tooth, that there was a government conspiracy to poison her, and that poison was coming through the vents in the Jail. In late June 2015, a psychiatrist at the Jail diagnosed Small with paranoid schizophrenia. Similarly to Charles, her diagnosis, medications, and counseling needs were documented by the Jail Clinic in a document titled "Intervention/Care Plan." But like Charles, Small was not provided with a copy of that document.

         In September 2015, Small was transferred to the inpatient ward at Kings County Hospital for intensive treatment for her mental illness. In October, after her condition stabilized, she was transferred back to the Jail. Upon her return, medical employees of the Orange County Department of Mental Health provided Small with medically necessary treatment and continued to prescribe and administer her daily prescription medication, which kept her stable.

         On January 11, 2016, an Immigration Judge granted Small immigration relief and ordered her release.[5] Small was released from the Jail on January 19, 2016 at around 6:30 PM, in below-freezing temperatures, with $80 in cash. Small was not given an interim supply of her prescribed medicines, a list of her medications, a description of the treatment she had received while detained, or a list of outside referrals or providers for continuing care. During the roughly six months in which Small was treated for her mental illness at the Jail, she was not provided with any discharge planning.

         Upon her release, Small took the train from Orange County to Penn Station. She stayed briefly with family members, and then a social worker from the organization that had provided Small with immigration representation arranged for her to live in a shelter. While Small was struggling to re-establish her life after release, she was extremely distressed and worried for her own health and the possibility of relapsing without the medication she had been taking to treat her mental illness. On January 21, 2016, Small checked herself into the emergency room at North Central Bronx Hospital in an effort to obtain medication. Because Small had written down a list of the medications ...

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