United States Court of Appeals
For the First Circuit
No. 04-1300
CARLOS MORALES FELICIANO ET AL.,
Plaintiffs, Appellees,
v.
JOHN A. RULLÁN, SECRETARY OF THE PUERTO RICO
DEPARTMENT OF HEALTH, ET AL.,
Defendant, Appellant.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Juan M. Pérez-Giménez, U.S. District Judge]
Before
Selya, Lynch and Lipez,
Circuit Judges.
Carlos A. Del Valle Cruz, with whom Anabelle Rodríguez,
Secretary of Justice, Eileen Landrón Guardiola, Eduardo A. Vera
Ramírez, and Landrón & Vera, LLP, were on brief, for appellant.
Carlos V. García Gutiérrez, with whom Alejandra Bird López,
Manuel A. Rodríguez Banchs, Ricardo Alfonso García, and Civil
Action and Education Corporation were on brief, for appellees.
August 6, 2004
SELYA, Circuit Judge. Like the legendary Phoenix, this
class action litigation involving prison conditions in Puerto Rico
is seemingly incapable of eternal rest. The iteration now before
us focuses on prospective injunctive relief ordered by the district
court in 1998 (the centerpiece of which is the proposed
privatization of medical and mental health care throughout the
correctional system). Despite his predecessor's enthusiastic
assent to that arrangement, the Commonwealth's Secretary of Health
(the Secretary), acting in his official capacity, sought five years
later to vacate or terminate the consent decree embodying that
relief.1 Following an evidentiary hearing, the district court
rejected that initiative. Morales Feliciano v. Calderón Serra, 300
F. Supp. 2d 321 (D.P.R. 2004) (Morales IV). The Secretary now
attacks this decision on several fronts. He asserts, inter alia,
that the court acted ultra vires; that the court's 1998 order was
void ab initio for failure to meet the requirements of section 802
of the Prison Litigation Reform Act (PLRA), Pub. L. No. 104-134,
110 Stat. 1321-66, § 802 (1996), codified at 18 U.S.C. § 3626; and
that in all events, the order should be terminated because the
district court's supportive factfinding was clearly erroneous and
infected by errors of law. As a fallback, he argues that the
district court bungled the evidentiary hearing and that, at a bare
1
We note that a new administration, representing a different
political party, took office following the general election held in
November of 2000.
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minimum, the matter should be remanded for reconsideration.
Finding these importunings unpersuasive, we affirm the decision
below.
I. BACKGROUND
Given the long and tortuous history of this litigation —
two years ago, we acknowledged that "the lore of this case is
Byzantine," Morales Feliciano v. Rullán, 303 F.3d 1, 3 (1st Cir.
2002) (Morales III) — we confine our introductory comments to those
events that are most directly germane to this appeal. The shelves
of any well-stocked law library will satisfy the appetites of
readers who hunger for more exegetic detail. See, e.g., Morales
III, 303 F.3d 1; Morales Feliciano v. Parole Bd., 887 F.2d 1 (1st
Cir. 1989); Morales IV, 300 F. Supp. 2d 321; Morales Feliciano v.
Rosselló Gonzalez, 124 F. Supp. 2d 774 (D.P.R. 2000); Morales
Feliciano v. Rosselló Gonzalez, 13 F. Supp. 2d 151 (D.P.R. 1998)
(Morales II); Morales Feliciano v. Hernandez Colon, 775 F. Supp.
487 (D.P.R. 1991); Morales Feliciano v. Hernandez Colon, 775 F.
Supp. 477 (D.P.R. 1991); Morales Feliciano v. Hernandez Colon, 771
F. Supp. 11 (D.P.R. 1991); Morales Feliciano v. Hernandez Colon,
754 F. Supp. 942 (D.P.R. 1991); Morales Feliciano v. Hernandez
Colon, 704 F. Supp. 16 (D.P.R. 1988); Morales Feliciano v.
Hernandez Colon, 697 F. Supp. 51 (D.P.R. 1988); Morales Feliciano
v. Hernandez Colon, 672 F. Supp. 627 (D.P.R. 1987); Morales
Feliciano v. Hernandez Colon, 697 F. Supp. 26 (D.P.R. 1986);
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Morales Feliciano v. Romero Barcelo, 672 F. Supp. 591 (D.P.R.
1986); Morales Feliciano v. Romero Barcelo, 605 F. Supp. 967
(D.P.R. 1985); Morales Feliciano v. Romero Barcelo, 497 F. Supp. 14
(D.P.R. 1979) (Morales I).
In the 1970s, a group of prison inmates initiated a class
action alleging "dire shortcomings in virtually every aspect of
prisoner confinement" in the Puerto Rican correctional system.
Morales III, 303 F.3d at 3. The district court found the
plaintiffs likely to succeed on the merits and issued preliminary
injunctive relief. Morales I, 497 F. Supp. at 39-41. The
defendants made little progress and the district court, in March of
1986, appointed a monitor. See Morales III, 303 F.3d at 3; Morales
Feliciano v. Romero Barcelo, 672 F. Supp. at 621. The court
charged the monitor with studying various elements of the
correctional system and recommending remedial action. With the
monitor's assistance, the court became more proactive and issued a
torrent of orders, including temporary restrainers and contempt
citations. The court thereafter imposed multimillion dollar fines
for the most egregious failures to comply with its directives.
In 1990, the court ordered the implementation of medical
and mental health care plans recommended by the monitor. These
plans transferred the primary responsibility for medical and mental
health care in the correctional system from the Administrator of
Corrections (the AOC) to the Secretary. The plans also required
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that the Secretary employ for a minimum of three years a chief
health care coordinator (the CHCC) who would bear responsibility
for easing the transition and coordinating compliance.
Over time, prison conditions improved. In 1996, the
district court entered a partial final judgment that settled
several disputed issues and urged attempts at consensus-based
compliance efforts as to other issues. Despite improvements in
many areas, the delivery of medical and mental health care lagged
behind.
In April of 1997, a court-appointed expert found the
existing health care programs incapable of meeting constitutional
standards and suggested, as an alternative, the appointment of a
receiver. The parties (who, over a quarter of a century, have
agreed on little else) unanimously opposed this recommendation.
They suggested instead the formation of a private non-profit
corporation to provide medical and mental health services to the
inmate population. On September 26, 1997, the parties drafted,
executed, and filed a stipulation embodying this consensus. Under
the terms of the stipulation, a non-profit corporation was to be
formed. The corporation would be structured to provide health care
services, consistent with the 1990 plan, to all individuals held in
institutions operated by the AOC. The stipulation pledged the
parties' full cooperation, required the Secretary and the AOC to
lay the groundwork for a transition, and offered to subject the
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process of privatization to the supervision of the district court.
Finally, the stipulation memorialized the parties' agreement to
engage in further discussions concerning the role and authority of
the CHCC.
The district court endorsed the stipulation and, thus,
assumed ownership of the privatization plan that had been conceived
by the parties. See Morales III, 303 F.3d at 3-4; see also Morales
II, 13 F. Supp. 2d at 212-14 (justifying the adoption of the
privatization remedy by elaborating on the grave constitutional
deficiencies that continued to haunt the existing programs). The
order, as it pertains to this appeal, has retained its original
substance. The non-profit entity, known as the Correctional Health
Services Corporation (the CHSC), has been formed.
The parties and the district court envisioned the CHSC as
a key piece of the privatization machinery. Withal, the CHSC was
intended as a transitional device rather than as the exclusive
provider of inmate health care services in perpetuity. The parties
expected that within a few years of its full implementation, the
CHSC would compete with private health care providers for contracts
to furnish health care services to those persons held in the AOC's
custody. This expectation remains in force.
The CHSC has a checkered history. Originally, the
parties hoped that it would begin to function as early as July 1,
1998, and become fully operational as a provider of health care to
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the inmate population by the end of that year. That prediction
proved wildly optimistic. Although the district court, using
accrued fines, has made substantial funding available to the CHSC
— as of the date of the district court's decision, roughly
$55,000,000 had been spent on the privatization solution — this
monetary infusion has not yet brought the project to fruition.
While the CHSC has made substantial progress toward reaching its
stated goals, the pace has been much slower than anticipated. To
this point, the CHSC has developed an administrative
infrastructure, fashioned an impressive set of substantive
programs, and constructed needed facilities. As a result, it has
begun contributing to the management of payroll, staff assignments,
inventory, purchasing, billing, and financing. The CHSC's
achievements in formulating substantive programs include the
creation of an electronic database for health records, patient
tracking, and the keeping of appointments; the design of a
telemedicine program to enable remote diagnosis and treatment of
psychiatric illnesses; and the training of personnel to maximize
the efficacy of these (and other) programs. The CHSC also has
improved the quality of the facilities and equipment dedicated to
the provision of inmate health care. In the same vein, it has
purchased and installed computers at most of the institutions
operated by the AOC. Last — but far from least — it is in the
process of developing a new acute care hospital.
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Without in any way minimizing either the value or extent
of these accomplishments, it is evident that the CHSC has lagged
far behind the timetable that its proponents originally envisioned.
Part of the reason is that court supervision has made the process
cumbersome (for example, lengthy periods of time have been consumed
in the submission and approval of budget proposals). Other
factors, such as snail's-pace negotiations with outside
contractors, false starts, and resistance to change, have
contributed to the delay. Though this lag time may have been
unavoidable, the fact remains that, to this date, not a single
patient has been treated by the CHSC.
On October 1, 2003, the Secretary, emphasizing this
protracted period of delay and the mounting costs of completing the
necessary infrastructure, filed a motion under the PLRA to vacate
or terminate the privatization component of the extant consent
decree. The plaintiffs cross-moved to modify the medical and
mental health plans by terminating sections of the decree that
assigned the primary responsibility for inmate health care to the
Secretary. See Morales IV, 300 F. Supp. 2d at 342-43. The cross-
motion went unopposed and the district court granted it. Id. at
343.
Following an evidentiary hearing on the main motion, the
court found that pervasive and persistent constitutional violations
continued to shackle the delivery of health care in Puerto Rico's
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correctional system. Id. at 323-31. The court also found that the
contemplated relief — privatization — satisfied the requirements of
the PLRA. Id. at 331-38. Accordingly, the court upheld the
challenged portion of the consent decree and directed the AOC to
meet with the plaintiff class and submit a further plan for
achieving constitutional compliance. Id. at 344-45. The Secretary
now appeals.2
II. APPELLATE JURISDICTION
We start by clarifying the extent of our jurisdiction.
It is beyond serious question that we have jurisdiction over the
main elements of this appeal. See 28 U.S.C. § 1292(a)(1)
(conferring jurisdiction over interlocutory orders refusing to
terminate injunctions). The Secretary, however, has also attempted
to raise a tangential issue. With regard to that issue, appellate
jurisdiction is more problematic.
The circumstances are as follows. As part of its ruling
below, the district court ordered the AOC to "meet [with the
plaintiff class] and file with the Court within forty-five (45)
days . . . a plan on how the [AOC] will assume his legal
responsibility to provide health care to inmates." Morales IV, 300
F. Supp. 2d at 345. The Secretary asserts that this order, ex
proprio vigore, violates the PLRA and contravenes Supreme Court
2
The AOC has not appealed, and the district court's ukase has
not been stayed. We are advised that meetings between the AOC and
the plaintiffs are proceeding apace.
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precedent regarding limitations on the power of federal courts to
enforce state law against state officers. Pennhurst State Sch. &
Hosp. v. Halderman, 465 U.S. 89, 117 (1984) ("[A] federal suit
against state officials on the basis of state law contravenes the
Eleventh Amendment when . . . the relief sought and ordered has an
impact directly on the State itself."). We cannot reach the merits
of these claims for we have no jurisdiction over them.
This result is largely dictated by the rationale of our
decision in a prior phase of this seemingly endless litigation. In
Morales III, we ruled that an order that "was within the lower
court's reserved power to establish procedures for compliance with
the court's earlier decrees" was not immediately appealable. 303
F.3d at 10. That reasoning is apposite here. A necessary
correlate of the lower court's duty to supervise the ongoing
process of privatization is the power to issue subsidiary orders in
aid of that objective. We thus have no jurisdiction to entertain
an interlocutory appeal from this portion of the court's decision
(or even to consider the plaintiffs' contention that the Secretary
lacks standing to register such a protest).3
3
With only isthmian exceptions, the courts of appeals are
prohibited from exercising pendent appellate jurisdiction. See
Swint v. Chambers County Comm'n, 514 U.S. 35, 49-51 (1995); Limone
v. Condon, 372 F.3d 39, 51-52 (1st Cir. 2004). The Secretary
offers no developed argumentation on this point and, as matters
stand, we believe that this case is not a credible candidate for
the exercise of pendent appellate jurisdiction.
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III. THE MERITS
We proceed to examine the remainder of the Secretary's
asseverational array. He has loosed a scattershot attack. Only
four of his claims are worthy of extended discussion, namely, (i)
that the lower court lacked general equitable power to grant a
privatization remedy; (ii) that the PLRA mandates vacation of the
1998 order as void ab initio; (iii) that, after almost five years
of wheel-spinning, the PLRA now mandates termination of the
prospective relief; and (iv) that the court repeatedly erred in the
course of the evidentiary hearing.4 We address these issues (some
of which have subparts) sequentially.
A. General Equitable Powers.
The Secretary's first broadside need not detain us. He
posits that the relief ordered here is an invalid exercise of
4
The Secretary makes a fifth argument: that the relief
ordered by the district court requires Puerto Rican officials to
act in contravention of local law. The district court refused to
address this argument on the ground that the Secretary did not
sufficiently specify the nature of the alleged violations. That
ruling is supportable, and it precludes reliance on the argument
here. See Teamsters Union v. Superline Transp. Co., 953 F.2d 17,
21 (1st Cir. 1991) (holding that arguments not squarely raised in
the trial court cannot be advanced on appeal). In all events, the
Secretary's appellate presentation suffers from the same lack of
specificity; he alleges the violations in the most general terms
and does not inform us of where in the record we might find any
evidence of them. This lack of developed appellate argumentation
constitutes an independently sufficient basis for deeming the
argument abandoned. See United States v. Zannino, 895 F.2d 1, 17
(1st Cir. 1990) ("It is not enough merely to mention a possible
argument in the most skeletal way, leaving the court to do
counsel's work, create the ossature for the argument, and put flesh
on its bones.").
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federal equitable power. Because this argument presents a purely
legal issue, it engenders de novo review. See Sunshine Dev., Inc.
v. FDIC, 33 F.3d 106, 111 (1st Cir. 1994).
At the outset, we note that this argument quite likely is
by the boards. The Secretary's predecessor in office stipulated to
the privatization remedy, and there is no claim that he lacked
authority to do so. Normally, that would constitute a waiver,
which would prevent the Secretary from making this argument
altogether.
Even if the Secretary is not bound by his predecessor's
acquiescence — a matter on which we take no view — the Secretary
did not present this argument to the district court and attempts to
raise it for the first time on appeal. "It is a bedrock rule that
when a party has not presented an argument to the district court,
[he] may not unveil it in the court of appeals." United States v.
Slade, 980 F.2d 27, 30 (1st Cir. 1992). At the least, then, the
argument is forfeited.
We nonetheless inquire briefly into the merits, as
forfeited arguments (unlike waived arguments) ordinarily warrant
review for plain error. Gómez v. Rivera Rodríguez, 344 F.3d 103,
118 (1st Cir. 2003). That type of review "entails four showings:
(1) that an error occurred (2) which was clear or obvious and which
not only (3) affected the [appellant's] substantial rights, but
also (4) seriously impaired the fairness, integrity, or public
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reputation of judicial proceedings." United States v. Duarte, 246
F.3d 56, 60 (1st Cir. 2001).
The Secretary concedes that injunctions — like this one
— that have been issued pursuant to 42 U.S.C. § 1983 are limited
only by the court's inherent equitable powers. See, e.g., Giles v.
Harris, 189 U.S. 475, 486 (1903) (Holmes, J.). He insists,
however, that a federal court's equitable powers are restricted to
the remedies that were available in equity in 1789 (at the time of
the passage of the First Judiciary Act). This proposition is a
correct statement of the law, see Grupo Mexicano de Desarrollo v.
Alliance Bond Fund, Inc., 527 U.S. 308, 318-19 (1999), but the
Secretary's application of it fails plain error review.
Specifically, the Secretary characterizes privatization
as "a fairly recent endeavor" and claims, therefore, that there is
no reasonable basis for holding that court-imposed privatization of
duties ordinarily ascribed to the government is within the district
court's armamentarium. Appellant's Br. at 29. If this crabbed
view reflected the state of the law, equitable remedies would be
frozen in time and new remedial applications could never be
developed to meet contemporary needs. The view, however, is
fundamentally at odds with the core principle that equity must
evolve over time "in order to meet the requirements of every case,
and to satisfy the needs of a progressive social condition in which
new primary rights and duties are constantly arising and new kinds
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of wrongs are constantly committed." Union Pac. Ry. Co. v.
Chicago, Rock Island & Pac. Ry. Co., 163 U.S. 564, 601 (1896).
Consistent with this principle, the Supreme Court has
made clear that the inquiry into the availability of equitable
relief in a particular case focuses upon whether the general manner
of relief sought was available at equity in 1789. See Grupo
Mexicano, 527 U.S. at 322. This inquiry is informed by a
recognition that equity is flexible and that the boundaries of
permissible relief are broad. Id. Thus, the relevant question is
not whether a specific application of relief was available in 1789,
but, rather, whether that general type of relief was available.
In this case, the answer to that question is affirmative.
At bottom, the endorsed anodyne — privatization — calls for relief
in the nature of a mandatory injunction, and injunctive relief is
a classic equitable remedy. Great-West Life & Annuity Ins. Co. v.
Knudson, 534 U.S. 204, 211 n.1 (2002); Mertens v. Hewitt Assocs.,
508 U.S. 248, 256 (1993); Griggs v. E.I. Dupont de Nemours & Co.,
237 F.3d 371, 384 (4th Cir. 2001). A survey of contemporary
applications of this rule supports this conclusion. Courts
consistently have upheld relief in equity notwithstanding the fact
that the particular remedial application was not available in 1789.
School busing orders exemplify this point. See, e.g., Swann v.
Charlotte-Mecklenburg Bd. of Educ., 402 U.S. 1, 30 (1971); Morgan
v. Kerrigan, 530 F.2d 401, 414-15 (1st Cir. 1976). If the
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Secretary's argument were sound, all such orders would be beyond
the equitable power of a federal court.
The short of it is that a federal district court, faced
with pervasive and persistent constitutional violations, has not
only the power but also the duty to render a decree that will,
insofar as is possible, return matters to a constitutionally
acceptable level. While the privatization remedy constitutes
extraordinary relief and can be justified in only the most
exceptional circumstances, the nature of the remedy is no different
than that of a garden-variety mandatory injunction. Seen in this
light, we conclude that the district court did not commit plain
error in determining that it had the authority to approve and
implement a privatization remedy jointly proposed by the parties.
B. Compliance with the PLRA.
In 1996, Congress enacted the PLRA, partially in an
effort to curb the involvement of the federal judiciary in day-to-
day prison management. See 141 Cong. Rec. 13,319 (1995) (statement
of Sen. Abraham); id. at 14,418 (statement of Sen. Hatch). This
ambient intent must guide our interpretation of the statutory text.
See Inmates of Suffolk County Jail v. Rouse, 129 F.3d 649, 655 (1st
Cir. 1997).
The PLRA establishes standards for the entry and
termination of all prospective relief in civil actions challenging
prison conditions. See Miller v. French, 530 U.S. 327, 333 (2000).
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The term "prospective relief" encompasses "all relief other than
compensatory monetary damages." 18 U.S.C. § 3626(g)(7). The
statute requires that prospective relief "shall extend no further
than necessary to correct the violation of the Federal right of a
particular plaintiff or plaintiffs." Id. § 3626(a)(1). It further
provides that a federal court "shall not grant or approve any
prospective relief unless the court finds that such relief is
narrowly drawn, extends no further than necessary to correct the
violation of the Federal right, and is the least intrusive means
necessary to correct the violation of the Federal right." Id. A
party is entitled to immediate termination of any relief that has
been granted in the absence of findings as to these criteria. Id.
§ 3626(b)(2). Conversely, however, prospective relief "shall not
terminate if the court makes written findings based on the record
that prospective relief [meets the above requirements]." Id. §
3626(b)(3).
This statutory backdrop provides the setting for the
Secretary's next challenge to the propriety of the privatization
order. This challenge has three foci, each spawned by the PLRA.
We deal with them in order.
1. Validity of the 1998 Order. The Secretary first
argues that, when originally entered in 1998, the order approving
privatization did not meet the PLRA's requirements and, thus, "must
be set aside without further consideration." Appellant's Br. at
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31. Because the district court did not make the findings
specifically required by the PLRA coincident with the entry of its
1998 order, the Secretary's thesis runs, the order was void ab
initio.5
The Secretary's thesis hinges on the premise that when
prospective relief does not meet the PLRA's requirements at the
moment of issuance, the decree is void without reference to the
statutory termination procedure. On this premise, the termination
procedure applies only to (i) prospective relief entered before the
effective date of the PLRA and (ii) prospective relief entered
after that date which is accompanied by the requisite narrowness-
need-intrusiveness findings. Prospective relief entered after the
PLRA's effective date but unaccompanied by narrowness-need-
intrusiveness findings is simply void.
There is no textual support for the Secretary's position.
He relies on the mandatory language of 18 U.S.C. § 3626(a), which
states that "[t]he court shall not grant or approve any prospective
5
Although we assume arguendo the correctness of the
Secretary's assessment of what transpired in 1998, we note that the
district court made a series of contemporaneous written findings,
which may well have satisfied the narrowness-need-intrusiveness
requirements. See Morales II, 13 F. Supp. 2d at 212 (holding that
privatization "is necessary to protect the members of the plaintiff
class from cruel and unusual punishment through constitutionally
unacceptable health care services," that the remedy "extends no
further than is necessary to correct the violation of the Federal
rights of members of the plaintiff class," that "such relief is
narrowly drawn," and that there "is no less intrusive means to
correct the violation of plaintiffs' Federal rights").
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relief" in the absence of specific findings. But this subsection
sets forth the standard district courts must follow when
determining whether prospective relief not yet ordered is permitted
by the PLRA. Gilmore v. California, 220 F.3d 987, 999 (9th Cir.
2000) ("If prospective relief has already been granted by a court,
§ 3626(b) controls."). Here, however, privatization constitutes
the status quo (and the Secretary advanced no PLRA-based argument
at the time that privatization was originally approved).
The only authority cited by the Secretary — Rouse — does
not support his point of view. He asserts that Rouse drew a
distinction between orders issued prior to the enactment of the
PLRA and those issued subsequent thereto. That is incorrect.
Rouse drew a distinction between "existing federal court orders"
and those "not yet obtained." 129 F.3d at 654. That distinction
contradicts the position that the Secretary advocates in this
appeal.
Accordingly, we hold that the procedure limned in 18
U.S.C. § 3626(b) applies to any existing prospective relief,
regardless of when that relief was first ordered. See Miller, 530
U.S. at 333 (stating that section 3626(b) applies to "existing
injunctions"); Harvey v. Schoen, 245 F.3d 718, 720 (9th Cir. 2001)
(holding that prospective relief made "in the absence of the
required findings" is immediately terminable "regardless of when
ordered"); see also Rouse, 129 F.3d at 654 (suggesting that the
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termination procedures set forth in section 3626(b) apply to all
existing federal court orders).
Since privatization is required by a preexisting court
order, the situation is controlled by subsection (b), not
subsection (a). See Rouse, 129 F.3d at 654. That makes a
significant difference. Nothing in subsection (b) or in its
legislative history speaks of vacating consent decrees but only of
terminating them. That linguistic shift has practical
consequences. "While terminating a consent decree strips it of
future potency, the decree's past puissance is preserved . . . ."
Id. at 662.
That gets the grease from the goose. Although 18 U.S.C.
§ 3626(b) entitles a defendant to termination of existing
prospective relief ordered in the absence of the requisite
findings, that proviso excepts cases in which the court supportably
finds that the particular form of prospective relief remains at the
time of the challenge narrowly tailored, necessary, and relatively
unintrusive. See id.; see also Guajardo v. Tex. Dep't of Crim.
Justice, 363 F.3d 392, 394 (5th Cir. 2004) (per curiam). There is
no time limitation present in section 3626(b)(2), nor does its
language suggest that it reaches only those orders issued prior to
the PLRA's effective date.
To cinch matters, section 3626(b) provides that any order
made in the absence of the required findings is subject to
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"immediate termination." This word choice is significant. See
Rouse, 129 F.3d at 662. The verb "terminate" means "to put an end
to" or "to end." Black's Law Dictionary 1482 (7th ed., 1999). If
Congress had intended that orders issued in the absence of the
required findings be void ab initio, it would almost certainly have
chosen a phrase such as "void."
To sum up, the PLRA grants the Secretary a right to move
for the termination of prospective relief. The PLRA does not,
however, confer any right to argue, five years after the fact, that
an order should be deemed void ab initio for lack of
contemporaneous findings. Therefore, this aspect of the
Secretary's challenge founders.
2. The Constitutional Violations. Upon a motion to
terminate prospective injunctive relief under the PLRA, a court may
continue the relief only if it supportably finds that there are
ongoing constitutional violations. 18 U.S.C. § 3626(b). The
district court purposed to make such findings in this instance.
See Morales IV, 300 F. Supp. 2d at 323-31, 342. The Secretary
counters that the record does not show infirmities sufficient to
justify ongoing relief and that the district court's contrary
findings are clearly erroneous.
An inquiry into whether current prison conditions
constitute an ongoing violation of a federal right "comprises a
mixed question of fact and law, the answer to which we review along
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a degree-of-deference continuum, ranging from plenary review for
law-dominated questions to clear-error review for fact-dominated
questions." Rouse, 129 F.3d at 661. Here, the question is fact-
intensive — the Secretary frontally challenges the lower court's
factfinding — so our standard of review is deferential. See id.;
see also Dedham Water Co. v. Cumberland Farms Dairy, Inc., 972 F.2d
453, 457 (1st Cir. 1992) (admonishing that appellate courts should
respect the trial court's findings of fact unless convinced, after
a careful review of the record, that a mistake has been made). If
there are two permissible views of the evidence, the factfinder's
choice between them must be respected. See Fed. Refin. Co. v.
Klock, 352 F.3d 16, 29 (1st Cir. 2003). The lower court's factual
findings easily pass muster under this deferential standard.
We have painstakingly reviewed the record and examined
the numerous findings of fact, mindful that a trial court generally
is considered the most informed interpreter of its own prior
rulings and findings. See Rouse, 129 F.3d at 661. In this
instance, the court was very careful to update the record and to
consider the ways in which conditions had changed since its
original endorsement of the privatization concept. See Morales IV,
300 F. Supp. 2d at 323-31. The court painted a compelling, record-
rooted picture of how and in what respects health care for inmates
in Puerto Rican prisons remains constitutionally deficient. See
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id. On this grim record, it is simply implausible to suggest that
these findings are clearly erroneous.
The district court characterized the denial of medical
and mental health services as "massive and systematic." Id. at
324. That characterization seems apt. No useful purpose would be
served by rehearsing the court's findings in minute detail. We
offer instead a few of the more glaring examples. As of 2003, one-
fourth of all inmates who requested sick call did not get it; only
55% of all ambulatory care appointments actually took place; only
49% of specialist consultations deemed necessary for serious
conditions were arranged; as a rule, medically prescribed diets for
inmates were habitually ignored; only 31.3% of inmates who had been
diagnosed HIV-positive were receiving treatment; and inmate
mortality rates were rising. See id. at 323-31. These are but the
tip of a particularly unattractive iceberg. Despite the CHSC's
efforts, physical facilities for inmate health care remain
inadequate and there is an acute shortage of psychiatric expertise.
See id. at 326-27, 331. Basic health care is critical to
maintaining a decent quality of life, and Puerto Rico's
correctional system is not delivering a constitutionally acceptable
level of health care to its captive population.
We acknowledge that in the course of making these
findings, the district court largely disregarded the testimony of
the Secretary's expert witness as lacking in credibility. Although
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the Secretary complains bitterly about this rejection, it is
hornbook law that matters of credibility are ordinarily for the
court of first instance, not for the appellate court. Laurent v.
Ashcroft, 359 F.3d 59, 64 (1st Cir. 2004). Unless the record
mandates a contrary finding — and this record most assuredly does
not — the court of appeals ought not disturb a trial court's
credibility determination. See Anthony v. Sundlun, 952 F.2d 603,
606 (1st Cir. 1991); see also 9A Charles Alan Wright & Arthur R.
Miller, Federal Practice & Procedure § 2586 (2d ed. 1994)
(collecting cases). Here, moreover, there is much to commend the
district court's assessment of the witness's dubious credibility
(for example, the witness provided haphazard and inconsistent
testimony and, on cross-examination, withdrew or corrected a myriad
of statements).
The Secretary accurately observes that some noteworthy
advances have been made in the delivery of health care to inmates.
He overlooks, however, that notwithstanding these improvements, the
district court found substantial deficiencies attendant to
virtually every aspect of the inmate health care system. Morales
IV, 300 F. Supp. 2d at 324. However laudable the advances may be,
the district court's supportable finding that constitutional
violations persist suffices to satisfy the requirements of the PLRA
and to justify a comprehensive injunctive decree.
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To say more on this subject would be supererogatory. We
hold, without serious question, that the district court's findings
and conclusions about the incidence of continuing constitutional
violations are adequately anchored in the record.
3. The Narrowness-Need-Intrusiveness Findings. The PLRA
mandates "the termination of extant consent decrees altogether
unless the district court makes the specific findings that are
necessary to keep a particular decree alive." Rouse, 129 F.3d at
655. In addition to ongoing constitutional violations, this
compendium includes a finding that the ordered relief satisfies the
statutory narrowness-need-intrusiveness criteria. See 18 U.S.C. §
3626(b). The district court made such findings here. See Morales
IV, 300 F. Supp. 2d at 342. The Secretary argues that the facts of
this case, as found, require termination of the decree because the
chosen remedy — privatization — does not meet the narrowness, need,
and intrusiveness requirements delineated in the PLRA.
Congress plainly intended the PLRA to operate as a
mechanism that would decrease federal judicial involvement in
prison administration. See Rouse, 129 F.3d at 655. Congress left
room, however, for needed injunctive relief. The Secretary's
insistence that Congress did not want courts involved in prison
administration begs the real question — which is whether a
particular set of facts, measured under the statutorily specified
criteria, warrants continued judicial involvement. We think that
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this is a close call in the case at hand, but for the time being,
we find supportable the district court's conclusions regarding
narrowness, need, and lack of intrusiveness.
The narrowness-need-intrusiveness criteria are, to some
extent, self-explicating. The devil is in the details attendant to
their application. The application of those criteria is case-
specific and must be undertaken in light of both the magnitude of
existing constitutional violations and the available remedial
alternatives.6 See, e.g., Clement v. Cal. Dep't of Corrections,
364 F.3d 1148, 1153 (9th Cir. 2004). The constitutional violations
here are substantial in both scope and degree. They have defied
correction for more than two decades. The district court has tried
more conventional measures, but found them wanting. It has
afforded the Commonwealth ample opportunity to bring preexisting
mechanisms up to speed or otherwise to correct the phalanx of
problems. It has witnessed the Commonwealth's continued inability
to cure the constitutional infirmities plaguing the delivery of
health care in the correctional system. This record of abject
failure matters in the narrowness-need-intrusiveness inquiry. See
6
We reject out of hand the Secretary's argument that an order
to privatize is a per se violation of the narrowness requirement of
the PLRA. The narrowness of a remedy necessarily involves a close
examination of a particular set of facts and a determination
concerning what steps are reasonable to cure the ongoing
constitutional violations. Because this will necessarily be
influenced by a variety of factors, we are wary of adopting
ironclad rules.
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Benjamin v. Fraser, 343 F.3d 35, 49 (2d Cir. 2003) (upholding
narrowness-need-intrusiveness findings "in light of the district
court's finding that the [defendant's] compliance with its remedial
responsibilities has been consistently incomplete and inadequate").
The need for continued prospective injunctive relief is
patent. The lower court has been dealing with the deficiencies of
Puerto Rico's correctional system since 1979, and we acknowledge
that the sheer passage of so much time counsels restraint in
ordering further extensions of prospective injunctive relief. See,
e.g., Spangler v. Pasadena City Bd. of Educ., 611 F.2d 1239, 1241
(9th Cir. 1979). However, the correctional system is sprawling,
the problems with which the court has had to grapple are massive,
the Commonwealth's acceptance of the need for reforms has ranged
from inconsistent to grudging (witness the current state of affairs
in which the AOC embraces privatization as the Secretary seeks to
dismantle it), and progress has been correspondingly slow. Insofar
as health care is concerned, the level of improvement still falls
well short of bringing serious violations into constitutional
compliance. Morales IV, 300 F. Supp. 2d at 323-31. In some
respects, backsliding has occurred. See id. at 324. In light of
these facts, we have no difficulty affirming the district court's
finding that a need for ongoing injunctive relief exists.
We next consider the district court's findings regarding
narrow tailoring and lack of intrusiveness. In 2003, the district
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court was keenly aware of its duty to ensure that prospective
remediation complies with the PLRA's requirements. See Morales IV,
300 F. Supp. 2d at 331. It was, however, faced with a
constitutional crisis and only three proposed solutions: turning
back the health care clock to reinstate the system that had failed
miserably for two decades, placing the system into receivership, or
persisting with the plan for privatization (which the parties had
conceived and to which they originally had agreed). The status quo
ante alternative had proven to be ineffective, and, thus, was
undesirable. No one favored the receivership alternative. That
left privatization. Against this mise-ên-scéne, we cannot say that
the lower court's choice of that alternative was unreasonable.
The Secretary nonetheless argues that privatization is
much broader than necessary to forfend against cruel and unusual
treatment of inmates. If this were the district court's first
attempt at remediation, we quite likely would agree. But the
district court has attempted narrower, less intrusive alternatives
— and those alternatives have failed to restore the constitutional
balance. For this reason, a more innovative remedy is justifiable.
The increased intrusiveness and broader scope of the privatization
remedy is a direct response to the unique need created by the
Commonwealth's own failure — for more than twenty years — to
correct serious constitutional inadequacies. Drastic times call
for drastic measures.
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The Secretary has one final shot in his sling. He
laments that privatization is far behind schedule and has
accomplished very little to date. Nevertheless, a great deal of
time, effort, and money has been spent in constructing facilities,
procuring equipment, creating programs, and building a more
responsive infrastructure. Perhaps more important, the CHSC has
developed a functional information technology system. Knowledge is
power, and that platform seems reasonably likely to contribute
measurably to the long-term success of the prison health care
system. It provides a means of maintaining accurate records and
thus creating accountability. See, e.g., Carol Gentry, Health-Care
Firms Face Costly Change, Wall St. J., Jan. 3, 2000, at A3 ("By
speeding up the transmission and improving the accuracy of
information, health plans should be able to do a better job of
monitoring the quality of care."); Laura Landro, Health Care Goes
Digital: Doctors and Hospitals Find They Can't Stay Offline Any
Longer, Wall St. J., June 10, 2002, at R6 ("There is a clear
linkage now between technology and better patient outcomes."). The
district court has cultivated this tree patiently and at great
expense, and it would be rash for us to insist that it be uprooted
just when it shows promise of bearing fruit.
The Secretary's related complaint — that the
ineffectiveness of privatization to date defeats the finding of
narrowness — is unpersuasive for two reasons. First, a
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determination of narrowness requires a court to decide whether
ordered relief is tailored to rectify existing constitutional
violations. See Cason v. Seckinger, 231 F.3d 777, 784 (11th Cir.
2000) ("The court must make new findings about whether the relief
currently complies with the need-narrowness-intrusiveness
requirements, given the nature of the current violations."); see
also Castillo v. Cameron County, 238 F.3d 339, 354 (5th Cir. 2001).
Whether a remedy is capable of successfully ameliorating
constitutional violations has no necessary correlation with whether
it is narrowly drawn. Narrow relief can be completely ineffectual.
See Morales II, 13 F. Supp. 2d at 157-58 (noting the failure of
limited injunctive orders to bring the Puerto Rican correctional
system into constitutional compliance). That the privatization
concept has been slow to come to fruition does nothing to prove
that the order is overly broad (or overly intrusive, for that
matter).
Second, we think that the PLRA is too blunt an instrument
for addressing this concern. As said, the PLRA limits courts to
terminating prospective relief. Not every unforseen difficulty in
implementing injunctive decrees necessitates the total abandonment
of a remedy. It is true that the CHSC has lagged far behind the
original schedule and that the corporation has, to date, not
accomplished its ultimate goals. It is also true that an
ineffective remedy is a cause for concern. In light of the
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substantial progress that has been made, however, the mere fact
that privatization is behind schedule does not convince us that it
fails the narrowness-need-intrusiveness test.7
We are well aware that federal oversight of Puerto Rico's
correctional system cannot — and should not — last forever. We
strongly urge both the district court and the litigants to move the
privatization process forward with all practicable speed. For now,
however, we conclude, based on the record evidence and the factual
findings of the district court, that the privatization order meets
the PLRA's requirements. The privatization solution has not yet
been put into practice and common sense dictates that it be given
a fair chance to work. The order appealed from provides that
chance.
C. The Evidentiary Hearing.
The Secretary's fallback position is that the district
court committed reversible error in its manner of conducting the
evidentiary hearing on the motion to terminate prospective relief.
This contention has four branches. All of them are acarpous.
1. Burden of Proof. The Secretary first suggests that
the district court impermissibly shifted the burden of proof. This
suggestion derives primarily from the court's decision to order the
7
It may well be that modification, or some other more limited
adjustment, is appropriate to address such concerns, see Fed. R.
Civ. P. 60(b)(5) — but that issue is not before us.
-30-
proof by directing the Secretary (rather than the inmate class) to
come forward, at the start of the hearing, with his evidence.
It is axiomatic that district courts enjoy wide latitude
in matters concerning the ordering of proof and the presentation of
evidence. See, e.g., United States v. Holmquist, 36 F.3d 154, 163
(1st Cir. 1994); Elgabri v. Lekas, 964 F.2d 1255, 1260 (1st Cir.
1992); see also Fed. R. Evid. 611(a). We review a trial court's
determinations concerning the mode and order of proof for abuse of
discretion. Nat'l R.R. Pass. Corp. v. Certain Temporary Easements,
357 F.3d 36, 42 (1st Cir. 2004). We will reverse only if a
determination has unfairly prejudiced the complaining party. Id.
The decision to require the Secretary to present his
proof first was not an abuse of discretion. In arriving at its
decision on the motion to terminate, the court was free to rely on
any aspect of the record that tended to shed light on whether
constitutional violations persisted. See Laaman v. Warden, N.H.
State Prison, 238 F.3d 14, 17-18 (1st Cir. 2001) (noting that the
court's familiarity with the record and its receipt of periodic
reports may afford it "comprehensive knowledge of whether a prison
is, or is not, continuing to violate the consent decree"). At the
beginning of the hearing, the court had before it a full
evidentiary record, developed over many years, together with a
cache of periodic reports as to progress under the consent decree.
This plethoric evidence was sufficient, if unrebutted, to support
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a finding that constitutional violations endured. With this in
mind, it was sensible for the court to invite the Secretary to
offer evidence to the contrary.
To be sure, a trial court's authority to regulate the
order of proof does not include the power to shift the burden of
proof. Brown Daltas & Assocs., Inc. v. Gen. Accid. Ins. Co., 48
F.3d 30, 37 (1st Cir. 1995) (reversing a judgment because the trial
court erroneously shifted the burden of proof); see also 9 J.
Wigmore, Evidence § 2489 (J. Chadbourn ed. 1981). But that is not
what happened here: the court's election to hear the Secretary's
evidence first in no way betokened reallocation of the burden of
proof. In its subsequent review of the evidence, the court said
nothing that indicated any misunderstanding as to where the burden
of proof rested. Rather, it supportably determined that the facts
presented by the Secretary lacked sufficient probative force to
blunt the thrust of the accumulated evidence of record. Morales
IV, 300 F. Supp. 2d at 339-40 (relying on the Secretary's own
evidence to find continuing constitutional violations). In short,
the contention that the lower court impermissibly shifted the
burden of proof has no footing in the record.
2. The Agreement Between the Parties. The Secretary
next maintains that the district court erred by relying on the
existence of a "private agreement" (by private agreement, he means
the stipulation that was signed in 1997 by, inter alios, his
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predecessor in office). Specifically, the Secretary asserts that
the fact that there was an agreement between the parties should
have had no bearing on the continuing viability of the subsequent
order approving privatization (entered in 1998). This assertion
overlooks that the so-called private agreement was embodied in a
stipulation presented to and adopted by the district court. Upon
its adoption, the private agreement became a judicially enforceable
consent decree. Frew ex rel. Frew v. Hawkins, 124 S. Ct. 899, 903
(2004) ("A consent decree embodies an agreement of the parties and
is also an agreement that the parties desire and expect will be
reflected in, and be enforceable as, a judicial decree that is
subject to the rules generally applicable to other judgments and
decrees." (internal quotation marks omitted)); In re Pearson, 990
F.2d 653, 658 (1st Cir. 1993) (similar).
This is significant because the Secretary's argument
blurs the crucial distinction, for PLRA purposes, between private
side agreements and consent decrees. The latter may serve as a
vehicle for prospective relief under the PLRA; the former may not.
See 18 U.S.C. § 3626(a); see also id. § 3626(c)(1).
In all events, the lower court did not rely impermissibly
on the parties' original agreement. Although the court noted the
existence of that agreement and scolded the Secretary for trying to
renege on it, the holding in Morales IV was in no way premised
either on an estoppel or on the fact that the parties previously
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had agreed to explore a privatization alternative. For these
reasons, the Secretary's argument fails.
3. The Exclusion of Evidence. The Secretary also
contends that the district court erred in refusing to allow him to
introduce evidence as to the narrowness-need-intrusiveness
criteria. On this point, as is so often true in litigation,
context is decisive.
After the Secretary had presented his evidence as to the
existence vel non of continuing constitutional violations, the
district court asked him to summarize the evidence that he planned
to adduce on the narrowness-need-intrusiveness criteria. The
Secretary proceeded to make an offer of proof. Having heard the
proffer, the court determined that nothing in it bore directly upon
the narrowness of, need for, or potential intrusiveness of the
privatization remedy. Consequently, the court rejected the
Secretary's offer of proof on relevancy grounds.
We descry no error. In many instances, relevancy boils
down to a judgment call. See generally Fed. R. Evid. 401 (deeming
evidence relevant if it has "any tendency to make the existence of
any fact that is of consequence to the determination of the action
more probable or less probable than it would be without the
evidence"). Accordingly, district courts enjoy wide latitude in
determining the relevancy vel non of evidence. Laaman, 238 F.3d at
18-19; United States v. Tierney, 760 F.2d 382, 387 (1st Cir. 1985).
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In this instance, the district court concluded that the offer of
proof had no bearing on the appropriateness of the remedy under the
PLRA's narrowness-need-intrusiveness criteria. Morales IV, 300 F.
Supp. 2d at 337-38. Having reviewed the offer of proof, we find
that this ruling was within the realm of the district court's
discretion. We explain briefly.
By way of his offer of proof, the Secretary proposed to
introduce evidence designed to show the ineffectiveness of the
remedy. He began the proffer by alleging generally that the non-
profit corporation was not a viable remedy because it had not yet
treated a single patient. The district court asked for
elaboration, and the Secretary expressed a desire to take discovery
on the matter. Morales IV, 300 F. Supp. 2d at 337. When the court
refused that untimely request, the only details proffered by the
Secretary tended to show that the CHSC was not complying with
either the district court orders or Puerto Rico laws, and that it
was not ready to begin treating patients. Id. at 338. This is a
distinct line of inquiry. See Hadix v. Johnson, 228 F.3d 662, 673
(6th Cir. 2000) (explaining that inquiries into compliance and
inquiries into necessity under the PLRA are separate and distinct).
As the district court sagely noted, compliance was not at issue in
the evidentiary hearing. Morales IV, 300 F. Supp. 2d at 338.
We — like the district court — do not see how the
Secretary's offer of proof informs a determination of whether the
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privatization remedy is a narrowly tailored, relatively unintrusive
response to the serious constitutional violations that the district
court found still existed. We note, moreover, that the Secretary
has not explained the connection. We thus cannot fault the
district court either for the rejection of the offer of proof or
for its consequent exclusion of the proffered evidence.
4. Rule 52(c). Finally, the Secretary assigns error to
the district court's use of Fed. R. Civ. P. 52(c) as an
adjudicative tool. See Morales IV, 300 F. Supp. 2d at 344. Rule
52(c) provides a court conducting a bench trial with a means for
issuing a judgment on partial findings. The rule is designed for
use when "a party has been fully heard on an issue and the court
finds against the party on that issue." Fed. R. Civ. P. 52(c).
The district court invoked that procedure here. The
Secretary asseverates that this was not permissible on the facts of
this case. We reject this asseveration.
To be frank, we find the Secretary's argument difficult
to fathom. The text of the rule is clear. When a party has
finished presenting evidence and that evidence is deemed by the
trier insufficient to sustain the party's position, the court need
not waste time, but, rather, may call a halt to the proceedings and
enter judgment accordingly. See Fed. R. Civ. P. 52 advisory
committee note ("Subdivision (c) . . . authorizes the court to enter
judgment at any time that it can appropriately make a dispositive
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finding of fact on the evidence."); see also Atl. Track & Turnout
Co. v. Perini Corp., 989 F.2d 541 (1st Cir. 1993). The fact that
the inmate class had the burden of proof did not place Rule 52(c)
off limits. A judgment under Rule 52(c) can be entered for or
against either a plaintiff or a defendant, regardless of the
allocation of the burden of proof. See Bursztajn v. United States,
367 F.3d 485, 488 (5th Cir. 2004); Fed. Refin. Co., 352 F.3d at 26;
see also 9A Wright & Miller, supra § 2573.1.
Here, the Secretary had advanced his proof and the
district court supportably concluded that the Secretary's evidence
could not withstand the probative force of the historical record.
In other words, even after taking the Secretary's case into account,
the court determined that the plaintiffs had sustained their burden
of showing pervasive and persistent constitutional violations.
Morales IV, 300 F. Supp. 2d at 340-42. The court also supportably
determined that the privatization remedy satisfied the narrowness-
need-intrusiveness criteria, and that the Secretary's offer of proof
did not include any relevant evidence to the contrary. Based on
these findings, the district court appropriately entered judgment
pursuant to Rule 52(c). That the court made a series of credibility
calls in reaching these conclusions in no way detracts from the
legitimacy of its approach. See Wright & Miller, supra § 2573.1,
at 497-99 (noting that the court's task under Rule 52(c) is to weigh
the evidence, without drawing any special inferences in the
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nonmovant's favor, resolve any conflicts in the evidence, and
"decide for itself where the preponderance lies").
IV. CONCLUSION
We are sensitive both to Congress's manifest desire to
limit federal judicial oversight of state correctional systems and
to the length of time that Puerto Rico's prisons have been under
federal hegemony. These concerns impel us to counsel the parties
and the district court to move forward as swiftly as possible to
cross the threshold of constitutional adequacy so that federal
judicial involvement may cease. For now, however, we accept the
well-documented judgment of the district court — a court intimately
acquainted with the details of this litigation and the intricacies
of the Puerto Rican correctional system — that inmate health care
remains constitutionally unacceptable and that the privatization
remedy holds promise for bringing inmate health care into compliance
with constitutionally mandated standards.8 Consequently, we reject
the Secretary's current effort to vacate or terminate the existing
consent decree.
We add a few words of caution. There are now significant
financial reserves (in the form of accumulated fines) available for
improvements in health care delivery, and the AOC seems willing to
8
Should the circumstances change, or a substantial interval
pass without significant progress, the Secretary is, of course,
free to ask the lower court to reexamine these findings and
reconsider the advisability of the ordered relief.
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work for change. We urge the district court to move toward
extricating itself from the toils of this litigation as soon as it
can do so without defaulting on its responsibilities under the
Constitution.
We need go no further. For the foregoing reasons, we
affirm the district court's denial of the Secretary's motion to
vacate or terminate the pertinent portions of the existing consent
decree. We take no view of the district court's procedural order,
see supra Part II, as we lack jurisdiction to review that order on
this interlocutory appeal.
Affirmed. Costs shall be taxed in favor of the
plaintiffs.
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