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The state has settled a long-running lawsuit over poor medical treatment and unsafe conditions at the Baltimore City Detention Center and Central Booking.

The federal class-action suit has been around in some form since 1971.

In the settlement agreement filed Tuesday, the state agrees to make dozens of changes, including screening new detainees for medical and psychiatric conditions and improving their access to important medications such as insulin for diabetics and antiretroviral drugs for the HIV-positive.

“I believe that the state acted in good faith and that if the state continues to act in good faith and actually implements what it has agreed to do, that it will make a significant difference, that detainees locked up in the jail will suffer a reduced risk of dying,” said Elizabeth Alexander, director of the American Civil Liberties Union’s National Prison Project and a lawyer for the detainees.

The settlement must still be approved in U.S. District Court by Judge J. Frederick Motz.

Now known as Duvall et al. v. O’Malley et al, the case includes two consolidated cases, one filed in 1971 and one in 1976. In 1993, the matter was resolved by a consent decree; however, that decree was put on hold in 1999 after Congress passed the Prison Litigation Reform Act, which allowed states to end litigation if the original constitutional violations had been corrected.

Alexander said the ACLU grew concerned again with conditions at the detention center in 2002, when it asked for and received a temporary restraining order regarding excessive heat at the city’s Women’s Detention Center.

A 2002 Department of Justice report also enumerated health and safety violations at the jail.

In 2003, the detainees’ lawyers moved to reopen the consent decree.

In the last two years, while that issue was in litigation, the two sides began talking about a settlement.

In addition to screening new detainees and ensuring access to necessary medications, the state agreed to develop care plans for detainees with chronic health problems and provide appropriate housing for the disabled.

Rick Binetti, a spokesman for the state’s Department of Public Safety and Correctional Services, said the state has already made most of the changes the agreement dictates.

“Basically, most of the things that are discussed in the settlement [have] already been underway and been improving through working together with the Department of Justice over the last five to six years,” he said.

Specifically, he said the detention center has instituted a methadone program, hired more medical staff to screen detainees, and brought in contractors to improve sanitation and pest control.

But Alexander said there are still big problems to be resolved.

“It has been my experience in working with individual clients that the medication system is still not implemented,” she said.

She said the jail also has yet to reliably provide sanitary napkins to female detainees.

The settlement covers all issues except protecting certain classes of detainees from heat-related injuries. That issue will go to Motz for resolution.

In the settlement, the parties agree that the detainees’ lawyers may monitor the state’s compliance for two years. They will have access to detainees’ medical records, will be informed of detainee deaths and may tour the detention center and Central Booking. The state will report quarterly on its compliance with the settlement agreement.

If the state does not comply with the agreement, the two sides will first try to resolve the problem; if that fails, the state can move to reopen the lawsuit. The state can also petition the court to reopen the suit in case of an emergency.

After two years, if the detainees’ attorneys do not move to reopen the case, it will be dismissed without prejudice.