A class of Illinois Department of Corrections prisoners sued state officials over inadequate medical and dental care, ultimately reaching a 2019 consent decree requiring IDOC to create an implementation plan to fix systemic deficiencies. After years of delays and contempt findings against IDOC, a court-appointed monitor essentially rewrote the implementation plan when IDOC failed to address identified problems.

Circuit Judge David Lee affirmed the district court's middle-ground approach, writing that while 'defendants' history of noncompliance does not blunt the requirements of the PLRA,' the court properly amended the decree to require Prison Litigation Reform Act findings before enforcing plan terms. The modification requires that any prospective relief be 'narrowly drawn, extend no further than necessary to correct the violation of the Federal right, and the least intrusive means necessary to correct the violation.'

The appeals arose after IDOC filed multiple Rule 60(b) motions seeking to strike compliance stipulations and remove the implementation plan entirely from the consent decree. District Judge Jorge Alonso initially denied IDOC's requests but later granted partial relief by modifying the decree to clarify PLRA requirements, finding that complete removal would leave the consent decree 'rudderless.'

The ruling preserves the implementation plan while requiring case-by-case PLRA compliance findings for enforcement, potentially affecting how prison reform consent decrees are structured nationwide. IDOC conceded at oral argument that the plan now imposes no binding obligations without proper judicial findings, while plaintiffs acknowledged they cannot enforce plan provisions without satisfying the modified requirements.