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COLUMBIA, S.C. (AP) — Eleven years after mental health advocates sued South Carolina over the treatment of mentally ill inmates, prison officials said Wednesday they have reached a final agreement on how to reform inmates' care.

The Department of Corrections announced the agreement with Protection and Advocacy for People with Disabilities on a plan to establish timelines and goals for settling a 2005 lawsuit. It still needs court approval.

The state and the advocates have been in mediation since 2014, when a judge sided with the advocacy group.

Protection and Advocacy said it sued on behalf of all of South Carolina's mentally ill inmates. The group estimates they number as many as 4,400, or about 19 percent of the state's inmate population. The department estimates it's closer to 12 or 13 percent.

Those inmates, according to the group, spend an inordinate amount of time in solitary confinement compared to other prisoners.

One man, according to court papers, suffers from paranoid schizophrenia and "believes that at night, while he is sleeping, doctors come into his cell and perform surgery on him." Instead of being placed at the prison system's sole psychiatric hospital, attorneys for the group wrote, he "has lived for most of the last sixteen years in an SCDC lock-up unit," kept alone in a cell nearly 24 hours a day and seeing a counselor only once a month.

Based on disciplinary records for 110 mentally ill inmates, the group said nearly all — 98 percent — spent more than a year in solitary confinement, while 20 percent were in solitary for more than five years. Others lost visitation and phone privileges for years after being found guilty of disciplinary infractions like masturbation or threatening other inmates.

The lawsuit alleged a lack of effective counseling and too much reliance on tactics like isolation and force to subdue mentally ill prisoners, all in violation of the Constitution.

In his ruling, Judge Michael Baxley chided the department for failing to screen new inmates for mental health problems, properly administer medication and prevent suicide.

"People are clearly dying at the Department of Corrections because they lack basic health care," Baxley said in court then. "What would you have the court do, sir? Would you have the court walk away and leave it as it is?"

At the time, the department appealed the ruling but said it had already improved mental health services for inmates and consulted with the state Department of Mental Health on evaluating Corrections' policies. The agency also said it was using $1 million in recurring funds to pay for more staff, training and specialized programming in hopes of reducing mentally ill inmates' time in isolation units due to disciplinary infractions.

With mediation still underway, Corrections started making other changes. In 2014, Director Bryan Stirling told The Associated Press that 24 correctional officers had volunteered for specialized training on how to calm down unruly, mentally ill inmates without using force or lockup.

Under a January 2015 preliminary agreement, South Carolina's prisons would hire more mental health specialists, create safer surroundings and offer more monitoring and screening for mental illness. The final agreement lays out timelines and goals that will be supervised by independent experts. There's an overall four-year timeframe to implement the changes.

Both sides heralded the agreement as a win for the state and its inmates. Protection and Advocacy executive director Gloria Prevost applauded Stirling himself, saying his leadership enabled the case to move past years of "stone cold resistance to anything resembling fairness and justice" on the issue of inmate mental health.

The agency estimates a one-time cost of $1.7 million for facility upgrades and $7 million annually for mental health staffing, which is being phased in over three years.

Documents released in January 2015 by Corrections officials enumerated $1.6 million in mental health-related projects, including the expansion of recreation yards for inmates in lockup and new surveillance cameras so officers can monitor inmate safety. Other projects focus on replacing glass on cell doors with non-breakable material.

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Kinnard can be reached at http://twitter.com/MegKinnardAP/ . Read more of her work at http://bigstory.ap.org/content/meg-kinnard/ .

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