In Massachusetts, sexually dangerous persons (SDPs), sex offenders who have been ordered to civil commitment, reside in the Massachusetts Treatment Center in Bridgewater, Massachusetts. In 1974, following lawsuits alleging "medieval" conditions at the Center, a district count entered consent decrees ordering the Center to shape up. In 1999, the district court concluded that the problems had been remedied and terminated the consent decrees, but still made the Center subject to a settlement plan.
In 2001, Jeffrey Healey brought suit to enforce the provisions of the plan and to allege constitutional violations. After more litigation and two trials, the district court found that it had breached the terms of the plan by failing to provide "adequate pharmacological evaluation and treatment." This appeal followed, where the Massachusetts Department of Corrections (DOC) wanted the determination in Healey's favor reversed, along with a determination that the settlement plan wasn't an enforceable order.