As California’s Overcrowding Problem Bleeds Into Jails, Even Inmates Awaiting Trial Face Medical Neglect

Inmates sit in crowded conditions at California State Prison, Los Angeles. CREDIT: AP Photo/California Department of Corrections
Inmates sit in crowded conditions at California State Prison, Los Angeles. CREDIT: AP Photo/California Department of Corrections

Several years ago, the U.S. Supreme Court affirmed that California has a chronic overcrowding problem that makes living conditions cruel and unusual for many of the state’s inmates. But those conditions don’t just apply to those who have been sentenced and are serving an extended prison term. In some of California’s jails, which hold inmates awaiting trial but not yet convicted of a crime, conditions are just as bad, according to documents released as part of a class action lawsuit this week.

Neutral assessments of the county jail facilities commissioned jointly by the county and the plaintiffs found a host of deficient and dangerous conditions. Five out of the six opinions issued by experts were negative, citing severe overcrowding that has led to potentially avoidable illness, deaths, and suicides, and security risks exacerbated by grossly inadequate staffing. As described by the assessments, the jail initially held mostly inmates awaiting trial and those convicted for minor crimes with months-long sentences, as is typical of county jails. But partly as a result of moves to reduce overcrowding at state facilities, many inmates serving longer sentences were moved to the jails, both contributing to the crowds and creating heightened security needs.

There were more than 150 incidents of violence between prisoners over the course of less than a year, more than 100 of them requiring medical treatment, according to data collected from the Monterey County Sheriff’s Department.

The jail is served by a private health care company that was described as having cramped, insufficient space; unsanitary work spaces and no protocol for sanitizing; poor record-keeping of medications; and insufficient medical intake screening, which fails to “protect incoming detainees from harm.”


The independent medical assessment recorded instances in which patients were hospitalized simply because medical staff failed to administer medications on time, were given the wrong medications that put their health at risk, and and had injuries neglected by staff.

Jail facilities featured a “sobering cell” that has rubberized walls, floor, and ceiling, according to correctional medical expert Michael Hackett. It contains no toilet but only a grate in the floor where all bodily fluids are to go. The drain can only be flushed from outside the room, and Hackett reported that the room was unsanitary and smelled of excrement. Hackett also reported that inmates are sleeping on this floor, although it is unsanitary to do so. The room is far removed from nurse observation while many individuals are suffering the effects of withdrawal from drugs or alcohol, which Hackett said renered the room “inadequate for its stated purpose” of sobering up inmates.

Likewise, inmates suffering from withdrawal are placed in “isolation cells” without any monitoring or access to medical assistance, which Hackett called “unacceptable.” In particular, it found that the medical screening by officers rather than nurses contributed to significant medical problems at the facility.

Affidavits from prisoners told stories of inmates awaiting trial who were assaulted in their cell, suffering fractured skull bones, vision loss, and being deprived of critical medications.

The American Civil Liberties Union of California points out that these conditions could be significantly alleviated by not holding so many inmates while charges are pending in what is known as pretrial detention. Pretrial detainees still make up 80 percent of the jail inmates, according to the ACLU. But between the influx of new inmates from prisons and state resistance to complying with countless court orders on its prison conditions, California may need to take up additional reforms in the legislature to reduce its inmate saturation.