Currently, health care in California’s prison system is under court supervision, in the aftermath of a lawsuit pointing out that conditions were so poor in California’s prisons that an average of one inmate per week was dying due to inadequate health care. Huge numbers of people in California’s prisons are disabled; just for example, people with developmental disabilities make up around four percent of California’s inmate population. This adds considerably to the complexity of providing health care services in California prisons, as does the very high rate of infectious disease observed in most prisons.
The state recently attempted to end the receivership of its prisons on the grounds that conditions had improved. More studies were conducted to assess the current situation, and Judge Charles Breyer issued a tentative ruling that the court supervision must continue because conditions in many California prisons still do not meet basic standards of health and safety. The human and civil rights of California prisoners are being violated, in no small part because the state is struggling with a massive prison population paired with epic budget cuts, which is pretty much a recipe for disaster.
Here’s the judge, discussing why he decided not to end the receivership:
Breyer, brother of U.S. Supreme Court Justice Stephen Breyer, went further in his proposed findings.
The inmates “are regularly verbally, physically, and sexually assaulted, exploited, and discriminated against in California prisons,” he wrote. “Developmentally disabled prisoners are punished for violating prison rules that they do not understand, and are punished at hearings which they cannot comprehend.”
They regularly have their food and property stolen, or give it up to buy protection or help from other inmates. They often lack the help they need with basic hygiene, or with getting routine medical treatment, the judge found.
At one point, Breyer suggested that the state sought to end his oversight “simply because ongoing Court supervision is annoying them.”
Billions of dollars are being spent, and it’s still not enough. Of the 17 prisons expected, only two ‘met the minimum standards for health care.’ Perhaps unsurprisingly, one of the biggest areas of failing was in preventative care. The prison environment is stressful and crowded, which tends to increase susceptibility to infectious disease while also making inmates more prone to the development of mental health problems. For intellectually and developmentally disabled inmates, prison conditions are even worse, as many prisons don’t know how to handle these inmates, don’t provide basic services they need, and essentially leave them at the mercy of the general population.
It’s not surprising that HIV, tuberculosis, and hep C infection rates are all on the rise in prisons as a result of poor preventative care and infection control. We should be asking ourselves when it was decided that a prison sentence should also came with an almost certain sentence for developing an infectious and potentially fatal disease, just as we should be asking ourselves why prison rape continues to be tolerated.
Prisoners are not receiving the health care services they need, when they need them. That’s a problem. It’s a problem when the state is imprisoning people in my name, using my tax dollars to fund it, and it can’t even promise me that those people will have access to basic health care services. It can’t promise that the people being imprisoned ‘for public safety’ will be safe themselves in prison, and this is categorically unacceptable. We owe a duty of care to prison inmates, no matter who they are, no matter what crimes they have committed, and prisoner rights is one of the most ignored areas in the human rights community in the United States. The conditions in California’s prisons can be seen elsewhere across the United States, where prisoners die because they can’t access medical care in addition to being raped, exploited, and abused.
The findings of the report on California’s prisons recommend that the most effective way to improve access to health care for California inmates is to reduce the prison population by releasing inmates. Early release has already been promoted to deal with overcrowding as well as budget problems. However, we also need to approach this from the other side; it’s important not just to reduce the prison population, but to put fewer people in prison in the first place. This requires a major overhaul of California’s mandatory sentencing laws and approach to law enforcement, both of which are long overdue.
There are also colossal intersections with race here. Nonwhite people and people of colour are far more likely to be incarcerated in the United States. This is not because members of these communities are more likely to commit crimes, despite the beliefs of some conservatives. It is because they are more likely to be profiled as criminals, more likely to be arrested and prosecuted when a white person would get a warning, more likely to get longer prison sentences, more likely to be convicted. We need to address the racialised dynamics of the ‘justice system’ in the United States to get at the bottom of why so many people are in prison.
I’m glad that the decision to continue court supervision of health services in California prisons was made. It’s clear that the prison system can’t regulate itself or provide the services it is legally and ethically obligated to provide, and I hope the court can compel it to do so. At the same time we work to secure safer and healthier conditions for prisoners now, I want to see a radical shift of the way we handle law enforcement and justice for people in the future.