With assistance from American Civil Liberties Union's National Prison Project (NPP) attorneys, plaintiffs were able to fend off an attempt to terminate a 37-year-old class-action civil-rights lawsuit challenging the provision of medical and mental health services to pretrial detainees in the 8,200-bed jail system of Maricopa County, Arizona. An Arizona federal judge issued an order denying the motion to terminate on September 30, 2014. In doing so, the court held that the defendants--the county's sheriff and supervisors--had failed to comply with the previous judgment or the constitution in providing prisoners health care.

The court noted that the high-volume, short-stay nature of much of the jail population complicated the provision of medical and mental health services, but, instead of developing strategies to address those difficulties, the defendants had chosen to resist the implementation of the judgment for more than five years before filing the motion to dismiss. Some of the new practices cited in support of the motion had only been in place for a few days, making it impossible to determine whether they were being successfully implemented and were producing the intended results. "Defendants' six-year history of incomplete compliance with the medical and mental health terms" of the previous judgment "now requires the judicial crafting of remedies."

The court found that the defendants had failed to show that all pretrial detainees whose screening upon intake at the jail indicated a serious medical issue were seen by a medical provider within 24 hours or transferred to an appropriate medical facility in a timely fashion. They had not shown that needed treatment was initiated, including laboratory and radiological studies, for pretrial detainees who presented with serious medical needs at intake. They did not show that intake screening consistently identified pretrial detainees in danger of harm from suicide or withdrawal from drugs or alcohol.

The court found that some mentally ill pretrial detainees were placed in close custody housing following intake without such placement being cleared by a mental health provider. Defendants failed to show that a timely assessment by a mental health provider was made for pretrial detainees presenting with serious mental health needs at intake. "A substantial number of pretrial detainees who report they are taking psychotropic medications at the time of booking may not be seen by any mental health staff."

Defendants also failed to show that they ordered medical records of detainees with serious medical issues, performed TB, HIV and syphilis tests on all pretrial detainees, provided continuity of mediation, promptly responded to requests for medical services that showed a serious need, or identified and treated all pretrial detainees suffering from withdrawal from drugs or alcohol.

Due to the failures noted above, the provision of medical and mental health services in the jail system remained unconstitutional. The court denied the motion and issued a specific set of thirty-two orders for defendants to bring the jail system up to constitutional muster in a new amended judgment.

"Those in charge of Maricopa County's jails can no longer skirt their constitutional responsibility for detainee's health," said NPP staff attorney Eric Balaban. "Judge Wake found severe problems with the jails' medical care, from intake to treatment. Detainees have had serious illnesses that the jails' staff missed or ignored, causing permanent injuries and even deaths. With today's decision, every detainee at Maricopa County should have access to adequate medical and mental health care. At last." See: Graves v. Arpaio, U.S.D.C.-D.AZ, Case No. 2:77-cv-00479-NVW.

Additional sources: Arizona Republic, ACLU Press Release of 09-30-2014.

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