Sacramento is on track to have the deadliest jail per capita in California. We must act now

As a physician who has worked in the jail, I have seen its despicable conditions within. Hearing about the recent COVID outbreak and multiple deaths, I was concerned. Reading the latest Consent Decree monitoring reports, I am horrified.

Court-appointed experts publish biannual monitoring reports as a component of the “Mays Consent Decree,” Sacramento County’s binding agreement following a 2018 lawsuit regarding the inhumane and unconstitutional jail conditions in the Main Jail and Rio Cosumnes Correctional Center.

They document ongoing concerns regarding high suicide rates, inadequate healthcare, privacy and disability laws violations, excessive use of force, and solitary confinement. The county has shown negligible progress on nearly all metrics, and is now performing worse in many areas.

The report states that patients “with serious medical needs continue to experience harm as a result of lack of an adequate infrastructure, systems issues and quality of care.” There is a “culture in which custody decisions interfere with or override medical care,” causing delays, missed appointments, skipped medications and inconsistent monitoring, putting patients “at daily risk of harm.”

Predictably, there is another COVID outbreak in the jails, now with over 2,100 cases to date. There are reports of denied or delayed testing, inconsistent masking by sheriff staff, no physical distancing and asymptomatic people forcibly exposed to COVID-positive people.

Incarcerated people can’t move freely or seek care; they can only submit requests. These requests go weeks or months without responses. This is particularly distressing during a pandemic, while confined in close proximity with other prisoners and jail staff (both groups also have below-average vaccination rates and inconsistent mask use).

Sacramento is on track to have the deadliest jail per capita in California. There have been at least three deaths since September. The monitoring reports document a man diagnosed with COVID-19 in February. He submitted multiple health service requests and died several weeks later, without ever receiving a response.

Our jail has consistently demonstrated that it cannot keep people safe inside. How much preventable death and dehumanizing treatment are we willing to tolerate before we demand meaningful changes?

We are supposedly innocent until proven guilty, but nearly 70% of the jail population is held pre-trial, before conviction of any crime. It’s unconscionable to neglect legally innocent people who lack autonomy, leaving them at the mercy of a sheriff who has repeatedly demonstrated indifference, resulting in avoidable loss of life and untold magnitudes of suffering.

The experts state that “there is no disagreement among the parties that the current space is completely inadequate for the population” and they explicitly call for leadership to “develop an interim plan to address lack of adequate space, privacy, sanitation, and disinfection.”

We have a choice to make: 1) irresponsibly pour money into a perpetually, unjustifiably growing jail, or 2) decrease the jail population, relying on sensible, proven, safe and humane policies, focusing on alternatives to incarceration and investing in the needs of our community.

We do not need a larger jail. Our incarceration rate is excessive. Law enforcement already consumes the majority of the county’s budget. Our problem is clearly not underfunding, it’s over-incarceration.

However, no action has been taken. Even correctional health leadership has bemoaned the crowded conditions that impair care. Yet there’s been a net increase in jail population, from 2,721 (April 2020) to 3,146 (September 2021). The main jail is operating at 99% capacity.

We need to immediately release as many people as possible, and minimize the number of people booked into jail. Especially with another COVID outbreak raging, it’s unethical to keep people trapped inside and at-risk.

A comprehensive jail population reduction strategy is necessary if we ever intend make our jails humane and constitutionally compliant. We cannot continue the current path of disregard for human dignity and human rights.