Rights to Medical Care in Jails and Prisons

While many individuals housed in jails and prisons across the country face heightened risks to their health and safety, under both federal and California law, those in custody are entitled to certain rights to medical care. However, people have different rights depending on their criminal case status. Follow the flowchart below to learn more about these rights.

*Note: This is for educational purposes only and is not intended to be legal advice

Pre-Plea / Pre-Trial

Post-Plea / Sentencing

Court cases have established that under the 14th Amendment, those in custody awaiting trial are entitled to freedom from: deliberate indifference to a serious medical need. deliberate indifference a) The defendant (the person being sued) made an intentional decision regarding the conditions of the plaintiff (the person whose rights were violated)'s confinement. (b) The plaintiff was exposed to a substantial risk of suffering serious harm as a result of those conditions (c) The defendant did not take reasonable actions to decrease that risk, even though another person in the same circumstances would have realized the level of risk involved. (d) The defendant’s failure to take action caused injury to the plaintiff. serious medical need: any condition or injury, including psychological, that would cause further harm if left untreated or that interferes with daily activities.

-- What is the difference? -- For those who have been convicted of a crime, unintentional denial of medical treatment for a serious medical need is not a rights violation. In contrast, for those in-custody pre-trial, if a reasonable person in the same circumstances would have realized the risk of delaying or denying access to medical care, the State could liable for a constitutional rights violation via 14th Amendment incorporation

The 8th Amendment of the Constitution prohibits the infliction of “cruel and unusual punishments” which includes deliberate indifference to the serious medical needs of incarcerated individuals. a) The defendant knew of an excessive risk to the plaintiff’s health and safety b) The defendant disregarded that risk, failing to act in order to decrease the risk. The definition of a serious medical need remains the same as for pre-trial detainees.

Suing a County, State, or Other Public Entity

When the plaintiff is not an individual person but a municipality (such as the county or state in charge of the jail or prison) or a private entity serving a public function (for example, a private company that is contracted by a county or state to administer medical care in a jail), the case must also meet the following criteria:

  • The organization had a policy (a) An expressly adopted policy (such as a procedure included in staff training manuals) (b) A longstanding custom or practice (for example, an unwritten but frequently taken action by county employees) (c) The person who committed the constitutional violation had the ability to create policy or someone with this type of power okayed the unconstitutional decision or action

  • The policy amounts to deliberate indifference to the defendant’s serious medical needs 

  • The policy served as the “moving force” behind the constitutional violation

Requirements for Government Employees

California Government Code section 845.6 establishes that a government employee can be held legally liable if they:

  1. Know or should know based on the available information that a person in-custody (either pre-trial or post-conviction) is in need of immediate medical care

  2. Fail to take reasonable action to summon such medical care

Links Legislation, Judicial Opinions, and California-relevant Policy

  • Title 15 of the California Code of Regulations outlines minimum standards and requirements for jails in California, including rules for access to medical care and other health and safety resources

  • Title 24 of the California Building Code establishes minimum standards for the design of jails in California, including requirements for safety cells and medical examination rooms

  • California Penal Code Section 919 says that a county civil grand jury must inquire into the condition and management of the public prisons within the county. The grand jury may inquire into the case of every person imprisoned in the jail of the county on a criminal charge and not indicted.

  • California Government Code section 845.6 establishes that a government employee can be held legally liable if they know or should know based on the available information that a person in-custody is in need of immediate medical care, and they fail to take reasonable action to summon such medical care.

  • The 8th and 14th Amendments of the U.S. Constitution protect incarcerated people from “deliberate indifference to serious medical conditions” (Brown v. Plata US 2011).

  • Section 1983 of Title 42 of the US Civil Code gave people the right to sue state government employees and others acting "under color of state law" for civil rights violations in a civil action.