Document ID: ./input/supremecourt_opinions/opinions/10pdf/09-1233.pdf
Page Number: 17.0

Cite as:  563 U. S. ____ (2011) 

11 

Opinion of the Court 

too often not available when needed. . . .  Indeed, it is 
a misnomer to call the existing chaos a ‘medical deliv-
ery  system’—it  is  more  an  act  of  desperation  than  a
system.”  Record  in  No.  3:01–CV–01351–TEH  (ND 
Cal.), Doc. 1136, p. 5. 

A report by the Receiver detailed the impact of overcrowd-
ing  on  efforts  to  remedy  the  violation.  The  Receiver  ex-
plained that “overcrowding, combined with staffing short-
ages,  has  created  a  culture  of  cynicism,  fear,  and  despair
which  makes  hiring  and  retaining  competent  clinicians
extremely difficult.”  App. 1031.  “[O]vercrowding, and the 
resulting  day  to  day  operational  chaos  of  the  [prison  sys-
tem], creates regular ‘crisis’ situations which . . . take time
[and]  energy  . . .  away  from  important  remedial  pro-
grams.”  Id.,  at  1035.    Overcrowding  had  increased  the 
incidence of infectious disease, id., at 1037–1038, and had 
led to rising prison violence and greater reliance by custo-
dial  staff  on  lockdowns,  which  “inhibit  the  delivery  of
medical  care  and  increase  the  staffing  necessary  for  such
care.”  Id.,  at  1037.  “Every  day,”  the  Receiver  reported, 
“California  prison  wardens  and  health  care  managers
make the difficult decision as to which of the class actions, 
Coleman . . . or Plata they will fail to comply with because 
of staff shortages and patient loads.”  Id., at 1038. 

D 
The Coleman and Plata plaintiffs, believing that a rem-
edy  for  unconstitutional  medical  and  mental  health  care
could  not  be  achieved  without  reducing  overcrowding,
moved their respective District Courts to convene a three-
judge  court  empowered  under  the  PLRA  to  order  reduc-
tions in the prison population.  The judges in both actions 
granted  the  request,  and  the  cases  were  consolidated 
before a single three-judge court.  The State has not chal-
lenged  the  validity  of  the  consolidation  in  proceedings
before this Court, so its propriety is not presented by this