Document ID: ./input/supremecourt_opinions/opinions/10pdf/09-1233.pdf
Page Number: 82.0

8 

BROWN v. PLATA 

ALITO, J., dissenting 

finds “by clear and convincing evidence that . . . crowding 
is  the  primary  cause  of  the  violation  of  a  Federal  right”
and  that  “no  other  relief  will  remedy  the  violation  of  the
Federal right.”  §3626(a)(3)(E).

These  statutory  restrictions  largely  reflect  general
standards for injunctive relief aimed at remedying consti-
tutional  violations  by  state  and  local  governments.    “The 
power of the federal courts to restructure the operation of 
local  and  state  governmental  entities  is  not  plenary.  . . .
Once a constitutional violation is found, a federal court is 
required to tailor the scope of the remedy to fit the nature 
and extent of the constitutional violation.”  Dayton Bd. of 
Ed.  v.  Brinkman,  433 U. S.  406,  419–420  (1977)  (internal 
quotation marks omitted). 

Here, the majority and the court below maintain that no
remedy  short  of  a  massive  release  of  prisoners  from  the
general prison population can remedy the State’s failure to
provide constitutionally adequate health care.  This argu-
ment is implausible on its face and is not supported by the 
requisite clear and convincing evidence. 

It is instructive to consider the list of deficiencies in the 
California  prison  health  care  system  that  are  highlighted 
in today’s opinion for this Court and in the opinion of the 
court  below.  The  deficiencies  noted  by  the  majority  here
include  the  following:  “ ‘[e]xam  tables  and  counter  tops, 
where  prisoners  with  . . .  communicable  diseases  are 
treated, [are] not routinely disinfected,’ ” ante, at 10; medi-
cal facilities “ ‘are in an abysmal state of disrepair,’ ” ibid.; 
medications  “ ‘are  too  often  not  available  when  needed,’ ” 
ante,  at  10–11;  “ ‘[b]asic  medical  equipment  is  often  not 
available  or  used,’ ”  ante,  at  10;  prisons  “would  ‘hire  any 
doctor  who  had  “a  license,  a  pulse  and  a  pair  of  shoes,” ’ ” 
ibid.;  and  medical  and  mental  health  staff  positions  have 
high  vacancy  rates,  ante,  at  20.  The  three-judge  court 
pointed  to  similar  problems.    See  Juris.  App.  93a–121a
(citing,  among  other  things,  staffing  vacancies,  too  few