Brown v. Plata ( 2011 )


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  • (Slip Opinion)              OCTOBER TERM, 2010                                       1
    Syllabus
    NOTE: Where it is feasible, a syllabus (headnote) will be released, as is
    being done in connection with this case, at the time the opinion is issued.
    The syllabus constitutes no part of the opinion of the Court but has been
    prepared by the Reporter of Decisions for the convenience of the reader.
    See United States v. Detroit Timber & Lumber Co., 
    200 U.S. 321
    , 337.
    SUPREME COURT OF THE UNITED STATES
    Syllabus
    BROWN, GOVERNOR OF CALIFORNIA, ET AL. v.
    PLATA ET AL.
    APPEAL FROM THE UNITED STATES DISTRICT COURTS FOR
    THE EASTERN AND NORTHERN DISTRICTS OF CALIFORNIA
    No. 09–1233. Argued November 30, 2010—Decided May 23, 2011
    California’s prisons are designed to house a population just under
    80,000, but at the time of the decision under review the population
    was almost double that. The resulting conditions are the subject of
    two federal class actions. In Coleman v. Brown, filed in 1990, the
    District Court found that prisoners with serious mental illness do not
    receive minimal, adequate care. A Special Master appointed to over
    see remedial efforts reported 12 years later that the state of mental
    health care in California’s prisons was deteriorating due to increased
    overcrowding. In Plata v. Brown, filed in 2001, the State conceded
    that deficiencies in prison medical care violated prisoners’ Eighth
    Amendment rights and stipulated to a remedial injunction. But
    when the State had not complied with the injunction by 2005, the
    court appointed a Receiver to oversee remedial efforts. Three years
    later, the Receiver described continuing deficiencies caused by over
    crowding. Believing that a remedy for unconstitutional medical and
    mental health care could not be achieved without reducing over
    crowding, the Coleman and Plata plaintiffs moved their respective
    District Courts to convene a three-judge court empowered by the
    Prison Litigation Reform Act of 1995 (PLRA) to order reductions in
    the prison population. The judges in both actions granted the re
    quest, and the cases were consolidated before a single three-judge
    court. After hearing testimony and making extensive findings of fact,
    the court ordered California to reduce its prison population to 137.5%
    of design capacity within two years. Finding that the prison popula
    tion would have to be reduced if capacity could not be increased
    through new construction, the court ordered the State to formulate a
    compliance plan and submit it for court approval.
    2                         BROWN v. PLATA
    Syllabus
    Held:
    1. The court-mandated population limit is necessary to remedy the
    violation of prisoners’ constitutional rights and is authorized by the
    PLRA. Pp. 12–41.
    (a) If a prison deprives prisoners of basic sustenance, including
    adequate medical care, the courts have a responsibility to remedy the
    resulting Eighth Amendment violation. See Hutto v. Finney, 
    437 U.S. 678
    , 687, n. 9. They must consider a range of options, including
    the appointment of special masters or receivers, the possibility of
    consent decrees, and orders limiting a prison’s population. Under the
    PLRA, only a three-judge court may limit a prison population. 
    18 U.S. C
    . §3626(a)(3). Before convening such a court, a district court
    must have entered an order for less intrusive relief that failed to
    remedy the constitutional violation and must have given the defen
    dant a reasonable time to comply with its prior orders.
    §3626(a)(3)(A). Once convened, the three-judge court must find by
    clear and convincing evidence that “crowding is the primary cause of
    the violation” and “no other relief will remedy [the] violation,”
    §3626(a)(3)(E); and that the relief is “narrowly drawn, extends no fur
    ther than necessary. . . , and is the least intrusive means necessary to
    correct the violation,” §3626(a)(1)(A). The court must give “substan
    tial weight to any adverse impact on public safety or the operation of
    a criminal justice system caused by the relief.” 
    Ibid. Its legal deter
     minations are reviewed de novo, but its factual findings are reviewed
    for clear error. Pp. 12–15.
    (b) The Coleman and Plata courts acted reasonably in convening
    a three-judge court. Pp. 15–19.
    (1) The merits of the decision to convene are properly before
    this Court, which has exercised its 
    28 U.S. C
    . §1253 jurisdiction to
    determine the authority of a court below, including whether a three
    judge court was properly constituted. Gonzalez v. Automatic Employ
    ees Credit Union, 
    419 U.S. 90
    , 95, n. 12. Pp. 15–16.
    (2) Section 3626(a)(3)(A)(i)’s previous order requirement was
    satisfied in Coleman by the Special Master’s 1995 appointment and
    in Plata by the 2002 approval of a consent decree and stipulated in
    junction. Both orders were intended to remedy constitutional viola
    tions and were given ample time to succeed—12 years in Coleman,
    and 5 years in Plata.               Contrary to the State’s claim,
    §3626(a)(3)(A)(ii)’s reasonable time requirement did not require the
    District Courts to give more time for subsequent remedial efforts to
    succeed. Such a reading would in effect require courts to impose a
    moratorium on new remedial orders before issuing a population limit,
    which would delay an eventual remedy, prolong the courts’ involve
    ment, and serve neither the State nor the prisoners. The Coleman
    Cite as: 563 U. S. ____ (2011)                      3
    Syllabus
    and Plata courts had a solid basis to doubt that additional efforts to
    build new facilities and hire new staff would achieve a remedy, given
    the ongoing deficiencies recently reported by both the Special Master
    and the Receiver. Pp. 16–19.
    (c) The three-judge court did not err in finding that “crowding
    [was] the primary cause of the violation,” §3626(a)(3)(E)(i). Pp. 19–
    29.
    (1) The trial record documents the severe impact of burgeoning
    demand on the provision of care. The evidence showed that there
    were high vacancy rates for medical and mental health staff, e.g.,
    20% for surgeons and 54.1% for psychiatrists; that these numbers
    understated the severity of the crisis because the State has not budg
    eted sufficient staff to meet demand; and that even if vacant positions
    could be filled, there would be insufficient space for the additional
    staff. Such a shortfall contributes to significant delays in treating
    mentally ill prisoners, who are housed in administrative segregation
    for extended periods while awaiting transfer to scarce mental health
    treatment beds. There are also backlogs of up to 700 prisoners wait
    ing to see a doctor for physical care. Crowding creates unsafe and
    unsanitary conditions that hamper effective delivery of medical and
    mental health care. It also promotes unrest and violence and can
    cause prisoners with latent mental illnesses to worsen and develop
    overt symptoms. Increased violence requires increased reliance on
    lockdowns to keep order, and lockdowns further impede the effective
    delivery of care. Overcrowding’s effects are particularly acute in
    prison reception centers, which process 140,000 new or returning
    prisoners annually, and which house some prisoners for their entire
    incarceration period. Numerous experts testified that crowding is the
    primary cause of the constitutional violations. Pp. 19–24.
    (2) Contrary to the State’s claim, the three-judge court prop
    erly admitted, cited, and considered evidence of current prison condi
    tions as relevant to the issues before it. Expert witnesses based their
    conclusions on recent observations of prison conditions; the court ad
    mitted recent reports on prison conditions by the Receiver and Spe
    cial Master; and both parties presented testimony related to current
    conditions. The court’s orders cutting off discovery a few months be
    fore trial and excluding evidence not pertinent to the issue whether a
    population limit is appropriate under the PLRA were within the
    court’s sound discretion. Orderly trial management may require dis
    covery deadlines and a clean distinction between litigation of the
    merits and the remedy. The State points to no significant evidence
    that it was unable to present and that would have changed the out
    come here. Pp. 24–26.
    (3) It was permissible for the three-judge court to conclude that
    4                            BROWN v. PLATA
    Syllabus
    overcrowding was the “primary,” but not the only, cause of the viola
    tions, and that reducing crowding would not entirely cure the viola
    tions. This understanding of the primary cause requirement is con
    sistent with the PLRA. Had Congress intended to require that
    crowding be the only cause, the PLRA would have said so. Pp. 26–29.
    (d) The evidence supports the three-judge court’s finding that “no
    other relief [would] remedy the violation,” §3626(a)(3)(E)(ii). The
    State’s claim that out-of-state transfers provide a less restrictive al
    ternative to a population limit must fail because requiring transfers
    is a population limit under the PLRA. Even if they could be regarded
    as a less restrictive alternative, the three-judge court found no evi
    dence of plans for transfers in numbers sufficient to relieve over
    crowding. The court also found no realistic possibility that California
    could build itself out of this crisis, particularly given the State’s ongo
    ing fiscal problems. Further, it rejected additional hiring as a realis
    tic alternative, since the prison system was chronically understaffed
    and would have insufficient space were adequate personnel retained.
    The court also did not err when it concluded that, absent a population
    reduction, the Receiver’s and Special Master’s continued efforts
    would not achieve a remedy. Their reports are persuasive evidence
    that, with no reduction, any remedy might prove unattainable and
    would at the very least require vast expenditures by the State. The
    State asserts that these measures would succeed if combined, but a
    long history of failed remedial orders, together with substantial evi
    dence of overcrowding’s deleterious effects on the provision of care,
    compels a different conclusion here. Pp. 29–33.
    (e) The prospective relief ordered here was narrowly drawn, ex
    tended no further than necessary to correct the violation, and was the
    least intrusive means necessary to correct the violation. Pp. 33–41.
    (1) The population limit does not fail narrow tailoring simply
    because prisoners beyond the plaintiff class will have to be released
    through parole or sentencing reform in order to meet the required re
    duction. While narrow tailoring requires a “ ‘ “fit” between the [rem
    edy’s] ends and the means chosen to accomplish those ends,’ ” Board
    of Trustees of State Univ. of N. Y. v. Fox, 
    492 U.S. 469
    , 480, a narrow
    and otherwise proper remedy for a constitutional violation is not in
    valid simply because it will have collateral effects. Nor does the
    PLRA require that result. The order gives the State flexibility to de
    termine who should be released, and the State could move the three
    judge court to modify its terms. The order also is not overbroad be
    cause it encompasses the entire prison system, rather than sepa
    rately assessing each institution’s need for a population limit. The
    Coleman court found a systemwide violation, and the State stipulated
    to systemwide relief in Plata. Assuming no constitutional violation
    Cite as: 563 U. S. ____ (2011)                      5
    Syllabus
    results, some facilities may retain populations in excess of the 137.5%
    limit provided others fall sufficiently below it so the system as a
    whole remains in compliance with the order. This will afford the
    State flexibility to accommodate differences between institutions.
    The order may shape or control the State’s authority in the realm of
    prison administration, but it leaves much to the State’s discretion.
    The order’s limited scope is necessary to remedy a constitutional vio
    lation. The State may move the three-judge court to modify its order,
    but it has proposed no realistic alternative remedy at this time.
    Pp. 33–36.
    (2) The three-judge court gave “substantial weight” to any po
    tential adverse impact on public safety from its order. The PLRA’s
    “substantial weight” requirement does not require the court to certify
    that its order has no possible adverse impact on the public. Here,
    statistical evidence showed that prison populations had been lowered
    without adversely affecting public safety in some California counties,
    several States, and Canada. The court found that various available
    methods of reducing overcrowding—good time credits and diverting
    low-risk offenders to community programs—would have little or no
    impact on public safety, and its order took account of such concerns
    by giving the State substantial flexibility to select among the means
    of reducing overcrowding. The State complains that the court ap
    proved the State’s population reduction plan without considering
    whether its specific measures would substantially threaten public
    safety. But the court left state officials the choice of how best to com
    ply and was not required to second-guess their exercise of discretion.
    Developments during the pendency of this appeal, when the State
    has begun to reduce the prison population, support the conclusion
    that a reduction can be accomplished without an undue negative ef
    fect on public safety. Pp. 37–41.
    2. The three-judge court’s order, subject to the State’s right to seek
    its modification in appropriate circumstances, must be affirmed.
    Pp. 41–48.
    (a) To comply with the PLRA, a court must set a population limit
    at the highest level consistent with an efficacious remedy, and it
    must order the population reduction to be achieved in the shortest
    period of time reasonably consistent with public safety. Pp. 41–42.
    (b) The three-judge court’s conclusion that the prison population
    should be capped at 137.5% of design capacity was not clearly errone
    ous. The court concluded that the evidence supported a limit be
    tween the 130% limit supported by expert testimony and the Federal
    Bureau of Prisons and the 145% limit recommended by the State
    Corrections Independent Review Panel. The PLRA’s narrow tailoring
    requirement is satisfied so long as such equitable, remedial judg
    6                            BROWN v. PLATA
    Syllabus
    ments are made with the objective of releasing the fewest possible
    prisoners consistent with an efficacious remedy. Pp. 42–44.
    (c) The three-judge court did not err in providing a 2-year dead
    line for relief, especially in light of the State’s failure to contest the
    issue at trial. The State has not asked this Court to extend the dead
    line, but the three-judge court has the authority, and responsibility,
    to amend its order as warranted by the exercise of sound discretion.
    Proper respect for the State and for its governmental processes re
    quire that court to exercise its jurisdiction to accord the State consid
    erable latitude to find mechanisms and make plans that will
    promptly and effectively correct the violations consistent with public
    safety. The court may, e.g., grant a motion to extend the deadline if
    the State meets appropriate preconditions designed to ensure that
    the plan will be implemented without undue delay. Such observa
    tions reflect the fact that the existing order, like all ongoing equitable
    relief, must remain open to appropriate modification, and are not in
    tended to cast doubt on the validity of the order’s basic premise.
    Pp. 44–48.
    Affirmed.
    KENNEDY, J., delivered the opinion of the Court, in which GINSBURG,
    BREYER, SOTOMAYOR, and KAGAN, JJ., joined. SCALIA, J., filed a dissent
    ing opinion, in which THOMAS, J., joined. ALITO, J., filed a dissenting
    opinion, in which ROBERTS, C. J., joined.
    Cite as: 563 U. S. ____ (2011)                              1
    Opinion of the Court
    NOTICE: This opinion is subject to formal revision before publication in the
    preliminary print of the United States Reports. Readers are requested to
    notify the Reporter of Decisions, Supreme Court of the United States, Wash
    ington, D. C. 20543, of any typographical or other formal errors, in order
    that corrections may be made before the preliminary print goes to press.
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 09–1233
    _________________
    EDMUND G. BROWN, JR., GOVERNOR OF CAL-
    IFORNIA, ET AL., APPELLANTS v. MARCIANO
    PLATA ET AL.
    ON APPEAL FROM THE UNITED STATES DISTRICT COURTS
    FOR THE EASTERN DISTRICT AND THE NORTHERN
    DISTRICT OF CALIFORNIA
    [May 23, 2011]
    JUSTICE KENNEDY delivered the opinion of the Court.
    This case arises from serious constitutional violations in
    California’s prison system. The violations have persisted
    for years. They remain uncorrected. The appeal comes to
    this Court from a three-judge District Court order direct
    ing California to remedy two ongoing violations of the
    Cruel and Unusual Punishments Clause, a guarantee
    binding on the States by the Due Process Clause of the
    Fourteenth Amendment. The violations are the subject of
    two class actions in two Federal District Courts. The first
    involves the class of prisoners with serious mental disor
    ders. That case is Coleman v. Brown. The second involves
    prisoners with serious medical conditions. That case is
    Plata v. Brown. The order of the three-judge District
    Court is applicable to both cases.
    After years of litigation, it became apparent that a
    remedy for the constitutional violations would not be ef
    fective absent a reduction in the prison system popula
    tion. The authority to order release of prisoners as a
    remedy to cure a systemic violation of the Eighth Amend
    2                     BROWN v. PLATA
    Opinion of the Court
    ment is a power reserved to a three-judge district court,
    not a single-judge district court. 
    18 U.S. C
    . §3626(a). In
    accordance with that rule, the Coleman and Plata District
    Judges independently requested that a three-judge court
    be convened. The Chief Judge of the Court of Appeals for
    the Ninth Circuit convened a three-judge court composed
    of the Coleman and Plata District Judges and a third,
    Ninth Circuit Judge. Because the two cases are interre
    lated, their limited consolidation for this purpose has a
    certain utility in avoiding conflicting decrees and aiding
    judicial consideration and enforcement. The State in this
    Court has not objected to consolidation, although the State
    does argue that the three-judge court was prematurely
    convened. The State also objects to the substance of the
    three-judge court order, which requires the State to reduce
    overcrowding in its prisons.
    The appeal presents the question whether the remedial
    order issued by the three-judge court is consistent with
    requirements and procedures set forth in a congressional
    statute, the Prison Litigation Reform Act of 1995 (PLRA).
    
    18 U.S. C
    . §3626; see Appendix A, infra. The order leaves
    the choice of means to reduce overcrowding to the discre
    tion of state officials. But absent compliance through new
    construction, out-of-state transfers, or other means—or
    modification of the order upon a further showing by the
    State—the State will be required to release some number
    of prisoners before their full sentences have been served.
    High recidivism rates must serve as a warning that mis
    taken or premature release of even one prisoner can cause
    injury and harm. The release of prisoners in large num
    bers—assuming the State finds no other way to comply
    with the order—is a matter of undoubted, grave concern.
    At the time of trial, California’s correctional facilities
    held some 156,000 persons. This is nearly double the
    number that California’s prisons were designed to hold,
    and California has been ordered to reduce its prison popu
    Cite as: 563 U. S. ____ (2011)           3
    Opinion of the Court
    lation to 137.5% of design capacity. By the three-judge
    court’s own estimate, the required population reduction
    could be as high as 46,000 persons. Although the State
    has reduced the population by at least 9,000 persons dur
    ing the pendency of this appeal, this means a further
    reduction of 37,000 persons could be required. As will be
    noted, the reduction need not be accomplished in an indis
    criminate manner or in these substantial numbers if sat
    isfactory, alternate remedies or means for compliance
    are devised. The State may employ measures, including
    good-time credits and diversion of low-risk offenders and
    technical parole violators to community-based programs,
    that will mitigate the order’s impact. The population
    reduction potentially required is nevertheless of unprece
    dented sweep and extent.
    Yet so too is the continuing injury and harm resulting
    from these serious constitutional violations. For years the
    medical and mental health care provided by California’s
    prisons has fallen short of minimum constitutional re
    quirements and has failed to meet prisoners’ basic health
    needs. Needless suffering and death have been the well
    documented result. Over the whole course of years during
    which this litigation has been pending, no other remedies
    have been found to be sufficient. Efforts to remedy the
    violation have been frustrated by severe overcrowding in
    California’s prison system. Short term gains in the provi
    sion of care have been eroded by the long-term effects of
    severe and pervasive overcrowding.
    Overcrowding has overtaken the limited resources of
    prison staff; imposed demands well beyond the capacity
    of medical and mental health facilities; and created unsan
    itary and unsafe conditions that make progress in the
    provision of care difficult or impossible to achieve. The
    overcrowding is the “primary cause of the violation of a
    Federal right,” 
    18 U.S. C
    . §3626(a)(3)(E)(i), specifically
    the severe and unlawful mistreatment of prisoners
    4                         BROWN v. PLATA
    Opinion of the Court
    through grossly inadequate provision of medical and
    mental health care.
    This Court now holds that the PLRA does authorize the
    relief afforded in this case and that the court-mandated
    population limit is necessary to remedy the violation of
    prisoners’ constitutional rights. The order of the three
    judge court, subject to the right of the State to seek
    its modification in appropriate circumstances, must be
    affirmed.
    I
    A
    The degree of overcrowding in California’s prisons is
    exceptional. California’s prisons are designed to house a
    population just under 80,000, but at the time of the three
    judge court’s decision the population was almost double
    that. The State’s prisons had operated at around 200% of
    design capacity for at least 11 years. Prisoners are
    crammed into spaces neither designed nor intended to
    house inmates. As many as 200 prisoners may live in a
    gymnasium, monitored by as few as two or three correc
    tional officers. App. 1337–1338, 1350; see Appendix B,
    infra. As many as 54 prisoners may share a single toilet.
    App. 1337.
    The Corrections Independent Review Panel, a body
    appointed by the Governor and composed of correctional
    consultants and representatives from state agencies,
    concluded that California’s prisons are “ ‘severely over
    crowded, imperiling the safety of both correctional em
    ployees and inmates.’ ”1 Juris. Statement App., O. T. 2009,
    ——————
    1 A similar conclusion was reached by the Little Hoover Commission,
    a bipartisan and independent state body, which stated that
    “[o]vercrowded conditions inside the prison walls are unsafe for inmates
    and staff,” Solving California’s Corrections Crisis: Time is Running Out
    17 (Jan. 2007), and that “California’s correctional system is in a tail
    spin,” 
    id., at i.
                          Cite as: 563 U. S. ____ (2011)                       5
    Opinion of the Court
    No. 09–416, p. 56a (hereinafter Juris. App.). In 2006,
    then-Governor Schwarzenegger declared a state of emer
    gency in the prisons, as “ ‘immediate action is necessary to
    prevent death and harm caused by California’s severe
    prison overcrowding.’ ” 
    Id., at 61a.
    The consequences of
    overcrowding identified by the Governor include “ ‘in
    creased, substantial risk for transmission of infectious
    illness’ ” and a suicide rate “ ‘approaching an average of
    one per week.’ ” 
    Ibid. Prisoners in California
    with serious mental illness do
    not receive minimal, adequate care. Because of a shortage
    of treatment beds, suicidal inmates may be held for pro
    longed periods in telephone-booth sized cages without
    toilets. See Appendix C, infra. A psychiatric expert re
    ported observing an inmate who had been held in such a
    cage for nearly 24 hours, standing in a pool of his own
    urine, unresponsive and nearly catatonic. Prison officials
    explained they had “ ‘no place to put him.’ ” App. 593.
    ——————
    At trial, current and former California prison officials also testified to
    the degree of overcrowding. Jeanne Woodford, who recently adminis
    tered California’s prison system, stated that “ ‘[o]vercrowding in the
    [California Department of Corrections and Rehabilitation (CDCR)] is
    extreme, its effects are pervasive and it is preventing the Department
    from providing adequate mental and medical health care to prisoners.’ ”
    Juris. App. 84a. Matthew Cate, the head of the California prison
    system, stated that “ ‘overpopulation makes everything we do more
    difficult.’ ” 
    Ibid. And Robin Dezember,
    chief deputy secretary of Cor
    rectional Healthcare Services, stated that “we are terribly overcrowded
    in our prison system” and “overcrowding has negative effects on every
    body in the prison system.” Tr. 853, 856.
    Experts from outside California offered similar assessments. Doyle
    Wayne Scott, the former head of corrections in Texas, described con
    ditions in California’s prisons as “appalling,” “inhumane,” and “unac
    ceptable” and stated that “[i]n more than 35 years of prison work
    experience, I have never seen anything like it.” App. 1337. Joseph
    Lehman, the former head of correctional systems in Washington,
    Maine, and Pennsylvania, concluded that “[t]here is no question that
    California’s prisons are overcrowded” and that “this is an emergency
    situation; it calls for drastic and immediate action.” 
    Id., at 1312.
    6                          BROWN v. PLATA
    Opinion of the Court
    Other inmates awaiting care may be held for months in
    administrative segregation, where they endure harsh and
    isolated conditions and receive only limited mental health
    services. Wait times for mental health care range as high
    as 12 months. 
    Id., at 704.
    In 2006, the suicide rate
    in California’s prisons was nearly 80% higher than the
    national average for prison populations; and a court
    appointed Special Master found that 72.1% of suicides
    involved “some measure of inadequate assessment, treat
    ment, or intervention, and were therefore most probably
    foreseeable and/or preventable.”2 
    Id., at 1781.
      Prisoners suffering from physical illness also receive
    severely deficient care. California’s prisons were designed
    to meet the medical needs of a population at 100% of
    design capacity and so have only half the clinical space
    needed to treat the current population. 
    Id., at 1024.
    A
    correctional officer testified that, in one prison, up to 50
    sick inmates may be held together in a 12- by 20-foot cage
    for up to five hours awaiting treatment. Tr. 597–599. The
    number of staff is inadequate, and prisoners face signifi
    cant delays in access to care. A prisoner with severe
    abdominal pain died after a 5-week delay in referral to a
    specialist; a prisoner with “constant and extreme” chest
    ——————
    2 At
    the time of the three-judge court’s decision, 2006 was the most
    recent year for which the Special Master had conducted a detailed
    study of suicides in the California prisons. The Special Master later
    issued an analysis for the year 2007. This report concluded that the
    2007 suicide rate was “a continuation of the CDCR’s pattern of exceed
    ing the national prison suicide rate.” Record in No. 2:90–CV–00520–
    LKK–JFM (ED/ND Cal.), Doc. 3677, p. 1. The report found that the
    rate of suicides involving inadequate assessment, treatment, or inter
    vention had risen to 82% and concluded that “[t]hese numbers clearly
    indicate no improvement in this area during the past several years, and
    possibly signal a trend of ongoing deterioration.” 
    Id., at 12.
    No de
    tailed study has been filed since then, but in September 2010 the
    Special Master filed a report stating that “the data for 2010 so far is not
    showing improvement in suicide prevention.” App. 868.
    Cite as: 563 U. S. ____ (2011)                     7
    Opinion of the Court
    pain died after an 8-hour delay in evaluation by a doctor;
    and a prisoner died of testicular cancer after a “failure of
    MDs to work up for cancer in a young man with 17 months
    of testicular pain.”3 California Prison Health Care Receiv
    ership Corp., K. Imai, Analysis of CDCR Death Reviews
    2006, pp. 6–7 (Aug. 2007). Doctor Ronald Shansky, former
    medical director of the Illinois state prison system, sur
    veyed death reviews for California prisoners. He con
    cluded that extreme departures from the standard of
    care were “widespread,” Tr. 430, and that the proportion
    of “possibly preventable or preventable” deaths was “ex
    tremely high.” 
    Id., at 429.4
    Many more prisoners, suffer
    ——————
    3 Because   plaintiffs do not base their case on deficiencies in care
    provided on any one occasion, this Court has no occasion to consider
    whether these instances of delay—or any other particular deficiency in
    medical care complained of by the plaintiffs—would violate the Consti
    tution under Estelle v. Gamble, 
    429 U.S. 97
    , 104–105 (1976), if consid
    ered in isolation. Plaintiffs rely on systemwide deficiencies in the
    provision of medical and mental health care that, taken as a whole,
    subject sick and mentally ill prisoners in California to “substantial risk
    of serious harm” and cause the delivery of care in the prisons to fall
    below the evolving standards of decency that mark the progress of a
    maturing society. Farmer v. Brennan, 
    511 U.S. 825
    , 834 (1994).
    4 In 2007, the last year for which the three-judge court had available
    statistics, an analysis of deaths in California’s prisons found 68 pre
    ventable or possibly preventable deaths. California Prison Health Care
    Receivership Corp., K. Imai, Analysis of Year 2007 Death Reviews 18
    (Nov. 2008). This was essentially unchanged from 2006, when an
    analysis found 66 preventable or possibly preventable deaths. 
    Ibid. These statistics mean
    that, during 2006 and 2007, a preventable or
    possibly preventable death occurred once every five to six days.
    Both preventable and possibly preventable deaths involve major
    lapses in medical care and are a serious cause for concern. In one
    typical case classified as a possibly preventable death, an analysis
    revealed the following lapses: “16 month delay in evaluating abnormal
    liver mass; 8 month delay in receiving regular chemotherapy . . . ;
    multiple providers fail to respond to jaundice and abnormal liver
    function tests causing 17 month delay in diagnosis.” California Prison
    Health Care Receivership Corp., K. Imai, Analysis of Year 2009 Inmate
    Death Reviews—California Prison Health Care System 12 (Sept. 2010)
    8                          BROWN v. PLATA
    Opinion of the Court
    ing from severe but not life-threatening conditions, experi
    ence prolonged illness and unnecessary pain.
    B
    These conditions are the subject of two federal cases.
    The first to commence, Coleman v. Brown, was filed in
    1990. Coleman involves the class of seriously mentally ill
    persons in California prisons. Over 15 years ago, in 1995,
    after a 39-day trial, the Coleman District Court found
    “overwhelming evidence of the systematic failure to de
    liver necessary care to mentally ill inmates” in California
    prisons. Coleman v. Wilson, 
    912 F. Supp. 1282
    , 1316 (ED
    Cal.). The prisons were “seriously and chronically under
    staffed,” 
    id., at 1306,
    and had “no effective method for
    ensuring . . . the competence of their staff,” 
    id., at 1308.
    The prisons had failed to implement necessary suicide
    prevention procedures, “due in large measure to the severe
    understaffing.” 
    Id., at 1315.
    Mentally ill inmates “lan
    guished for months, or even years, without access to nec
    essary care.” 
    Id., at 1316.
    “They suffer from severe hallu
    cinations, [and] they decompensate into catatonic states.”
    
    Ibid. The court appointed
    a Special Master to oversee
    development and implementation of a remedial plan of
    action.
    In 2007, 12 years after his appointment, the Special
    ——————
    (hereinafter 2009 Death Reviews).
    The three-judge court did not have access to statistics for 2008, but in
    that year the number of preventable or possibly preventable deaths
    held steady at 66. California Prison Health Care Receivership Corp.,
    K. Imai, Analysis of Year 2008 Death Reviews 9 (Dec. 2009). In 2009,
    the number of preventable or possibly preventable deaths dropped to
    46. 2009 Death Reviews 11, 13. The three-judge court could not have
    anticipated this development, and it would be inappropriate for this
    Court to evaluate its significance for the first time on appeal. The
    three-judge court should, of course, consider this and any other evi
    dence of improved conditions when considering future requests by the
    State for modification of its order. See infra, at 45–48.
    Cite as: 563 U. S. ____ (2011)           9
    Opinion of the Court
    Master in Coleman filed a report stating that, after years
    of slow improvement, the state of mental health care
    in California’s prisons was deteriorating. App. 489. The
    Special Master ascribed this change to increased over
    crowding. The rise in population had led to greater
    demand for care, and existing programming space and
    staffing levels were inadequate to keep pace. Prisons had
    retained more mental health staff, but the “growth of the
    resource [had] not matched the rise in demand.” 
    Id., at 482.
    At the very time the need for space was rising, the
    need to house the expanding population had also caused a
    “reduction of programming space now occupied by inmate
    bunks.” 
    Id., at 479.
    The State was “facing a four to five
    year gap in the availability of sufficient beds to meet the
    treatment needs of many inmates/patients.” 
    Id., at 481.
    “[I]ncreasing numbers of truly psychotic inmate/patients
    are trapped in [lower levels of treatment] that cannot meet
    their needs.” 
    Ibid. The Special Master
    concluded that
    many early “achievements have succumbed to the inexo
    rably rising tide of population, leaving behind growing
    frustration and despair.” 
    Id., at 489.
                                 C
    The second action, Plata v. Brown, involves the class of
    state prisoners with serious medical conditions. After this
    action commenced in 2001, the State conceded that defi
    ciencies in prison medical care violated prisoners’ Eighth
    Amendment rights. The State stipulated to a remedial
    injunction. The State failed to comply with that injunc
    tion, and in 2005 the court appointed a Receiver to oversee
    remedial efforts. The court found that “the California
    prison medical care system is broken beyond repair,”
    resulting in an “unconscionable degree of suffering and
    death.” App. 917. The court found: “[I]t is an uncontested
    fact that, on average, an inmate in one of California’s
    prisons needlessly dies every six to seven days due to
    10                     BROWN v. PLATA
    Opinion of the Court
    constitutional deficiencies in the [California prisons’]
    medical delivery system.” 
    Ibid. And the court
    made
    findings regarding specific instances of neglect, including
    the following:
    “[A] San Quentin prisoner with hypertension, diabetes
    and renal failure was prescribed two different medica
    tions that actually served to exacerbate his renal fail
    ure. An optometrist noted the patient’s retinal bleed
    ing due to very high blood pressure and referred him
    for immediate evaluation, but this evaluation never
    took place. It was not until a year later that the pa
    tient’s renal failure was recognized, at which point he
    was referred to a nephrologist on an urgent basis;
    he should have been seen by the specialist within 14
    days but the consultation never happened and the pa
    tient died three months later.” 
    Id., at 928
    (citations
    omitted).
    Prisons were unable to retain sufficient numbers of com
    petent medical staff, 
    id., at 937,
    and would “hire any
    doctor who had ‘a license, a pulse and a pair of shoes,’ ” 
    id., at 926.
    Medical facilities lacked “necessary medical equip
    ment” and did “not meet basic sanitation standards.” 
    Id., at 944.
    “Exam tables and counter tops, where prisoners
    with . . . communicable diseases are treated, [were] not
    routinely disinfected.” 
    Ibid. In 2008, three
    years after the District Court’s decision,
    the Receiver described continuing deficiencies in the
    health care provided by California prisons:
    “Timely access is not assured. The number of medical
    personnel has been inadequate, and competence has
    not been assured. . . . Adequate housing for the dis
    abled and aged does not exist. The medical facilities,
    when they exist at all, are in an abysmal state of dis
    repair. Basic medical equipment is often not available
    or used. Medications and other treatment options are
    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
    12                    BROWN v. PLATA
    Opinion of the Court
    appeal.
    The three-judge court heard 14 days of testimony and
    issued a 184-page opinion, making extensive findings of
    fact. The court ordered California to reduce its prison
    population to 137.5% of the prisons’ design capacity within
    two years. Assuming the State does not increase capacity
    through new construction, the order requires a population
    reduction of 38,000 to 46,000 persons. Because it appears
    all but certain that the State cannot complete sufficient
    construction to comply fully with the order, the prison
    population will have to be reduced to at least some extent.
    The court did not order the State to achieve this reduction
    in any particular manner. Instead, the court ordered the
    State to formulate a plan for compliance and submit its
    plan for approval by the court.
    The State appealed to this Court pursuant to 
    28 U.S. C
    .
    §1253, and the Court postponed consideration of the ques
    tion of jurisdiction to the hearing on the merits. Schwar
    zenegger v. Plata, 560 U. S. ___ (2010).
    II
    As a consequence of their own actions, prisoners may be
    deprived of rights that are fundamental to liberty. Yet the
    law and the Constitution demand recognition of certain
    other rights. Prisoners retain the essence of human dig
    nity inherent in all persons. Respect for that dignity
    animates the Eighth Amendment prohibition against cruel
    and unusual punishment. “ ‘The basic concept underlying
    the Eighth Amendment is nothing less than the dignity of
    man.’ ” Atkins v. Virginia, 
    536 U.S. 304
    , 311 (2002) (quot
    ing Trop v. Dulles, 
    356 U.S. 86
    , 100 (1958) (plurality
    opinion)).
    To incarcerate, society takes from prisoners the means
    to provide for their own needs. Prisoners are dependent
    on the State for food, clothing, and necessary medical care.
    A prison’s failure to provide sustenance for inmates “may
    Cite as: 563 U. S. ____ (2011)           13
    Opinion of the Court
    actually produce physical ‘torture or a lingering death.’ ”
    Estelle v. Gamble, 
    429 U.S. 97
    , 103 (1976) (quoting In re
    Kemmler, 
    136 U.S. 436
    , 447 (1890)); see generally A.
    Elsner, Gates of Injustice: The Crisis in America’s Prisons
    (2004). Just as a prisoner may starve if not fed, he or she
    may suffer or die if not provided adequate medical care. A
    prison that deprives prisoners of basic sustenance, includ
    ing adequate medical care, is incompatible with the con
    cept of human dignity and has no place in civilized society.
    If government fails to fulfill this obligation, the courts
    have a responsibility to remedy the resulting Eighth
    Amendment violation. See Hutto v. Finney, 
    437 U.S. 678
    ,
    687, n. 9 (1978). Courts must be sensitive to the State’s
    interest in punishment, deterrence, and rehabilitation, as
    well as the need for deference to experienced and expert
    prison administrators faced with the difficult and danger
    ous task of housing large numbers of convicted criminals.
    See Bell v. Wolfish, 
    441 U.S. 520
    , 547–548 (1979). Courts
    nevertheless must not shrink from their obligation to “en
    force the constitutional rights of all ‘persons,’ including
    prisoners.” Cruz v. Beto, 
    405 U.S. 319
    , 321 (1972) (per
    curiam). Courts may not allow constitutional violations to
    continue simply because a remedy would involve intrusion
    into the realm of prison administration.
    Courts faced with the sensitive task of remedying un
    constitutional prison conditions must consider a range of
    available options, including appointment of special mas
    ters or receivers and the possibility of consent decrees.
    When necessary to ensure compliance with a constitu
    tional mandate, courts may enter orders placing limits on
    a prison’s population. By its terms, the PLRA restricts the
    circumstances in which a court may enter an order “that
    has the purpose or effect of reducing or limiting the prison
    population.” 
    18 U.S. C
    . §3626(g)(4). The order in this
    case does not necessarily require the State to release any
    prisoners. The State may comply by raising the design
    14                    BROWN v. PLATA
    Opinion of the Court
    capacity of its prisons or by transferring prisoners to
    county facilities or facilities in other States. Because the
    order limits the prison population as a percentage of de
    sign capacity, it nonetheless has the “effect of reducing or
    limiting the prison population.” 
    Ibid. Under the PLRA,
    only a three-judge court may enter an
    order limiting a prison population. §3626(a)(3)(B). Before
    a three-judge court may be convened, a district court first
    must have entered an order for less intrusive relief that
    failed to remedy the constitutional violation and must
    have given the defendant a reasonable time to comply
    with its prior orders. §3626(a)(3)(A). The party request
    ing a three-judge court must then submit “materials suffi
    cient to demonstrate that [these requirements] have been
    met.” §3626(a)(3)(C). If the district court concludes that
    the materials are, in fact, sufficient, a three-judge court
    may be convened. Ibid.; see also 
    28 U.S. C
    . §2284(b)(1)
    (stating that a three-judge court may not be convened if
    the district court “determines that three judges are not
    required”); 17A C. Wright, A. Miller, E. Cooper, & V.
    Amar, Federal Practice and Procedure §4235 (3d ed. 2007).
    The three-judge court must then find by clear and con
    vincing 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.” 
    18 U.S. C
    .
    §3626(a)(3)(E). As with any award of prospective relief
    under the PLRA, the relief “shall extend no further than
    necessary to correct the violation of the Federal right of
    a particular plaintiff or plaintiffs.” §3626(a)(1)(A). The
    three-judge court must therefore find that the relief is
    “narrowly drawn, extends no further than necessary . . . ,
    and is the least intrusive means necessary to correct the
    violation of the Federal right.” 
    Ibid. In making this
    de
    termination, the three-judge court must give “substantial
    weight to any adverse impact on public safety or the op
    eration of a criminal justice system caused by the relief.”
    Cite as: 563 U. S. ____ (2011)           15
    Opinion of the Court
    
    Ibid. Applying these standards,
    the three-judge court
    found a population limit appropriate, necessary, and
    authorized in this case.
    This Court’s review of the three-judge court’s legal
    determinations is de novo, but factual findings are re
    viewed for clear error. See Anderson v. Bessemer City, 
    470 U.S. 564
    , 573–574 (1985). Deference to trial court fact
    finding reflects an understanding that “[t]he trial judge’s
    major role is the determination of fact, and with experi
    ence in fulfilling that role comes expertise.” 
    Id., at 574.
    The three-judge court oversaw two weeks of trial and
    heard at considerable length from California prison offi
    cials, as well as experts in the field of correctional admini
    stration. The judges had the opportunity to ask relevant
    questions of those witnesses. Two of the judges had over
    seen the ongoing remedial efforts of the Receiver and
    Special Master. The three-judge court was well situated
    to make the difficult factual judgments necessary to fash
    ion a remedy for this complex and intractable constitu
    tional violation. The three-judge court’s findings of fact
    may be reversed only if this Court is left with a “ ‘definite
    and firm conviction that a mistake has been committed.’ ”
    
    Id., at 573
    (quoting United States v. United States Gypsum
    Co., 
    333 U.S. 364
    , 395 (1948)).
    A
    The State contends that it was error to convene the
    three-judge court without affording it more time to comply
    with the prior orders in Coleman and Plata.
    1
    The parties dispute this Court’s jurisdiction to review
    the determinations of the Coleman and Plata District
    Courts that a three-judge court should be convened.
    Plaintiffs claim the State was required to raise this issue
    first in the Court of Appeals by appealing the orders of the
    16                    BROWN v. PLATA
    Opinion of the Court
    District Courts. When exercising jurisdiction under 
    28 U.S. C
    . §1253, however, this Court “has not hesitated to
    exercise jurisdiction ‘to determine the authority of the
    court below,’ ” including whether the three-judge court was
    properly constituted. Gonzalez v. Automatic Employees
    Credit Union, 
    419 U.S. 90
    , 95, n. 12 (1974) (quoting Bailey
    v. Patterson, 
    369 U.S. 31
    , 34 (1962) (per curiam)); see also
    Gully v. Interstate Natural Gas Co., 
    292 U.S. 16
    , 18 (1934)
    (per curiam) (“The case is analogous to those in which this
    Court, finding that the court below has acted without
    jurisdiction, exercises its appellate jurisdiction to correct
    the improper action”). The merits of the decision to con
    vene the three-judge court, therefore, are properly before
    this Court.
    2
    Before a three-judge court may be convened to consider
    whether to enter a population limit, the PLRA requires
    that the court have “previously entered an order for less
    intrusive relief that has failed to remedy the deprivation
    of the Federal right sought to be remedied.” 
    18 U.S. C
    .
    §3626(a)(3)(A)(i). This provision refers to “an order.” It
    is satisfied if the court has entered one order, and this sin
    gle order has “failed to remedy” the constitutional viola
    tion. The defendant must also have had “a reasonable
    amount of time to comply with the previous court orders.”
    §3626(a)(3)(A)(ii). This provision refers to the court’s
    “orders.” It requires that the defendant have been given a
    reasonable time to comply with all of the court’s orders.
    Together, these requirements ensure that the “ ‘last resort
    remedy’ ” of a population limit is not imposed “ ‘as a first
    step.’ ” Inmates of Occoquan v. Barry, 
    844 F.2d 828
    , 843
    (CADC 1988).
    The first of these conditions, the previous order re
    quirement of §3626(a)(3)(A)(i), was satisfied in Coleman
    by appointment of a Special Master in 1995, and it was
    Cite as: 563 U. S. ____ (2011)         17
    Opinion of the Court
    satisfied in Plata by approval of a consent decree and
    stipulated injunction in 2002. Both orders were intended
    to remedy the constitutional violations. Both were given
    ample time to succeed. When the three-judge court was
    convened, 12 years had passed since the appointment of
    the Coleman Special Master, and 5 years had passed since
    the approval of the Plata consent decree. The State does
    not claim that either order achieved a remedy. Although
    the PLRA entitles a State to terminate remedial orders
    such as these after two years unless the district court
    finds that the relief “remains necessary to correct a
    current and ongoing violation of the Federal right,”
    §3626(b)(3), California has not attempted to obtain relief
    on this basis.
    The State claims instead that the second condition, the
    reasonable time requirement of §3626(a)(3)(A)(ii), was not
    met because other, later remedial efforts should have been
    given more time to succeed. In 2006, the Coleman District
    Judge approved a revised plan of action calling for con
    struction of new facilities, hiring of new staff, and im
    plementation of new procedures. That same year, the
    Plata District Judge selected and appointed a Receiver to
    oversee the State’s ongoing remedial efforts. When the
    three-judge court was convened, the Receiver had filed a
    preliminary plan of action calling for new construction,
    hiring of additional staff, and other procedural reforms.
    Although both the revised plan of action in Coleman and
    the appointment of the Receiver in Plata were new devel
    opments in the courts’ remedial efforts, the basic plan to
    solve the crisis through construction, hiring, and proce
    dural reforms remained unchanged. These efforts had
    been ongoing for years; the failed consent decree in Plata
    had called for implementation of new procedures and
    hiring of additional staff; and the Coleman Special Master
    had issued over 70 orders directed at achieving a remedy
    through construction, hiring, and procedural reforms. The
    18                     BROWN v. PLATA
    Opinion of the Court
    Coleman Special Master and Plata Receiver were unable
    to provide assurance that further, substantially similar
    efforts would yield success absent a population reduction.
    Instead, the Coleman Special Master explained that
    “many of the clinical advances . . . painfully accomplished
    over the past decade are slip-sliding away” as a result of
    overcrowding. App. 481–482. And the Plata Receiver
    indicated that, absent a reduction in overcrowding, a
    successful remedial effort could “all but bankrupt” the
    State of California. App. 1053.
    Having engaged in remedial efforts for 5 years in Plata
    and 12 in Coleman, the District Courts were not required
    to wait to see whether their more recent efforts would
    yield equal disappointment. When a court attempts to
    remedy an entrenched constitutional violation through
    reform of a complex institution, such as this statewide
    prison system, it may be necessary in the ordinary course
    to issue multiple orders directing and adjusting ongoing
    remedial efforts. Each new order must be given a reason
    able time to succeed, but reasonableness must be assessed
    in light of the entire history of the court’s remedial efforts.
    A contrary reading of the reasonable time requirement
    would in effect require district courts to impose a morato
    rium on new remedial orders before issuing a population
    limit. This unnecessary period of inaction would delay an
    eventual remedy and would prolong the courts’ involve
    ment, serving neither the State nor the prisoners. Con
    gress did not require this unreasonable result when it
    used the term “reasonable.”
    The Coleman and Plata courts had a solid basis to doubt
    that additional efforts to build new facilities and hire new
    staff would achieve a remedy. Indeed, although 5 years
    have now passed since the appointment of the Plata
    Receiver and approval of the revised plan of action in
    Coleman, there is no indication that the constitutional
    violations have been cured. A report filed by the Coleman
    Cite as: 563 U. S. ____ (2011)           19
    Opinion of the Court
    Special Master in July 2009 describes ongoing violations,
    including an “absence of timely access to appropriate
    levels of care at every point in the system.” App. 807. A
    report filed by the Plata Receiver in October 2010 likewise
    describes ongoing deficiencies in the provision of medical
    care and concludes that there are simply “too many pris
    oners for the healthcare infrastructure.” 
    Id., at 1655.
    The
    Coleman and Plata courts acted reasonably when they
    convened a three-judge court without further delay.
    B
    Once a three-judge court has been convened, the court
    must find additional requirements satisfied before it may
    impose a population limit. The first of these requirements
    is that “crowding is the primary cause of the violation of a
    Federal right.” 
    18 U.S. C
    . §3626(a)(3)(E)(i).
    1
    The three-judge court found the primary cause require
    ment satisfied by the evidence at trial. The court found
    that overcrowding strains inadequate medical and mental
    health facilities; overburdens limited clinical and custodial
    staff; and creates violent, unsanitary, and chaotic condi
    tions that contribute to the constitutional violations and
    frustrate efforts to fashion a remedy. The three-judge
    court also found that “until the problem of overcrowding is
    overcome it will be impossible to provide constitutionally
    compliant care to California’s prison population.” Juris.
    App. 141a.
    The parties dispute the standard of review applicable to
    this determination. With respect to the three-judge court’s
    factual findings, this Court’s review is necessarily deferen
    tial. It is not this Court’s place to “duplicate the role” of
    the trial court. 
    Anderson, 470 U.S., at 573
    . The ultimate
    issue of primary cause presents a mixed question of law
    and fact; but there, too, “the mix weighs heavily on the
    20                        BROWN v. PLATA
    Opinion of the Court
    ‘fact’ side.” Lilly v. Virginia, 
    527 U.S. 116
    , 148 (1999)
    (Rehnquist, C. J., concurring in judgment). Because the
    “district court is ‘better positioned’ . . . to decide the issue,”
    our review of the three-judge court’s primary cause deter
    mination is deferential. Salve Regina College v. Russell,
    
    499 U.S. 225
    , 233 (1991).
    The record documents the severe impact of burgeoning
    demand on the provision of care. At the time of trial,
    vacancy rates for medical and mental health staff ranged
    as high as 20% for surgeons, 25% for physicians, 39% for
    nurse practitioners, and 54.1% for psychiatrists. Juris.
    App. 105a, 108a. These percentages are based on the
    number of positions budgeted by the State. Dr. Ronald
    Shansky, former medical director of the Illinois prison
    system, concluded that these numbers understate the se
    verity of the crisis because the State has not budgeted
    sufficient staff to meet demand.5              According to Dr.
    Shansky, “even if the prisons were able to fill all of their
    vacant health care positions, which they have not been
    able to do to date, . . . the prisons would still be unable to
    handle the level of need given the current overcrowding.”
    Record in No. 2:90–CV–00520–LKK–JFM (ED Cal.), Doc.
    3231–13, p. 16 (hereinafter Doc. 3231–13). Dr. Craig
    Haney, a professor of psychology, reported that mental
    health staff are “managing far larger caseloads than is
    appropriate or effective.” App. 596. A prison psychiatrist
    told Dr. Haney that “ ‘we are doing about 50% of what we
    should be doing.’ ” 
    Ibid. In the context
    of physical care Dr.
    Shansky agreed that “demand for care, particularly for the
    high priority cases, continues to overwhelm the resources
    ——————
    5 Dr. Craig Haney likewise testified that the State had “significantly
    underestimated the staffing needed to implement critical portions of the
    Coleman Program Guide requirements,” that “key tasks were omitted
    when determining staffing workloads,” and that estimates were based
    on “key assumptions” that caused the State to underestimate demand
    for mental health care. App. 596–597.
    Cite as: 563 U. S. ____ (2011)                  21
    Opinion of the Court
    available.” 
    Id., at 1408.
        Even on the assumption that vacant positions could be
    filled, the evidence suggested there would be insufficient
    space for the necessary additional staff to perform their
    jobs. The Plata Receiver, in his report on overcrowding,
    concluded that even the “newest and most modern pris
    ons” had been “designed with clinic space which is only
    one-half that necessary for the real-life capacity of the
    prisons.” App. 1023 (emphasis deleted). Dr. Haney re
    ported that “[e]ach one of the facilities I toured was short
    of significant amounts of space needed to perform other
    wise critical tasks and responsibilities.” 
    Id., at 597–598.
    In one facility, staff cared for 7,525 prisoners in space
    designed for one-third as many. Juris. App. 93a. Staff
    operate out of converted storage rooms, closets, bath
    rooms, shower rooms, and visiting centers. These make
    shift facilities impede the effective delivery of care and
    place the safety of medical professionals in jeopardy,
    compounding the difficulty of hiring additional staff.
    This shortfall of resources relative to demand contrib
    utes to significant delays in treatment. Mentally ill pris
    oners are housed in administrative segregation while
    awaiting transfer to scarce mental health treatment beds
    for appropriate care. One correctional officer indicated
    that he had kept mentally ill prisoners in segregation for
    “ ‘6 months or more.’ ” App. 594. Other prisoners awaiting
    care are held in tiny, phone-booth sized cages. The record
    documents instances of prisoners committing suicide while
    awaiting treatment.6
    Delays are no less severe in the context of physical care.
    ——————
    6 For instance, Dr. Pablo Stewart reported that one prisoner was
    referred to a crisis bed but, “[a]fter learning that the restraint room
    was not available and that there were no crisis beds open, staff moved
    [the prisoner] back to his administrative segregation cell without any
    prescribed observation.” App. 736. The prisoner “hanged himself that
    night in his cell.” Ibid.; see also Juris. App. 99a.
    22                         BROWN v. PLATA
    Opinion of the Court
    Prisons have backlogs of up to 700 prisoners waiting to see
    a doctor. Doc. 3231–13, at 18. A review of referrals for
    urgent specialty care at one prison revealed that only 105
    of 316 pending referrals had a scheduled appointment,
    and only 2 had an appointment scheduled to occur within
    14 days. 
    Id., at 22–23.
    Urgent specialty referrals at one
    prison had been pending for six months to a year. 
    Id., at 27.
      Crowding also creates unsafe and unsanitary living
    conditions that hamper effective delivery of medical and
    mental health care. A medical expert described living
    quarters in converted gymnasiums or dayrooms, where
    large numbers of prisoners may share just a few toilets
    and showers, as “ ‘breeding grounds for disease.’ ”7 Juris.
    App. 102a. Cramped conditions promote unrest and vio
    lence, making it difficult for prison officials to monitor and
    control the prison population. On any given day, prisoners
    in the general prison population may become ill, thus
    entering the plaintiff class; and overcrowding may prevent
    immediate medical attention necessary to avoid suffering,
    death, or spread of disease. After one prisoner was as
    saulted in a crowded gymnasium, prison staff did not even
    learn of the injury until the prisoner had been dead for
    several hours. Tr. 382. Living in crowded, unsafe, and
    unsanitary conditions can cause prisoners with latent
    mental illnesses to worsen and develop overt symptoms.
    Crowding may also impede efforts to improve delivery of
    ——————
    7 Correctional officials at trial described several outbreaks of disease.
    One officer testified that antibiotic-resistant staph infections spread
    widely among the prison population and described prisoners “bleeding,
    oozing with pus that is soaking through their clothes when they come
    in to get the wound covered and treated.” Tr. 601, 604–605. Another
    witness testified that inmates with influenza were sent back from the
    infirmary due to a lack of beds and that the disease quickly spread to
    “more than half ” the 340 prisoners in the housing unit, with the result
    that the unit was placed on lockdown for a week. 
    Id., at 720–721.
                     Cite as: 563 U. S. ____ (2011)           23
    Opinion of the Court
    care. Two prisoners committed suicide by hanging after
    being placed in cells that had been identified as requiring
    a simple fix to remove attachment points that could sup
    port a noose. The repair was not made because doing so
    would involve removing prisoners from the cells, and there
    was no place to put them. 
    Id., at 769–777.
    More gen
    erally, Jeanne Woodford, the former acting secretary of
    California’s prisons, testified that there “ ‘are simply too
    many issues that arise from such a large number of pris
    oners,’ ” and that, as a result, “ ‘management spends virtu
    ally all of its time fighting fires instead of engaging in
    thoughtful decision-making and planning’ ” of the sort
    needed to fashion an effective remedy for these constitu
    tional violations. Juris. App. 82a.
    Increased violence also requires increased reliance on
    lockdowns to keep order, and lockdowns further impede
    the effective delivery of care. In 2006, prison officials
    instituted 449 lockdowns. 
    Id., at 116a.
    The average lock
    down lasted 12 days, and 20 lockdowns lasted 60 days or
    longer. 
    Ibid. During lockdowns, staff
    must either escort
    prisoners to medical facilities or bring medical staff to the
    prisoners. Either procedure puts additional strain on
    already overburdened medical and custodial staff. Some
    programming for the mentally ill even may be canceled
    altogether during lockdowns, and staff may be unable to
    supervise the delivery of psychotropic medications.
    The effects of overcrowding are particularly acute in
    the prisons’ reception centers, intake areas that process
    140,000 new or returning prisoners every year. 
    Id., at 85a.
    Crowding in these areas runs as high as 300% of
    design capacity. 
    Id., at 86a.
    Living conditions are
    “ ‘toxic,’ ” and a lack of treatment space impedes efforts to
    identify inmate medical or mental health needs and pro
    vide even rudimentary care. 
    Id., at 92a.
    The former
    warden of San Quentin reported that doctors in that
    prison’s reception center “ ‘were unable to keep up with
    24                    BROWN v. PLATA
    Opinion of the Court
    physicals or provid[e] any kind of chronic care follow-up.’ ”
    
    Id., at 90a.
    Inmates spend long periods of time in these
    areas awaiting transfer to the general population. Some
    prisoners are held in the reception centers for their entire
    period of incarceration.
    Numerous experts testified that crowding is the primary
    cause of the constitutional violations. The former warden
    of San Quentin and former acting secretary of the Califor
    nia prisons concluded that crowding “makes it ‘virtually
    impossible for the organization to develop, much less
    implement, a plan to provide prisoners with adequate
    care.’ ” 
    Id., at 83a.
    The former executive director of the
    Texas Department of Criminal Justice testified that
    “ ‘[e]verything revolves around overcrowding” and that
    “ ‘overcrowding is the primary cause of the medical and
    mental health care violations.’ ” 
    Id., at 127a.
    The former
    head of corrections in Pennsylvania, Washington, and
    Maine testified that overcrowding is “ ‘overwhelming the
    system both in terms of sheer numbers, in terms of the
    space available, in terms of providing healthcare.’ ” 
    Ibid. And the current
    secretary of the Pennsylvania Depart
    ment of Corrections testified that “ ‘‘the biggest inhibiting
    factor right now in California being able to deliver appro
    priate mental health and medical care is the severe over
    crowding.’ ” 
    Id., at 82a.
                                 2
    The State attempts to undermine the substantial evi
    dence presented at trial, and the three-judge court’s find
    ings of fact, by complaining that the three-judge court did
    not allow it to present evidence of current prison condi
    tions. This suggestion lacks a factual basis.
    The three-judge court properly admitted evidence of
    current conditions as relevant to the issues before it. The
    three-judge court allowed discovery until a few months
    before trial; expert witnesses based their conclusions on
    Cite as: 563 U. S. ____ (2011)             25
    Opinion of the Court
    recent observations of prison conditions; the court ad
    mitted recent reports on prison conditions by the Plata
    Receiver and Coleman Special Master; and both parties
    presented testimony related to current conditions, includ
    ing understaffing, inadequate facilities, and unsanitary
    and unsafe living conditions. 
    See supra, at 4
    –8, 19–24.
    Dr. Craig Haney, for example, based his expert report on
    tours of eight California prisons. App. 539. These tours
    occurred as late as August 2008, two weeks before Dr.
    Haney submitted his report and less than four months
    before the first day of trial. 
    Id., at 585;
    see also 
    id., at 563,
    565, 580 (July tours). Other experts submitted reports
    based on similar observations. See, e.g., Doc. 3231–13,
    at 6 (Dr. Shansky); App. 646 (Dr. Stewart); 
    id., at 1245
    (Austin); 
    id., at 1312
    (Lehman).
    The three-judge court’s opinion cited and relied on this
    evidence of current conditions. The court relied exten
    sively on the expert witness reports. See generally Juris.
    App. 85a–143a. The court cited the most current data
    available on suicides and preventable deaths in the Cali
    fornia prisons. 
    Id., at 123a,
    125a. The court relied on
    statistics on staff vacancies that dated to three months
    before trial, 
    id., at 105a,
    108a, and statistics on shortages
    of treatment beds for the same period, 
    id., at 97a.
    These
    are just examples of the extensive evidence of current
    conditions that informed every aspect of the judgment of
    the three-judge court. The three-judge court did not abuse
    its discretion when it also cited findings made in earlier
    decisions of the Plata and Coleman District Courts. Those
    findings remained relevant to establish the nature of these
    longstanding, continuing constitutional violations.
    It is true that the three-judge court established a cutoff
    date for discovery a few months before trial. The order
    stated that site inspections of prisons would be allowed
    until that date, and that evidence of “changed prison
    conditions” after that date would not be admitted. App.
    26                     BROWN v. PLATA
    Opinion of the Court
    1190. The court also excluded evidence not pertinent to
    the issue whether a population limit is appropriate under
    the PLRA, including evidence relevant solely to the exis
    tence of an ongoing constitutional violation. The court
    reasoned that its decision was limited to the issue of rem
    edy and that the merits of the constitutional violation had
    already been determined. The three-judge court made
    clear that all such evidence would be considered “[t]o the
    extent that it illuminates questions that are properly
    before the court.” App. 2339.
    Both rulings were within the sound discretion of the
    three-judge court. Orderly trial management may require
    discovery deadlines and a clean distinction between litiga
    tion of the merits and the remedy. The State in fact
    represented to the three-judge court that it would be “ap
    propriate” to cut off discovery before trial because “like
    plaintiffs, we, too, are really gearing up and going into a
    pretrial mode.” 
    Id., at 1683.
    And if the State truly be
    lieved there was no longer a violation, it could have argued
    to the Coleman and Plata District Courts that a three
    judge court should not be convened because the District
    Courts’ prior orders had not “failed to remedy the dep
    rivation” of prisoners’ constitutional rights. 
    18 U.S. C
    .
    §3626(a)(3)(A)(i); see 
    also supra, at 16
    –17. Once the three
    judge court was convened, that court was not required to
    reconsider the merits. Its role was solely to consider the
    propriety and necessity of a population limit.
    The State does not point to any significant evidence that
    it was unable to present and that would have changed the
    outcome of the proceedings. To the contrary, the record
    and opinion make clear that the decision of the three
    judge court was based on current evidence pertaining to
    ongoing constitutional violations.
    3
    The three-judge court acknowledged that the violations
    Cite as: 563 U. S. ____ (2011)                  27
    Opinion of the Court
    were caused by factors in addition to overcrowding and
    that reducing crowding in the prisons would not entirely
    cure the violations. This is consistent with the reports
    of the Coleman Special Master and Plata Receiver, both
    of whom concluded that even a significant reduction in the
    prison population would not remedy the violations absent
    continued efforts to train staff, improve facilities, and
    reform procedures. App. 487, 1054.8 The three-judge
    court nevertheless found that overcrowding was the pri
    mary cause in the sense of being the foremost cause of the
    violation.
    This understanding of the primary cause requirement is
    consistent with the text of the PLRA. The State in fact
    concedes that it proposed this very definition of primary
    cause to the three-judge court. “Primary” is defined as
    “[f]irst or highest in rank, quality, or importance; princi
    pal.” American Heritage Dictionary 1393 (4th ed. 2000);
    see also Webster’s Third New International Dictionary
    1800 (2002) (defining “primary” as “first in rank or impor
    tance”); 12 Oxford English Dictionary 472 (2d ed. 1989)
    (defining “primary” as “[o]f the first or highest rank or
    importance; that claims the first consideration; principal,
    chief ”). Overcrowding need only be the foremost, chief, or
    principal cause of the violation. If Congress had intended
    ——————
    8 The Plata Receiver concluded that those who believed a population
    reduction would be a panacea were “simply wrong.” App. 1054–1055.
    The Receiver nevertheless made clear that “the time this process will
    take, and the cost and the scope of intrusion by the Federal Court
    cannot help but increase, and increase in a very significant manner, if
    the scope and characteristics of [California prison] overcrowding
    continue.” 
    Id., at 1053.
    The Coleman Special Master likewise found
    that a large release of prisoners, without other relief, would leave the
    violation “largely unmitigated” even though deficiencies in care “are
    unquestionably exacerbated by overcrowding” and “defendants’ ability
    to provide required mental health services would be enhanced consid
    erably by a reduction in the overall census” of the prisons. App. 486–
    487.
    28                    BROWN v. PLATA
    Opinion of the Court
    to require that crowding be the only cause, it would have
    said so, assuming in its judgment that definition would be
    consistent with constitutional limitations.
    As this case illustrates, constitutional violations in
    conditions of confinement are rarely susceptible of simple
    or straightforward solutions. In addition to overcrowding
    the failure of California’s prisons to provide adequate
    medical and mental health care may be ascribed to chronic
    and worsening budget shortfalls, a lack of political will in
    favor of reform, inadequate facilities, and systemic admin
    istrative failures. The Plata District Judge, in his order
    appointing the Receiver, compared the problem to “ ‘a
    spider web, in which the tension of the various strands is
    determined by the relationship among all the parts of the
    web, so that if one pulls on a single strand, the tension of
    the entire web is redistributed in a new and complex
    pattern.’ ” App. 966–967 (quoting Fletcher, The Discre
    tionary Constitution: Institutional Remedies and Judicial
    Legitimacy, 91 Yale L. J. 635, 645 (1982)); see also 
    Hutto, 437 U.S., at 688
    (noting “the interdependence of the con
    ditions producing the violation,” including overcrowd
    ing). Only a multifaceted approach aimed at many causes,
    including overcrowding, will yield a solution.
    The PLRA should not be interpreted to place undue
    restrictions on the authority of federal courts to fashion
    practical remedies when confronted with complex and
    intractable constitutional violations. Congress limited the
    availability of limits on prison populations, but it did not
    forbid these measures altogether. See 
    18 U.S. C
    . §3626.
    The House Report accompanying the PLRA explained:
    “While prison caps must be the remedy of last re
    sort, a court still retains the power to order this
    remedy despite its intrusive nature and harmful con
    sequences to the public if, but only if, it is truly
    necessary to prevent an actual violation of a prisoner’s
    Cite as: 563 U. S. ____ (2011)             29
    Opinion of the Court
    federal rights.” H. R. Rep. No. 104–21, p. 25 (1995).
    Courts should presume that Congress was sensitive to the
    real-world problems faced by those who would remedy
    constitutional violations in the prisons and that Congress
    did not leave prisoners without a remedy for violations of
    their constitutional rights. A reading of the PLRA that
    would render population limits unavailable in practice
    would raise serious constitutional concerns. See, e.g.,
    Bowen v. Michigan Academy of Family Physicians, 
    476 U.S. 667
    , 681, n. 12 (1986). A finding that overcrowding
    is the “primary cause” of a violation is therefore permissi
    ble, despite the fact that additional steps will be required
    to remedy the violation.
    C
    The three-judge court was also required to find by clear
    and convincing evidence that “no other relief will remedy
    the violation of the Federal right.” §3626(a)(3)(E)(ii).
    The State argues that the violation could have been
    remedied through a combination of new construction,
    transfers of prisoners out of State, hiring of medical per
    sonnel, and continued efforts by the Plata Receiver and
    Coleman Special Master. The order in fact permits the
    State to comply with the population limit by transferring
    prisoners to county facilities or facilities in other States, or
    by constructing new facilities to raise the prisons’ design
    capacity. And the three-judge court’s order does not bar
    the State from undertaking any other remedial efforts. If
    the State does find an adequate remedy other than a
    population limit, it may seek modification or termination
    of the three-judge court’s order on that basis. The evi
    dence at trial, however, supports the three-judge court’s
    conclusion that an order limited to other remedies would
    not provide effective relief.
    The State’s argument that out-of-state transfers provide
    a less restrictive alternative to a population limit must fail
    30                        BROWN v. PLATA
    Opinion of the Court
    because requiring out-of-state transfers itself qualifies as
    a population limit under the PLRA.9 Such an order “has
    the purpose or effect of reducing or limiting the prison
    population, or . . . directs the release from or nonadmission
    of prisoners to a prison.” §3626(g)(4). The same is true of
    transfers to county facilities. Transfers provide a means
    to reduce the prison population in compliance with the
    three-judge court’s order. They are not a less restrictive
    alternative to that order.
    Even if out-of-state transfers could be regarded as a less
    restrictive alternative, the three-judge court found no
    evidence of plans for transfers in numbers sufficient to
    relieve overcrowding. The State complains that the Cole
    man District Court slowed the rate of transfer by requir
    ing inspections to assure that the receiving institutions
    were in compliance with the Eighth Amendment, but the
    State has made no effort to show that it has the resources
    and the capacity to transfer significantly larger numbers
    of prisoners absent that condition.
    Construction of new facilities, in theory, could alleviate
    overcrowding, but the three-judge court found no realistic
    possibility that California would be able to build itself out
    of this crisis. At the time of the court’s decision the State
    had plans to build new medical and housing facilities, but
    funding for some plans had not been secured and funding
    for other plans had been delayed by the legislature for
    years. Particularly in light of California’s ongoing fiscal
    crisis, the three-judge court deemed “chimerical” any
    “remedy that requires significant additional spending by
    the state.” Juris. App. 151a. Events subsequent to the
    ——————
    9 A program of voluntary transfers by the State would, of course, be
    less restrictive than an order mandating a reduction in the prison
    population. In light of the State’s longstanding failure to remedy these
    serious constitutional violations, the three-judge court was under no
    obligation to consider voluntary population-reduction measures by the
    State as a workable alternative to injunctive relief.
    Cite as: 563 U. S. ____ (2011)          31
    Opinion of the Court
    three-judge court’s decision have confirmed this conclu
    sion. In October 2010, the State notified the Coleman
    District Court that a substantial component of its con
    struction plans had been delayed indefinitely by the legis
    lature. And even if planned construction were to be
    completed, the Plata Receiver found that many so-called
    “expansion” plans called for cramming more prisoners into
    existing prisons without expanding administrative and
    support facilities. Juris. App. 151a–152a. The former
    acting secretary of the California prisons explained that
    these plans would “ ‘compound the burdens imposed on
    prison administrators and line staff’’ ” by adding to the
    already overwhelming prison population, creating new
    barriers to achievement of a remedy. 
    Id., at 152a.
      The three-judge court also rejected additional hiring as
    a realistic means to achieve a remedy. The State for years
    had been unable to fill positions necessary for the ade
    quate provision of medical and mental health care, and
    the three-judge court found no reason to expect a change.
    Although the State points to limited gains in staffing
    between 2007 and 2008, the record shows that the prison
    system remained chronically understaffed through trial in
    2008. 
    See supra, at 20
    . The three-judge court found that
    violence and other negative conditions caused by crowding
    made it difficult to hire and retain needed staff. The court
    also concluded that there would be insufficient space for
    additional staff to work even if adequate personnel could
    somehow be retained. Additional staff cannot help to
    remedy the violation if they have no space in which to see
    and treat patients.
    The three-judge court also did not err, much less commit
    clear error, when it concluded that, absent a population
    reduction, continued efforts by the Receiver and Special
    Master would not achieve a remedy. Both the Receiver
    and the Special Master filed reports stating that over
    crowding posed a significant barrier to their efforts. The
    32                    BROWN v. PLATA
    Opinion of the Court
    Plata Receiver stated that he was determined to achieve
    a remedy even without a population reduction, but he
    warned that such an effort would “all but bankrupt” the
    State. App. 1053. The Coleman Special Master noted
    even more serious concerns, stating that previous reme
    dial efforts had “succumbed to the inexorably rising tide of
    population.” App. 489. Both reports are persuasive evi
    dence that, absent a reduction in overcrowding, any rem
    edy might prove unattainable and would at the very least
    require vast expenditures of resources by the State. Noth
    ing in the long history of the Coleman and Plata actions
    demonstrates any real possibility that the necessary re
    sources would be made available.
    The State claims that, even if each of these measures
    were unlikely to remedy the violation, they would succeed
    in doing so if combined together. Aside from asserting this
    proposition, the State offers no reason to believe it is so.
    Attempts to remedy the violations in Plata have been
    ongoing for 9 years. In Coleman, remedial efforts have
    been ongoing for 16. At one time, it may have been possi
    ble to hope that these violations would be cured without a
    reduction in overcrowding. A long history of failed reme
    dial orders, together with substantial evidence of over
    crowding’s deleterious effects on the provision of care,
    compels a different conclusion today.
    The common thread connecting the State’s proposed
    remedial efforts is that they would require the State to
    expend large amounts of money absent a reduction in
    overcrowding. The Court cannot ignore the political and
    fiscal reality behind this case. California’s Legislature has
    not been willing or able to allocate the resources necessary
    to meet this crisis absent a reduction in overcrowding.
    There is no reason to believe it will begin to do so now,
    when the State of California is facing an unprecedented
    budgetary shortfall. As noted above, the legislature re
    cently failed to allocate funds for planned new construc
    Cite as: 563 U. S. ____ (2011)           33
    Opinion of the Court
    tion. Supra, at 30–31. Without a reduction in overcrowd
    ing, there will be no efficacious remedy for the unconsti
    tutional care of the sick and mentally ill in California’s
    prisons.
    D
    The PLRA states that no prospective relief shall issue
    with respect to prison conditions unless it is narrowly
    drawn, extends no further than necessary to correct the
    violation of a federal right, and is the least intrusive
    means necessary to correct the violation. 
    18 U.S. C
    .
    §3626(a). When determining whether these requirements
    are met, courts must “give substantial weight to any ad
    verse impact on public safety or the operation of a criminal
    justice system.” 
    Ibid. 1 The three-judge
    court acknowledged that its order “is
    likely to affect inmates without medical conditions or
    serious mental illness.” Juris. App. 172a. This is because
    reducing California’s prison population will require reduc
    ing the number of prisoners outside the class through
    steps such as parole reform, sentencing reform, use of
    good-time credits, or other means to be determined by the
    State. Reducing overcrowding will also have positive
    effects beyond facilitating timely and adequate access to
    medical care, including reducing the incidence of prison
    violence and ameliorating unsafe living conditions. Ac
    cording to the State, these collateral consequences are
    evidence that the order sweeps more broadly than
    necessary.
    The population limit imposed by the three-judge court
    does not fail narrow tailoring simply because it will have
    positive effects beyond the plaintiff class. Narrow tailor
    ing requires a “ ‘ “fit” between the [remedy’s] ends and the
    means chosen to accomplish those ends.’ ” Board of Trus
    34                    BROWN v. PLATA
    Opinion of the Court
    tees of State Univ. of N. Y. v. Fox, 
    492 U.S. 469
    , 480
    (1989). The scope of the remedy must be proportional
    to the scope of the violation, and the order must extend
    no further than necessary to remedy the violation. This
    Court has rejected remedial orders that unnecessarily
    reach out to improve prison conditions other than those
    that violate the Constitution. Lewis v. Casey, 
    518 U.S. 343
    , 357 (1996). But the precedents do not suggest that a
    narrow and otherwise proper remedy for a constitutional
    violation is invalid simply because it will have collateral
    effects.
    Nor does anything in the text of the PLRA require that
    result. The PLRA states that a remedy shall extend no
    further than necessary to remedy the violation of the
    rights of a “particular plaintiff or plaintiffs.” 
    18 U.S. C
    .
    §3626(a)(1)(A). This means only that the scope of the
    order must be determined with reference to the consti
    tutional violations established by the specific plaintiffs
    before the court.
    This case is unlike cases where courts have impermis
    sibly reached out to control the treatment of persons or
    institutions beyond the scope of the violation. See Dayton
    Bd. of Ed. v. Brinkman, 
    433 U.S. 406
    , 420 (1977). Even
    prisoners with no present physical or mental illness may
    become afflicted, and all prisoners in California are at risk
    so long as the State continues to provide inadequate care.
    Prisoners in the general population will become sick, and
    will become members of the plaintiff classes, with rou-
    tine frequency; and overcrowding may prevent the timely
    diagnosis and care necessary to provide effective treat
    ment and to prevent further spread of disease. Relief
    targeted only at present members of the plaintiff classes
    may therefore fail to adequately protect future class mem
    bers who will develop serious physical or mental illness.
    Prisoners who are not sick or mentally ill do not yet have a
    claim that they have been subjected to care that violates
    Cite as: 563 U. S. ____ (2011)           35
    Opinion of the Court
    the Eighth Amendment, but in no sense are they remote
    bystanders in California’s medical care system. They are
    that system’s next potential victims.
    A release order limited to prisoners within the plaintiff
    classes would, if anything, unduly limit the ability of State
    officials to determine which prisoners should be released.
    As the State acknowledges in its brief, “release of seriously
    mentally ill inmates [would be] likely to create special
    dangers because of their recidivism rates.” Consolidated
    Reply Brief for Appellants 34. The order of the three
    judge court gives the State substantial flexibility to
    determine who should be released. If the State truly be
    lieves that a release order limited to sick and mentally ill
    inmates would be preferable to the order entered by the
    three-judge court, the State can move the three-judge
    court for modification of the order on that basis. The State
    has not requested this relief from this Court.
    The order also is not overbroad because it encompasses
    the entire prison system, rather than separately assessing
    the need for a population limit at every institution. The
    Coleman court found a systemwide violation when it first
    afforded relief, and in Plata the State stipulated to sys
    temwide relief when it conceded the existence of a viola
    tion. Both the Coleman Special Master and the Plata
    Receiver have filed numerous reports detailing system
    wide deficiencies in medical and mental health care.
    California’s medical care program is run at a systemwide
    level, and resources are shared among the correctional
    facilities.
    Although the three-judge court’s order addresses the
    entire California prison system, it affords the State flexi
    bility to accommodate differences between institutions.
    There is no requirement that every facility comply with
    the 137.5% limit. Assuming no constitutional violation
    results, some facilities may retain populations in excess of
    the limit provided other facilities fall sufficiently below it
    36                    BROWN v. PLATA
    Opinion of the Court
    so the system as a whole remains in compliance with the
    order. This will allow prison officials to shift prisoners
    to facilities that are better able to accommodate over
    crowding, or out of facilities where retaining sufficient
    medical staff has been difficult. The alternative—a series
    of institution-specific population limits—would require
    federal judges to make these choices. Leaving this discre
    tion to state officials does not make the order overbroad.
    Nor is the order overbroad because it limits the State’s
    authority to run its prisons, as the State urges in its brief.
    While the order does in some respects shape or control the
    State’s authority in the realm of prison administration, it
    does so in a manner that leaves much to the State’s discre
    tion. The State may choose how to allocate prisoners
    between institutions; it may choose whether to increase
    the prisons’ capacity through construction or reduce the
    population; and, if it does reduce the population, it may
    decide what steps to take to achieve the necessary reduc
    tion. The order’s limited scope is necessary to remedy a
    constitutional violation.
    As the State implements the order of the three-judge
    court, time and experience may reveal targeted and effec
    tive remedies that will end the constitutional violations
    even without a significant decrease in the general prison
    population. The State will be free to move the three-judge
    court for modification of its order on that basis, and these
    motions would be entitled to serious consideration. See
    infra, at 45–48. At this time, the State has not proposed
    any realistic alternative to the order. The State’s desire to
    avoid a population limit, justified as according respect to
    state authority, creates a certain and unacceptable risk of
    continuing violations of the rights of sick and mentally ill
    prisoners, with the result that many more will die or
    needlessly suffer. The Constitution does not permit this
    wrong.
    Cite as: 563 U. S. ____ (2011)          37
    Opinion of the Court
    2
    In reaching its decision, the three-judge court gave
    “substantial weight” to any potential adverse impact on
    public safety from its order. The court devoted nearly 10
    days of trial to the issue of public safety, and it gave the
    question extensive attention in its opinion. Ultimately,
    the court concluded that it would be possible to reduce
    the prison population “in a manner that preserves public
    safety and the operation of the criminal justice system.”
    Juris. App. 247a–248a.
    The PLRA’s requirement that a court give “substantial
    weight” to public safety does not require the court to cer
    tify that its order has no possible adverse impact on the
    public. A contrary reading would depart from the statute’s
    text by replacing the word “substantial” with “conclusive.”
    Whenever a court issues an order requiring the State to
    adjust its incarceration and criminal justice policy, there
    is a risk that the order will have some adverse impact on
    public safety in some sectors. This is particularly true
    when the order requires release of prisoners before their
    sentence has been served. Persons incarcerated for even
    one offense may have committed many other crimes prior
    to arrest and conviction, and some number can be ex
    pected to commit further crimes upon release. Yet the
    PLRA contemplates that courts will retain authority to
    issue orders necessary to remedy constitutional violations,
    including authority to issue population limits when neces
    sary. 
    See supra, at 28
    –29. A court is required to consider
    the public safety consequences of its order and to struc
    ture, and monitor, its ruling in a way that mitigates those
    consequences while still achieving an effective remedy of
    the constitutional violation.
    This inquiry necessarily involves difficult predictive
    judgments regarding the likely effects of court orders.
    Although these judgments are normally made by state
    officials, they necessarily must be made by courts when
    38                        BROWN v. PLATA
    Opinion of the Court
    those courts fashion injunctive relief to remedy serious
    constitutional violations in the prisons. These questions
    are difficult and sensitive, but they are factual questions
    and should be treated as such. Courts can, and should,
    rely on relevant and informed expert testimony when
    making factual findings. It was proper for the three-judge
    court to rely on the testimony of prison officials from
    California and other States. Those experts testified on the
    basis of empirical evidence and extensive experience in
    the field of prison administration.
    The three-judge court credited substantial evidence that
    prison populations can be reduced in a manner that does
    not increase crime to a significant degree. Some evidence
    indicated that reducing overcrowding in California’s pris
    ons could even improve public safety. Then-Governor
    Schwarzenegger, in his emergency proclamation on over
    crowding, acknowledged that “ ‘overcrowding causes harm
    to people and property, leads to inmate unrest and mis
    conduct, . . . and increases recidivism as shown within this
    state and in others.’ ” Juris. App. 191a–192a. The former
    warden of San Quentin and acting secretary of the Cali
    fornia prison system testified that she “ ‘absolutely be
    lieve[s] that we make people worse, and that we are not
    meeting public safety by the way we treat people.’ ”10 
    Id., at 129a.
    And the head of Pennsylvania’s correctional
    system testified that measures to reduce prison population
    ——————
    10 The former head of correctional systems in Washington, Maine, and
    Pennsylvania, likewise referred to California’s prisons as “ ‘crimino
    genic.’ ” Juris. App. 191a. The Yolo County chief probation officer
    testified that “ ‘it seems like [the prisons] produce additional criminal
    behavior.’ ” 
    Id., at 190a.
    A former professor of sociology at George
    Washington University, reported that California’s present recidivism
    rate is among the highest in the Nation. App. 1246. And the three
    judge court noted the report of California’s Little Hoover Commission,
    which stated that “ ‘[e]ach year, California communities are burdened
    with absorbing 123,000 offenders returning from prison, often more
    dangerous than when they left.’ ” Juris. App. 191a.
    Cite as: 563 U. S. ____ (2011)                   39
    Opinion of the Court
    may “actually improve on public safety because they ad
    dress the problems that brought people to jail.” Tr. 1552–
    1553.
    Expert witnesses produced statistical evidence that
    prison populations had been lowered without adversely
    affecting public safety in a number of jurisdictions, includ
    ing certain counties in California, as well as Wisconsin,
    Illinois, Texas, Colorado, Montana, Michigan, Florida, and
    Canada. Juris. App. 245a.11 Washington’s former secretary
    of corrections testified that his State had implemented
    population reduction methods, including parole reform
    and expansion of good time credits, without any “deleteri
    ous effect on crime.” Tr. 2008–2009. In light of this evi
    dence, the three-judge court concluded that any negative
    impact on public safety would be “substantially offset, and
    perhaps entirely eliminated, by the public safety benefits”
    ——————
    11 Philadelphia’s experience in the early 1990’s with a federal court
    order mandating reductions in the prison population was less positive,
    and that history illustrates the undoubted need for caution in this area.
    One congressional witness testified that released prisoners committed
    79 murders and multiple other offenses. See Hearing on S. 3 et al.
    before the Senate Committee on the Judiciary, 104th Cong., 1st Sess.,
    45 (1995) (statement of Lynne Abraham, District Attorney of Philadel
    phia). Lead counsel for the plaintiff class in that case responded that
    “[t]his inflammatory assertion has never been documented.” 
    Id., at 212
    (statement of David Richman). The Philadelphia decree was also
    different from the order entered in this case. Among other things, it
    “prohibited the City from admitting to its prisons any additional
    inmates, except for persons charged with, or convicted of, murder,
    forcible rape, or a crime involving the use of a gun or knife in the
    commission of an aggravated assault or robbery.” Harris v. Reeves, 
    761 F. Supp. 382
    , 384–385 (ED Pa. 1991); see also Crime and Justice
    Research Institute, J. Goldkamp & M. White, Restoring Accountability
    in Pretrial Release: The Philadelphia Pretrial Release Supervision
    Experiments 6–8 (1998). The difficulty of determining the precise
    relevance of Philadelphia’s experience illustrates why appellate courts
    defer to the trier of fact. The three-judge court had the opportunity to
    hear testimony on population reduction measures in other jurisdictions
    and to ask relevant questions of informed expert witnesses.
    40                        BROWN v. PLATA
    Opinion of the Court
    of a reduction in overcrowding. Juris. App. 248a.
    The court found that various available methods of re
    ducing overcrowding would have little or no impact on
    public safety. Expansion of good-time credits would allow
    the State to give early release to only those prisoners who
    pose the least risk of reoffending. Diverting low-risk
    offenders to community programs such as drug treatment,
    day reporting centers, and electronic monitoring would
    likewise lower the prison population without releasing
    violent convicts.12 The State now sends large numbers of
    persons to prison for violating a technical term or condi
    tion of their parole, and it could reduce the prison popula
    tion by punishing technical parole violations through
    community-based programs. This last measure would be
    particularly beneficial as it would reduce crowding in the
    reception centers, which are especially hard hit by over
    crowding. 
    See supra, at 23
    –24. The court’s order took
    account of public safety concerns by giving the State sub
    stantial flexibility to select among these and other means
    of reducing overcrowding.
    The State submitted a plan to reduce its prison popula
    tion in accordance with the three-judge court’s order, and
    it complains that the three-judge court approved that
    plan without considering whether the specific measures
    contained within it would substantially threaten public
    safety. The three-judge court, however, left the choice of
    how best to comply with its population limit to state
    ——————
    12 Expanding such community-based measures may require an ex
    penditure of resources by the State to fund new programs or expand
    existing ones. The State complains that the order therefore requires it
    to “divert” savings that will be achieved by reducing the prison popula
    tion and that setting budgetary priorities in this manner is a “severe,
    unlawful intrusion on the State authority.” Brief for Appellants 55.
    This argument is not convincing. The order does not require the State
    to use any particular approach to reduce its prison population or
    allocate its resources.
    Cite as: 563 U. S. ____ (2011)           41
    Opinion of the Court
    prison officials. The court was not required to second
    guess the exercise of that discretion. Courts should pre
    sume that state officials are in a better position to gauge
    how best to preserve public safety and balance competing
    correctional and law enforcement concerns. The decision
    to leave details of implementation to the State’s discretion
    protected public safety by leaving sensitive policy deci
    sions to responsible and competent state officials.
    During the pendency of this appeal, the State in fact
    began to implement measures to reduce the prison popula
    tion. See Supp. Brief for Appellants 1. These measures
    will shift “thousands” of prisoners from the state prisons
    to the county jails by “mak[ing] certain felonies punishable
    by imprisonment in county jail” and “requir[ing] that
    individuals returned to custody for violating their condi
    tions of parole ‘serve any custody term in county jail.’ ”
    
    Ibid. These developments support
    the three-judge court’s
    conclusion that the prison population can be reduced in
    a manner calculated to avoid an undue negative effect on
    public safety.
    III
    Establishing the population at which the State could
    begin to provide constitutionally adequate medical and
    mental health care, and the appropriate time frame within
    which to achieve the necessary reduction, requires a de
    gree of judgment. The inquiry involves uncertain predic
    tions regarding the effects of population reductions, as
    well as difficult determinations regarding the capacity of
    prison officials to provide adequate care at various popu
    lation levels. Courts have substantial flexibility when
    making these judgments. “ ‘Once invoked, “the scope of a
    district court’s equitable powers . . . is broad, for breadth
    and flexibility are inherent in equitable remedies.” ’ ”
    
    Hutto, 437 U.S., at 687
    , n. 9 (quoting Milliken v. Bradley,
    
    433 U.S. 267
    , 281 (1977), in turn quoting Swann v.
    42                    BROWN v. PLATA
    Opinion of the Court
    Charlotte-Mecklenburg Bd. of Ed., 
    402 U.S. 1
    , 15 (1971)).
    Nevertheless, the PLRA requires a court to adopt a
    remedy that is “narrowly tailored” to the constitutional
    violation and that gives “substantial weight” to public
    safety. 
    18 U.S. C
    . §3626(a). When a court is imposing a
    population limit, this means the court must set the limit
    at the highest population consistent with an efficacious
    remedy. The court must also order the population reduc
    tion achieved in the shortest period of time reasonably
    consistent with public safety.
    A
    The three-judge court concluded that the population of
    California’s prisons should be capped at 137.5% of design
    capacity. This conclusion is supported by the record.
    Indeed, some evidence supported a limit as low as 100% of
    design capacity. The chief deputy secretary of Correc
    tional Healthcare Services for the California prisons tes
    tified that California’s prisons “ ‘were not designed and
    made no provision for any expansion of medical care space
    beyond the initial 100% of capacity.’ ” Juris. App. 176a.
    Other evidence supported a limit as low as 130%. The
    head of the State’s Facilities Strike Team recommended
    reducing the population to 130% of design capacity as a
    long-term goal. 
    Id., at 179a–180a.
    A former head of cor
    rectional systems in Washington State, Maine, and Penn
    sylvania testified that a 130% limit would “ ‘give prison
    officials and staff the ability to provide the necessary
    programs and services for California’s prisoners.’ ” 
    Id., at 180a.
    A former executive director of the Texas prisons
    testified that a limit of 130% was “ ‘realistic and appro
    priate’ ” and would “ ‘ensure that [California’s] prisons are
    safe and provide legally required services.’ ” 
    Ibid. And a former
    acting secretary of the California prisons agreed
    with a 130% limit with the caveat that a 130% limit might
    prove inadequate in some older facilities. 
    Ibid. Cite as: 563
    U. S. ____ (2011)           43
    Opinion of the Court
    According to the State, this testimony expressed the
    witnesses’ policy preferences, rather than their views as to
    what would cure the constitutional violation. Of course,
    courts must not confuse professional standards with con
    stitutional requirements. Rhodes v. Chapman, 
    452 U.S. 337
    , 348, n. 13 (1981). But expert opinion may be relevant
    when determining what is obtainable and what is accept
    able in corrections philosophy. 
    See supra, at 37
    –38.
    Nothing in the record indicates that the experts in this
    case imposed their own policy views or lost sight of the
    underlying violations. To the contrary, the witnesses
    testified that a 130% population limit would allow the
    State to remedy the constitutionally inadequate provision
    of medical and mental health care. When expert opinion
    is addressed to the question of how to remedy the relevant
    constitutional violations, as it was here, federal judges can
    give it considerable weight.
    The Federal Bureau of Prisons (BOP) has set 130% as a
    long-term goal for population levels in the federal prison
    system. Brief for Appellants 43–44. The State suggests
    the expert witnesses impermissibly adopted this profes
    sional standard in their testimony. But courts are not
    required to disregard expert opinion solely because it
    adopts or accords with professional standards. Profes
    sional standards may be “helpful and relevant with re
    spect to some questions.” 
    Chapman, supra, at 348
    , n. 13.
    The witnesses testified that a limit of 130% was necessary
    to remedy the constitutional violations, not that it should
    be adopted because it is a BOP standard. If anything, the
    fact that the BOP views 130% as a manageable population
    density bolsters the three-judge court’s conclusion that a
    population limit of 130% would alleviate the pressures
    associated with overcrowding and allow the State to begin
    to provide constitutionally adequate care.
    Although the three-judge court concluded that the “evi
    dence in support of a 130% limit is strong,” it found that
    44                   BROWN v. PLATA
    Opinion of the Court
    some upward adjustment was warranted in light of “the
    caution and restraint required by the PLRA.” Juris. App.
    183a, 184a. The three-judge court noted evidence support
    ing a higher limit. In particular, the State’s Corrections
    Independent Review Panel had found that 145% was the
    maximum “operable capacity” of California’s prisons, 
    id., at 181a–182a,
    although the relevance of that determina
    tion was undermined by the fact that the panel had not
    considered the need to provide constitutionally adequate
    medical and mental health care, as the State itself con
    cedes. Brief for Coleman Appellees 45. After considering,
    but discounting, this evidence, the three-judge court con
    cluded that the evidence supported a limit lower than
    145%, but higher than 130%. It therefore imposed a limit
    of 137.5%.
    This weighing of the evidence was not clearly erroneous.
    The adversary system afforded the court an opportunity
    to weigh and evaluate evidence presented by the parties.
    The plaintiffs’ evidentiary showing was intended to justify
    a limit of 130%, and the State made no attempt to show
    that any other number would allow for a remedy. There
    are also no scientific tools available to determine the
    precise population reduction necessary to remedy a consti
    tutional violation of this sort. The three-judge court made
    the most precise determination it could in light of the
    record before it. The PLRA’s narrow tailoring require
    ment is satisfied so long as these equitable, remedial
    judgments are made with the objective of releasing the
    fewest possible prisoners consistent with an efficacious
    remedy. In light of substantial evidence supporting an
    even more drastic remedy, the three-judge court complied
    with the requirement of the PLRA in this case.
    B
    The three-judge court ordered the State to achieve this
    reduction within two years. At trial and closing argument
    Cite as: 563 U. S. ____ (2011)           45
    Opinion of the Court
    before the three-judge court, the State did not argue that
    reductions should occur over a longer period of time. The
    State later submitted a plan for court approval that would
    achieve the required reduction within five years, and that
    would reduce the prison population to 151% of design
    capacity in two years. The State represented that this
    plan would “safely reach a population level of 137.5% over
    time.” App. to Juris. Statement 32a. The three-judge
    court rejected this plan because it did not comply with the
    deadline set by its order.
    The State first had notice that it would be required to
    reduce its prison population in February 2009, when the
    three-judge court gave notice of its tentative ruling after
    trial. The 2-year deadline, however, will not begin to run
    until this Court issues its judgment. When that happens,
    the State will have already had over two years to begin
    complying with the order of the three-judge court. The
    State has used the time productively. At oral argument,
    the State indicated it had reduced its prison population
    by approximately 9,000 persons since the decision of the
    three-judge court. After oral argument, the State filed a
    supplemental brief indicating that it had begun to imple
    ment measures to shift “thousands” of additional prisoners
    to county facilities. Supp. Brief for Appellants at 1.
    Particularly in light of the State’s failure to contest the
    issue at trial, the three-judge court did not err when
    it established a 2-year deadline for relief. Plaintiffs pro
    posed a 2-year deadline, and the evidence at trial was
    intended to demonstrate the feasibility of a 2-year dead
    line. See Tr. 2979. Notably, the State has not asked this
    Court to extend the 2-year deadline at this time.
    The three-judge court, however, retains the authority,
    and the responsibility, to make further amendments to the
    existing order or any modified decree it may enter as
    warranted by the exercise of its sound discretion. “The
    power of a court of equity to modify a decree of injunctive
    46                    BROWN v. PLATA
    Opinion of the Court
    relief is long-established, broad, and flexible.” New York
    State Assn. for Retarded Children, Inc. v. Carey, 
    706 F.2d 956
    , 967 (CA2 1983) (Friendly, J.). A court that invokes
    equity’s power to remedy a constitutional violation by an
    injunction mandating systemic changes to an institution
    has the continuing duty and responsibility to assess the
    efficacy and consequences of its order. 
    Id., at 969–971.
    Experience may teach the necessity for modification or
    amendment of an earlier decree. To that end, the three
    judge court must remain open to a showing or demonstra
    tion by either party that the injunction should be altered
    to ensure that the rights and interests of the parties are
    given all due and necessary protection.
    Proper respect for the State and for its governmental
    processes require that the three-judge court exercise its
    jurisdiction to accord the State considerable latitude to
    find mechanisms and make plans to correct the violations
    in a prompt and effective way consistent with public
    safety. In order to “give substantial weight to any adverse
    impact on public safety,” 
    18 U.S. C
    . §3626(a)(1)(A), the
    three-judge court must give due deference to informed
    opinions as to what public safety requires, including the
    considered determinations of state officials regarding
    the time in which a reduction in the prison population can
    be achieved consistent with public safety. An extension of
    time may allow the State to consider changing political,
    economic, and other circumstances and to take advantage
    of opportunities for more effective remedies that arise as
    the Special Master, the Receiver, the prison system, and
    the three-judge court itself evaluate the progress being
    made to correct unconstitutional conditions. At the same
    time, both the three-judge court and state officials must
    bear in mind the need for a timely and efficacious remedy
    for the ongoing violation of prisoners’ constitutional rights.
    The State may wish to move for modification of the
    three-judge court’s order to extend the deadline for the
    Cite as: 563 U. S. ____ (2011)          47
    Opinion of the Court
    required reduction to five years from the entry of the
    judgment of this Court, the deadline proposed in the
    State’s first population reduction plan. The three-judge
    court may grant such a request provided that the State
    satisfies necessary and appropriate preconditions designed
    to ensure that measures are taken to implement the plan
    without undue delay. Appropriate preconditions may
    include a requirement that the State demonstrate that it
    has the authority and the resources necessary to achieve
    the required reduction within a 5-year period and to meet
    reasonable interim directives for population reduction.
    The three-judge court may also condition an extension of
    time on the State’s ability to meet interim benchmarks for
    improvement in provision of medical and mental health
    care.
    The three-judge court, in its discretion, may also con
    sider whether it is appropriate to order the State to begin
    without delay to develop a system to identify prisoners
    who are unlikely to reoffend or who might otherwise be
    candidates for early release. Even with an extension of
    time to construct new facilities and implement other
    reforms, it may become necessary to release prisoners to
    comply with the court’s order. To do so safely, the State
    should devise systems to select those prisoners least likely
    to jeopardize public safety. An extension of time may
    provide the State a greater opportunity to refine and elab
    orate those systems.
    The State has already made significant progress toward
    reducing its prison population, including reforms that will
    result in shifting “thousands” of prisoners to county jails.
    See Supp. Brief for Appellants at 1. As the State makes
    further progress, the three-judge court should evaluate
    whether its order remains appropriate. If significant
    progress is made toward remedying the underlying consti
    tutional violations, that progress may demonstrate that
    further population reductions are not necessary or are less
    48                    BROWN v. PLATA
    Opinion of the Court
    urgent than previously believed. Were the State to make
    this showing, the three-judge court in the exercise of its
    discretion could consider whether it is appropriate to ex
    tend or modify this timeline.
    Experience with the three-judge court’s order may also
    lead the State to suggest other modifications. The three
    judge court should give any such requests serious consid
    eration. The three-judge court should also formulate its
    orders to allow the State and its officials the authority
    necessary to address contingencies that may arise during
    the remedial process.
    These observations reflect the fact that the three-judge
    court’s order, like all continuing equitable decrees, must
    remain open to appropriate modification. They are not
    intended to cast doubt on the validity of the basic premise
    of the existing order. The medical and mental health care
    provided by California’s prisons falls below the standard of
    decency that inheres in the Eighth Amendment. This
    extensive and ongoing constitutional violation requires
    a remedy, and a remedy will not be achieved without a
    reduction in overcrowding. The relief ordered by the
    three-judge court is required by the Constitution and was
    authorized by Congress in the PLRA. The State shall
    implement the order without further delay.
    The judgment of the three-judge court is affirmed.
    It is so ordered.
    Cite as: 563 U. S. ____ (2011)           49
    Opinion of the Court
    APPENDIXES
    A
    
    18 U.S. C
    . §3626:
    “(a) REQUIREMENTS FOR RELIEF.
    “(1) PROSPECTIVE RELIEF.—(A) Prospective relief in any
    civil action with respect to prison conditions shall extend
    no further than necessary to correct the violation of the
    Federal right of a particular plaintiff or plaintiffs. The
    court shall not grant or approve any prospective relief
    unless the court finds that such relief is narrowly drawn,
    extends no further than necessary to correct the violation
    of the Federal right, and is the least intrusive means
    necessary to correct the violation of the Federal right. The
    court shall give substantial weight to any adverse impact
    on public safety or the operation of a criminal justice
    system caused by the relief.
    .            .           .            .            .
    “(3) PRISONER RELEASE ORDER.—(A) In any civil action
    with respect to prison conditions, no court shall enter a
    prisoner release order unless—
    “(i) a court has previously entered an order for less
    intrusive relief that has failed to remedy the deprivation
    of the Federal right sought to be remedied through the
    prisoner release order; and
    “(ii) the defendant has had a reasonable amount of time
    to comply with the previous court orders.
    “(B) In any civil action in Federal court with respect to
    prison conditions, a prisoner release order shall be entered
    only by a three-judge court in accordance with section
    2284 of title 28, if the requirements of subparagraph (E)
    have been met.
    “(C) A party seeking a prisoner release order in Federal
    court shall file with any request for such relief, a request
    50                    BROWN v. PLATA
    Opinion of the Court
    for a three-judge court and materials sufficient to demon
    strate that the requirements of subparagraph (A) have
    been met.
    “(D) If the requirements under subparagraph (A) have
    been met, a Federal judge before whom a civil action with
    respect to prison conditions is pending who believes that a
    prison release order should be considered may sua sponte
    request the convening of a three-judge court to determine
    whether a prisoner release order should be entered.
    “(E) The three-judge court shall enter a prisoner release
    order only if the court finds by clear and convincing evi
    dence that—
    “(i) crowding is the primary cause of the violation of a
    Federal right; and
    “(ii) no other relief will remedy the violation of the Fed
    eral right.
    “(F) Any State or local official including a legislator or
    unit of government whose jurisdiction or function includes
    the appropriation of funds for the construction, operation,
    or maintenance of prison facilities, or the prosecution or
    custody of persons who may be released from, or not ad
    mitted to, a prison as a result of a prisoner release order
    shall have standing to oppose the imposition or continua
    tion in effect of such relief and to seek termination of such
    relief, and shall have the right to intervene in any pro
    ceeding relating to such relief.
    .             .            .            .            .
    (g) DEFINITIONS.—As used in this section
    .             .            .            .            .
    “(4) the term “prisoner release order” includes any order,
    including a temporary restraining order or preliminary
    injunctive relief, that has the purpose or effect of reducing
    or limiting the prison population, or that directs the re
    lease from or nonadmission of prisoners to a prison . . . .”
    Cite as: 563 U. S. ____ (2011)
    51
    Opinion of the Court
    B
    Mule Creek State Prison
    Aug. 1, 2008
    California Institution for Men
    Aug. 7, 2006
    52                       BROWN v. PLATA
    Opinion of the Court
    C
    Salinas Valley State Prison
    July 29, 2008
    Correctional Treatment Center (dry cages/holding cells for people wait
    ing for mental health crisis bed)
    Cite as: 563 U. S. ____ (2011)           1
    SCALIA, J., dissenting
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 09–1233
    _________________
    EDMUND G. BROWN, JR., GOVERNOR OF CAL-
    IFORNIA, ET AL., APPELLANTS v. MARCIANO
    PLATA ET AL.
    ON APPEAL FROM THE UNITED STATES DISTRICT COURTS
    FOR THE EASTERN DISTRICT AND THE NORTHERN
    DISTRICT OF CALIFORNIA
    [May 23, 2011]
    JUSTICE SCALIA, with whom JUSTICE THOMAS joins,
    dissenting.
    Today the Court affirms what is perhaps the most radi
    cal injunction issued by a court in our Nation’s history: an
    order requiring California to release the staggering num
    ber of 46,000 convicted criminals.
    There comes before us, now and then, a case whose
    proper outcome is so clearly indicated by tradition and
    common sense, that its decision ought to shape the law,
    rather than vice versa. One would think that, before
    allowing the decree of a federal district court to release
    46,000 convicted felons, this Court would bend every effort
    to read the law in such a way as to avoid that outrageous
    result. Today, quite to the contrary, the Court disregards
    stringently drawn provisions of the governing statute, and
    traditional constitutional limitations upon the power of a
    federal judge, in order to uphold the absurd.
    The proceedings that led to this result were a judicial
    travesty. I dissent because the institutional reform the
    District Court has undertaken violates the terms of the gov
    erning statute, ignores bedrock limitations on the power
    of Article III judges, and takes federal courts wildly
    beyond their institutional capacity.
    2                     BROWN v. PLATA
    SCALIA, J., dissenting
    I
    A
    The Prison Litigation Reform Act (PLRA) states that
    “[p]rospective relief in any civil action with respect to
    prison conditions shall extend no further than necessary
    to correct the violation of the Federal right of a particular
    plaintiff or plaintiffs”; that such relief must be “narrowly
    drawn, [and] exten[d] no further than necessary to correct
    the violation of the Federal right”; and that it must be “the
    least intrusive means necessary to correct the violation of
    the Federal right.” 
    18 U.S. C
    . §3626(a)(1)(A). In deciding
    whether these multiple limitations have been complied
    with, it is necessary to identify with precision what is the
    “violation of the Federal right of a particular plaintiff or
    plaintiffs” that has been alleged. What has been alleged
    here, and what the injunction issued by the Court is
    tailored (narrowly or not) to remedy is the running of a
    prison system with inadequate medical facilities. That
    may result in the denial of needed medical treatment to “a
    particular [prisoner] or [prisoners],” thereby violating (ac
    cording to our cases) his or their Eighth Amendment
    rights. But the mere existence of the inadequate system
    does not subject to cruel and unusual punishment the
    entire prison population in need of medical care, including
    those who receive it.
    The Court acknowledges that the plaintiffs “do not base
    their case on deficiencies in care provided on any one
    occasion”; rather, “[p]laintiffs rely on systemwide deficien
    cies in the provision of medical and mental health care
    that, taken as a whole, subject sick and mentally ill pris
    oners in California to ‘substantial risk of serious harm’
    and cause the delivery of care in the prisons to fall below
    the evolving standards of decency that mark the progress
    of a maturing society.” Ante, at 7, n. 3. But our judge
    empowering “evolving standards of decency” jurisprudence
    (with which, by the way, I heartily disagree, see, e.g.,
    Cite as: 563 U. S. ____ (2011)            3
    SCALIA, J., dissenting
    Roper v. Simmons, 
    543 U.S. 551
    , 615–616 (2005) (SCALIA,
    J., dissenting)) does not prescribe (or at least has not until
    today prescribed) rules for the “decent” running of schools,
    prisons, and other government institutions. It forbids
    “indecent” treatment of individuals—in the context of this
    case, the denial of medical care to those who need it. And
    the persons who have a constitutional claim for denial of
    medical care are those who are denied medical care—not
    all who face a “substantial risk” (whatever that is) of being
    denied medical care.
    The Coleman litigation involves “the class of seriously
    mentally ill persons in California prisons,” ante, at 8, and
    the Plata litigation involves “the class of state prisoners
    with serious medical conditions,” ante, at 9. The plaintiffs
    do not appear to claim—and it would absurd to suggest—
    that every single one of those prisoners has personally
    experienced “torture or a lingering death,” ante, at 13
    (internal quotation marks omitted), as a consequence of
    that bad medical system. Indeed, it is inconceivable that
    anything more than a small proportion of prisoners in
    the plaintiff classes have personally received sufficiently
    atrocious treatment that their Eighth Amendment right
    was violated—which, as the Court recognizes, is why the
    plaintiffs do not premise their claim on “deficiencies in
    care provided on any one occasion.” Ante, at 7, n. 3.
    Rather, the plaintiffs’ claim is that they are all part of a
    medical system so defective that some number of prisoners
    will inevitably be injured by incompetent medical care,
    and that this number is sufficiently high so as to render
    the system, as a whole, unconstitutional.
    But what procedural principle justifies certifying a class
    of plaintiffs so they may assert a claim of systemic uncon
    stitutionality? I can think of two possibilities, both of
    which are untenable. The first is that although some or
    most plaintiffs in the class do not individually have viable
    Eighth Amendment claims, the class as a whole has collec
    4                      BROWN v. PLATA
    SCALIA, J., dissenting
    tively suffered an Eighth Amendment violation. That
    theory is contrary to the bedrock rule that the sole purpose
    of classwide adjudication is to aggregate claims that are
    individually viable. “A class action, no less than tradi
    tional joinder (of which it is a species), merely enables a
    federal court to adjudicate claims of multiple parties at
    once, instead of in separate suits. And like traditional
    joinder, it leaves the parties’ legal rights and duties intact
    and the rules of decision unchanged.” Shady Grove Or
    thopedic Associates, P. A. v. Allstate Ins. Co., 559 U. S. ___,
    ___ (2010) (plurality opinion) (slip op., at 14).
    The second possibility is that every member of the plain
    tiff class has suffered an Eighth Amendment violation
    merely by virtue of being a patient in a poorly-run prison
    system, and the purpose of the class is merely to aggregate
    all those individually viable claims. This theory has the
    virtue of being consistent with procedural principles, but
    at the cost of a gross substantive departure from our case
    law. Under this theory, each and every prisoner who
    happens to be a patient in a system that has systemic
    weaknesses—such as “hir[ing] any doctor who had a li
    cense, a pulse and a pair of shoes,” ante, at 10 (internal
    quotation marks omitted)—has suffered cruel or unusual
    punishment, even if that person cannot make an individu
    alized showing of mistreatment. Such a theory of the
    Eighth Amendment is preposterous. And we have said as
    much in the past: “If . . . a healthy inmate who had suf
    fered no deprivation of needed medical treatment were
    able to claim violation of his constitutional right to medi
    cal care . . . simply on the ground that the prison medical
    facilities were inadequate, the essential distinction be
    tween judge and executive would have disappeared: it
    would have become the function of the courts to assure
    adequate medical care in prisons.” Lewis v. Casey, 
    518 U.S. 343
    , 350 (1996).
    Whether procedurally wrong or substantively wrong,
    Cite as: 563 U. S. ____ (2011)            5
    SCALIA, J., dissenting
    the notion that the plaintiff class can allege an Eighth
    Amendment violation based on “systemwide deficiencies”
    is assuredly wrong. It follows that the remedy decreed
    here is also contrary to law, since the theory of systemic
    unconstitutionality is central to the plaintiffs’ case. The
    PLRA requires plaintiffs to establish that the systemwide
    injunction entered by the District Court was “narrowly
    drawn” and “extends no further than necessary” to correct
    “the violation of the Federal right of a particular plaintiff
    or plaintiffs.” If (as is the case) the only viable constitu
    tional claims consist of individual instances of mistreat
    ment, then a remedy reforming the system as a whole goes
    far beyond what the statute allows.
    It is also worth noting the peculiarity that the vast
    majority of inmates most generously rewarded by the re
    lease order—the 46,000 whose incarceration will be ended—
    do not form part of any aggrieved class even under the
    Court’s expansive notion of constitutional violation. Most
    of them will not be prisoners with medical conditions or
    severe mental illness; and many will undoubtedly be fine
    physical specimens who have developed intimidating
    muscles pumping iron in the prison gym.
    B
    Even if I accepted the implausible premise that the
    plaintiffs have established a systemwide violation of
    the Eighth Amendment, I would dissent from the Court’s
    endorsement of a decrowding order. That order is an
    example of what has become known as a “structural in
    junction.” As I have previously explained, structural
    injunctions are radically different from the injunctions
    traditionally issued by courts of equity, and presumably
    part of “the judicial Power” conferred on federal courts by
    Article III:
    “The mandatory injunctions issued upon termination
    of litigation usually required ‘a single simple act.’ H.
    6                     BROWN v. PLATA
    SCALIA, J., dissenting
    McClintock, Principles of Equity §15, pp. 32–33 (2d
    ed. 1948). Indeed, there was a ‘historical prejudice of
    the court of chancery against rendering decrees which
    called for more than a single affirmative act.’ 
    Id., §61, at
    160. And where specific performance of contracts
    was sought, it was the categorical rule that no decree
    would issue that required ongoing supervision. . . .
    Compliance with these ‘single act’ mandates could, in
    addition to being simple, be quick; and once it was
    achieved the contemnor’s relationship with the court
    came to an end, at least insofar as the subject of the
    order was concerned. Once the document was turned
    over or the land conveyed, the litigant’s obligation to
    the court, and the court’s coercive power over the liti
    gant, ceased. . . . The court did not engage in any on
    going supervision of the litigant’s conduct, nor did its
    order continue to regulate its behavior.” Mine Work
    ers v. Bagwell, 
    512 U.S. 821
    , 841–842 (1994) (SCALIA,
    J., concurring).
    Structural injunctions depart from that historical prac
    tice, turning judges into long-term administrators of
    complex social institutions such as schools, prisons, and
    police departments. Indeed, they require judges to play a
    role essentially indistinguishable from the role ordinarily
    played by executive officials. Today’s decision not only
    affirms the structural injunction but vastly expands its
    use, by holding that an entire system is unconstitutional
    because it may produce constitutional violations.
    The drawbacks of structural injunctions have been
    described at great length elsewhere. See, e.g., 
    Lewis, supra, at 385
    –393 (1996) (THOMAS, J., concurring); Mis
    souri v. Jenkins, 
    515 U.S. 70
    , 124–133 (1995) (THOMAS,
    J., concurring); Horowitz, Decreeing Organizational
    Change: Judicial Supervision of Public Institutions, 1983
    Duke L. J. 1265. This case illustrates one of their most
    Cite as: 563 U. S. ____ (2011)            7
    SCALIA, J., dissenting
    pernicious aspects: that they force judges to engage in a
    form of factfinding-as-policymaking that is outside the
    traditional judicial role. The factfinding judges tradition
    ally engage in involves the determination of past or pre
    sent facts based (except for a limited set of materials of
    which courts may take “judicial notice”) exclusively upon
    a closed trial record. That is one reason why a district
    judge’s factual findings are entitled to plain-error review:
    because having viewed the trial first hand he is in a better
    position to evaluate the evidence than a judge reviewing a
    cold record. In a very limited category of cases, judges
    have also traditionally been called upon to make some
    predictive judgments: which custody will best serve the
    interests of the child, for example, or whether a particular
    one-shot injunction will remedy the plaintiff’s grievance.
    When a judge manages a structural injunction, however,
    he will inevitably be required to make very broad empiri
    cal predictions necessarily based in large part upon policy
    views—the sort of predictions regularly made by legis
    lators and executive officials, but inappropriate for the
    Third Branch.
    This feature of structural injunctions is superbly illus
    trated by the District Court’s proceeding concerning the
    decrowding order’s effect on public safety. The PLRA
    requires that, before granting “[p]rospective relief in [a]
    civil action with respect to prison conditions,” a court must
    “give substantial weight to any adverse impact on public
    safety or the operation of a criminal justice system caused
    by the relief.” 
    18 U.S. C
    . §3626(a)(1)(A). Here, the Dis
    trict Court discharged that requirement by making the
    “factual finding” that “the state has available methods by
    which it could readily reduce the prison population to
    137.5% design capacity or less without an adverse impact
    on public safety or the operation of the criminal justice
    system.” Juris. Statement App., O. T. 2009, No. 09-416, p.
    253a. It found the evidence “clear” that prison overcrowd
    8                      BROWN v. PLATA
    SCALIA, J., dissenting
    ing would “perpetuate a criminogenic prison system that
    itself threatens public safety,” 
    id., at 186a,
    and volun
    teered its opinion that “[t]he population could be reduced
    even further with the reform of California’s antiquated
    sentencing policies and other related changes to the laws.”
    
    Id., at 253a.
    It “reject[ed] the testimony that inmates
    released early from prison would commit additional new
    crimes,” 
    id., at 200a,
    finding that “shortening the length of
    stay through earned credits would give inmates incentives
    to participate in programming designed to lower recidi
    vism,” 
    id., at 204a,
    and that “slowing the flow of technical
    parole violators to prison, thereby substantially reducing
    the churning of parolees, would by itself improve both
    the prison and parole systems, and public safety.” 
    Id., at 209a.
    It found that “the diversion of offenders to commu
    nity correctional programs has significant beneficial ef
    fects on public safety,” 
    id., at 214a,
    and that “additional
    rehabilitative programming would result in a significant
    population reduction while improving public safety,” 
    id., at 216a.
       The District Court cast these predictions (and the Court
    today accepts them) as “factual findings,” made in reliance
    on the procession of expert witnesses that testified at trial.
    Because these “findings” have support in the record, it is
    difficult to reverse them under a plain-error standard of
    review. Ante, at 38. And given that the District Court
    devoted nearly 10 days of trial and 70 pages of its opinion
    to this issue, it is difficult to dispute that the District
    Court has discharged its statutory obligation to give “sub
    stantial weight to any adverse impact on public safety.”
    But the idea that the three District Judges in this case
    relied solely on the credibility of the testifying expert
    witnesses is fanciful. Of course they were relying largely
    on their own beliefs about penology and recidivism. And
    of course different district judges, of different policy views,
    would have “found” that rehabilitation would not work
    Cite as: 563 U. S. ____ (2011)           9
    SCALIA, J., dissenting
    and that releasing prisoners would increase the crime
    rate. I am not saying that the District Judges rendered
    their factual findings in bad faith. I am saying that it is
    impossible for judges to make “factual findings” without
    inserting their own policy judgments, when the factual
    findings are policy judgments. What occurred here is no
    more judicial factfinding in the ordinary sense than would
    be the factual findings that deficit spending will not lower
    the unemployment rate, or that the continued occupation
    of Iraq will decrease the risk of terrorism. Yet, because
    they have been branded “factual findings” entitled to
    deferential review, the policy preferences of three District
    Judges now govern the operation of California’s penal
    system.
    It is important to recognize that the dressing-up of pol
    icy judgments as factual findings is not an error pecu-
    liar to this case. It is an unavoidable concomitant of insti
    tutional-reform litigation. When a district court issues an
    injunction, it must make a factual assessment of the an
    ticipated consequences of the injunction. And when the
    injunction undertakes to restructure a social institution,
    assessing the factual consequences of the injunction is
    necessarily the sort of predictive judgment that our sys
    tem of government allocates to other government officials.
    But structural injunctions do not simply invite judges to
    indulge policy preferences. They invite judges to indulge
    incompetent policy preferences. Three years of law school
    and familiarity with pertinent Supreme Court precedents
    give no insight whatsoever into the management of social
    institutions. Thus, in the proceeding below the District
    Court determined that constitutionally adequate medical
    services could be provided if the prison population was
    137.5% of design capacity. This was an empirical finding
    it was utterly unqualified to make. Admittedly, the court
    did not generate that number entirely on its own; it heard
    the numbers 130% and 145% bandied about by various
    10                    BROWN v. PLATA
    SCALIA, J., dissenting
    witnesses and decided to split the difference. But the
    ability of judges to spit back or even average-out numbers
    spoon-fed to them by expert witnesses does not render
    them competent decisionmakers in areas in which they
    are otherwise unqualified.
    The District Court also relied heavily on the views of the
    Receiver and Special Master, and those reports play a
    starring role in the Court’s opinion today. The Court notes
    that “the Receiver and the Special Master filed reports
    stating that overcrowding posed a significant barrier to
    their efforts” and deems those reports “persuasive evi
    dence that, absent a reduction in overcrowding, any rem
    edy might prove unattainable and would at the very least
    require vast expenditures of resources by the State.” Ante,
    at 31–32. The use of these reports is even less consonant
    with the traditional judicial role than the District Court’s
    reliance on the expert testimony at trial. The latter, even
    when, as here, it is largely the expression of policy judg
    ments, is at least subject to cross-examination. Relying on
    the un-cross-examined findings of an investigator, sent
    into the field to prepare a factual report and give sugges
    tions on how to improve the prison system, bears no re
    semblance to ordinary judicial decisionmaking. It is true
    that the PLRA contemplates the appointment of Special
    Masters (although not Receivers), but Special Masters are
    authorized only to “conduct hearings and prepare pro
    posed findings of fact” and “assist in the development of
    remedial plans,” 
    18 U.S. C
    . §3626(f)(6). This does not
    authorize them to make factual findings (unconnected to
    hearings) that are given seemingly wholesale deference.
    Neither the Receiver nor the Special Master was selected
    by California to run its prisons, and the fact that they may
    be experts in the field of prison reform does not justify the
    judicial imposition of their perspectives on the state.
    Cite as: 563 U. S. ____ (2011)
    11
    SCALIA, J., dissenting
    C
    My general concerns associated with judges’ running
    social institutions are magnified when they run prison
    systems, and doubly magnified when they force prison
    officials to release convicted criminals. As we have previ
    ously recognized:
    “[C]ourts are ill equipped to deal with the increasingly
    urgent problems of prison administration and re-
    form. . . . [T]he problems of prisons in America are
    complex and intractable, and, more to the point, they
    are not readily susceptible of resolution by decree. . . .
    Running a prison is an inordinately difficult under
    taking that requires expertise, planning, and the com
    mitment of resources, all of which are peculiarly
    within the province of the legislative and executive
    branches of government. Prison is, moreover, a task
    that has been committed to the responsibility of those
    branches, and separation of powers concerns counsel a
    policy of judicial restraint. Where a state penal sys
    tem is involved, federal courts have . . . additional
    reason to accord deference to the appropriate prison
    authorities.” Turner v. Safley, 
    482 U.S. 78
    , 84–85
    (1987) (internal quotation marks omitted).
    These principles apply doubly to a prisoner-release
    order. As the author of today’s opinion explained earlier
    this Term, granting a writ of habeas corpus “ ‘disturbs the
    State’s significant interest in repose for concluded litiga
    tion, denies society the right to punish some admitted
    offenders, and intrudes on state sovereignty to a degree
    matched by few exercises of federal judicial authority.’ ”
    Harrington v. Richter, 562 U. S. ___, ___ (2011) (slip op., at
    13) (quoting Harris v. Reed, 
    489 U.S. 255
    , 282 (1989)
    (KENNEDY, J., dissenting)). Recognizing that habeas relief
    must be granted sparingly, we have reversed the Ninth
    Circuit’s erroneous grant of habeas relief to individual
    12                    BROWN v. PLATA
    SCALIA, J., dissenting
    California prisoners four times this Term alone. Cullen
    v. Pinholster, 563 U. S. ___ (2011); Felkner v. Jackson,
    562 U. S. ___ (2011) (per curiam); Swarthout v. Cooke, 562
    U. S. ___ (2011) (per curiam); 
    Harrington, supra
    . And yet
    here, the Court affirms an order granting the functional
    equivalent of 46,000 writs of habeas corpus, based on its
    paean to courts’ “substantial flexibility when making these
    judgments.” Ante, at 41. It seems that the Court’s respect
    for state sovereignty has vanished in the case where it
    most matters.
    II
    The Court’s opinion includes a bizarre coda noting
    that “[t]he State may wish to move for modification of the
    three-judge court’s order to extend the deadline for the
    required reduction to five years.” Ante, at 46–47. The Dis
    trict Court, it says, “may grant such a request provided
    that the State satisfies necessary and appropriate precon
    ditions designed to ensure the measures are taken to
    implement the plan without undue delay”; and it gives
    vague suggestions of what these preconditions “may in
    clude,” such as “interim benchmarks.” Ante, at 47. It also
    invites the District Court to “consider whether it is appro
    priate to order the State to begin without delay to develop
    a system to identify prisoners who are unlikely to reof
    fend,” and informs the State that it “should devise systems
    to select those prisoners least likely to jeopardize public
    safety.” 
    Ibid. (What a good
    idea!)
    The legal effect of this passage is unclear—I suspect
    intentionally so. If it is nothing but a polite remainder to
    the State and to the District Court that the injunction is
    subject to modification, then it is entirely unnecessary. As
    both the State and the District Court are undoubtedly
    aware, a party is always entitled to move to modify an
    equitable decree, and the PLRA contains an express provi
    sion authorizing District Courts to modify or terminate
    Cite as: 563 U. S. ____ (2011)           13
    SCALIA, J., dissenting
    prison injunctions. See 
    18 U.S. C
    . §3626(b).
    I suspect, however, that this passage is a warning shot
    across the bow, telling the District Court that it had better
    modify the injunction if the State requests what we invite
    it to request. Such a warning, if successful, would achieve
    the benefit of a marginal reduction in the inevitable mur
    ders, robberies, and rapes to be committed by the released
    inmates. But it would achieve that at the expense of in
    tellectual bankruptcy, as the Court’s “warning” is en-
    tirely alien to ordinary principles of appellate review of
    injunctions. When a party moves for modification of
    an injunction, the district court is entitled to rule on that
    motion first, subject to review for abuse of discretion if it
    declines to modify the order. Horne v. Flores, 557 U. S.
    ___, ___, ___ (2009) (slip op., at 10, 20). Moreover, when a
    district court enters a new decree with new benchmarks,
    the selection of those benchmarks is also reviewed under
    a deferential, abuse-of-discretion standard of review—a
    point the Court appears to recognize. Ante, at 45. Appel
    late courts are not supposed to “affirm” injunctions while
    preemptively noting that the State “may” request, and the
    District Court “may” grant, a request to extend the State’s
    deadline to release prisoners by three years based on some
    suggestions on what appropriate preconditions for such a
    modification “may” include.
    Of course what is really happening here is that the
    Court, overcome by common sense, disapproves of the
    results reached by the District Court, but cannot remedy
    them (it thinks) by applying ordinary standards of appel
    late review. It has therefore selected a solution unknown
    in our legal system: A deliberately ambiguous set of sug
    gestions on how to modify the injunction, just deferential
    enough so that it can say with a straight face that it is
    “affirming,” just stern enough to put the District Court on
    notice that it will likely get reversed if it does not follow
    them. In doing this, the Court has aggrandized itself,
    14                    BROWN v. PLATA
    SCALIA, J., dissenting
    grasping authority that appellate courts are not supposed
    to have, and using it to enact a compromise solution with
    no legal basis other than the Court’s say-so. That we are
    driven to engage in these extralegal activities should be a
    sign that the entire project of permitting district courts to
    run prison systems is misbegotten.
    But perhaps I am being too unkind. The Court, or at
    least a majority of the Court’s majority, must be aware
    that the judges of the District Court are likely to call its
    bluff, since they know full well it cannot possibly be an
    abuse of discretion to refuse to accept the State’s proposed
    modifications in an injunction that has just been approved
    (affirmed) in its present form. An injunction, after all,
    does not have to be perfect; only good enough for govern
    ment work, which the Court today says this is. So perhaps
    the coda is nothing more than a ceremonial washing of the
    hands—making it clear for all to see, that if the terrible
    things sure to happen as a consequence of this outrageous
    order do happen, they will be none of this Court’s respon
    sibility. After all, did we not want, and indeed even sug
    gest, something better?
    III
    In view of the incoherence of the Eighth Amendment
    claim at the core of this case, the nonjudicial features of
    institutional reform litigation that this case exemplifies,
    and the unique concerns associated with mass prisoner
    releases, I do not believe this Court can affirm this injunc
    tion. I will state my approach briefly: In my view, a court
    may not order a prisoner’s release unless it determines
    that the prisoner is suffering from a violation of his consti
    tutional rights, and that his release, and no other relief,
    will remedy that violation. Thus, if the court determines
    that a particular prisoner is being denied constitutionally
    required medical treatment, and the release of that pris
    oner (and no other remedy) would enable him to obtain
    Cite as: 563 U. S. ____ (2011)                   15
    SCALIA, J., dissenting
    medical treatment, then the court can order his release;
    but a court may not order the release of prisoners who
    have suffered no violations of their constitutional rights,
    merely to make it less likely that that will happen to them
    in the future.
    This view follows from the PLRA’s text that I discussed
    at the outset, 
    18 U.S. C
    . §3626(a)(1)(A). “[N]arrowly
    drawn” means that the relief applies only to the “particu
    lar [prisoner] or [prisoners]” whose constitutional rights
    are violated; “extends no further than necessary” means
    that prisoners whose rights are not violated will not obtain
    relief; and “least intrusive means necessary to correct the
    violation of the Federal right” means that no other relief is
    available.*
    I acknowledge that this reading of the PLRA would se
    verely limit the circumstances under which a court could
    issue structural injunctions to remedy allegedly unconsti
    tutional prison conditions, although it would not eliminate
    them entirely. If, for instance, a class representing all
    prisoners in a particular institution alleged that the tem
    perature in their cells was so cold as to violate the Eighth
    Amendment, or that they were deprived of all exercise
    time, a court could enter a prisonwide injunction ordering
    that the temperature be raised or exercise time be pro
    vided. Still, my approach may invite the objection that the
    PLRA appears to contemplate structural injunctions in
    general and mass prisoner-release orders in particular.
    The statute requires courts to “give substantial weight to
    ——————
    * Any doubt on this last score, at least as far as prisoner-release or
    ders are concerned, is eliminated by §3626(a)(3)(E) of the statute, which
    provides that to enter a prisoner-release order the court must find
    “by clear and convincing evidence that—
    (i) crowding is the primary cause of the violation of a Federal right;
    and
    (ii) no other relief will remedy the violation of the Federal right.”
    16                    BROWN v. PLATA
    SCALIA, J., dissenting
    any adverse impact on public safety or the operation of a
    criminal justice system caused by the relief” and author
    izes them to appoint Special Masters, §3626 (a)(1)(A), (f),
    provisions that seem to presuppose the possibility of a
    structural remedy. It also sets forth criteria under which
    courts may issue orders that have “the purpose or effect of
    reducing or limiting the prisoner population,” §3626(g)(4).
    I do not believe that objection carries the day. In addi
    tion to imposing numerous limitations on the ability of
    district courts to order injunctive relief with respect to
    prison conditions, the PLRA states that “[n]othing in this
    section shall be construed to . . . repeal or detract from
    otherwise applicable limitations on the remedial powers of
    the courts.” §3626(a)(1)(C). The PLRA is therefore best
    understood as an attempt to constrain the discretion of
    courts issuing structural injunctions—not as a mandate
    for their use. For the reasons I have outlined, structural
    injunctions, especially prisoner-release orders, raise grave
    separation-of-powers concerns and veer significantly from
    the historical role and institutional capability of courts. It
    is appropriate to construe the PLRA so as to constrain
    courts from entering injunctive relief that would exceed
    that role and capability.
    *     *    *
    The District Court’s order that California release 46,000
    prisoners extends “further than necessary to correct the
    violation of the Federal right of a particular plaintiff or
    plaintiffs” who have been denied needed medical care. 
    18 U.S. C
    . §3626(a)(1)(A). It is accordingly forbidden by the
    PLRA—besides defying all sound conception of the proper
    role of judges.
    Cite as: 563 U. S. ____ (2011)          1
    ALITO, J., dissenting
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 09–1233
    _________________
    EDMUND G. BROWN, JR., GOVERNOR OF CAL-
    IFORNIA, ET AL., APPELLANTS v. MARCIANO
    PLATA ET AL.
    ON APPEAL FROM THE UNITED STATES DISTRICT COURTS
    FOR THE EASTERN DISTRICT AND THE NORTHERN
    DISTRICT OF CALIFORNIA
    [May 23, 2011]
    JUSTICE ALITO, with whom THE CHIEF JUSTICE joins,
    dissenting.
    The decree in this case is a perfect example of what
    the Prison Litigation Reform Act of 1995 (PLRA), 110 Stat.
    1321–66, was enacted to prevent.
    The Constitution does not give federal judges the au
    thority to run state penal systems. Decisions regarding
    state prisons have profound public safety and financial
    implications, and the States are generally free to make
    these decisions as they choose. See Turner v. Safley, 
    482 U.S. 78
    , 85 (1987).
    The Eighth Amendment imposes an important—but
    limited—restraint on state authority in this field. The
    Eighth Amendment prohibits prison officials from de-
    priving inmates of “the minimal civilized measure of life’s
    necessities.” Rhodes v. Chapman, 
    452 U.S. 337
    , 347
    (1981). Federal courts have the responsibility to ensure
    that this constitutional standard is met, but undesirable
    prison conditions that do not violate the Constitution are
    beyond the federal courts’ reach.
    In this case, a three-judge court exceeded its authority
    under the Constitution and the PLRA. The court ordered
    a radical reduction in the California prison population
    2                     BROWN v. PLATA
    ALITO, J., dissenting
    without finding that the current population level violates
    the Constitution.
    Two cases were before the three-judge court, and neither
    targeted the general problem of overcrowding. Indeed, the
    plaintiffs in one of those cases readily acknowledge that
    the current population level is not itself unconstitutional.
    Brief for Coleman Appellees 56. Both of the cases were
    brought not on behalf of all inmates subjected to over
    crowding, but rather in the interests of much more limited
    classes of prisoners, namely, those needing mental health
    treatment and those with other serious medical needs.
    But these cases were used as a springboard to implement
    a criminal justice program far different from that chosen
    by the state legislature. Instead of crafting a remedy to
    attack the specific constitutional violations that were
    found—which related solely to prisoners in the two plain
    tiff classes—the lower court issued a decree that will at
    best provide only modest help to those prisoners but that
    is very likely to have a major and deleterious effect on
    public safety.
    The three-judge court ordered the premature release of
    approximately 46,000 criminals—the equivalent of three
    Army divisions.
    The approach taken by the three-judge court flies in the
    face of the PLRA. Contrary to the PLRA, the court’s rem
    edy is not narrowly tailored to address proven and ongoing
    constitutional violations. And the three-judge court vio
    lated the PLRA’s critical command that any court con
    templating a prisoner release order must give “substantial
    weight to any adverse impact on public safety.” 
    18 U.S. C
    . §3626(a)(1)(A). The three-judge court would have
    us believe that the early release of 46,000 inmates will not
    imperil—and will actually improve—public safety. Juris.
    Statement App., O. T. 2009, No. 09–416, pp. 248a–249a
    (hereinafter Juris. App.). Common sense and experience
    counsel greater caution.
    Cite as: 563 U. S. ____ (2011)           3
    ALITO, J., dissenting
    I would reverse the decision below for three interrelated
    reasons. First, the three-judge court improperly refused
    to consider evidence concerning present conditions in the
    California prison system. Second, the court erred in hold
    ing that no remedy short of a massive prisoner release can
    bring the California system into compliance with the
    Eighth Amendment. Third, the court gave inadequate
    weight to the impact of its decree on public safety.
    I
    Both the PLRA and general principles concerning in
    junctive relief dictate that a prisoner release order cannot
    properly be issued unless the relief is necessary to remedy
    an ongoing violation. Under the PLRA, a prisoner release
    may be decreed only if crowding “is the primary cause” of
    an Eighth Amendment violation and only if no other re
    lief “will remedy” the violation. §3626(a)(3)(E) (emphasis
    added). This language makes it clear that proof of past
    violations alone is insufficient to justify a court-ordered
    prisoner release.
    Similarly, in cases not governed by the PLRA, we have
    held that an inmate seeking an injunction to prevent a
    violation of the Eighth Amendment must show that prison
    officials are “knowingly and unreasonably disregarding an
    objectively intolerable risk of harm, and that they will
    continue to do so . . . into the future.” Farmer v. Brennan,
    
    511 U.S. 825
    , 846 (1994). The “deliberate indifference”
    needed to establish an Eighth Amendment violation must
    be examined “in light of the prison authorities’ current
    attitudes and conduct,” Helling v. McKinney, 
    509 U.S. 25
    ,
    36 (1993), which means “their attitudes and conduct at the
    time suit is brought and persisting thereafter,” 
    Farmer, supra, at 845
    .
    For these reasons, the propriety of the relief ordered
    here cannot be assessed without ascertaining the nature
    and scope of any ongoing constitutional violations. Proof
    4                         BROWN v. PLATA
    ALITO, J., dissenting
    of past violations will not do; nor is it sufficient simply
    to establish that some violations continue. The scope of
    permissible relief depends on the scope of any continuing
    violations, and therefore it was essential for the three
    judge court to make a reliable determination of the extent
    of any violations as of the time its release order was is
    sued. Particularly in light of the radical nature of its
    chosen remedy, nothing less than an up-to-date assess
    ment was tolerable.
    The three-judge court, however, relied heavily on out
    dated information and findings and refused to permit
    California to introduce new evidence. Despite evidence of
    improvement,1 the three-judge court relied on old findings
    made by the single-judge courts, see Juris. App. 76a–77a,
    including a finding made 14 years earlier, see 
    id., at 170a
    (citing Coleman v. Wilson, 
    912 F. Supp. 1282
    , 1316, 1319
    (ED Cal. 1995)). The three-judge court highlighted death
    statistics from 2005, see Juris. App. 9a, while ignoring the
    “significant and continuous decline since 2006,” California
    Prison Health Care Receivership Corp., K. Imai, Analysis
    of Year 2008 Death Reviews 31 (Dec. 2009) (hereinafter
    2008 Death Reviews). And the court dwelled on conditions
    at a facility that has since been replaced. See Juris. App.
    19a–20a, 24a, 89a–90a, 94a, 107a, 111a.
    Prohibiting the State from introducing evidence about
    conditions as of the date when the prisoner release order
    was under consideration, 
    id., at 76a–78a,
    and n. 42, the
    three-judge court explicitly stated that it would not “evalu
    ate the state’s continuing constitutional violations.” 
    Id., at ——————
       1 Before requesting the appointment of a three-judge court, the Dis
    trict Court in Coleman recognized “commendable progress” in the
    State’s effort to provide adequate mental health care, Juris. App. 294a,
    and the District Court in Plata acknowledged that “the Receiver has
    made much progress since his appointment,” 
    id., at 280a.
    The report of
    the Special Master to which the Court refers, ante, at 18–19, identifies
    a “generally positive trend.” App. 803.
    Cite as: 563 U. S. ____ (2011)                     5
    ALITO, J., dissenting
    77a. Instead, it based its remedy on constitutional defi
    ciencies that, in its own words, were found “years ago.”
    Ibid.2
    The three-judge court justified its refusal to receive up
    to-date evidence on the ground that the State had not filed
    a motion to terminate prospective relief under a provision
    of the PLRA, §3626(b). See Juris. App. 77a. Today’s
    opinion for this Court endorses that reasoning, ante, at 26.
    But the State’s opportunity to file such a motion did not
    eliminate the three-judge court’s obligation to ensure that
    its relief was necessary to remedy ongoing violations.3
    Moreover, the lower court’s reasoning did not properly
    take into account the potential significance of the evidence
    that the State sought to introduce. Even if that evidence
    did not show that all violations had ceased—the showing
    needed to obtain the termination of relief under
    §3626(b)—that evidence was highly relevant with respect
    to the nature and scope of permissible relief.4
    ——————
    2 For   this reason, it is simply not the case that “evidence of current
    conditions . . . informed every aspect of the judgment of the three-judge
    court,” as the majority insists, ante, at 25.
    3 Because the Ninth Circuit places the burden on the State to prove
    the absence of an ongoing violation when it moves to terminate pro
    spective relief, see Gilmore v. California, 
    220 F.3d 987
    , 1007 (CA9
    2000), even if the State had unsuccessfully moved to terminate pro
    spective relief under 
    18 U.S. C
    . §3626(b), there would still have been no
    determination that plaintiffs had carried their burden under the PLRA
    to establish by clear and convincing evidence that a prisoner release
    order is necessary to correct an ongoing rights violation.
    4 It is also no answer to say, as the Court now does, ante, at 26, that
    the State had the opportunity to resist the convening of the three-judge
    court on the ground that there were no unremedied constitutional
    violations as of that date. See §3626(a)(3)(A)(i). The District Courts
    granted plaintiffs’ motions to convene a three-judge court in 2007, three
    years before the remedial decree here was issued. Thus, the conditions
    in the prison system as of the date when the decree was issued were not
    necessarily the same as those that existed before the three-judge court
    proceedings began. Moreover, as noted above, even if all of the viola
    tions in the system had not been cured at the time of the remedial
    6                          BROWN v. PLATA
    ALITO, J., dissenting
    The majority approves the three-judge court’s refusal to
    receive fresh evidence based largely on the need for “[o]r
    derly trial management.” Ante, at 26. The majority rea
    sons that the three-judge court had closed the book on the
    question of constitutional violations and had turned to
    the question of remedy. 
    Ibid. As noted, however,
    the ex-
    tent of any continuing constitutional violations was highly
    relevant to the question of remedy.
    The majority also countenances the three-judge court’s
    reliance on dated findings. The majority notes that the
    lower court considered recent reports by the Special Mas
    ter and Receiver, ante, at 18–19, but the majority provides
    no persuasive justification for the lower court’s refusal to
    receive hard, up-to-date evidence about any continuing
    violations. With the safety of the people of California in
    the balance, the record on this issue should not have been
    closed.
    The majority repeats the lower court’s error of reciting
    statistics that are clearly out of date. The Court notes
    the lower court’s finding that as of 2005 “an inmate in one
    of California’s prisons needlessly dies every six to seven
    days.” See ante, at 9. Yet by the date of the trial before
    the three-judge court, the death rate had been trending
    downward for 10 quarters, App. 2257, and the number of
    likely preventable deaths fell from 18 in 2006 to 3 in 2007,
    a decline of 83 percent.5 Between 2001 and 2007, the
    ——————
    decree, an accurate assessment of conditions as of that date was essen
    tial in order to ensure that the relief did not sweep more broadly than
    necessary.
    5 2008 Death Reviews 22. The majority elides the improvement by
    combining likely preventable deaths with those that were “possibly
    preventable,” ante, at 7, n. 4, that is, cases in which “[i]n the judgment
    of the reviewer,” 2008 Death Reviews 3, “it’s fifty-fifty that better care
    would have possibly prevented the death,” App. 2277; 
    id., at 2256.
    As
    the majority acknowledges, even this class of cases is now dramatically
    diminished, and the three-judge court must take the current conditions
    into account when revising its remedy going forward. Ante, at 7, n. 4.
    Cite as: 563 U. S. ____ (2011)                   7
    ALITO, J., dissenting
    California prison system had the 13th lowest average
    mortality rate of all 50 state systems.6
    The majority highlights past instances in which particu
    lar prisoners received shockingly deficient medical care.
    See ante, at 5, 6–7, 10 (recounting five incidents). But
    such anecdotal evidence cannot be given undue weight in
    assessing the current state of the California system. The
    population of the California prison system (156,000 in
    mates at the time of trial) is larger than that of many
    medium-sized cities,7 and an examination of the medical
    care provided to the residents of many such cities would
    likely reveal cases in which grossly deficient treatment
    was provided. Instances of past mistreatment in the
    California system are relevant, but prospective relief must
    be tailored to present and future, not past, conditions.
    II
    Under the PLRA, a court may not grant any prospective
    relief unless the court finds that the relief is narrowly
    drawn, extends no further than necessary to correct the
    “violation of [a] Federal right, and is the least intrusive
    means necessary to correct the violation of the Federal
    right.” §3626(a)(1)(A). In addition, the PLRA prohibits
    the issuance of a prisoner release order unless the court
    ——————
    6 Bureau of Justice Statistics, State Prison Deaths, 2001–2007, avail
    able at http://bjs.ojp.usdoj.gov/index.cfm?ty=pbdetail&iid=2093 (Table
    13) (all Internet materials as visited May 20, 2011, and available in
    Clerk of Court’s case file); see also App. 2257–2258. California had the
    14th lowest “ ‘average annual illness mortality [rate] per 100,000 state
    prisoners from 2001 to 2004.’ ” Juris. App. 125a. According to a 2007
    report, state prisoners had a 19 percent lower death rate than the
    general U. S. adult population as of 2004. Bureau of Justice Statistics,
    Medical Causes of Death in State Prisons, 2001–2004, p. 1, available at
    http://bjs.ojp.usdoj.gov/content/pub/pdf/mcdsp04.pdf.
    7 For example, the population of the California prison system ex-
    ceeds that of Syracuse, New York; Bridgeport, Connecticut; Springfield,
    Massachusetts; Eugene, Oregon; and Savannah, Georgia.
    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
    Cite as: 563 U. S. ____ (2011)           9
    ALITO, J., dissenting
    beds for mentally ill prisoners, and an outmoded records
    management system).
    Is it plausible that none of these deficiencies can be
    remedied without releasing 46,000 prisoners? Without
    taking that radical and dangerous step, exam tables and
    counter tops cannot properly be disinfected? None of the
    system’s dilapidated facilities can be repaired? Needed
    medications and equipment cannot be purchased and
    used? Staff vacancies cannot be filled? The qualifica
    tions of prison physicians cannot be improved? A better
    records management system cannot be developed and
    implemented?
    I do not dispute that general overcrowding contributes to
    many of the California system’s healthcare problems. But
    it by no means follows that reducing overcrowding is the
    only or the best or even a particularly good way to allevi
    ate those problems. Indeed, it is apparent that the pris
    oner release ordered by the court below is poorly suited for
    this purpose. The release order is not limited to prisoners
    needing substantial medical care but instead calls for a
    reduction in the system’s overall population. Under the
    order issued by the court below, it is not necessary for
    a single prisoner in the plaintiff classes to be released.
    Although some class members will presumably be among
    those who are discharged, the decrease in the number of
    prisoners needing mental health treatment or other forms
    of extensive medical care will be much smaller than the
    total number of prisoners released, and thus the release
    will produce at best only a modest improvement in the
    burden on the medical care system.
    The record bears this out. The Special Master stated
    dramatically that even releasing 100,000 inmates (two
    thirds of the California system’s entire inmate popula
    tion!) would leave the problem of providing mental health
    treatment “largely unmitigated.” App. 487. Similarly, the
    Receiver proclaimed that “ ‘those . . . who think that popu
    10                    BROWN v. PLATA
    ALITO, J., dissenting
    lation controls will solve California’s prison health care
    problems . . . are simply wrong.’ ” Juris. App. 282a.
    The State proposed several remedies other than a mas
    sive release of prisoners, but the three-judge court, seem
    ingly intent on attacking the broader problem of general
    overcrowding, rejected all of the State’s proposals. In
    doing so, the court made three critical errors.
    First, the court did not assess those proposals and other
    remedies in light of conditions proved to exist at the time
    the release order was framed. Had more recent evidence
    been taken into account, a less extreme remedy might
    have been shown to be sufficient.
    Second, the court failed to distinguish between condi
    tions that fall below the level that may be desirable as a
    matter of public policy and conditions that do not meet the
    minimum level mandated by the Constitution. To take
    one example, the court criticized the California system
    because prison doctors must conduct intake exams in
    areas separated by folding screens rather than in separate
    rooms, creating conditions that “do not allow for appropri
    ate confidentiality.” 
    Id., at 88a.
    But the legitimate pri
    vacy expectations of inmates are greatly diminished, see
    Hudson v. Palmer, 
    468 U.S. 517
    , 525–526 (1984), and this
    Court has never suggested that the failure to provide
    private consultation rooms in prisons amounts to cruel
    and unusual punishment.
    Third, the court rejected alternatives that would not
    have provided “ ‘immediate’ ” relief. Juris. App. 148a. But
    nothing in the PLRA suggests that public safety may be
    sacrificed in order to implement an immediate remedy
    rather than a less dangerous one that requires a more
    extended but reasonable period of time.
    If the three-judge court had not made these errors, it is
    entirely possible that an adequate but less drastic reme
    dial plan could have been crafted. Without up-to-date
    information, it is not possible to specify what such a plan
    Cite as: 563 U. S. ____ (2011)          11
    ALITO, J., dissenting
    might provide, and in any event, that is not a task that
    should be undertaken in the first instance by this Court.
    But possible components of such a plan are not hard to
    identify.
    Many of the problems noted above plainly could be
    addressed without releasing prisoners and without in
    curring the costs associated with a large-scale prison
    construction program. Sanitary procedures could be im
    proved; sufficient supplies of medicine and medical
    equipment could be purchased; an adequate system of
    records management could be implemented; and the num
    ber of medical and other staff positions could be increased.
    Similarly, it is hard to believe that staffing vacancies
    cannot be reduced or eliminated and that the qualifica
    tions of medical personnel cannot be improved by any
    means short of a massive prisoner release. Without spe
    cific findings backed by hard evidence, this Court should
    not accept the counterintuitive proposition that these
    problems cannot be ameliorated by increasing salaries,
    improving working conditions, and providing better train
    ing and monitoring of performance.
    While the cost of a large-scale construction program
    may well exceed California’s current financial capabilities,
    a more targeted program, involving the repair and per
    haps the expansion of current medical facilities (as op
    posed to general prison facilities), might be manageable.
    After all, any remedy in this case, including the new pro
    grams associated with the prisoner release order and
    other proposed relief now before the three-judge court, will
    necessarily involve some state expenditures.
    Measures such as these might be combined with tar
    geted reductions in critical components of the State’s
    prison population. A certain number of prisoners in the
    classes on whose behalf the two cases were brought might
    be transferred to out-of-state facilities. The three-judge
    court rejected the State’s proposal to transfer prisoners to
    12                          BROWN v. PLATA
    ALITO, J., dissenting
    out-of-state facilities in part because the number of pro
    posed transfers was too small. See 
    id., at 160a.
    See also
    ante, at 30. But this reasoning rested on the court’s insis
    tence on a reduction in the State’s general prison popula
    tion rather than the two plaintiff classes.
    When the State proposed to make a targeted transfer of
    prisoners in one of the plaintiff classes (i.e., prisoners
    needing mental health treatment), one of the District
    Judges blocked the transfers for fear that the out-of-state
    facilities would not provide a sufficiently high level of care.
    See App. 434–440. The District Judge even refused to
    allow out-of-state transfers for prisoners who volunteered
    for relocation. See 
    id., at 437.
    And the court did this even
    though there was not even an allegation, let alone clear
    evidence, that the States to which these prisoners would
    have been sent were violating the Eighth Amendment.
    The District Judge presumed that the receiving States
    might fail to provide constitutionally adequate care, but
    “ ‘in the absence of clear evidence to the contrary, courts
    presume that [public officers] have properly discharged
    their official duties.’ ” United States v. Armstrong, 
    517 U.S. 456
    , 464 (1996) (quoting United States v. Chemical
    Foundation, Inc., 
    272 U.S. 1
    , 14–15 (1926)); Postal Service
    v. Gregory, 
    534 U.S. 1
    , 10 (2001) (“[A] presumption of
    regularity attaches to the actions of Government agen
    cies”); see also McKune v. Lile, 
    536 U.S. 24
    , 51 (2002)
    (O’Connor, J., concurring in judgment) (“[W]e may assume
    that the prison is capable of controlling its inmates so that
    respondent’s personal safety is not jeopardized . . . ,at least
    in the absence of proof to the contrary”).8
    Finally, as a last resort, a much smaller release of pris
    ——————
    8 The Court rejects the State’s argument that out-of-state transfers offer
    a less restrictive alternative to a prisoner release order because “requir
    ing out-of-state transfers itself qualifies as a population limit under the
    PLRA.” Ante, at 29–30. But the PLRA does not apply when the State
    voluntarily conducts such transfers, as it has sought to do.
    Cite as: 563 U. S. ____ (2011)           13
    ALITO, J., dissenting
    oners in the two plaintiff classes could be considered.
    Plaintiffs proposed not only a systemwide population cap,
    but also a lower population cap for inmates in specialized
    programs. Tr. 2915:12–15 (Feb. 3, 2009). The three-judge
    court rejected this proposal, and its response exemplified
    what went wrong in this case. One judge complained that
    this remedy would be deficient because it would protect
    only the members of the plaintiff classes. The judge
    stated:
    “The only thing is we would be protecting the class
    members. And maybe that’s the appropriate thing to
    do. I mean, that’s what this case is about, but it
    would be . . . difficult for me to say yes, and the hell
    with everybody else.” 
    Id., at 2915:23–2916:2.
    Overstepping his authority, the judge was not content to
    provide relief for the classes of plaintiffs on whose behalf
    the suit before him was brought. Nor was he content to
    remedy the only constitutional violations that were
    proved—which concerned the treatment of the members of
    those classes. Instead, the judge saw it as his responsibil
    ity to attack the general problem of overcrowding.
    III
    Before ordering any prisoner release, the PLRA com
    mands a court to “give substantial weight to any adverse
    impact on public safety or the operation of a criminal
    justice system caused by the relief.” §3626(a)(1)(A). This
    provision unmistakably reflects Congress’ view that pris
    oner release orders are inherently risky.
    In taking this view, Congress was well aware of the
    impact of previous prisoner release orders. The prisoner
    release program carried out a few years earlier in Phila
    delphia is illustrative. In the early 1990’s, federal courts
    enforced a cap on the number of inmates in the Philadel
    phia prison system, and thousands of inmates were set
    14                         BROWN v. PLATA
    ALITO, J., dissenting
    free. Although efforts were made to release only those
    prisoners who were least likely to commit violent crimes,
    that attempt was spectacularly unsuccessful. During an
    18-month period, the Philadelphia police rearrested thou
    sands of these prisoners for committing 9,732 new crimes.
    Those defendants were charged with 79 murders, 90
    rapes, 1,113 assaults, 959 robberies, 701 burglaries, and
    2,748 thefts, not to mention thousands of drug offenses.9
    Members of Congress were well aware of this experience.10
    Despite the record of past prisoner release orders, the
    three-judge court in this case concluded that loosing
    46,000 criminals would not produce a tally like that in
    Philadelphia and would actually improve public safety.
    Juris. App. 248a–249a. In reaching this debatable con
    clusion, the three-judge court relied on the testimony of
    selected experts, 
    id., at 248a,
    and the majority now defers
    to what it characterizes as the lower court’s findings of
    fact on this controversial public policy issue, ante, at 15,
    19–20, 24.
    This is a fundamental and dangerous error. When a
    ——————
    9 Hearing   on Prison Reform before the Senate Committee on the Ju
    diciary, 104th Cong., 1st Sess., 49 (1995) (statement of Lynne Abraham,
    District Attorney of Philadelphia); Hearings before the Subcommittee
    on Crime of the House Committee on the Judiciary, 104th Cong., 1st
    Sess., 259 (1995) (same); see also Hearing before the Subcommittee on
    Crime, Terrorism, and Homeland Security of the House Committee on
    the Judiciary, 110th Cong., 2d Sess., 31 (2008) (statement of Sarah V.
    Hart, Assistant District Attorney, Philadelphia District Attorney’s
    Office).
    10 Condemning the inappropriate imposition of prison population
    caps, Senator Sarbanes cited “the case of Philadelphia, where a court
    ordered prison cap has put thousands of violent criminals back on
    the city’s streets, often with disastrous consequences.” 141 Cong. Rec.
    26549 (1995). Senator Abraham complained that “American citizens
    are put at risk every day by court decrees . . . that cure prison crowding
    by declaring that we must free dangerous criminals before they have
    served their time.” 
    Id., at 26448.
    “The most egregious example,” he
    added, “is the city of Philadelphia.” 
    Ibid. Cite as: 563
    U. S. ____ (2011)                   15
    ALITO, J., dissenting
    trial court selects between the competing views of experts
    on broad empirical questions such as the efficacy of
    preventing crime through the incapacitation of convicted
    criminals, the trial court’s choice is very different from a
    classic finding of fact and is not entitled to the same de
    gree of deference on appeal.
    The particular three-judge court convened in this case
    was “confident” that releasing 46,000 prisoners pursuant
    to its plan “would in fact benefit public safety.” Juris.
    App. 248a–249a. According to that court, “overwhelming
    evidence” supported this purported finding. 
    Id., at 232a.
    But a more cautious court, less bent on implementing its
    own criminal justice agenda, would have at least acknowl
    edged that the consequences of this massive prisoner
    release cannot be ascertained in advance with any degree
    of certainty and that it is entirely possible that this re
    lease will produce results similar to those under prior
    court-ordered population caps. After all, the sharp in
    crease in the California prison population that the three
    judge court lamented, see 
    id., at 254a,
    has been accompa
    nied by an equally sharp decrease in violent crime.11
    These California trends mirror similar developments at
    the national level,12 and “[t]here is a general consensus
    that the decline in crime is, at least in part, due to more
    and longer prison sentences.”13 If increased incarceration
    ——————
    11 From 1992 to 2009, the violent crime rate in California per 100,000
    residents fell from 1,119.7 to 472.0—a decrease of 57.8 percent. Simi
    larly, in the United States from 1992 to 2009, the violent crime rate per
    100,000 residents fell from 757.7 to 429.4—a decrease of 43.3 percent.
    Dept. of Justice, Federal Bureau of Investigation, Uniform Crime
    Reporting Statistics, http://www.ucrdatatool.gov.
    12 According to the three-judge court, California’s prison population
    has increased by 750 percent since the mid-1970’s. Juris. App. 254a.
    From 1970 to 2005, the Nation’s prison population increased by 700
    percent. Public Safety, Public Spending: Forecasting America’s Prison
    Population 2007–2011, 19 Fed. Sent. Rep. 234, 234 (2007).
    13 Paternoster, How Much Do We Really Know About Criminal Deter
    16                       BROWN v. PLATA
    ALITO, J., dissenting
    in California has led to decreased crime, it is entirely
    possible that a decrease in imprisonment will have the
    opposite effect.
    Commenting on the testimony of an expert who stated
    that he could not be certain about the effect of the massive
    prisoner discharge on public safety, the three-judge court
    complained that “[s]uch equivocal testimony is not help
    ful.” 
    Id., at 247a.
    But testimony pointing out the diffi
    culty of assessing the consequences of this drastic remedy
    would have been valued by a careful court duly mindful of
    the overriding need to guard public safety.
    The three-judge court acknowledged that it “ha[d] not
    evaluated the public safety impact of each individual
    element” of the population reduction plan it ordered the
    State to implement. App. to Juris. Statement 3a. The
    majority argues that the three-judge court nevertheless
    gave substantial weight to public safety because its order
    left “details of implementation to the State’s discretion.”
    Ante, at 41. Yet the State had told the three-judge court
    that, after studying possible population reduction meas
    ures, it concluded that “reducing the prison population to
    137.5% within a two-year period cannot be accomplished
    without unacceptably compromising public safety.” Juris.
    App. 317a. The State found that public safety required a
    5-year period in which to achieve the ordered reduction.
    
    Ibid. Thus, the three-judge
    court approved a population
    reduction plan that neither it nor the State found could be
    implemented without unacceptable harm to public safety.
    And this Court now holds that the three-judge court dis
    charged its obligation to “give substantial weight to any
    adverse impact on public safety,” §3626(a)(1)(A), by defer
    ring to officials who did not believe the reduction could be
    ——————
    rence? 100 J. Crim. L. & Criminology 765, 801 (2010) (citing research
    on this issue).
    Cite as: 563 U. S. ____ (2011)           17
    ALITO, J., dissenting
    accomplished in a safe manner. I do not believe the
    PLRA’s public-safety requirement is so trivial.
    The members of the three-judge court and the experts
    on whom they relied may disagree with key elements of
    the crime-reduction program that the State of California
    has pursued for the past few decades, including “the shift
    to inflexible determinate sentencing and the passage of
    harsh mandatory minimum and three-strikes laws.” 
    Id., at 254a.
    And experts such as the Receiver are entitled to
    take the view that the State should “re-thin[k] the place of
    incarceration in its criminal justice system,” App. 489. But
    those controversial opinions on matters of criminal justice
    policy should not be permitted to override the reasonable
    policy view that is implicit in the PLRA—that prisoner
    release orders present an inherent risk to the safety of the
    public.
    *      *    *
    The prisoner release ordered in this case is unprece
    dented, improvident, and contrary to the PLRA. In largely
    sustaining the decision below, the majority is gambling
    with the safety of the people of California. Before putting
    public safety at risk, every reasonable precaution should
    be taken. The decision below should be reversed, and the
    case should be remanded for this to be done.
    I fear that today’s decision, like prior prisoner release
    orders, will lead to a grim roster of victims. I hope that
    I am wrong.
    In a few years, we will see.