More than five years after a federal judge put the Maricopa County jails operated by Sheriff Joe Arpaio under court order for neglect and abuse of detainees, that same judge, Neil Wake, has ruled that the jails remain under the order. Judge Wake found that the jails continue to provide detainees with unconstitutional and dangerously deficient medical and mental health care, neglecting serious medical conditions and mental illnesses. The American Civil Liberties Union and the ACLU of Arizona – which have represented the detainees for close to 20 years – showed during a trial that concluded in March that the scarcity and poor quality of the jails' medical and mental health care caused extreme suffering and death.

In October 2008, a federal court ruled that unconstitutional and life-threatening conditions in the jails necessitate federal court oversight to ensure that Sheriff Joe Arpaio and other county officials maintain safe and humane conditions and provide the thousands of detainees held there basic levels of medical and mental health care. And in 2010, a federal appeals court ruled that Arpaio and county officials are required to abide by a federal district court order mandating that they fix unconstitutional conditions in the jails that jeopardize the health and safety of prisoners.

Despite this victory, the thousands of men and women who are booked into MSCO jails each year remain at risk. In 2011, Ernesto "Marty" Atencio died after being severely beaten and Tased by deputies shortly after he was booked into the 4th Avenue Jail in downtown Phoenix. Atencio's death is one in a string of highly publicized fatalities at Maricopa County jails during Sheriff Arpaio's tenure. To date, the county has paid out tens of millions to settle wrongful injury and death lawsuits brought on behalf of Maricopa County inmates and their families.

In August 2013, the Maricopa County jails filed a motion to terminate the 2008 federal court order, arguing that the medical and mental health care for pre-trial detainees in its jails had improved sufficiently. In November 2013, the ACLU challenged that petition with a statement of facts showing systemic problems with the jails' medical and mental health systems. These deficiencies have caused detainees' medical conditions and mental illnesses to worsen unnecessarily, causing extreme suffering and even death. Today's ruling, which denies defendants' motion to terminate the 2008 federal court order, means that those in charge of Maricopa County's jails can no longer skirt their constitutional responsibility for detainees' health.

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