On June 30, U.S. District Judge Roslyn Silver determined that health care in Arizona prisons is “grossly inadequate” and “unconstitutional”.
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According to the the ACLUthe judge’s ruling found that the Arizona Department of Corrections, Rehabilitation and Rehabilitation (ADCRR) “systematically violates the constitutional rights of those incarcerated in state prisons by failing to provide them with the medical care and mental health and subjecting them to harsh and degrading conditions in segregation units”.
The lawsuit was originally filed in 2012 by the ACLU’s National Prison Project, the ACLU of Arizona, the Prison Law Office, the Arizona Center for Disability Law and Perkins Coie LLP.
Corene Kendrick, deputy director of the ACLU’s National Prison Project, underscored the significance of this federal court decision.
“It really reiterates that people who are incarcerated have a right to basic and adequate health care under the 8th Amendment, and that a prison sentence should never become a death sentence for people who have medical conditions. or treatable mental health,” she said. “And that is also a justification. These types of orders are not made very frequently by federal courts, which also makes this a landmark decision. »
Although the case was settled in 2014, with prison officials promising to improve health care conditions, Kendrick said the state and his attorneys instead fought tooth and nail against the plaintiffs and tried to revive all aspects of the case.
“What we’ve been through for 7 years is complete denial that these issues even exist, which has made it difficult to address them,” she said.
Critics of Arizona prison health care largely attribute its inadequacy to the privatization of the correctional health system. Under this privatized system, companies receive a flat per diem per inmate, which started at $12 per day per inmate, but has now increased significantly.
“What a court-appointed independent expert said is that when you have this perverse funding system, it creates an incentive not to provide care and not to fully staff health care positions, because basically , every unspent dollar is kept as profit,” Kendrick said. “The for-profit correctional provider is not only reimbursed for actual expenses.”
According to the judge’s conclusions and the medical expert report, much of the medical care provided in prisons is provided by nurses who often work outside their scope of practice. The limited number of higher-level medical and mental health providers leads to long delays in accessing care for inmates, often to the point that treatable conditions worsen significantly.
“One of the things that Judge Silva talks about is the fact that there are so few doctors for the entire prison system in the state that they really need to have more health care personnel and more of health personnel who [are] skilled nurses rather than demanding nurses,” Kendrick said. “These nurses are often very hard-working and very well-meaning, and they have a ridiculous number of patients they try to see.
But what is expected of them is really [practice] outside the scope of their licenses. Over the years, many healthcare staff have quit and said the reason they quit was because they were afraid of questioning their nursing license. And if they are asked to jeopardize their nursing license, they have an ethical duty not to find themselves in that situation. So, unfortunately, it kind of creates this vicious circle where they’re asked to do things that they’re not qualified to do, but if they give up, there’s even fewer people to do it.
The ACLU of Arizona asked the court to appoint a receiver to the corrections department to report directly to the federal judge, as well as strike down state law that privatized the prison health care system.
“They have to get rid of privatization because of the perverse funding structure associated with it,” Kendrick said. “They need to have leadership in the department that recognizes there is a problem and is committed to solving it rather than spending millions of taxpayer dollars on lawyers fighting us in district court at every turn.”
Kendrick added that members of the Arizona legislature have also been widely critical of the ACDRR health system.
The judge asked the ACLU to submit the names of neutral experts it can consult to draft a final order to be directed to prison officials on how to overhaul their health care and isolation units.