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Trial begins over health care for 27K Arizona prisoners

A trial is now underway after a lawsuit was filed challenging the quality of health care for more than 27,000 people incarcerated in Arizona’s prisons.

The trial comes after a 6-year-old settlement resolving the case was thrown out by a judge who concluded the state showed little interest in making many of the improvements it promised under the deal.

The decision in mid-July came after the state had already been hit with a total of $2.5 million in contempt of court fines for noncompliance. Judge Roslyn Silver had concluded the fines weren’t motivating Arizona to comply, faulted the state for making erroneous excuses and baseless legal arguments and said the failure to provide adequate care for prisoners led to suffering and preventable deaths.

Lawyers for the prisoners are asking the judge to take over health care operations in state-run prisons, appoint an official to run medical and mental health services there, ensure prisons have enough health care workers and reduce the use of isolation cells, including banning their use for prisoners under age 18 or those with serious mental illnesses.

In court papers this week, the attorneys said Arizona’s prison health care operations are understaffed and poorly supervised, routinely deny access to some necessary medications, fail to provide adequate pain management for end-stage cancer patients and others, and don’t meet the minimum standards for mental health care.

"So much of the death and suffering that our experts found was completely preventable," said Corene Kendrick, one of the attorneys for the prisoners. "And if there had been interventions earlier, we wouldn’t have people suffering permanent injury and death — including death by suicide and death by medical conditions that were ignored for all too long. But by the time the person got the care or treatment they needed, it was too late. It’s an all too common story."

The Arizona Department of Corrections, Rehabilitation and Reentry declined a request to comment on the trial.

In court records, the agency has denied allegations that it was providing inadequate care, delayed or issued outright denials of care and failed to give necessary medications.

The case will be decided by Silver, not a jury.

MORE: As Arizona’s prison population ages, taxpayers shoulder the burden of inmate healthcare

When questioned in the past about the court’s actions against the state for noncompliance in the case, Gov. Doug Ducey has said he wants state agency directors — not judges — running state agencies.

A court-appointed expert has concluded that understaffing, inadequate funding and privatization of health care services are significant barriers in improving health care in Arizona’s prisons.

The case was settled in 2014 just days before it was headed to trial. Another settlement isn’t expected.

The lawsuit alleges the state didn’t meet the basic requirements for providing adequate medical and mental health care for prisoners. Some prisoners complained that their cancer went undetected or that they were told to pray to be cured after begging for treatment, the lawsuit said. It also said the failure of the medical staff at one prison to diagnose a prisoner’s metastasized cancer resulted in his liver enlarging so much that his stomach swelled to the size of a pregnant woman at full term. Another prisoner who had a history of prostate cancer had to wait more than two years for a biopsy.

The case challenges health care in state-run prisons, not in the private prisons where the state houses 7,500 other people.

In the nine years since it was filed, the lawsuit has cost the state $20 million, including $10 million for attorneys defending prison officials and $8.1 million for lawyers who pressed the case on behalf of prisoners, according to records.

Inmates share their experience in court

The trial started with testimony from Kendall Johnson, an inmate at Perryville prison. She said Centurion, the health contractor with the state prisons, took too long to diagnose her multiple sclerosis.

She is now in a special needs unit, confined to a wheelchair and cannot feed herself. She alleges prison staff neglected her.

"Prisoners are in a really interesting position when it comes to healthcare. On one hand, they’re actually the only Americans constitutionally guaranteed the right to healthcare," said Beth Schwartzapfel, a staff writer at the Marshall Project, a journalism nonprofit covering criminal justice issues.

"I’m sure they would tell you they’d really like to see the judge place the state’s prison healthcare into a receivership. Basically, take it out of the hands of state officials because attorneys will say state officials have proven they cannot handle this task," Schwartzapfel said.

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