Deprivatization — not continual fines — is the solution to health care incompetency in Arizona prisons

In 2018, Arizona’s private prison health care contractor Centurion received $1.4 million in additional funding from the state to improve inmate health care. By 2020, that number had risen to $30 million. Yet just last week, the Arizona Department of Corrections (ADC) was fined — for the second time in three years — for refusing to comply with agreed-upon standards of health care for its inmates.

 

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In last week’s decision, U.S. District Court Judge Roslyn Silver fined ADC $1.1 million, finding the state guilty of noncompliance with performance measures including neglecting to promptly notify inmates of their medical results, providing them with needed medications and other violations.

Arizona faced a similar charge in 2018, when it was fined $1.4 million after hearings showed a failure to improve prison health care. In this instance, prisoners reported nurses withholding medicine from inmates, prison guards sleeping on the job and inmates with cancer being left untreated.

These charges stem from a 2012 class action lawsuit brought against ADC by the American Civil Liberties Union, filing suit on behalf of a group of Arizona prison inmates. In Parsons v. Ryan, the plaintiffs alleged that state prisons failed to deliver adequate medical care, dental care, mental health care and more to its inmate population. The two parties eventually reached a deal in 2015 in which ADC — while nonetheless claiming its innocence of the plaintiffs’ claims — agreed to increase its funding for prison health initiatives and comply with multiple standards of care for inmates.

Reports have shown the devastating impact COVID-19 has had on prisoners, who live in a confined space and often lack adequate preventive care. However, according to Rebecca Fealk, policy program coordinator for the American Friends Service Committee of Arizona (AFSC-AZ), the issue of low quality health care in Arizona prisons started long before the arrival of COVID-19. The foundation of this issue is Arizona’s shift from a public to a private prison system, she said.

Per their 2013 report on Arizona’s correctional health care system, AFSC-AZ says the ongoing transfer of power over Arizona prisons between contracted prison health care companies has perpetuated this issue. Following the removal of a statute provision that restricted over-priced privatization of state services like the prison system in 2011, correctional health care company Wexford assumed control of the state’s prison systems. Wexford was replaced with Corizon in 2013, and Centurion replaced Corizon in 2018.

According to Fealk, Wexford’s departure offered an opportunity for the state to address the ineffectiveness of its privatized system. Instead, Arizona chose to replace one private contractor with another.

“As opposed to Wexford being held accountable, they just shifted to a different provider, completely ignoring that Corizon had the same history.”

Fealk said the decision to privatize Arizona’s prison system was detrimental to the health of inmates because, through a privatized system, health care costs are an additional expense for private contractors. These companies have the ability to increasingly augment their budget while refusing to act in the best interest of prisoners by spending money on additional health services.

“They’re fine with paying fines and fees because that doesn’t mess with their profit margin. But if they actually provide health care, it costs more. So it’s this extremely damaging choice the state made to privatize these health care companies. It’s not like [these are] people who have health care and can choose a different provider — they have no choice. People are dying because of it.”

Fealk also explained that the harmful effects of prison privatization are not unique to Arizona; Mississippi, Idaho, Alabama and other states have also had this “pattern of privatization.”

She explained how the pandemic has only exacerbated the issue, saying COVID-19 outbreaks in prisons affect their surrounding communities as well as their inmates.

“It does not just stop in the prison walls. The communities that house the prisons, often more rural and low income communities, have been affected due to the staff who work in the prisons going in and out on a daily basis. Outbreaks in Yuma and Florence have been reported, where 5 of the 16 state prisons are located.”

When asked if she thought making the prisons fully public was the solution, Fealk said that while the issue is perhaps not that black and white, deprivatizing Arizona’s prisons and restoring accountability is a key start to solving the problem.

“We would definitely say that there is less harm done when the state is running it, and there’s evidence for that. That is one step. The solution is to actually ensure that people are being provided adequate health care inside, and the only way we’re going to allow that is that there has to be a certain transparency around that.”

Fealk said that Arizona must increase the transparency in its prison health care, but must do so without violating the Health Insurance Portability and Accountability Act (HIPAA) by publicizing the medical information of prisoners.

Inmates in need of mental health care have reportedly only been able to meet with a mental health professional for appointments lasting several minutes. After asking to see a provider for severe body pains, one inmate killed herself while her request remained unanswered ten days later. State prisons have also refused to provide needed cancer treatments to inmates.

“People in prison are some of the most vulnerable because of the ostracization we’ve done as a society, but also because it’s often people who are low income, people of color, who are most warehoused in our prisons due to all these other systemic issues.”