The Arizona Republic

Federal sanctions alone won’t fix prison health care

- Your Turn Tiera Rainey Guest columnist Tiera Rainey is a project coordinato­r for American Friends Service Committee-Arizona, which works to reduce the size and scope of the criminal punishment system. Reach her at trainey@afsc.org; on Twitter, @tbiz30.

In an unpreceden­ted ruling on Friday, U.S. Magistrate Judge David Duncan handed down $1.4 million in federal sanctions against the Arizona Department of Correction­s and its director, Chuck Ryan.

The agency and Ryan were found to be in contempt of court for failing to ensure that ADC’s current for-profit contractor of health-care services, Corizon Health Inc., is providing adequate care to more than 34,000 state prisoners.

We applaud Judge Duncan for finally holding Ryan and Corizon accountabl­e for the cruel and inhumane mistreatme­nt of prisoners, which has led to needless suffering since prison health care was privatized in 2011. However, sanctions alone will not fix this broken system.

The sanctions imposed by Judge Duncan are the result of ADC’s years-long legal battle with the American Civil Liberties Union and the class-action suit it filed against Ryan and ADC in 2012. The

Parsons vs. Ryan case spotlighte­d ADC’s systemic neglect, high death tolls, and overuse of solitary confinemen­t. ADC reached a settlement with the ACLU in 2015 in which it agreed to not only improve its health-care system, but also required ADC and Corizon to meet 100 health-care performanc­e measures.

When the ACLU brought Ryan and ADC back to court in October 2017, it provided overwhelmi­ng evidence of continued negligence by Corizon. The ACLU’s witnesses, collected testimonie­s, and ADC’s internal documents showed that health-care units remain understaff­ed, and prisoners are routinely denied access to essential services and medication­s, as well as to timely medical referrals. The sanctions are the first real consequenc­es that ADC has faced after years of broken promises to change and improve its system.

Admittedly, ADC-managed health care has always been problemati­c. But its underlying shortcomin­gs have only worsened with privatized care, which ADC began outsourcin­g in 2012.

That year, Wexford Health Sources took over ADC’s health care, only to have its $349 million contract canceled after a wave of negative press, including a story about a Wexford nurse creating a Hepatitis-C scare after reusing needles on prisoners.

As we at American Friends Service Committee-Arizona documented in our

report, Death Yards: Continuing Problems with Arizona’s Correction­al Healthcare, ADC recorded a combined 37 prisoner deaths in 2011 and 2012. When Corizon took over for Wexford in 2013, ADC reported 50 prisoner deaths within Corizon’s first eight months on the job.

While hefty sanctions are a symbolic – and welcome – punishment for ADC’s negligence and callous disregard for the people it incarcerat­es, fines are likely to have an adverse effect on prisoners and their families, through higher service fees for phone calls and commissary, and/or larger cuts to programmin­g and re-entry assistance. More importantl­y, the sanctions imposed by Judge Duncan do not require ADC to take meaningful actions to address the drivers of its ongoing health-care crises.

Despite the looming sanctions, ADC renewed Corizon’s contract in May for another year and increased Corizon’s per diem rate by 20 percent, which was rubber-stamped by a joint legislativ­e budget committee earlier this week. ADC has also released a new RFP for a three-year health-care contract to begin in 2019, further perpetuati­ng this vicious cycle by taking bids from companies with equally bad track records who hope to profit off Ryan’s malfeasanc­e.

Rather than lookfor innovative, people-first solutions that could include working with local, public hospitals and universiti­es, ADC chooses more of the same: providing inadequate­care to some of our state’s most vulnerable.

Judge Duncan’s sanctions are themselves an urgent call for change, but apathy is proving to be ADC’s only response.

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