The ‘Chaos’ of Arizona Prison Health Care

An Arizona public broadcasting investigation finds that the state and Corizon Health, its privately contract health care provider, haven’t lived up to the terms of a 2015 settlement with Arizona inmates over alleged flaws in dental, medical and health care in the state’s 10 prisons.

More than two years after the State of Arizona and Corizon Health, a privately owned correctional health care company, settled a lawsuit claiming poor health care conditions in state prisons, at least 100 stipulations agreed to in the settlement have not been met, according to an investigation by the Arizona public radio station KJZZ.

A federal judge is now threatening to fine the state millions of dollars for what the station alleged was the continuing “chaos” of mental, dental and health care in Arizona’s 10 state prisons, the station said.

After the investigation aired last week, an Arizona magistrate who said he was “shocked” by the findings demanded a public hearing.

“I’m standing literally this morning because I am standing up for the inmates in Arizona prisons,” said Magistrate Judge David Duncan during a hearing in federal court last week.

In a 15-minute address to the court, Duncan described an email uncovered during the investigation alleging Corizon Health’s avoidance of fines as a potential “smoking gun.”

He said his staff had received calls from Corizon employees telling him “it is so much worse than you think.”

The KJZZ report cited Dr. Jan Watson, a former prison doctor worked at Arizona State Prison Complex-Eyman in Florence, and the daughter of Walter Jordan, an inmate who died of cancer while incarcerated.

Watson said her requests for medical treatment for inmates were repeatedly denied.

Judge Duncan questioned whether there was corruption within the system.

“I have used words like shocked and flabbergasted, but I have run out of words,” he said.

Judge Duncan set a hearing for Feb. 9 to investigate the allegations made in KJZZ’s report.

The state’s contractor, Corizon Health, has not been able to fill the number of provider-level physicians required in its contract. The company also struggles to find outside providers to treat inmates with specialty care.

Corizon and the Arizona Department of Corrections (ADC) said the reasons for this include the fact that doctors don’t want inmates in their waiting rooms.

ADC assistant director Richard Pratt testified he recently learned of a potential bankruptcy of Arizona Oncology Network, one of Corizon’s oncology subcontractors, which generated a large backlog of requests for cancer treatment.

In a sharp exchange with Pratt, Duncan demanded, “Who at the state is responsible for this?”

“A large amount of patients are having their oncology care delayed. Is it on your shoulders, Mr. Pratt? Who has trouble sleeping at night? Is there anyone in the state employ who worries about this?”

“I worry,” Pratt responded.

Jimmy Jenkins is a senior field correspondent for KJZZ, and a 2017 John Jay/Measures for Justice Fellow. This story was also reported by Sky Schaudt and Phil Latzman. The complete version and broadcast reports are available here. Readers’ comments are welcome.


Arizona Prisons Grapple with Upsurge in Inmate ‘Self-Harm’

More than 80 inmates tried to hang themselves so far this year, and 138 attempted drug overdoses, at a time when the Arizona Department of Corrections is under fire over allegedly inadequate health care. The state still has no mental health director, according to a report by the Phoenix public radio station.

Hundreds of people in Arizona prisons are hurting themselves and trying to take their own lives.

New data from the Arizona Department of Corrections (ADC) show inmates are harming themselves at an alarmingly increasing rate.

Numbers collected by ADC show a dramatic uptick in self-harm among inmates in the past year. Total incidents increased by almost 70 percent.

In fiscal year 2017, more than 80 inmates tried to hang themselves, and 138 tried to overdose on illegal drugs.

Table courtesy Arizona Department of Corrections

The number of inmates using blunt-force trauma — which can include inserting objects in the body and banging the head against a wall — has almost tripled in a single year.

The surge in self-harm reports comes as ADC is attempting to settle a lawsuit over poor health-care conditions in state prisons.

But reports generated for that settlement show ADC and its private contractor Corizon are still understaffing critical health-care positions.

The latest numbers from August show the state prison in Douglas, AZ has no medical director and just one psych associate.

The state prison in Phoenix is designated for seriously mentally ill people. The facility has no psychiatric director, no mental health director and less than half of the psych technicians specified by the contract with Corizon.

There is also no state director of mental health.

EDITOR’S NOTE: This story has been updated to specify that the numbers reported by ADC are incidents of self-harm, not necessarily individual inmates.

MORE: Arizona Prison Health Care Contract Leads To ‘Severe Understaffing’

David Fathi, an attorney for the inmates in the settlement, said there may be other factors at play but the staffing shortages cannot be helping.

“This is behavior that we often see with mentally ill people in particular whose mental illness is not being effectively treated,” Fathi said.

Incidents of cutting increased by nearly 50 percent. Fathi said that while not all cutting incidents are life-threatening, they should be taken seriously.

“This is potentially lethal behavior. Some incidents of self-harm result in serious injury or even death,” Fathi said. “And that can happen even if the person doesn’t intend to cause death. Any kind of self-harm behavior has to be treated extremely seriously.”

Fathi called the numbers extraordinary and said the increase in self-harm events “cries out for some sort of investigation.”

In a written response to questions about the increase, ADC spokesman Andrew Wilder said “personnel work very hard to identify, intervene and prevent inmates from committing acts of self-harm.”

He said ADC will begin a mental-health training program for correctional officers this month.

But Wilder’s statement downplayed the seriousness of the self-harm numbers, saying they should not “be construed as all being suicide attempts, as they certainly are not.”

“More commonly, these self-harm behaviors involve scratching, biting, ingesting/inserting objects, banging one’s head or hitting one’s self, etc., where there is no intention to commit suicide,” Wilder said

Wilder said the state “has put into place a mental-health transitional watch program aimed at assisting inmates as they come off of a watch and transition back into a general population environment. The goal is to reduce incidents of self-harm behaviors. The department is already in the process of expanding the program.”

According to ADC, there have already been 142 incidents of self-harm in Arizona prisons in fiscal year 2018, putting it on track to be the worst year on record.

ADC August Health Care Staffing Report

Jimmy Jenkins is a 2017 John Jay/Measures for Justice Reporting Fellow. This is a slightly abridged version of a story broadcast earlier this week by KJZZ in Phoenix as part of his fellowship project. Readers’ comments are welcome.