Because of the Arizona Department of Corrections’ continuing failure to meet standards for physical and mental healthcare for prisoners, a federal judge recently ruled that the state faces a $1,000 fine for each prisoner who does not receive care that meets certain benchmarks at some prisons.

“I have just had enough,” said U.S. Magistrate Judge David K. Duncan in a June 14, 2017, hearing where he proclaimed the potential for fines.

In mid-July, the Department of Corrections must file with the court a report listing every prisoner who did not receive proper care in the prior 30 days for particular health care benchmarks at specific prisons. Every single failure to meet these benchmarks could result in a $1,000 fine to the state.

For instance, prisoners who are being transferred between facilities should have all of their medications transferred with them or otherwise provided at the receiving prison without interruption. However, this has not been happening reliably at the Eyman, Florence, Lewis, Phoenix, and Tucson state-run prisons. Now, for every prisoner at one of these five facilities who does not have uninterrupted access to medications following a transfer, the judge may fine the state $1,000.

Here are other benchmarks eligible for per-prisoner $1,000 fines and the prisons to which they apply:

  • Chronic care and psychotropic medication renewals will be completed in a manner such that there is no interruption or lapse in medication (Perryville).
  • Prisoners who are given urgent provider referrals are to be seen by a medical provider within 24 hours of the referral (Eyman).
  • A medical provider will review diagnostic reports, including pathology reports, and act upon reports with abnormal values within five calendar days of receiving the report at the prison (Douglas, Eyman, Florence, Lewis, Perryville, Phoenix, Tucson).
  • Urgent specialty consultations and urgent specialty diagnostic services will be scheduled and completed within 30 calendar days of the consultation being requested by the provider (Florence).
  • Specialty consultation reports will be reviewed and acted on by a provider within seven calendar days of receiving the report (Florence).
  • For prisoners in an infirmary, medical provider encounters will occur at a minimum every 72 hours (Florence, Lewis, Tucson).

These benchmarks, also called performance measures, were established in a legal settlement of the lawsuit Parsons v. Ryan, a lawsuit filed in 2012 by the ACLU and others that challenged the inhumane and unconstitutional failures of the Arizona Department of Corrections to provide minimally adequate medical, mental health and dental care to people in state custody, and to end the abusive conditions in the solitary confinement units.

In 2014, plaintiffs’ counsel reached a settlement with the Arizona Department of Corrections. The settlement, on behalf of all prisoners in Arizona’s state-run prisons (currently more than 33,900 people), required the Department of Corrections to meet more than 100 health care performance measures, covering issues such as care for prisoners with diabetes, hypertension, and other chronic conditions; care for pregnant prisoners; and dental care. The complete list of performance measures is available here (pages 8-15 of the embedded PDF).

The settlement aimed to fix a broken health care system plagued by long-term and systemic problems that caused numerous deaths and preventable injuries. However, a year after the settlement agreement went into effect, it was clear that the Department of Corrections was not in compliance.

The department’s own documents showed prisons are chronically failing to meet key health care performance measures, and our experts identified numerous cases in which Arizona’s failure to provide minimally adequate medical and mental health care had resulted in needless suffering, aggravation of illness, and avoidable death.

Last year, the court found Arizona to be in violation of the settlement and ordered the Department of Corrections to take prisoners to medical providers outside of the prisons as needed to ensure that care is provided in a timely manner.

Now, the court has taken the extraordinary step of establishing a fine structure for continued violations of critical performance measures. Furthermore, the court intends to appoint an expert at ADC’s expense to advise Arizona on how to improve recruitment and retention of health care staff.

To learn more about the Arizona Department of Corrections’ health care failures and steps they should take to come into compliance with the Parsons v. Ryan settlement, read reports from our experts here and here