Arizona Legislature adjourned after budget. But prison healthcare mandate wasn't fully funded

Gov. Katie Hobbs wanted the Legislature to fund 615 more prison healthcare workers in the budget year that begins July 1 to comply with a federal judge's order requiring Arizona to dramatically boost staffing so it could provide constitutionally adequate care to inmates.

But the Democratic governor got less than half the money needed to fund those new posts in a budget deal she cut with Republicans who control the state House and Senate.

Instead of the $108.2 million for new staff she sought in her January budget proposal, lawmakers only agreed to provide $45.1 million — enough to pay for slightly less than 42% of the workers the judge said in a 2025 order are needed. Hobbs also sought, and actually got, another $9.5 million for health operating costs at the Arizona Department of Corrections, Rehabilitation and Reentry.

Lawmakers passed the budget on Thursday, and then adjourned for the year two days later.

That's significant, because U.S. District Judge Roslyn Silver ordered the increased staffing after years of litigation by prisoners and failures by the corrections department to provide decent care.

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Here's what a new receiver overseeing Arizona prison health care could do, journalist says

Mark Brodie

The state Department of Corrections, Rehabilitation and Reentry late last week announced it planned to appeal a judge’s ruling that appointed a receiver to oversee Arizona’s prison health care system.

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Twice this year she’s shown her patience with the state is running out.

Earlier this year, Silver decided the state was not capable of fixing the broken prisoner healthcare system and said she would appoint an outside receiver to run prison healthcare — with the power to require the state to provide more funding and hire the new workers.

Last month, she said in an order that she wanted that receiver in place soon, in part so that person could negotiate with Hobbs and the Legislature to provide more funding in the new budget.

That didn't happen.

As of Thursday, an order formally appointing the receiver that lawyers for the corrections department and the prisoners who sued have agreed to put in the powerful post hasn't been issued. The tentative choice is former Ohio corrections director Annette Chambers-Smith.

But with the budget now formally adopted — and without the money that the judge said was necessary to comply with her order — what comes next in the lawsuit which has been going on now since 2012 is an open question.

Hobbs acknowledged on Thursday that she was frustrated that the GOP-controlled Legislature didn't provide the money she wanted for the new doctors, nurses and other healthcare workers the judge's order says are needed. She said she got all the money she was able to persuade GOP lawmakers to agree to provide for in the budget deal but will continue to work to meet the judge's terms.

Hobbs pointed out that she's only been in office since 2023 and it was previous Republican governors and majority GOP lawmakers who control the Legislature who got the state prison system in its current spot.

"I want to just remind you, we inherited this lawsuit that had been ignored for years and years. And we're trying to fix overnight what should have been in the works, in progress already,'' Hobbs told Capitol Media Services. "We are playing catch-up to try to meet the needs of the court on this and to treat prisoners according to the Constitution.''

The case was filed on behalf of Arizona inmates by attorneys with the American Civil Liberties Union, the Prison Law Office and other prisoner rights groups. It alleged grossly inadequate care that harmed and even killed inmates and violated the U.S. Constitution.

There are about 25,000 inmates in state-run prisons, plus nearly 10,000 in private prisons not covered by the lawsuit.

Although she hasn't yet laid out in detail the receiver's powers and responsibilities, the judge said in a May 11 order that they would be sweeping.

The most important task for whoever is ultimately appointed will be "correcting the systemic constitutional failures that have plagued defendants' healthcare delivery for over a decade,'' Silver wrote.

They include fixing chronic understaffing and the state's failure to enforce its contract with the private company overseeing inmate care, ensuring inmates are treated by physicians instead of nurses and addressing persistent failures in the system of patient referrals, data collection and reporting.

Silver also said the receiver must ensure there's enough state funding and facilities to care for ill inmates. That can include requiring the Legislature to spend more money.

That, however, didn't happen.

Republicans believe Silver has overstepped her authority, although every appeal they filed in the years-old case have been rebuffed.

"From my point of view, the judge has overextended herself into our territory, overextended the boundaries,'' said Rep. David Livingston, R-Peoria, the House appropriations committee chair and a key budget negotiator. He said the Legislature is responsible for appropriating money, not Judge Silver.

"We don't need to fund what she's asking for, either,'' Livingston said. "So, in a way, we're in a stalemate. I'm not quite sure what happens next.''

Corene Kendrick, an attorney for the American Civil Liberties Union who has worked on the case for more than a decade, said the judge will now have to decide if the new money included in the just-approved state budget is enough.

She noted that Republicans passed their own budget last month, one not in cooperation with Hobbs which the governor promptly vetoed. And it included no new money at all for prisoner healthcare.

"Obviously 42% of the funding versus 0% of the funding is better, but that's still a failing grade to only potentially be able to implement 40% of the court's order,'' Kendrick said in an interview Thursday, as the Legislature was voting on the budget. "As Judge Silver has written in the past, the woefully inadequate health care staffing is the Achilles heel of the department, and frankly is the reason why, after 15 years of litigation, the department has not come anywhere near meeting the constitutional requirements for a minimally adequate health care system.''

Kendrick said that whether that new money will satisfy Silver is a wild card, and the state could push for more delays.