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.
Last month, Judge Roslyn Silver said the time had come to take control of the system away from the state, after fines and promises from the state to do better, saying “after nearly 14 years of litigation with defendants having not gained compliance, or even a semblance of compliance with the injunction and the Constitution, this approach has not only failed completely but, if continued, would be nothing short of judicial indulgence of deeply entrenched unconstitutional conduct.”
Beth Schwartzapfel, an investigative reporter covering the criminal justice system for the Marshall Project, joined The Show to talk more.
Full conversation
MARK BRODIE: Beth, good morning.
BETH SCHWARTZAPFEL: Hi. Thanks for having me.
BRODIE: Thanks for being here. So I guess how big of a surprise is it not so much that the judge made this ruling, but that the state decided that, "hey, we're gonna appeal this. We think we've actually made some progress"?
SCHWARTZAPFEL: I guess I'll take your questions one at a time. I will say I don't think it's a surprise necessarily that the judge announced her intention to appoint a receiver in this case because she's been hinting for years that if things didn't improve, she was going to move in that direction.
That said, it's extremely unusual. I mean, you could count on probably one hand the number of times that judges in modern history have appointed a receiver to oversee medical care in a prison system.
So the fact that she's been signaling this, this doesn't sort of reduce how surprising it is in the sense that things had to be really, really bad for a really long time for her to take this step.
BRODIE: Do we have a sense of just how bad it is? Like what the conditions are that inmates are dealing with?
SCHWARTZAPFEL: The primary issue or the issue that everything stems from is understaffing. There aren't enough doctors. There aren't enough nurses. And so people are not getting the medical care they need. And there are throughout the records just many, many instances of people dying of preventable diseases, people who died of suicide because they weren't adequately monitored. There weren't enough staff to take proper care of them.
There are lots of other instances as well of people not having access to medications or people not having access to specialists. But the issue that came up more than any other or the issue that sort of leads to all these other issues so seems to be staffing. There are just not enough doctors and nurses to do the work that needs to be done.
BRODIE: And we should point out this is not the state doing the work, right. The state contracts with a private company to do this.
SCHWARTZAPFEL: That's right, the state does. And in fact, the Legislature some years ago required that the state privatize their health care. And at the time legislators told said that their rationale was that it would save the state money.
So since then there have been a number of analyses that raise questions about whether that's true or not, whether this is actually saving the state money, especially since now they've been fined millions of dollars for their non-compliance in this case.
And now the receiver is going to be free to spend money as he or she sees fit, regardless of what the budget might say. And so in the end, I think there are some really big questions about whether privatization save the state money.
But, but yes, you're right, it is the contractor that's actually providing the care or not providing the care. But at the end of the day, I think the judge and the plaintiffs in the case would say, you know, the buck still stops with the state. It is the contractor that's doing the work. But they still answer to the state.
BRODIE: Right. So you mentioned that it's pretty rare for a judge to take this step. But I wonder in those rare cases where a receiver has been appointed, like has it worked out? Have things gotten better?
SCHWARTZAPFEL: The most prominent example is in California. The health care providers in California were placed under receivership in 2006. And just so you know, like just how complex these kind of things are, California is still at least partially under receivership. And again, that was 20 years ago.
Yes, because the judge in that case found that the state was literally either unable or unwilling to fix the health care on its own. And in that time, the lawyer for that case, and this is, you know, somebody's been fighting with the California DOC for many years, not a friend to them, for certainly said that the health care is better.
He said it's certainly not Cadillac care, but he said it's much, much better than it was. It's constitutional now, and I'll just say, too, that constitutional medical care is not, you know, this is not concierge care.
In fact, the judge in this, in the Arizona case said the Eighth Amendment rights do not require the highest quality of health care, the community standard of health care, or even the most pleasant accommodations possible.
But health care and conditions of confinement must reflect basic common decency and a recognition of the dignity the government must accord all human beings. That's a direct quote from the judge.
So what she's finding here is that they're not even doing that. And so what the receiver is meant to do is make the health care constitutional. That means adequate, not even great, not even good.
BRODIE: So, I mean, obviously nobody can predict the future, but given the experience in California, is it safe to extrapolate out to Arizona, to say that assuming things get to the level of being constitutional here, at least in the eyes of the judge, is it safe to say that it will probably take some amount of time and some amount of money to get there?
SCHWARTZAPFEL: Oh, it is definitely safe to say that. You know, obviously it's hard to say how much time, but certainly the problem, and this is the state itself often says this in its court filings, there's a legislative cap on how much they're allowed to pay health care providers. The state legislators have said you can only pay, you know, doctors in your prison system a maximum of this amount of money.
So naturally, it's really hard to hire people for these difficult jobs. They're dangerous jobs. Prisons are often in very remote rural areas, unless you make it worth their while. And so because they're have been unable to do that all this time, what the receiver can do is sidestep those kind of laws. The receiver doesn't have to answer to the Legislature.
The receiver makes his or her own decisions based on how best to get things up to, you know, constitutional muster.
And so, yes, the receiver will, I can say with almost certainty, pay doctors and nurses more, because that is what you have to do to recruit enough people.
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The Arizona Supreme Court has issued an execution warrant for Leroy Dean McGill. -
Grijalva, local leaders and a few dozen protesters gathered outside the gated-off Marana Prison complex – an old state prison sold to the for-profit Management & Training Corporation last year for $15 million. -
In an 83-page order, Judge Roslyn Silver detailed complaints that go back 14 years about inadequate physical and mental health care at the 10 prison complexes across the state. That included a history of agreements to do better, injunctions and even multimillion dollar fines. -
Republican lawmakers on a Senate committee advanced a pair of bills that would give inmates a new option to choose for their method of execution, death by firing squad. -
Eleven individuals wrongly convicted of crimes have applied for millions of dollars in compensation from Arizona, swamping a state fund that has only $3 million.
