Arizona’s NaphCare Stays Out of Compliance Despite 2022 Legal Action on Prison Healthcare

In 2022, Judge Roslyn Silver determined that Arizona was failing to meet the healthcare needs of inmates, which led to preventable deaths within the prison system. This conclusion stemmed from the case Jensen v. Thornell, prompting the Arizona Department of Corrections Rehabilitation and Reentry to initiate changes within their healthcare protocols. The aim was to meet constitutional standards by improving staffing levels and enhancing both physical and mental healthcare access.

Despite these efforts, significant issues persisted. In 2023, a district court issued an injunction mandating expedited improvements in healthcare staffing and requiring additional physicians to meet set benchmarks. Yet, as of 2024, the situation remains dire. “They’re still enormous problems, and some of them haven’t improved at all,” stated Donna Leone Hamm, director of Middle Ground Prison Reform, an Arizona-based nonprofit.

The ongoing conflict involves the Department of Corrections, NaphCare—the contracted healthcare provider—and Arizona courts. For over a decade, these parties have struggled to achieve compliance, with courts indicating that advancements have only been marginal. Independent reports filed in July revealed that many court objectives remained unmet as of April, highlighting issues such as inadequate psychiatric staffing, insufficient medical facilities, and noncompliance with emergency response requirements.

Conversely, NaphCare representatives assert they are making strides. “NaphCare is continuing to innovate and enhance healthcare services within Arizona prisons,” said a spokesperson, noting improvements in technology, staff training, and patient engagement. Despite these claims, the effectiveness of their initiatives remains in question.

This past July, the Department of Corrections launched a pilot project at a Yuma prison to assess staffing needs. However, progress has stalled as hiring was put on hold until amendments to existing contracts with the state are finalized. “There’s all this new staff that needed to be hired, and NaphCare would not do it for months because they said their contract with the state needed to be amended first,” explained Corene Kendrick, deputy director of the American Civil Liberties Union National Prison Project.

As efforts continue to resolve staffing shortages and enhance inmate access to care, the problems remain urgent. Hamm emphasized, “On a daily basis, people are suffering because of inadequate medical care.” She detailed distressing cases, including individuals with untreated cancer and severe parasitic infections that have been neglected for months.

NaphCare’s track record is under scrutiny, having faced multiple lawsuits nationwide, including significant penalties in Pima County, totaling around $3.1 million for unmet contractual obligations. In 2022, the county jail reported per-capita deaths four times higher than the national average, raising alarms about the effectiveness of provider services.

Despite facing fines, Hamm asserts that NaphCare’s profits diminish the impact of these sanctions. “They’re making so much money in profits that it doesn’t hurt them to be fined,” she remarked. Meanwhile, NaphCare maintains that it has sufficiently staffed critical areas and implemented new mental health evaluations for incoming prisoners.

Additionally, NaphCare has introduced programs targeting specific healthcare needs, such as the care of transgender inmates and statewide Hepatitis C treatment. Meanwhile, the Corrections Department reported some progress in addressing the injunction issues, including an increase in residential care units and a reduction in the population within maximum custody settings.

However, the court remains unconvinced, with Judge Silver asserting that current conditions are still “fundamentally lacking.” The ACLU and other advocacy groups have been pushing for a court-appointed receiver to take control of inmate healthcare delivery, citing ongoing failures to implement necessary reforms.

“So far, she has not done so,” Kendrick noted, emphasizing the need for decisive intervention. The call for reform continues as Arizona’s prison system grapples with delivering adequate healthcare to its inmates.