PHOENIX (AP) — Arizona's corrections chief testified at a trial on Tuesday over the quality of medical and mental health care in state prisons that incarcerated people often have greater access to health services than people who aren't locked up.
The defense by Corrections Director David Shinn of the health care system for prisoners came after the state has faced years of complaints about poor health care behind bars and has been fined $2.5 million for not complying with a settlement over the issue.
The settlement was thrown out this summer by a judge who concluded that the state showed little interest in making many improvements it promised under the 6-year-old deal and that inadequate care for prisoners had led to suffering and preventable deaths.
"They often have greater access to care than I do as a private citizen," Shinn said of prisoners.
Lawyers for the prisoners are asking U.S. District Judge Roslyn Silver to take over health care operations in state-run prisons, appoint an official to run medical and mental health services there, ensure prisons have enough health care workers and reduce the use of isolation cells, including banning their use for prisoners under age 18 or those with serious mental illnesses.
They said Arizona's prison health care operations are understaffed and poorly supervised, routinely deny access to some necessary medications, fail to provide adequate pain management for end-stage cancer patients and others, and don't meet the minimum standards for mental health care.
The Arizona Department of Corrections, Rehabilitation and Reentry has denied allegations that it was providing inadequate care, delayed or issued outright denials of care and failed to give necessary medications. Its lawyers said the prisoners can't meet key elements in proving their case — that the state was deliberately indifferent to the risk of harm to prisoners and that the health care problems occur across the state-run prison system, not just a particular prison.
A court-appointed expert has previously concluded that understaffing, inadequate funding and privatization of health care services are significant barriers in improving health care in Arizona's prisons.
The case challenges health care for the more than 27,000 people incarcerated in state-run prisons, not in the private prisons where the state houses 7,500 other people.
Shinn, a former federal prisons official appointed to the state post by Gov. Doug Ducey in October 2019, was grilled on shortages of corrections officers and health care workers at Arizona's prisons, expressed confidence in the companies that have provided health care services in state prisons and defended his agency's efforts to guard against COVID-19.
Shinn said he believes Arizona prisons — where at least 56 incarcerated people have been confirmed to have died from the virus and 80% of prisoners are vaccinated — are one of the safest places to be during pandemic. For one stretch of time early pandemic, Arizona prisoners were barred from wearing masks, though that policy was reversed and incarcerated people were provided face coverings.
Attorneys for prisoners underscored that Arizona's previous contractor for prison health care services would have faced a $5,000 monthly sanction from the state for instances of noncompliance with the settlement. The current contractor would face only a $500 sanction in such cases.
Asked if the current contractor had reallocated health care staff to focus on compliance with the Arizona settlement, Shinn said he didn't have the data with him in court to answer that question.
Shinn said his agency was working with the state's prison health care contractor to improve its recruitment of health care workers. But he believes it's a myth that a certain number of health care workers must go to certain facilities.
He said the state can't force workers to move into communities that they may not find desirable. He also said the state was using telemedicine to care for incarcerated people in prisons away from urban areas.