This joins scores of articles I have concerning abominable prison health care.

Excerpts from the Article:

Prisoners, wardens, psychologists, correctional experts and medical specialists testified over the course of four weeks in the Jensen v. Shinn prison health care trial in Arizona.They described their personal experiences and observations in Arizona prisons in a legal challenge in which prisoners allege the state is providing unconstitutional levels of health care.

But on the last day of the trial on Wednesday, Dec. 8, the court heard “damning” testimony from the state’s prison health care provider, Centurion of Arizona, that may undermine the state’s entire defense.

Tom Dolan, Centurion Vice President for the Arizona prison contract, took the witness stand to discuss his company’s performance since it took over from the previous provider, Corizon Health, in 2019. “We learned early on that, in order to meet the needs of our clients, some facilities needed additional staff,” Dolan said.

Dolan testified that the health care staffing levels in the Arizona prison system were set by the Department in a 2019 request for proposals. The contract requires Centurion to have 1,052.75 full-time equivalent positions.

But soon after it took over in July of 2019, Dolan said Centurion did its own independent evaluation to determine if that number was sufficient. He said the company worked with the 10 state-run prison sites to identify what additional positions they needed in order to provide services that lived up to the performance measures agreed to in the Jensen v. Shinn lawsuit, which was still under a settlement agreement at the time.

“We look at all of the statistics that we collect each month,” Dolan said. “We look at provider visits, nurse lines, number of HNRs, med passes, number of meds that patients are on. We look at man-down encounters per facility. We look at the overall facility and then build the staffing on the data.”

Dolan said Centurion used that information to submit a proposal to the Department to amend the staffing matrix. In an email sent in January of 2020 to an administrator at the Arizona Department of Corrections health services contract monitoring bureau, Dolan outlined what he referred to as a staffing “wish list.”

According to an attorney for the Department, Dolan was responding to a request from DOC “to review the staffing matrix and submit a staffing proposal without budget constraints.”

Dolan’s staffing proposal called for 161.5 additional positions than were in the 2019 Centurion contract. The additional staff included administrators, nursing directors, regional directors, records clerks, nurses, physicians, and special “man down” teams dedicated to emergencies.

But Dolan testified that after he submitted the staffing proposal, the Department of Corrections did nothing with it. Dolan said the Department was not open to amending the contract to add the additional FTEs, and they were not included when the Centurion contract was extended in July 2021. He testified that the current Department staffing matrix is still the same as the one provided in the original 2019 contract.

ACLU National Prison Project Deputy Director Corene Kendrick, representing the prisoners in the lawsuit, called the staffing proposal a “damning admission.”

“The legal analysis for this type of case is something called deliberate indifference,” Kendrick said. “This document is the epitome of deliberate indifference. Prison officials were told in Jan 2020 that they needed to increase health care staff by 15 percent and nothing happened. Instead, what happened over the next year and half is that many, many people died preventable deaths because of the failure to provide basic medical care and mental health care.”

“I think what it shows is that Centurion’s leadership recognized that the current staffing model that the state has dictated to them is not adequate to provide basic health care,” Kendrick said.

In 2012, the federal court recognized a group of people in Arizona prisons who claimed their Eighth Amendment rights against cruel and unusual punishment were being violated. The class action lawsuit was then named Parsons v. Ryan, after named plaintiff Victor Parsons and then-director Charles Ryan. Arizona agreed to settle the case in 2014 and it was certified in 2015.

But since that time, the federal courts overseeing the settlement have found the state was not living up to the terms of the settlement agreement. Federal judges have twice held the Department in contempt, fining the agency millions of dollars. The case has outlasted judges, named plaintiffs and prison administrators. In 2021, it is now known as Jensen v. Shinn.

In July, Judge Roslyn Silver took the drastic measure of rescinding the settlement and ordering a bench trial, which began on Nov. 1.

During the four-week trial, the court heard testimony from several currently incarcerated people who claimed they had suffered due to lack of medical and mental health care.

Kendall Johnson, a witness for the plaintiffs incarcerated in the Perryville Women’s Prison, said she entered prison at age 19 in 2004 as a healthy young woman. In 2017, she started to experience numbness in her legs and feet. She repeatedly requested medical treatment for several years as her symptoms progressed. She said she experienced several falls that resulted in broken bones and eventually lost the ability to write and walk. In 2020, she was diagnosed with multiple sclerosis.

Johnson wrote health needs requests begging for proper treatment, but she didn’t get it until May 2021. She told the court she is now confined to a special needs medical unit at the prison where she spends her days “counting the ceiling tiles.”

She is nearly immobile and has trouble speaking. “I tried to get help but it was like hitting my head against the wall,” she said.

Dustin Brislan, a named plaintiff, testified from the Tucson prison. He provided the names of more than 10 officers he accused of taunting him and encouraging him to self-harm, a tactic known in the prisons as “kickstarting.” “Kickstarting is where an officer or mental health staff push your buttons — they know your triggers — and get you to react,” he said. “It happened many times.” Brislan said he would often cut himself with rust from the isolation cells while on constant suicide watch, while correctional officers were watching and encouraging him to do so. He said the officer would watch him and not act to stop him.

“The officers actually encourage me to cut myself,” he said. “They say they want to see how bad I can get. They heard stories about me and wanted to see how seriously I could hurt myself. They know exactly how serious I am. There’s a lot of them that do it.”

Judge Silver could order receivership, in which a federal monitor who answered to the courts would be in charge of the health care services for state prisons. Silver could also order Centurion to hire more prison health care workers, or she could order the state to resume direct operations of the health care in state prisons as opposed to hiring a contractor.

If the ruling is unfavorable to the Department, it will almost certainly be appealed, as has been the strategy of the defense team in most other instances in response to orders from the court in the Jensen lawsuit.

Kendrick said she feels optimistic about their case.

“We presented testimony from multiple experts and people who actually still work there, Kendrick said. “We showed that the conditions in isolation units and the medical and mental health care are abysmal.”

“We hope that Judge Silver will find that the department has been violating the rights of incarcerated people,” Kendrick said. “We’ve asked her in the past to appoint someone independent to oversee the delivery of health care. And we’ve asked her to place very strict limits on the use of solitary confinement, including banning its use on people with serious mental illness, pregnant people and juveniles.”

The parties must now file findings of fact and conclusions of law by Jan. 21. Responses to those filings are due Feb. 11, meaning the ruling might not happen until March.

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