Arizona Appeals Federal Takeover of Prison Health Care System After 14-Year Legal Battle
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Judge Orders Outside Control of Prison Medical Operations in State Prisons
The Arizona Department of Corrections, Rehabilitation and Reentry filed an appeal Thursday with the U.S. Court of Appeals for the Ninth Circuit, challenging a federal judge's order placing prison health care under outside control.
U.S. District Judge Roslyn Silver issued the order on Feb. 19, appointing a receiver to oversee all health care services in the nine state-run prisons run by the department. The receiver would not cover the nearly 10,000 people incarcerated in private prisons for state convictions.
The order gave the state and attorneys representing prisoners 60 days to submit a list of candidates to run health and mental health care operations in prisons.
Systemic Failures Over Decades
For over a decade, the state government has been dogged by criticism that its health care system for the 25,000 inmates in Arizona's state-run prisons was run shoddily and callously.
The state had vowed to overhaul medical and mental health services for prisoners in a 2014 settlement, but was soon accused of failing to keep many of those promises. That led to $2.5 million in contempt of court fines against the state and, eventually, the revocation of the agreement by Silver.
In her February order, Silver wrote that Arizona had not achieved compliance with court-ordered changes and the Constitution after nearly 14 years of litigation.
"This approach has not only failed completely, but, if continued, would be nothing short of judicial indulgence of deeply entrenched unconstitutional conduct," Silver wrote.
The judge said prisoners still remain exposed to "an intolerable grave and immediate threat of continuing harm and suffering because the systemic deficiencies pervade the administration of health care."
The Class Action Foundation
The current legal battle builds on Jensen v. Thornell, a class action lawsuit filed in 2012 by the American Civil Liberties Union, the Prison Law Office and Disability Rights Arizona on behalf of all people incarcerated in the state prison system.
Federal judges have issued three orders finding unconstitutional care and levied three contempt sanctions against the department, totaling $2.5 million.
Corene Kendrick, deputy director of the ACLU National Prison Project and an attorney for the plaintiffs in Jensen v. Thornell, said the interplay between the class action and individual cases has been critical.
"One of the big defenses that the department can make in these individual cases is, 'we weren't aware of the problems,'" Kendrick said. "It's hard for them to say in an individual case later on, 'we didn't realize that this person had a problem,' because there's evidence of it."
Individual inmate lawsuits continue to flood Arizona District Court. As of April 9, more than 250 cases named the department's current health care vendor, NaphCare, as a defendant.
Case Study: Tyson Anderson
Tyson Anderson started his lawsuit alone, but the court has since appointed pro bono counsel to represent him. Anderson was first incarcerated in 2018. He was designated as seriously mentally ill given a schizoaffective disorder diagnosis and a history of self harm and suicide risk.
Over the course of his incarceration, Anderson was primarily housed in a unit where he was required to use the stairs to get to his cell. He requested a transfer, claiming a threat to his physical safety — a threat that actualized when Anderson had a seizure and fell down the stairs.
Anderson lost his job due to lack of disability accommodations and spent more and more time in isolation. Then, a nurse discontinued his seizure medication after claiming he was faking. He had two more seizures.
In one instance, Anderson woke up face down in a pool of blood from a head injury. His mental state continued to worsen. In July 2021, Anderson attempted suicide by cutting his arm and ingesting sharp objects.
Department Pushes Back
Governor Katie Hobbs was unhappy with the order, as was the Department of Corrections.
"If this decision stands, an exorbitantly expensive, unnecessary receiver risks disrupting the significant progress we have made in our prisons, all with no time clock on its authority," Department Director Ryan Thornell stated.
"We will be promptly appealing the decision while continuing our work to comply with the Court's orders and running a secure, safe, and accountable prison system," Thornell said.
The department acknowledged it has not achieved full compliance with previous court orders but said it has made measurable improvements in health care delivery over the past several years.
Prisoners Say System Remains Broken
Lawyers for the prisoners said Arizona has made few improvements since the verdict and asked the judge for the more drastic remedy of creating such a receivership.
"This decision means that an independent authority will be able to implement the systemic changes necessary to ensure that medical and mental health care meets constitutional standards," said David Fathi, one of the lawyers representing the prisoners.
"This is a life-saving intervention, and it brings hope that the preventable suffering and deaths that have haunted Arizona's prison system for over a decade can finally end."
Lawyers for the department said the agency's leadership had been acting in good faith with the court's orders and that focusing on past circumstances rather than present improvements is unfair.
What a Receiver Could Do
A receiver would have broad authority to manage the prison health care system, including the power to hire and fire medical staff, approve medical procedures, and set policies for inmate care.
The state and attorneys representing prisoners must submit their candidate lists within 60 days, after which the judge would make the final selection.
If the appeal fails and the receivership takes effect, taxpayers will foot the bill for the new oversight system. The department has not released specific cost estimates.
The appeal process could take months or even years, leaving the current health care system in place until a judge rules on the Ninth Circuit appeal.
Sources
Arizona Capitol Times — https://azcapitoltimes.com/news/2026/04/10/arizona-prisons-face-growing-number-of-health-care-complaints/
Arizona's Family — https://www.azfamily.com/2026/03/20/arizona-prison-system-appeals-order-inmate-health-care-takeover/
KJZZ — https://www.kjzz.org/kjzz-news/2026-03-20/arizona-department-of-corrections-appeals-ruling-on-prison-health-care-takeover