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Arizona Privatizes Health Care in State Prison System

On April 27, 2011, Arizona Governor Jan Brewer signed into law House Bill 2154, which resulted in the privatization of medical care for prisoners in the Arizona Department of Corrections (ADC). The move comes three years after ADC’s food services were privatized. The Republican-dominated state government favors privatization as a means to cut costs and help reduce a large budget deficit.

The idea of privatizing the ADC’s health care system seemed dead in January 2011, but HB 2154 moved quickly through the legislature to the governor’s desk as an emergency measure. In a May 9, 2011 email, ADC Director Charles Ryan described the privatization debate as “a long and tedious issue for ADC and Health Services employees,” and urged prison medical staff to comply with the law and assist in the privatization transition.

The ADC began developing a plan to contract for medical services for the state’s 34,000 prisoners in July 2011. Understandably, ADC health care employees, who faced around 750 job losses due to privatization, were not happy.

Previous legislation introduced in 2009 (HB 2010) required that privatization of the ADC’s health care services not exceed the department’s cost for providing medical care to prisoners. HB 2154 removed that cost limitation.

“The legislation speaks to the best qualified. The legislation does not speak to a target dollar amount,” Ryan noted.

Ten companies responded to the ADC’s 2011 request for proposals (RFP) for the prison medical care contract, including Correctional Health Partners, Wexford Health Sources and Corizon; the latter company was formed following the merger of Prison Health Services and Correctional Medical Services in June 2011.

In April 2012, Wexford was awarded a three-year, $349 million contract. This works out to an average of $116.3 million annually – or $5 million more per year than the ADC spent on prisoner medical care in fiscal year 2011, which was $111.3 million. State Rep. John Kavanagh, who championed the privatization legislation, said money would be saved over time through reduced pension costs for ADC employees whose jobs were privatized.

Caroline Isaacs, director of the American Friends Service Committee’s office in Tucson, Arizona, disagreed. “This has never been about saving money; the real reason is that legislators are ideologically wedded to privatization and damn the evidence,” she said.

The ADC’s transition to privatization of prison medical services is expected to be finalized by June 30, 2012. Meanwhile, in November 2011 the ADC agreed to investigate complaints that prisoners had been denied treatment for serious medical conditions by state health care employees, and a lawsuit over inadequate prisoner medical care was filed by the ACLU and the California-based Prison Law Office on March 22, 2012. See: Parsons v. Ryan, U.S.D.C. (D. Ariz.), Case No. 2:12-cv-00601-NVW.

As reported extensively in PLN, private prison health care providers have a history of providing shoddy medical services while pursuing profits at the expense of prisoners, including Wexford Health Sources. [See, e.g.: PLN, June 2011, p.12; Dec. 2010, p.27; Nov. 2009, p.16].

According to a September 2007 study co-authored by University of California-Santa Barbara economist Kelly Bedard, which examined the results of privatization of prison health care services in 32 states, for every 20 percent increase in privatization of prison medical staff, the prisoner mortality rate increased by 2 percent.

Sources:, Arizona Capitol Times, Arizona Republic,, “Prison Health Care: Is Contracting Out Healthy?” by Kelly Bedard and H.E. Frech III (September 2007)

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Related legal case

Parsons v. Ryan