by Matt Clarke

On February 19, 2026, an Arizona federal court issued an order that will result in medical care for prisoners in the Arizona Department of Corrections, Rehabilitation & Re-entry (DCRR) being placed under a court-appointed receiver. This rare and drastic measure amounts to a takeover of that part of the DCRR.

The Court found that receivership was necessary because the DCRR had resisted all lesser measures aimed at correcting the unconstitutionally insufficient health care being provided to DCRR prisoners, which resulted in horrendous suffering and hundreds of premature deaths.

United States District Judge Roslyn O. Silver signed the order granting plaintiffs’ Motion for a Receiver in this class-action lawsuit that was first filed in 2012. The 128-page order detailed the herculean efforts by the Court and Court-appointed monitors in attempting to assist the DCRR in bringing its medical care up to minimal constitutional standards and how the DCRR frustrated every such attempt. The order gave the parties 30 days in which to file motions setting forth proposed duties, powers and authorities of the Receiver. It gave the parties and monitors 60 days to submit a list of up to five candidates each to serve as the Receiver.

The case was already unusual in that, after it was initially settled via joint stipulated agreement in 2014, the district court threw out the agreement due to the DCRR’s failure to comply with it. See: Jensen v. Pratt, 2021 U.S. Dist. LEXIS 163895 (D. Ariz.). There ensued a 5-week bench trial, after which the court issued detailed findings of unconstitutional conditions which led to the issuance of a permanent injunction, per Jensen v. Thornell, 2023 U.S. Dist. LEXIS 61747 (D. Ariz.). Defendants did not appeal.

“The Court identified the overarching failures in the delivery of healthcare as seriously insufficient staffing, inappropriate use of nurses beyond the scope of their licensure, failure to manage complex patients or employ a differential diagnosis approach, substantially inadequate mental health treatment, and a deficient health care record system,’ throughout the DCRR, Silver wrote.

A theme throughout the history of this litigation has been defendants’ willing agreement to abide by stipulations, injunctions, court orders, and monitors’ recommendations while in court only to balk afterwards at implementing them. These unfulfilled promises finally drove the Court to the most radical solution, taking prisoner health care out of the hands of prison officials, at the request of class attorneys Allison Hardy, David Spector and Sophie Hart of the Prison Law Office in Berkeley, California, and ACLU attorneys Corene Thaedra Kendrick, David Cyrus Fathi, Joseph Langley, Maria V. Morris and Lauren K. Beall.

“Plainly, only the imposition of the extraordinary can bring an end to this litigation and the reasons it was brought,” wrote Silver. “An end to unconstitutional preventable suicides. An end to unconstitutional preventable deaths. An end to unconstitutional failures to treat those in severe pain. The Motion for a Receiver will be granted.”

Complicating the provision of prisoner health care is an Arizona law requiring the DCRR to contract its provision with private entities. Over the course of the litigation, there have been four private health care companies with DCRR contracts. None have achieved adequate staffing for the provision of constitutionally-adequate health care. The current company, NaphCare, is more than two years into its contract.

The DCRR often tried to blame the private contractor for the substandard care it provided. Silver was having none of that. She held that the DCRR was responsible for providing constitutionally adequate healthcare and noted that the DCRR only rarely fined NaphCare when it violated the terms of its contract, such as having over 100 contract positions unfilled, as was the case when she issued the order.

Silver noted that the DCRR paid NaphCare over $300 million a year to provide prisoner health care … NaphCare, in turn, understaffed its facilities and relied on RNs and even LVNs, acting independently, to provide levels of care only physicians are supposed to provide, greatly increasing its profit margin while being fined only $1,424,900 in “offsets” for its failure to fully staff during the first two years of its contract.

In addition to blaming NaphCare, defendants complained of inadequate funding, a cumbersome funding process, and even attacked the competency of the very monitors they had previously approved.

“Either the Defendants are amnestic, or duplicitous or both,” Silver wrote. “The Monitors’ reports are thorough, amply supported, and their reasoning is fully explained. Defendants’ contentions to the contrary border on bad faith.”

Silver noted that the monitors had found the DCRR noncompliant with 131 of the 154 health care benchmarks set out in the injunction. She wrote that the violations are not “abstract. They are brought to life—or death—by the individuals who experience profound delays in receiving treatment or who failed to receive treatment at all.” Further, Silver wrote that the DCRR showed no inclination to correct, or even identify, problems in health care, calling its morbidity reviews “appalling in their illustration of callous, inhumane indifference displayed on a regular basis.”

Addressing the requirements for Silver involved considering the seven factors set out in United States v. Hinds Cnty. Bd. of Supervisors, 128 F.4th 616 (5th Cir. 2025), while noting that the first two factors—a threat of immediate harm and exhaustion or futility of lesser measures—are given predominant weight, per Plata v. Schwarzenegger, 2005 U.S. Dist. LEXIS 43796 (N.D. Cal.).

The Court held that the first two factors strongly favored plaintiffs and none of the factors favored defendants. Thus, the balance of Hinds factors favored receivership. See: Coleman v. Newsom, 2025 U.S. Dist. LEXIS 166993 (E.D. Cal.)

In the seminal Plata case, a federal court placed the California prison system under a receiver due to inadequate health care. Eventually, a court ordered California to reduce its prison population by 46,000 in order to pay for constitutionally adequate health care for the remaining prisoners, per Brown v. Plata, 563 U.S. 493 (2011).

The plaintiffs touted Plata as an example of a successful receivership and seeking Plata-like powers for the receiver in this case. Defendants scoffed, claiming Plata was an abject failure. Silver noted that progress was slow until the California prisoner population was reduced but between 2015 and 2017, the receiver returned authority over 16 prisons to California. Anticipating similar success in Arizona, Silver granted the Motion for a Receiver.

“Over the past 15 years, I would say we’re well into the hundreds of people who have passed away due to deficiencies in the [DCRR’s] medical care or mental health care,” commented Kendrick, deputy director of the ACLU’s National Prison Project. See: Jensen v. Thornell, 2026 U.S. Dist. LEXIS 33723 (D. Ariz.).  

Additional source: Arizona Capitol Times

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