Court Shuts Down Arizona Attempt to Fill Medical Staff Vacancies with Under-Qualified Providers
by Chuck Sharman
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n July 17, 2026, the U.S. District Court for the District of Arizona denied a request by the state Department of Corrections, Rehabilitation and Re-entry (DCRR) to allow the prison agency to lower professional qualifications for medical staff.
The move came in a long-running class-action challenge that in April 2023 saw the district court issue a permanent injunction (PI), specifying in detail what the DCRR must do to meet minimum constitutional standards for prisoner healthcare and mental health care, as well as conditions in isolation, as PLN reported. Almost three years later, after identifying “overarching failures in the delivery of healthcare” to prisoners, the district court issued another order in February 2026 placing the DCRR’s healthcare and mental health care in receivership. But as PLN also reported, state lawmakers then refused in June 2026 to fully fund staffing increases that the DCRR needed, setting up a potential constitutional crisis [See: PLN, Sep. 2023, p.63; May 2026, p.38; and July 2026, p.43.]
The budget impasse prompted the DCRR to ask the district court for a modification of the PI to lower licensure and certification qualifications for three existing medical directors and four staff physicians who were not board-certified, along with permission to make the same waiver of qualifications for up to half of its medical staff. All of that is needed, the prison system said, to ease a shortage that all parties have blamed for the persistent healthcare failures. Noting at least 62 applicants it had been forced to reject, the prison agency said that they could be hired if the proposed standard were adopted, going a long way toward closing the staffing gap.
The reply was a firm “no.” The district court said that Defendant DCRR officials “have utterly failed to comply with the Permanent Injunction’s requirements and have aggressively opposed its enforcement.” Their “essential argument is that they have made good faith efforts to comply with the requirements of [the PI], but the passage of time has established it is unworkable,” the district court observed. Yet in the three years since the PI was issued, “Defendants have not complied, nor have they ever demonstrated attempts to substantially comply with the entrenched order of the Court and the opinion of the Monitors that they must aggressively increase salaries to attract qualified healthcare staff.”
To the DCRR’s main supporting argument—that underqualified personnel are better than none at all—the district court said it missed the point. “Obviously,” the court noted, “the failure to fill positions points to the need to increase the salaries, not reduce the required qualifications of staff and, by extension, the quality of care.” And because the Monitors’ advice to increase salaries had never been taken seriously, “Defendants have never credibly established they are unable to attract fully qualified applicants certified in the designated areas” or “that increasing salaries would be ineffective.”
Accordingly, the motion to modify the PI was denied. The DCRR was ordered to hammer out narrow exceptions with the Monitors for the existing underqualified staff. See: Jensen v. Thornell, USDC (D. Ariz.), Case No. 2:12-cv-00601.
DCRR Ruled Non-Compliant
with PI Requirements for
Mentally Ill Prisoners
Although Defendants agreed with Plaintiffs to the appointment of former Ohio Department of Rehabilitation and Correction Director Annette Chambers-Smith to serve as Receiver, they also requested a stay of the order appointing her while they contested it at the U.S. Court of Appeals for the Ninth Circuit. That request was granted with a seven-day stay on August 5, 2026, and the appeal was then filed. See: Jensen v. Thornell, 2026 U.S. Dist. LEXIS 174067 (D. Ariz.); and Jensen v. Thornell, USCA (9th Cir.), Case No. 26-05060.
Just prior to that, the district court granted another request from Plaintiffs to enforce the PI’s limitations on out-of-cell time for prisoners suffering from serious mental illness (SMI). After that motion was made the previous March, the Monitor was dispatched to the Behavioral Management Unit (BMU) and Residential Mental Health Program (RMHP) at units of the State Prison Complex (ASPC) in Lewis and Eyman, to determine whether the DCRR was in compliance with PI provisions “that no prisoner designated as SMI shall be kept in a cell for more than 22 hours each day.”
Defendant DCRR officials claimed compliance, producing guards’ reports—”Correctional Service Journals”—and other electronic data as proof. After reviewing these, the Monitor allowed that they reflected “a semblance of compliance.” But Defendants seemed to believe that they were required to improve only the average time out-of-cell for SMI prisoners, rather than ensure that none remains in a cell for more than 22 hours on any day, as the PI actually required. Moreover, “the documentation continues to be seriously flawed, as well as the data collection,” the district court noted.
It concluded that Defendants “provided no data contradicting Plaintiffs’ assertions of noncompliance prior to March 1, 2026, and the data they rely upon for the time after March 1, 2026, is incomplete and riddled with inaccuracies.” Particularly troubling were “high levels” of recreation refusals by prisoners, who in interviews with the Monitors reported that guards bribed them with extra food or other privileges to voluntarily remain in their cells.
Accordingly, the DCRR was found noncompliant with the PI on August 3, 2026, and ordered to implement remedial efforts including: (1) a “reliable system to track and report … the out-of-cell time offered in all celled housing units primarily holding people designated SMI,” along with (2) “[r]equired specialized … training to all personnel” working in these housing units and (3) “[m]andatory removal” of any staff found “engag[ing] in misconduct involving physical or mental abuse.” See: Jensen v. Thornell, 2026 U.S. Dist. LEXIS 171783 (D. Ariz.).
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Related legal case
Jensen v. Thornell
| Year | 2026 |
|---|---|
| Cite | 2026 U.S. Dist. LEXIS 171783 (D. Ariz.) |
| Level | District Court |