Federal judge blocks Arizona prison agency’s push to hire less-qualified doctors for inmate care

A federal judge rejected a request from the Arizona Department of Corrections, Rehabilitation and Reentry that it be allowed to hire doctors who don’t meet agreed upon standards, sharply criticizing the state prison agency for failing to increase salaries, as it has been repeatedly advised to do.

It’s the latest loss for the state in a lawsuit that began in 2012 alleging that the healthcare provided to inmates in Arizona prisons is so poor that it is unconstitutional. In the 14 years since, the courts have sided with the inmates and agreed that shoddy healthcare in the prisons violated their Eighth Amendment right against “cruel and unusual punishment.” 

The class-action case has been marked by escalating judicial intervention, culminating in Judge Roslyn Silver ordering the prison healthcare system into receivership earlier this year.

In the three years since ADCRR and the plaintiffs agreed to the terms of a permanent injunction, “Defendants have utterly failed to comply with the Permanent Injunction’s requirements and have aggressively opposed its enforcement,” Silver wrote in an order she issued Thursday.

The order roundly rejected a bid by the Corrections Department to change the terms of the 2023 injunction to allow the state to hire doctors with fewer qualifications to treat inmates. That injunction, which was not issued until both ADCRR and the plaintiffs signed off on its terms, requires that all prison staff physicians and medical directors be either board certified or board-eligible in internal medicine or family practice.

ADCRR did not respond to a request for comment. Gov. Katie Hobbs’ office decline to comment.

In January, ADCRR filed a motion to amend that provision so that only half of the staff doctors meet those qualifications, and to allow it to continue to employ three existing medical directors and four physicians who are not board-certified in these specialties.

The Department of Corrections had argued that the standards needed to be lowered for physicians because, after three years, it had received applications from 62 physicians who, although they were otherwise qualified, could not be hired because they were not board-certified. 

The plaintiffs countered that nothing had changed since 2023, when they and the Corrections Department agreed to the terms of the preliminary injunction, including the standards for doctors. And they noted that the injunction specifically says that the state may need to increase pay for doctors to achieve the terms of the deal. 

The slight pay increase that did happen — a $2 per hour raise for physicians in 2024 and nothing since — is “anemic, at best,” they wrote. With no evidence of an aggressive attempt to increase compensation to attract qualified doctors, they added, the claim that the staffing challenges are “insurmountable” doesn’t pass muster.

In her order denying the motion to lower the qualifications for prison doctors, Silver concluded that the state has never sought to comply with the repeated recommendations from court-appointed monitors that ADCRR “aggressively” raise salaries for its doctors.

“Defendants argue ‘surely it is better to fill these positions with licensed, non-board-certified physicians rather than with no physicians at all.’ The argument is appealing, but Defendants have never credibly established they are unable to attract fully qualified applicants certified in the designated areas, and in particular that increasing salaries would be ineffective,” the judge wrote. 

“Obviously, 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.”

The defendants, Silver continued, “have not made good faith efforts to comply or shown compliance is impossible. This is plainly demonstrable because Defendants have refused to implement the changes they have been advised were necessary.”