The Arizona Department of Corrections, Rehabilitation and Re-entry (DCRR) has faced bitter criticism for the healthcare provided to state prisoners, which a federal judge in 2022 called “plainly, grossly inadequate,” as PLN reported. [See: PLN, Dec. 2022, p.1.] So it wasn’t surprising when its early response to the COVID-19 pandemic drew a 2020 warning from prisoner advocates in 11 faith groups that DCRR officials were sleepwalking through the pandemic and “not recognizing this reality nor addressing the asymptomatic nature of this virus.”

Yet the magnitude of the prison system’s failure—which, unlike the virus, was entirely within its own control—is only now coming to light. In a series of reports published on October 1, 2024, the nonprofit Citizens for Responsibility and Ethics in Washington (CREW) said that prisoners reported being given “fake” health checks—where no vital signs were taken—along with “do not resuscitate” orders that they never requested and were powerless to rescind.

Predictably, the DCRR’s response to criticism during the pandemic was to point the finger at private healthcare contractor Centurion Health, to which it paid $4,028,900 for COVID-19 tests in December 2020. But it was prison officials who then failed to strictly follow quarantine policies—signing off on transfers of infected prisoners to housing with other prisoners whose COVID-19 tests were still pending. Some prisoners complained of being housed with symptomatic fellow prisoners for days while waiting for test results to return.

Staffers with both the DCRR and Centurion were also repeatedly written up for not wearing masks, even as prisoners complained that masks were not made available to them. Some admitted reluctance to submit to COVID-19 testing, fearing a change in housing assignment from a positive result. But prison officials apparently ignored the risk that they may be carrying the virus. In January 2022, the DCRR’s then-Director David Shinn was forwarded reports received by the Attorney General that “hundreds of actually sick inmates with symptoms, and who refused testing, have not been segregated.”

A year earlier, Donna Hamm, the leader of the outside advocacy group Middle Ground Prison Reform (MGPR), forwarded Shinn other prisoner reports about food service disruptions. Spoiled milk and expired food items were on breakfast trays, and those with allergies and dietary restrictions were given two choices: Eat standard meals or nothing. At Huachuca Unit in Kingman, which is run for DCRR by private prison contractor The GEO Group, cooking allegedly ceased, and prisoners were fed uncooked food. Prisoners at both the DCRR and GEO Group lockups complained when laundry services were suspended.

As in other prison systems, the pandemic was also used to excuse long lockdowns, during which access to medical care, recreation and programming was severely curtailed. Yet the lockdowns’ purpose—to isolate infected prisoners—was undermined by staff. In January 2022, DCRR sanctioned Centurion twice, for a total of $20,000, for “failure to isolate” inmates with active COVID-19 infections in the Arizona State Prison Complex (ASPC) in Tucson. The entire lockup was then locked down while mass testing was performed. But it was too little too late—the close quarters and testing delays resulted in a spike of new infections. At one point, nearly half of the 1,000 prisoners in ASPC-Tucson’s Whetstone unit were positive with COVID-19. Then-Assistant Director of Medical Services Larry Gann privately called this the “Tucson blunder” in subsequent internal DCRR communications.

Some DCRR staffers joined in complaints against the agency. In April 2020, the head of the guards’ union, Arizona Correctional Peace Officers Association Executive Director Carlos Garcia, accused DCRR of “playing chicken” with the virus. By July 2020, DCRR said that prisoners were making their own masks, though some prisoners told journalists that they were disciplined for makeshift masking with tee-shirts. DCRR Deputy Director Joe Profiri forwarded that news to other officials, dryly warning that “[i]t would be prudent to determine if any inmates were disciplined before the media informs you.”

Another DCRR staffer who complained about masking and hygiene failures in December 2020 said that fear of retaliation stifled more complaints. “I do not want to be retaliated against for bringing up issues,” the staffer added. “I cannot stress enough how uncomfortable it is to write this email.”

In another email a year later, then-DCRR Assistant Director of Operations Lance Hetmer told Gann: “Larry this is ridiculous two inmates present with COVID symptoms are tested and sent back to their dorms. No quarantine no notification nothing. Now we have what appears to be a serious problem.”

While DCRR was publicly finger-pointing at Centurion, the healthcare contractor in turn scapegoated prison officials—and even some of its own employees. In December 2021, Centurion Statewide Medical Director Wendy Orm said that a new occupational health nurse at one prison was colluding with the warden to withhold positive COVID-19 test results for staffers, frustrating the firm’s efforts at contact mapping and containing new exposures.

According to the National Institutes of Health (NIH), the infection rate for COVID-19 in 2020 was “5.5 times higher in correctional facilities than in the community.” By the time the pandemic waned in 2023, there were 663,196 positive cases and 3,181 deaths reported from U.S. prisons and jails, as well as youth and immigration detention centers. The cost of so much preventable infection and death was not estimated.  

Sources: CREW, NIH

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