A new report alleges illegal and deadly mistreatment of Arizona inmates whose medical care the state contracted out to the country’s largest private prison health care provider.

The report, released last week by the American Friends Service Committee, a progressive Quaker group, comes as an American Civil Liberties Union lawsuit against the Arizona Department of Corrections awaits an appeals court ruling over the state’s challenge to its class action status. The ACLU alleges “grossly inadequate” care that creates “grave danger” for inmates, including “critically ill” people who were told to “be patient” or “pray” for healing, or that “it’s all in your head.”

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Shortly before that lawsuit was filed in March 2013, the state contracted with its current for-profit health provider, Corizon, to replace the departed company Wexford. But the AFSC charges that “Correspondence from prisoners; analysis of medical records, autopsy reports, and investigations; and interviews with anonymous prison staff and outside experts indicate that, if anything, things have gotten worse.” Among the allegations: “delays and denials of care, lack of timely emergency treatment, failure to provide medication and medical devices, low staffing levels, failure to provide care and protection from infectious disease, denial of specialty care and referrals, and insufficient health treatment…”

Asked about the report, Corizon sent a statement saying that since March, it has "increased the number and skill level of our healthcare staff with the goal of continually improving patient outcomes." Corizon said that its facilities are accredited and subject to internal audits, and that "ADC inmate patients receive care that meets their healthcare needs and satisfies constitutional requirements." It added that "As with any large healthcare provider, litigation does arise from time to time. However, the vast majority of lawsuits filed against Corizon are without merit and are dismissed or settled with no findings of wrongdoing." The Arizona Governor’s office did not immediately respond to an early morning Wednesday inquiry.

In 2011 and 2012, the deaths of thirty-seven total inmates were reported in the Arizona Republic. In contrast, writes the AFSC, fifty people have died in custody in the first two-thirds of this year. Last year, the Arizona Republic charged that “Arizona’s prison system has two death rows”: Those “officially sentenced to death” and those who “die as victims of prison violence, neglect and mistreatment.”

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The AFSC report includes a series of case studies drawn from media reports and individuals' accounts. The Arizona Capitol Times reported that a death-row inmate was diagnosed with throat cancer, “but his disease went unknown to him and untreated for seven more months.” A prisoner’s mother, a registered nurse, told AFSC that her son had lost his visitation and phone privileges for alleged “refusal” to provide urine for drug-testing, when the real and well-documented issue was his diagnosed post-chemotherapy bladder conditions. Staff at Tempe St. Luke’s Hospital recorded that a patient who had been discharged back to the Tucson complex “was supposed to follow up [with] pathology and receive a PET scan; unfortunately none of that workup was done at this time. The patients says that he request [nut] no oncology consults ever been performed at this time either…it is felt that the patient does have cancerous etiology and does need to receive further workup.”

AFDC argues that the privatization of medical services exacerbates such ills. The report notes that the state’s budget bill for fiscal year 2010 included language requiring the Department of Corrections to “issue a request for proposal to privatize correctional health services” and stated that the new contract must “Cost less than these services did in FY 2007-08…” After two years, with no such contract secured, the legislative requirement was changed and the government issued a request for proposals stating the winning contractor would be “the most qualified bidder.” AFDC concludes that “Contracting out the medical care at ADC has resulted in more bureaucracy, less efficiency, and decreased quality of care. What is required to correct the problem is transparency and accountability. Privatization functions only to hinder those processes.”

“I am a 58 year old man who is classified as SMI [Seriously Mentally Ill], my mental impairment is such, that I recognize that without the assistance of an advocate helping me to maneuver through this web of misdirection, confusion, and uncaring medical caregivers, I will simply be allowed to continue deteriorating at a fatally unhealthy rate,” an inmate diagnosed with cancer wrote to the Faith Lutheran Church’s prison ministry in a January letter cited by AFDC. “To say that I’m terrified would be an understatement. But I simply do not know what to do.” The man, Mackie McCabe, died in June.