Three Arizona correctional facilities all have high ratings for lack of access to health care and advocacy groups in the state are concerned the situation will worsen during the COVID-19 pandemic.
Healthcare Provider Shortage Areas, or HPSAs, are federally designated areas that are known to have a lack of health care providers or services available. The places in Arizona with the highest ratings – meaning the least access to health care – are correctional facilities.
HPSAs are a designation given to a geographic area, population or facility that has a shortage of primary care, dental or mental health providers or services. Some portions of the state have 100 percent of their population living within one.
The designation is determined by the Health Resources and Services Administration, the primary federal agency that helps with improving access to health care for people who are uninsured or in isolated areas.
Arizona ranks ninth in the nation for the most HPSAs and would need approximately 558 new doctors and nurses to be hired in order for the designation to be removed, according to an analysis of the data by the Kaiser Family Foundation.
HPSAs are given a rating on a scale of 0 to 26. There are 11 HPSAs in Arizona with scores of 21. Of those, three are correctional facilities: the Arizona State Prison in Douglas, the federal prison in Tucson and the U.S. Immigration and Customs Enforcement detention facility in Florence.
As of April 20, there have been 22 confirmed cases of COVID-19 at ICE facilities in Arizona – including nine at the Florence detention center – and 28 inmates in Arizona Department of Corrections Rehabilitation and Reentry custody have tested positive for the virus, but not at the Douglas prison.
The federal Bureau of Prisons, which oversees the Tucson prison, did not respond to questions about whether any inmates there have tested positive for COVID-19.
“At this time, FCC Tucson has not requested additional medical staff for their COVID-19 response,” BOP spokesperson Emery Nelson said to the Arizona Mirror.
Nelson said the agency has been limiting transfers between facilities and implementing quarantine and isolation procedures at all facilities.
“In addition, we suspended social and legal visits, cancelled staff training and travel, limited access for contractors and volunteers and established enhanced screening for staff and inmates, including temperature checks,” Nelson said.
BOP has also increased inmate phone allotments from 300 minutes a month to 500.
Inmates are also limited in their movements, and only small numbers of them are allowed into places such as the commissary, laundry, showers or other areas at a time, Nelson said.
“Just like in communities nationwide who have been required to shelter-in-place, the BOP implemented this course of action to mitigate the spread of the virus,” Nelson said.
Inmates at the Tucson facility who are at-risk also have the opportunity to participate in home confinement. BOP would not confirm if any inmates in Tucson have taken advantage of this option.
“We do not have any information regarding releases from specific institutions,” Nelson said, adding “all inmates releasing or transferring from BOP facilities to the community will be placed in quarantine for 14 days prior to their scheduled departure from the institution.”
ADCRR did not respond to multiple requests for comment for this story.
The state prison in Douglas has been listed as a HPSA since 2002.
So far, 148 of the almost 42,000 inmates in ADCRR custody have been tested for COVID-19.
A survey conducted by the American Friends Service Committee Arizona Chapter of families of those incarcerated in ADCRR facilities found that 64% of them received little to no information on COVID-19 in the prison where their loved one was staying.
Only 4% said their loved one had received information from the inside from a warden or a meeting.
AFSC Arizona also has been expressing concerns about access to soap and other supplies that inmates may need to help prevent the spread of the virus, all while inmates at the Douglas, Perryville and Florence facility are currently sewing masks for the guards but not themselves.
“We always are in communication, to the extent we can be, with incarcerated people,” AFSC Arizona Program Director Caroline Isaacs said.
While speaking with incarcerated people and their families, Isaacs and her group have found that many inmates in Arizona prisons are only getting access to small bars of soap, if they get it at all. Items such as alcohol-based hand sanitizer and face masks are off limits for inmates.
“Prisons are just the most dangerous place to be when you’re dealing with an infectious disease,” Isaacs said. “It’s literally impossible to socially distance.”
Arizona has another unique factor with its prison population: age.
Approximately 11% of prisoners in ADCRR’s care are over the age of 55, a little more than 4,800 people. Additionally, 10% of inmates have a medical score of 3 or above, meaning they have to be housed in special conditions or need special care.
“It’s a perfect storm for something like COVID to run rampant,” Isaacs said.
The group, along with other organizations, recently asked a judge for an emergency order in a separate long-running case about inmate health care to compel the department to consult with health care experts to develop a COVID-19 plan.
The judge did not approve the request, but did order the department to begin reporting the number of inmates infected with the virus.
“All indications are that these guidelines are not being implemented to the extent that they claim they are,” Isaacs said. Her group along with others have been monitoring posts on social media by guards and families who have been saying that practices such as taking temperatures and other CDC guidelines are not being followed.
Meanwhile, families are still being left in the dark, Isaacs said.
“There is very little up-to-the-minute guidance on how bad this is,” Isaacs said. “What happens is the rumor mill gets started and people get more frightened.”
Meanwhile at ICE facilities, hunger strikes are occurring by detainees demanding soap at a facility in New Jersey and field offices around the country have been ordered to release anyone over the age of 60 or with chronic illness.