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PHOENIX (AP) — A judge ruled Arizona has been violating the constitutional rights of incarcerated people in state-run prisons by providing them with inadequate medical and mental health care, saying the state has known about the problem for years but refused to correct its failures.

In a blistering verdict Thursday, U.

S. District Judge Roslyn Silver concluded the state’s inaction showed it is acting with “deliberate indifference” to the risks of inadequate care and said the state has adopted a health care system for prisoners that has led to preventable deaths.

She said there aren’t enough health employees to care for the roughly 25,000 incarcerated people housed in state-run prisons and that corrections officials have made no significant attempts to fix the understaffing problem.

The judge criticized Corrections Director David Shinn for pressing the state’s prison health care contractor hard enough to better staff its operations and for testifying that prisoners often have greater access to health service than people who aren’t locked up.

Shinn’s claim that access to care is greater in state prisons “is completely detached from reality,” Silver wrote. “Given the overwhelming evidence and repeated instances of insufficient care leading to suffering and death, Defendant Shinn could not possibly believe prisoners have the same access to care as people in the community.”

The ruling said prisoners aren’t getting timely access to emergency treatment, medications, treatment for chronic diseases and specialty care. Under the current system, nurses are the first — and often the only — medical professionals available to see prisoners. Sometimes the nurses, who may be insufficiently trained to diagnose and treat a given condition, miss obvious signs that should lead to a referral to a higher level provider, Silver wrote.

The judge is expected to order remedies in response to the constitutional violations. Lawyers representing prisoners have previously asked Silver to set up a receivership where the court would take over health care operations in state prisons and appoint an official to run those services there.

The Arizona Department of Corrections, Rehabilitation and Re-entry, which in the past has denied allegations that it was providing inadequate care, had no immediate comment Friday on the decision.

C.J Karamargin, a spokesman for Gov. Doug Ducey, who hired Shinn, said the state didn’t yet have any plans for an appeal. “It’s a lengthy ruling, and we are analyzing it closely now,” Karamargin said.

Corene Kendrick, an American Civil Liberties Union attorney who represented prisoners in the case, said Silver affirmed the bedrock principle that prisoners are entitled to basic health care under the Eighth Amendment.

“The department has abdicated its responsibility under the Constitution to provide minimal protections to the people it locks up,” Kendrick said.

The case was tried late last year after Silver threw a 6-year-old settlement over prison health care, saying the state showed little interest in making many of the improvements it promised under the deal. Silver also said that $2.5 million in contempt of court fines against the state didn’t motivate authorities to comply with the settlement.

After Silver threatened yet another round of contempt fines, Shinn wrote a February 2020 letter to the state’s prison health care contractor to say the state expected the company to provide enough resources to meet the settlement’s requirements for care. The corrections director also wrote that the company would be on the hook for costs associated with noncompliance.

In Thursday’s ruling, Silver chided Shinn for not knowing whether the contractor had reallocated staff within Arizona.

“The only possible conclusion to draw is that Defendant Shinn had little interest in changing the underlying reality,” Silver wrote. “Rather, his letter appears to have been nothing more than a half-hearted effort to generate a piece of paper he could cite to avoid contempt. Obviously, the Court expected Defendant Shinn to take more direct action than signing a letter.”

In the past, receiverships similar to the one being proposed by the Arizona prisoners have been ordered for prisons in other states, including California.

In 2005, a federal judge seized control of California’s prison medical system after finding that an average of one inmate a week was dying of medical neglect or malpractice. He appointed a receiver, who retains control of the medical system, although operations at individual prisons are gradually being returned to the state’s responsibility.

The lawsuit that prompted the change in California and a similar suit over poor mental health treatment of inmates led a panel of judges to declare that record prison crowding was making it impossible to improve conditions to constitutional standards.

The judges put a cap on California’s prison population that forced a dramatic drop in the number of people in prison as the state eased criminal penalties, kept lower-level offenders in county jails and increased opportunities for parole.

Copyright © 2022 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.

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Dems push Biden climate, health priorities toward Senate OK

WASHINGTON (AP) — Democrats drove their election-year economic package toward Senate approval early Sunday, debating a measure that is less ambitious than President Joe Biden’s original domestic goals but touches deep-rooted party dreams of slowing global warming,moderating pharmaceutical costs and taxing immense corporations.

The legislation cleared its first test in the evenly divided chamber when Democrats burst past unanimous Republican opposition and voted to begin debate 51-50, thanks to Vice President Kamala Harris’ tie-breaking vote. The House planned to return Friday to vote on what Democrats hope will be final congressional approval.

“It will reduce inflation. It will lower prescription drug costs. It will fight climate change. It will close tax loopholes and it will reduce and reduce the deficit,” Senate Majority Leader Chuck Schumer, D-N.Y., said of the package. “It will help every citizen in this country and make America a much better place.”

Republicans said the measure would undermine an economy that policymakers are struggling to keep from plummeting into recession. They said the bill’s business taxes would hurt job creation and force prices skyward, making it harder for people to cope with the nation’s worst inflation since the 1980s.

“Democrats have already robbed American families once through inflation, and now their solution is to rob American families a second time,” Senate Minority Leader Mitch McConnell, R-Ky., argued. He said spending and tax hikes in the legislation would eliminate jobs while having insignificant impact on inflation and climate change.

Nonpartisan analysts have said the Democrats’ Inflation Reduction Act would have a minor impact on surging consumer prices. The bill is barely more than one-tenth the size of Biden’s initial 10-year, $3.5 trillion rainbow of progressive dreams, and the new package abandoned universal preschool, paid family leave and expanded child care aid.

Even so, the measure gives Democrats a campaign-season showcase for action on coveted goals. It includes the largest ever federal effort on climate change — close to $400 billion — and would hand Medicare the power to negotiate pharmaceutical prices and extend expiring subsidies that help 13 million Americans afford health insurance.

Biden’s original measure collapsed after conservative Sen. Joe Manchin, D-W.Va., opposed it, saying it was too costly and would fuel inflation.

In an ordeal imposed on all budget bills like this one, the Senate descended into an hours-long “vote-a-rama” of rapid-fire amendments. Each tested Democrats’ ability to hold together a compromise negotiated by Schumer, progressives, Manchin and the inscrutable centrist Sen. Kyrsten Sinema, D-Ariz.

Progressive Sen. Bernie Sander, I-Vt., offered amendments to further expand the legislation’s health benefits, and they were defeated. But most proposed changes were fashioned by Republicans to unravel the bill or force Democrats into votes on dangerous political terrain.

One GOP proposal would have forced the Biden administration to continue Trump-era restrictions that cited the pandemic for reducing the flow of migrants across the Southwest border.

Earlier this year, Democrats facing tough reelections supported such an extension, forcing the party to drop its push for COVID-19 spending when Republicans conjoined the two issues. This time, with their far larger economic legislation at stake and elections approaching, Democrats rallied against the border controls.

Other GOP amendments would have required more gas and oil leasing on federal lands and blocked a renewal of a fee on oil that helps finance toxic waste cleanups. All were rejected on party-line votes. Republicans accused Democrats of being soft on border security and opening the door to higher energy and gas costs.

Before debate began Saturday, the bill’s prescription drug price curbs were diluted by the Senate’s non-partisan parliamentarian. Elizabeth MacDonough, who referees questions about the chamber’s procedures, said a provision should fall that would impose costly penalties on drugmakers whose price increases for private insurers exceed inflation.

It was the bill’s chief protection for the 180 million people with private health coverage through work or that they purchase themselves. Under special procedures that will let Democrats pass their bill by simple majority without the usual 60 vote margin, its provisions must be focused more on policy than dollar-and-cents budget changes.

But the thrust of their pharmaceutical price language remained. That included letting Medicare negotiate what it pays for drugs for its 64 million elderly recipients, penalizing manufacturers for exceeding inflation for drugs sold to Medicare and limiting beneficiaries out-of-pocket drug costs to $2,000 annually.

The bill also caps patients’ costs for insulin, the diabetes medication, at $35 monthly.

The measure’s final costs were being recalculated to reflect late changes, but overall it would raise more than $700 billion over a decade. The funding would come from a 15% minimum tax on a handful of corporations with yearly profits above $1 billion; a 1% tax on companies that repurchase their own stock, beefed up IRS tax collections and government savings from lower drug costs.

Sinema forced Democrats to drop a plan to prevent wealthy hedge fund managers from paying less than individual income tax rates for their earnings. She also joined with other Western senators to win $4 billion to combat the region’s horrific drought.

It was on the energy and environment side that Democrats’ compromise was most evident between progressives and Manchin, a champion of fossil fuels and his state’s coal industry.

Efforts fostering clean energy would be strengthened with tax credits for buying electric vehicles and manufacturing solar panels and wind turbines. There would be home energy rebates, funds for constructing factories building clean energy technology and money to promote climate-friendly farm practices and reduce pollution in minority communities.

Manchin won billions to help power plants lower carbon emissions plus language requiring more government auctions for oil drilling on federal land and waters. Party leaders also promised to push separate legislation this fall to accelerate permits for energy projects, which Manchin wants to include a nearly completed natural gas pipeline in his state.

Copyright © 2022 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.

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