Jensen et al v. Thornell et al

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WO
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ARIZONA
Shawn Jensen,
Plaintiff,
v.
Ryan Thornell, et al.,
Defendants.
No. CV-12-00601-PHX-ROS
ORDER
The SNU and IPC Health Care Staffing Analysis and Plan (“SNU and IPC Plan”),
was submitted in March 2026, (Doc. 5163). Both parties responded on May 1, 2026. (Docs.
5205; 5206). The Court will order Defendants to implement the SNU and IPC Plan
immediately.
Defendants argue against adoption of the Plan, saying:
The question is whether the specific staffing levels and
accompanying mandates in the Proposal are, as the PLRA
requires, narrowly drawn and the least intrusive means of
correcting the constitutional violations identified. The answer
is that they are not. The Proposal is most useful as guidance to
inform Defendants’ implementation of the Injunction’s
existing SNU and IPC requirements—not as mandates that go
beyond those requirements
(Doc. 5206 at 4). The PLRA does not require a line-by-line, figure-by-figure analysis.
Rather,
[T]he courts must do what they have always done when
determining the appropriateness of the relief ordered: consider
the order as a whole. In many cases it would not be possible
for a district court to produce meaningful need-narrowness-
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intrusiveness findings concerning each isolated provision of a
remedial order. Prospective relief for institutions as complex
as prisons is a necessarily aggregate endeavor, composed of
multiple elements that work together to redress violations of
the law. This is all the more true when relief must be narrow
and minimally intrusive: courts often must order defendants to
make changes in several different areas of policy and
procedure in order to avoid interjecting themselves too far into
any one particular area of prison administration. In such
circumstances, the necessity of any individual provision cannot
be evaluated in isolation. What is important, and what the
PLRA requires, is a finding that the set of reforms being
ordered—the “relief”—corrects the violations of prisoners'
rights with the minimal impact possible on defendants'
discretion over their policies and procedures.
Armstrong v. Schwarzenegger, 622 F.3d 1058, 1070-71 (9th Cir. 2010).
The Permanent Injunction issued in 2023 explicitly required the creation of a health
care staffing analysis and plan “to determine the number of staff necessary to care for
patients.” (Doc. 4410 at 14 § 1.17). The Court Monitors prepared and submitted the final
Health Care Staffing Analysis and Plan in April 2025, (Doc. 4858), and the Court ordered
its immediate implementation in June 2025, (Doc. 4916). According to the Health Care
Staffing Analysis and Plan, staffing needs in for SNU and IPC spaces be assessed and
reported in a separate “comprehensive staffing analysis and plan” was needed “for all SNU
and IPC space.” (Doc. 4963 at 26).
“A district court may . . . provide specific instructions to the State without running
afoul of the PLRA. In particular, when a district court has previously tried to correct the
deficiencies in prison operations through less intrusive means, and those attempts have
failed, relief prescribing more specific mechanisms of compliance is appropriate.”
Armstrong v. Newsom, 58 F.4th 1283, 1297 (9th Cir. 2023) (citation modified). Injunction
sections 7.5 – 7.6 address the requirements for SNU and IPC settings, (Doc. 4410 at 28-
29), and Defendants remain “far from reaching substantial compliance” with these
provisions, (Doc. 5163 at 4).1
1The Monitors describe “chronic care visits that do not address the SNU-related elements
of the patient’s needs” conducted by “random telehealth practitioners,” a lack of “necessary
physical exams,” and care that is “inefficient, fragmented, task-oriented, and error-prone.”
(Doc. 5163 at 8-10).
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Contrary to Defendant’s contention that the SNU and IPC Plan imposes “mandates
that go beyond” and “above the preexisting Injunction requirements,” the SNU and IPC
Plan rationally fills in the details of what is necessary to achieve compliance with the
Injunction’s requirements. Indeed, Defendants previously complained about the absence
of a “how-to guide” or “comprehensive plan” giving “detailed guidance on how to achieve
compliance.” (Doc. 4553 at 2).
Finally, Defendants propose the Court “defer adopting specific staffing levels until
the data the Proposal’s methodology requires has been collected and analyzed” because
that data has not been previously gathered and reported. (Doc. 5206 at 8) However,
prospective relief for institutions as complex as prisons is a necessarily aggregate endeavor,
composed of multiple elements that work together to redress violations of the law” and the
Court is “not required to take a piecemeal, wait-and-see approach.” Armstrong v. Newsom,
58 F.4th 1283, 1298-99 (9th Cir. 2023). The SNU and IPC Plan is designed to be responsive
to new data. It is “subject to review and adjustment eight months after a Court order to
implement it, and every six months thereafter,” (Doc. 5163 at 25), and includes the
provision that “special circumstances may arise in which it may be clinically safe to engage
lower staffing levels than those prescribed” and therefore Defendants may be permitted “to
make changes upon approval of the Monitors.” (Doc. 5163 at 3).
Having reviewed the SNU and IPC Plan, the parties responses, and the voluminous
record in this litigation, the Court finds the SNU and IPC Plan is narrowly drawn, extends
no further than necessary to correct the constitutional violations in the IPCs and SNUs, and
is the least intrusive means to correct those violations. The Court approves the SNU and
IPC plan and will order it be implemented immediately.
IT IS ORDERED the SNU and IPC Health Care Staffing Analysis and Plan (Doc.
5163) is approved.
IT IS ORDERED the SNU and IPC Health Care Staffing Analysis and Plan (Doc.
5163) shall be implemented immediately by Defendants.
IT IS FURTHER ORDERED Defendants shall reach full staffing based on the
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parameters of the SNU and IPC Health Care Staffing Analysis and Plan within 60 days of
this Order, and the clinical tools described therein are to be implemented within 90 days of
this Order.
IT IS FURTHER ORDERED The SNU and IPC Health Care Staffing Analysis
and Plan shall be subject to review and adjustment eight months after this Order, and every
six months thereafter.
Dated this 14th day of May, 2026.
Honorable Roslyn O. Silver
Senior United States District Judge
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