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, et al.,
Plaintiffs,
v.
Ryan Thornell, et al.,
Defendants.
No. CV-12-00601-PHX-ROS
ORDER
I. Appointment of the Receiver
On February 19, 2026, this Court granted Plaintiffs’ Motion for a Receiver finding
the appointment of a Receiver to assume control of the delivery of health care services to
the class of prisoners in the custody of the Arizona Department of Corrections,
Rehabilitation, and Reentry (ADCRR) was required to conclusively eliminate the
constitutional violations within ADCRR of health care pertaining to the class members.1
(Doc. 5123.)
Both parties proposed the appointment of Ms. Annette Chambers-Smith. The Court
conducted an interview and requested the Parties and the Monitors to conduct due diligence
regarding the appointment. The interview and due diligence are complete. (See Docs. 5218;
5256, 5260.) Accordingly, the Court will appoint Ms. Annette Chambers-Smith as the
Receiver.
Defendants have represented they intend to appeal the appointment of the Receiver.
1 References to health care include only medical and mental health care.
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See Jensen v. Thornell, CV 26-1746, Dkt 9.1 (9th Cir. May 21, 2026) (“Defendants-
Appellants . . . anticipate appealing from a[n] . . . order . . . appointing a receiver and
defining the receiver’s powers and duties.”). It appears Defendants also intend to seek a
stay of the appointment pending appeal. The Court will delay the effective date of the
Receiver’s appointment pending resolution of a motion to stay if filed. If Defendants opt
not to seek a stay, Defendants shall file that notice within five days of the date of this Order.
The Court ordered the parties to address “the proposed duties, powers, and
authorities of the Receiver, [including] how each proposal will extend as far as[,] but no
further than[,] necessary to correct Defendants’ constitutional violations.” (Doc. 5123 at
83.) The Court has evaluated the recommendations of the parties, and resolved what
authorities, responsibilities, and duties are essential for the Receiver to accomplish the
objectives of this Receivership. They are narrowly drawn and extend no further than
necessary to remedy the ongoing constitutional violations and are the least intrusive means
to correct the ongoing constitutional violations. See 18 U.S.C. § 3626(a)(1)(A).
II. Authority, Duties, and Responsibilities of the Receiver
During this multi-year, interminable litigation, the Court has identified entrenched
systemic failures in Defendants’ administration of health care to the Plaintiff class,
“including (1) chronic understaffing and failure to enforce contractual provisions with the
third-party vendor, (2) the persistence of nurse driven care and inappropriate assignment
of complex patients to advanced practice practitioners instead of physicians, (3) failures in
the referrals process, (4) data collection and reporting failures, and (5) inadequate
resources, including funding and facilities.” (Doc. 5218 at 2-3.) Accordingly, the Court
found that only a Receiver with the powers and authority necessary to address each of the
systemic failures would adequately remedy the failure of health care. (Id.)
The Receiver’s authority, duties, and responsibilities to administer and manage
ADCRR’s health care system to ensure constitutional health care for the class members are
what follows.
a. Leadership and Management
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The Receiver shall provide leadership and management of the health care system
including overseeing, supervising, and directing all ADCRR employees and contract
personnel who perform administrative, financial, accounting, contractual, legal, and other
operational functions required to ensure constitutional health care is provided to class
members. In exercising these responsibilities, the Receiver may consult with the Director
of ADCRR, and all relevant and knowledgeable ADCRR employees and contract
personnel.
b. Development and Implementation of Operational Plan
1. Within 180 days of the effective date of the Receiver’s appointment, the
Receiver shall prepare and file the “Receiver’s Operational Plan” (the “Plan”) designed to
remediate ADCRR’s unconstitutional health care identified in all of the Court’s Orders,
and address the constitutional violations identified in the June 30, 2022 Order and Findings
of Fact and Conclusions of Law (Doc. 4435). The Plan shall consider the compliance
criteria set forth in the April 7, 2023 Order and Permanent Injunction (Doc. 4410), the
March 31, 2025 ADCRR Health Care Staffing Analysis and Plan (Doc. 4963), the February
19, 2026 Order granting this Receivership (Doc. 5123), and the May 15, 2026 SNU and
IPC Health Care Staffing Analysis and Plan (Doc. 5230).
2. The Plan shall address the findings of the Court Monitors and include a
proposed schedule for completion and resolution of all identified solutions and remedies
with measurements and gauges by which to periodically evaluate ADCRR’s progress and
success. Throughout the Receivership, the Receiver shall report ADCRR’s benchmarks
and milestones and modify the Plan as deemed essential and required by the Receiver and
the Court to achieve the objectives.
3. Pending the final draft and implementation of the Plan, the Receiver shall
initially implement short-term measures essential for immediately improving critical health
care issues and begin the process of restructuring, developing, and implementing the
constitutionally adequate health care system.
c. Budgeting and Accounting
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On an annual basis, the Receiver shall establish the budget required for all
ADCRR health care for the class members. The Receiver shall engage in essential efforts
to secure adequate funding in consultation with Plaintiffs and Defendants, the Governor,
and the Legislature, including their designated representatives. Consistent with the
reporting requirements of II.d.ii below, the Receiver shall establish a calendar for
periodically reporting to the Court the status of the ADCRR health care budget, including
recommendations, and shall take all necessary steps to ensure transparency and
accountability of budget information.
d. Reporting
i. Permanent Injunction Audits
Monthly audits of all Permanent Injunction requirements are not required
of the Receiver. Rather, the frequency of such audits shall be determined by the Receiver
with Court approval and based upon an assessment of (1) the significance of each
requirement, (2) the time, resource, and costs of monitoring each requirement, and (3) the
history of performance or failure of performance for each requirement. While no single
factor dominates, the third factor is paramount.
ii. Reports to the Court
The Receiver shall file annual reports with a detailed analysis of the
progress of ADCRR in resolving the unconstitutional health care of the class and achieving
the requirements of the Plan. And as deemed necessary by the Receiver or the Court, the
Receiver shall file additional reports with the Court. These reports shall include (a) the
successes and failures achieved in implementing the Plan, including anticipated dates for
completion of each requirement of the Plan, (b) the obstacles or impediments to
implementing the Plan, and identifying any issue that has interfered with compliance,
including but not limited to pinpointing individuals, agencies, or entities responsible for
impeding compliance, (c) identification of the required expenditures, with detailed
explanations, and (d) all other issues required to allow the Court’s analysis, review and
approval of the progress made regarding the Plan. The Receiver shall meet with the Court
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following the issuance of each report and shall maintain direct communication with the
Court throughout the Receivership.
III. Powers and Authorities of the Receiver
a. General Powers
1. All duties and authorities vested by law in the Director of ADCRR relating to
the health care of the class members as set forth in A.R.S. § 41-1604 and A.R.S. § 31-
201.01 and other governing laws and regulations shall be vested in the Receiver. The
Receiver’s authority, actions, and decisions shall be subject to review of the Court.
2. All duties and authorities of the Director of ADCRR relating to the health care
of the class members are enjoined for the duration of the Receivership. Upon termination
of the Receivership, those duties and authorities shall be restored to the State and the
Director. However, the Director is authorized to confer with the Receiver where the
Receiver determines assistance would be advantageous to fulfilling her responsibilities.
b. Dental Care
The Receivership applies to medical and mental health care. However, a clear
boundary distinguishing dental care from health care is often not possible in the prison
context, particularly regarding contracts outsourcing health care. When this occurs, the
Receiver and Director of ADCRR shall engage in efforts to collaborate to resolve the
ambiguous dental issues that constitute health care. If the Receiver and the Director are
unable to resolve such issues, they shall jointly advise the Court in writing with notice to
Plaintiffs and Defendants, and the Court will determine the appropriate and best resolution.
c. Specific Authorities
Without diminishing the Receiver’s broad authority set forth in paragraph III.a
above, the Receiver shall have the specific authority to exercise the functions that follow,
as deemed necessary to fulfill the Receiver’s responsibilities and objectives under the Plan.
i. Personnel
1. The Receiver shall have the authority to hire, fire, suspend, supervise,
promote, transfer, discipline, and establish compensation for all ADCRR employees and
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contract staff who perform services related to the health care of class members. This
includes implementing additional personnel policies and creating, abolishing, or
transferring positions related to the health care of class members. See A.R.S. § 41-
1604(A)(2),(B)(2)(a-d).
2. The authority includes utilizing all employees presently working within,
or assigned to, ADCRR Health Services Division, and these employees shall remain in
their positions within the Health Services Division as the Receiver determines they are
essential for ensuring the constitutional health care of the class. This includes data
collection, contract oversight, and coordination of health care to class members.
3. The Receiver shall have the authority to issue instructions to ADCRR
employees and contract staff who perform services relevant to the delivery of health care
to class members. Custody employees and staff are excluded from the Receiver’s authority
unless determined essential to the provision of adequate health care and administration of
the Plan. The Receiver shall consult with the Director of ADCRR before finding custody
employees and contract staff are within the Receiver’s authority over health care for the
class and the Plan. If the Receiver and the Director disagree, the Receiver shall seek
resolution by the Court.2 In resolving the issue, the Court will consider input from both
Plaintiffs and Defendants and will determine the least intrusive and least disruptive means
of providing adequate constitutional health care.
ii. Policies and Procedures
1. The Receiver shall formulate additional essential ADCRR policies and
Department Orders, procedures, protocols, systems, and practices in accordance with the
Plan as relevant to the health care of class members and necessary to establish and ensure
adequate constitutional health care. See A.R.S. § 41-1604. As mandated by law, the
Receiver shall “be responsible for the overall operations and policies of the department”
2 It is contemplated the Receiver may supervise custody staff if, for example, the staff
provide on-site escort and off-site transportation to and from health care activities. Past
barriers to provision of health care regarding on-site escort and off-site transportation by
custody staff have been identified by the Monitors and the Court. (Doc. 4968 at 27.)
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related to the health care of class members, A.R.S. § 41-1604(A)(1), and “responsible for
the development of policies and programs that shall be recommended to the Governor and
the Legislature.” A.R.S. § 41-1604(A)(5). The Receiver may “adopt rules to implement the
purposes of the department and the duties and powers” of the Receiver. A.R.S. § 41-
1604(B)(1).
2. The Receiver shall not be responsible for maintaining security at
ADCRR. However, the Receiver shall formulate and implement procedures to provide the
necessary and adequate security and control of prisoners that pertains to implementation of
the Plan and that are required to maintain the health and safety of the class members.
iii. Budgeting
The Receiver shall be responsible for formulating and establishing the
annual ADCRR health care budget that ensures the provision of constitutional health care
to class members and shall have all authority vested by law in the Director of ADCRR
relating to the financing of the prison health care system.
iv. Contracts
1. The Receiver shall have the authority as vested in the Director of
ADCRR of all ADCRR’s health care vendors. This includes the authority to negotiate,
enforce, terminate, or renegotiate contracts related to the health care of class members in
accordance with law and as necessary to achieve the objectives and requirements of the
Plan, the provisions of the Permanent Injunction, and all other relevant Orders. See A.R.S.
§ 31-201.01(D) (The Director “shall provide medical and health services for the prisoners”
and “may contract for professional services to assist the Director in carrying out this
responsibility.”).
2. The Receiver shall provide the Director of ADCRR and the Department
of Administration with 30 days’ notice before the Receiver implements an amendment to
an existing contract or approves a new contract that may impact indemnification or
insurance requirements. In an emergency, the Receiver shall provide the Director and the
Department of Administration reasonable notice of not less than five days, before
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implementing such action regarding contracts.
v. Property, Equipment, and Tangible Goods
The Receiver shall have the authority to manage, acquire, dispose of,
increase, modernize, repair, and lease property, equipment, and other tangible goods
relevant to the delivery of health care to class members. Upon request of the Receiver,
ADCRR is required to assist in rectifying all issues relevant to property management,
including installation and operation of such property. The Receiver shall work with
ADCRR to ensure the allocation of sufficient space for class members to receive clinically
appropriate health care and for health care staff to perform services related to the health
care of class members. See A.R.S. § 41-1604(A)(2).
IV. Office of the Receiver
a. Compensation
The Receiver shall be compensated a salary of $500,000 annually.3 The Receiver
may seek the reasonable cost of living adjustments each year, and if the Receiver is granted
increases, the Court will apply the Administrative Office of the United States Court’s
policy and Cost of Living Adjustments as the reference to determine the reasonableness of
a request. If the Receiver is removed or resigns during the year, the amount of the salary
will be prorated to the portion of the year completed prior to the end of the Receiver’s
contract for that year. If the Receiver does not reside in or near the Receiver’s Office, she
3 “It is settled . . . that a federal court appointing a receiver ‘has full power to fix the
compensation of such receiver.’” Coleman v. Newsom, 2:90-CV-0520 KJM SCR P, 2025
WL 1163350, at *3 (E.D. Cal. Apr. 22, 2025) (quoting Drilling Exploration Corp. v.
Webster, 69 F.2d 416, 418 (9th Cir. 1934)); “A receiver’s compensation must be
‘reasonable.’” Id. “The court considers several factors in determining the receiver’s
compensation, including the benefits obtained by the receiver’s work, the time and skills
needed for ‘proper performance’ of the duties imposed ‘and their fair value, measured by
the common business standards; and the degree of activity, integrity, and dispatch with
which the work of the receivership is conducted.’” Id. (quoting Walton N. Moore Dry
Goods Co. v. Lieurance, 38 F.2d 186, 192 (9th Cir. 1930)). The Court has considered the
salaries in other cases, the “great, if not incalculable” benefits to be derived from the
Receiver’s work, that the Receiver will not receive benefits, and the complexity of the task
required of the Receiver. Thus, the Court finds the salary to be reasonable.
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will be personally responsible for the costs of lodging in or near the Receiver’s Office as
well as travel to and from her permanent residence.
b. Office and Staffing
1. The Receiver shall establish the Office of the Receiver and shall have the
authority to hire staff and consultants for discharging the duties and mandates of the Plan
and this Order. The Receiver shall establish, with approval of the Court, reasonable
compensation and terms of service for each member of the Receiver’s staff. And the
Receiver is authorized to enter into contracts with staff and consultants.
2. In order to facilitate the Receiver’s duties and authorities, ADCRR and the
Department of Administration shall work with the Receiver to obtain sufficient office space
within ADCRR’s operations center/headquarters, technological infrastructure, and
Information Technology programming and software support. Sufficiency and suitability
will be determined by square footage, location, and unity, i.e. space is deemed sufficiently
suitable if the square footage, proximity to key ADCRR operations, and ability to maintain
a physically unified operative space, ensure adequate performance of the Receiver’s
responsibilities pursuant to the Plan.
c. Financial Operations and Reporting
1. Within 30 days of appointment, the Receiver shall create an interest-bearing
account, with the Receiver as the signatory and fiduciary. The Receiver may appoint a
qualified person to perform this function when necessary. This account shall be designated
the “Receiver’s Office Fund Account” and shall be maintained solely for the reasonable
and necessary expenses incurred and related to the functions and responsibilities of the
Office of the Receiver, including, but not limited to, salaries, consulting fees, supplies,
equipment, office space, transportation, and travel. The Receiver shall, jointly with
Defendants, create a system for regular replenishment of the Receiver’s Office Fund
Account.
2. Within 60 days of appointment, the Receiver shall establish a budget for the
Office of the Receiver for the first year of operation and shall propose a budget for each
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subsequent year of operation, which will be due 90 days prior to the budget year.
Throughout the Receivership, the Receiver shall include in each report required by this
Order an accounting of all receipts and expenditures including the Receiver’s Office Fund
Account, and shall initiate an independent financial audit of the Receiver’s Office Fund
Account on an annual basis.
V. Additional Terms of the Receivership
a. Costs
All costs incurred during the Receivership shall be borne by Defendants,
including all the costs for establishing and maintaining the Office of the Receiver.
i. Initial Costs
Because time is of the essence for implementation of the Plan, the Receiver
shall, within 30 days of the effective date of appointment, submit a proposed order to the
Court authorizing payment to the Receiver of the funds essential for establishing the initial
operating fund for the Office of the Receiver. After the Court’s approval, those funds shall
be deposited in the Receiver’s Office Fund Account established by Section IV(c) above.
ii. Use of Contempt Funds
Pursuant to agreement of Plaintiffs and Defendants, the funds assessed as
a consequence of the findings of contempt during this litigation, and currently held by the
Court, may be used as additional funding to support the Receiver in the execution of her
duties. As of the date of this Order the available funds are estimated as approximately $2.2
million. The Receiver shall seek a Court Order for the release of funds as required to
supplement the operation of the Plan.
b. Access
1. The Receiver and the authorized staff of the Receiver shall have unrestricted
access as necessary for the Receiver to conduct a fiscal analysis and the Receiver shall
have access to relevant records outside the ADCRR to accomplish this function.
2. The Receiver and the authorized staff of the Receiver shall have unrestricted
access to all ADCRR facilities, with or without notice, as deemed necessary by the
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Receiver to accomplish the Receiver’s responsibilities pursuant to the Plan and this Order.
3. The Receiver shall have access to governmental records, e.g. records
maintained by AHCCCS and all others as necessary for the Receiver to conduct a fiscal
analysis and the Receiver shall have access to relevant records outside the ADCRR to
accomplish this function.
c. Ex Parte Communication
The Receiver and the Receiver’s authorized staff shall have authority, equal to
that of the Monitors, to communicate ex parte and confidentially (without the presence of
counsel) with all parties and each party’s legal representatives, and with the Court and the
Monitors.
d. Subclass
The Receiver shall not be responsible for monitoring Defendants’ compliance
with the provisions of the Injunction addressing relief for prisoners in isolation (paragraphs
19 through 31 of the Injunction) nor shall the Receiver exercise authority over ADCRR’s
custody operations related to the Subclass. Monitor Scott Frakes will continue his
responsibilities regarding the Subclass and continue reporting to the Court.
e. Governing State Laws, Regulations, and Contracts
The Receiver shall endeavor to perform all responsibilities and duties in
accordance with Arizona state laws, regulations, and contracts. If the Receiver determines
compliance with state laws, regulations, or contracts will interfere with, or preclude, the
Receiver from ensuring the provision of constitutional health care to class members or will
otherwise inhibit the Receiver’s fulfillment of the requirements of the Plan and this Order,
the Receiver shall request the Court waive compliance with those laws, regulations, and
contracts.4 Upon receipt of any such request, the Court shall solicit input from Defendants
4 This Court’s expert in 2019, and again in 2025, identified two state laws as persistent
barriers to provision of constitutional health care in the Arizona state prison system: (1)
The law requiring the privatization of correctional health care, and (2) the law capping
specialist compensation. See H.B. 2010, 49th Leg., 3d Spec. Sess. (Az. 2009); Ariz. Rev.
Stat. § 41- 1608; Doc. 4755 at 22, 26-27 (Dr. Stern’s 2025 report); Doc. 3379 at 102, 104-
08 (Dr. Stern’s 2019 report).
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and Plaintiffs before rendering a decision.
f. Immunity and Indemnification
Defendants shall unconditionally defend and indemnify the Receiver and the
Receiver’s personnel, including but not limited to all personnel involved in the operation
of the Office of the Receiver, in any litigation, causes of action, claims, liabilities, damages,
losses, costs and expenses (including reasonable attorneys’ fees and expenses), brought
against the Receiver and/or the Receiver’s personnel regarding activities arising out of, or
conducted in the course of the Receiver’s official duties and the operation of the Office of
the Receiver. See A.R.S. § 31-201.01(F).
g. Monitoring
Upon appointment, the Receiver shall assume and undertake all authorities,
duties, and responsibilities of ADCRR to provide health care to the class members and
ensure compliance with the Permanent Injunction, including those duties of the Monitors,
except as noted in paragraph V(d) above. The Receiver shall engage the assistance of the
Monitors for a period of 6 months from the effective date of the Receiver’s appointment.
This period may be extended as the Receiver determines will be useful and is warranted.
h. Length of Receivership
1. The Receivership shall extend for five years. Due to the protracted history of
this litigation and the substantial findings of the unconstitutional health care, this estimate
may be too generous, and it shall be extended as necessary.
2. Any party is authorized to request the Court replace the Receiver for cause.
The Court shall afford both parties the opportunity to be heard, and if the Court determines
a change in the Receiver is warranted, the parties shall be authorized to recommend
replacement candidates.
3. The Receivership was ordered by the Court as a last resort, and the Court in
this Order has established the authorities of the Receiver with the utmost caution. The Court
is in full alignment with the legal principle that a Receivership will not extend beyond what
is essential to accomplish constitutionally adequate health care for the class. See 18 U.S.C.
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§ 3626 (“Prospective relief shall not terminate if . . . that prospective relief remains
necessary to correct a current and ongoing violation of the Federal right, extends no further
than necessary to correct the violation of the Federal right, and that the prospective relief
is narrowly drawn and the least intrusive means to correct the violation”); see also WB
Music Corp. v. Royce International broadcasting Corporation, 47 F.4th 944, 953 (9th Cir.
2022) (“The decision on whether to terminate a receivership turns on the facts and
circumstances of each case, including any relevant equitable considerations”) (quoting 65
Am. Jur. 2d Receivers § 94 (2022)). Prior to a proposed order terminating the Receivership,
the Receiver shall prepare a recommendation, supported by facts and data, in favor of or
against termination and provide it to the Court.
4. The Court genuinely welcomes the eventual return to the State of Arizona of
the operational control of the health care relating to the class members, upon a finding that
the unconstitutional violations have been remedied and the unconstitutional health care
existing in the State of Arizona prison system has ceased. The Receiver shall work closely
with Defendants and the Director of ADCRR to develop effective leadership that generates
and supports a seamless transition of health care operations back to ADCRR that will
sustain permanent constitutional health care to all class members.
i. Modification and Review
This Order shall be modified upon request of the Receiver, or made to the
Receiver, as required for the Receiver to accomplish the responsibilities and to effectuate
the eventual return to ADCRR and the State of Arizona of the health care provided to the
class members. The Receiver shall have the authority to recommend modification of the
Receiver’s Plan and the 2023 Permanent Injunction.
VI. Cooperation
a. General Requirements
All Defendants and their employees, agents, and all persons acting under the
direction Defendants, and their counsel, shall fully cooperate with the Receiver and the
Receiver’s staff, including promptly responding to all Receiver inquiries and requests and
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Court orders. The Director of ADCRR shall cooperate and collaborate with the Receiver
on all matters essential to the success of the Receivership, including securing funding,
clinical and administrative space, adequate training of staff and contract workers, support
of the custody staff necessary for providing constitutionally adequate health care, and
ensuring, upon the termination of the Receivership, that ADCRR leadership is prepared
and capable of adequately assuming control of all functions required to ensure adequate
health care for the class members. Any person or entity interfering with the responsibilities
and authority of the Receiver or who otherwise attempts to thwart the performance of the
Receiver, pursuant to the Receiver’s Plan and Orders of the Court, will be subject to a
finding of contempt.
b. Resolution of Budget Disputes
Any time the Receiver determines the available funds in the fiscal year’s
ADCRR budget are inadequate to accomplish the Receiver’s authorities and duties, the
Receiver shall first consult the Director of ADCRR before notifying the Legislature and
the Governor’s Office of such deficiency. If the issue is not resolved, the Receiver or the
Plaintiffs or Defendants may request resolution by the Court, which may prompt the Court
to order the waiver of Arizona State laws, regulations, and contracts that interfere with the
requirements and desired outcome of the Receivership.
c. Notice
Counsel for Defendants shall ensure Arizona state agencies are given prompt
notice of this Order including the Governor’s Office, the Joint Legislative Budget
Committee, the Department of Administration, the State Personnel Board, and any other
state agencies Defendants deem should be notified. Further, Defendants shall ensure all
contractors, employees, and agents (including contract employees and staff) are given
prompt notice of this Order. Defendants shall file documentation of their compliance with
these notice requirements within 30 days of the date of this Order.
IT IS ORDERED Ms. Annette Chambers-Smith is appointed the Receiver in this
case, effective 21 days following the resolution of any Motion to Stay.
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IT IS FURTHER ORDERED the Receiver is authorized to and shall exercise and
carry out the duties and authorities described herein.
IT IS FURTHER ORDERED if Defendants do not intend to seek a stay, they shall
file such Notice within 5 days of the date of this Order.
Dated this 17th day of July, 2026.
Honorable Roslyn O. Silver
Senior United States District Judge
Case 2:12-cv-00601-ROS Document 5307 Filed 07/17/26 Page 15 of 15