Shawn Jensen v. Ryan Thornell, et al.

Opinion

1 WO 2 3 4 5

9 Shawn Jensen, No. CV-12-00601-PHX-ROS

10 Plaintiff, ORDER

11 v.

12 Ryan Thornell, et al.,

13 Defendants. 14 15 The SNU and IPC Health Care Staffing Analysis and Plan (“SNU and IPC Plan”), 16 was submitted in March 2026, (Doc. 5163). Both parties responded on May 1, 2026. (Docs. 17 5205; 5206). The Court will order Defendants to implement the SNU and IPC Plan 18 immediately. 19 Defendants argue against adoption of the Plan, saying: 20 The question is whether the specific staffing levels and accompanying mandates in the Proposal are, as the PLRA 21 requires, narrowly drawn and the least intrusive means of correcting the constitutional violations identified. The answer 22 is that they are not. The Proposal is most useful as guidance to inform Defendants’ implementation of the Injunction’s 23 existing SNU and IPC requirements—not as mandates that go beyond those requirements 24 25 (Doc. 5206 at 4). The PLRA does not require a line-by-line, figure-by-figure analysis. 26 Rather, 27 [T]he courts must do what they have always done when determining the appropriateness of the relief ordered: consider 28 the order as a whole. In many cases it would not be possible for a district court to produce meaningful need-narrowness- 1 intrusiveness findings concerning each isolated provision of a remedial order. Prospective relief for institutions as complex 2 as prisons is a necessarily aggregate endeavor, composed of multiple elements that work together to redress violations of 3 the law. This is all the more true when relief must be narrow and minimally intrusive: courts often must order defendants to 4 make changes in several different areas of policy and procedure in order to avoid interjecting themselves too far into 5 any one particular area of prison administration. In such circumstances, the necessity of any individual provision cannot 6 be evaluated in isolation. What is important, and what the PLRA requires, is a finding that the set of reforms being 7 ordered—the “relief”—corrects the violations of prisoners' rights with the minimal impact possible on defendants' 8 discretion over their policies and procedures. 9 Armstrong v. Schwarzenegger, 622 F.3d 1058, 1070-71 (9th Cir. 2010). 10 The Permanent Injunction issued in 2023 explicitly required the creation of a health 11 care staffing analysis and plan “to determine the number of staff necessary to care for 12 patients.” (Doc. 4410 at 14 § 1.17). The Court Monitors prepared and submitted the final 13 Health Care Staffing Analysis and Plan in April 2025, (Doc. 4858), and the Court ordered 14 its immediate implementation in June 2025, (Doc. 4916). According to the Health Care 15 Staffing Analysis and Plan, staffing needs in for SNU and IPC spaces be assessed and 16 reported in a separate “comprehensive staffing analysis and plan” was needed “for all SNU 17 and IPC space.” (Doc. 4963 at 26). 18 “A district court may . . . provide specific instructions to the State without running 19 afoul of the PLRA. In particular, when a district court has previously tried to correct the 20 deficiencies in prison operations through less intrusive means, and those attempts have 21 failed, relief prescribing more specific mechanisms of compliance is appropriate.” 22 Armstrong v. Newsom, 58 F.4th 1283, 1297 (9th Cir. 2023) (citation modified). Injunction 23 sections 7.5 – 7.6 address the requirements for SNU and IPC settings, (Doc. 4410 at 28- 24 29), and Defendants remain “far from reaching substantial compliance” with these 25 provisions, (Doc. 5163 at 4).1 26

27 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 28 physical exams,” and care that is “inefficient, fragmented, task-oriented, and error-prone.” (Doc. 5163 at 8-10). 1 Contrary to Defendant’s contention that the SNU and IPC Plan imposes “mandates 2 that go beyond” and “above the preexisting Injunction requirements,” the SNU and IPC 3 Plan rationally fills in the details of what is necessary to achieve compliance with the 4 Injunction’s requirements. Indeed, Defendants previously complained about the absence 5 of a “how-to guide” or “comprehensive plan” giving “detailed guidance on how to achieve 6 compliance.” (Doc. 4553 at 2). 7 Finally, Defendants propose the Court “defer adopting specific staffing levels until 8 the data the Proposal’s methodology requires has been collected and analyzed” because 9 that data has not been previously gathered and reported. (Doc. 5206 at 8) However, 10 prospective relief for institutions as complex as prisons is a necessarily aggregate endeavor, 11 composed of multiple elements that work together to redress violations of the law” and the 12 Court is “not required to take a piecemeal, wait-and-see approach.” Armstrong v. Newsom, 13 58 F.4th 1283, 1298-99 (9th Cir. 2023). The SNU and IPC Plan is designed to be responsive 14 to new data. It is “subject to review and adjustment eight months after a Court order to 15 implement it, and every six months thereafter,” (Doc. 5163 at 25), and includes the 16 provision that “special circumstances may arise in which it may be clinically safe to engage 17 lower staffing levels than those prescribed” and therefore Defendants may be permitted “to 18 make changes upon approval of the Monitors.” (Doc. 5163 at 3). 19 Having reviewed the SNU and IPC Plan, the parties responses, and the voluminous 20 record in this litigation, the Court finds the SNU and IPC Plan is narrowly drawn, extends 21 no further than necessary to correct the constitutional violations in the IPCs and SNUs, and 22 is the least intrusive means to correct those violations. The Court approves the SNU and 23 IPC plan and will order it be implemented immediately. 24 IT IS ORDERED the SNU and IPC Health Care Staffing Analysis and Plan (Doc. 25 5163) is approved. 26 IT IS ORDERED the SNU and IPC Health Care Staffing Analysis and Plan (Doc. 27 5163) shall be implemented immediately by Defendants. 28 IT IS FURTHER ORDERED Defendants shall reach full staffing based on the 1 || 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. 4 IT IS FURTHER ORDERED The SNU and IPC Health Care Staffing Analysis 5 || and Plan shall be subject to review and adjustment eight months after this Order, and every 6 || six months thereafter. 7 Dated this 14th day of May, 2026. 8 fo .

Honorable Roslyn ©. Silver ll Senior United States District Judge 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

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