Is It Time for Pima County to Take Jail Health Care In-House? Evaluating the NaphCare Contract Renewal – Insights from AZ Luminaria

Mary Faith Casey’s tragic story began in August 2022 when she was brought to a Pima County courtroom, visibly frail after losing 50 pounds in four months while incarcerated. The judge quickly transferred her to a hospital, but despite treatment, she ended up in hospice and died shortly afterward.

This case highlights serious concerns about medical care in Pima County jail, prompting a federal judge to link Casey’s death to systemic failures. Critics argue that the for-profit healthcare provider, NaphCare, has not met its contractual obligations, leading county officials to consider taking healthcare services in-house as its $65 million contract approaches renewal.

Casey’s fate is not an isolated incident. Since 2017, there have been at least 61 reported deaths in the jail, leading to public outcry and scrutiny of NaphCare’s performance. A federal ruling deemed Casey’s medical care to have been neglectful, further igniting discussions around the quality of healthcare in correctional facilities.

Pima County Supervisor Matt Heinz, a physician, expressed concern over NaphCare’s track record. He believes it’s time for the county to reassess its options, suggesting they might renew the contract but only for a short period to explore the potential of an in-house solution. Since 2022, NaphCare has faced ongoing allegations of inadequate healthcare services, underscored by reports revealing staffing shortages and missed medical evaluations.

A startling aspect of the healthcare crisis is the consistency of NaphCare’s failures. Reports show that in audits from April to June 2025, the company often didn’t conduct timely mental health evaluations or manage withdrawal symptoms adequately. For example, they failed to follow up on six high-risk patients in June 2024, highlighting a systemic failure to provide necessary mental health care.

These medical inadequacies have broader implications, with Arizona’s courts previously ruling that prisons must provide adequate medical care as a constitutional requirement. Failure to do so can be seen as cruel and unusual punishment, raising serious legal and ethical questions about how inmates are treated.

Public sentiment echoes the urgency for reform. Social media has echoed outrage over cases like Casey’s, with advocates rallying for improved conditions and health services within the jail system. Stories shared by former inmates reveal a pattern of indifference: slow responses to medical requests, staffing shortages, and insufficient mental health support.

Statistically, the problem isn’t unique to Pima County. A 2020 Reuters investigation indicated jails contracted with for-profit healthcare providers often had the highest inmate death rates. This national trend raises serious questions about the effectiveness of privatizing prison healthcare.

Complicating the discussions, Pima County’s health officials state that issues often stem from document management or staffing vacancies, not outright care quality. However, advocates and families affected look for accountability, particularly as the county debates whether to end its ties with NaphCare.

In light of these issues, one thing is clear: real change is necessary in how inmate healthcare is managed. With healthcare being a constitutional requirement, Pima County is at a crossroads about how to ensure that those detained receive the care they deserve—before more lives are lost.

As Casey’s family continues to seek justice, they hope that by raising awareness, they can prevent other families from experiencing similar heartaches. They’re not just advocating for change; they’re calling for accountability in a system that must prioritize the health and safety of its most vulnerable populations.

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