Judge Blasts State Prisons Over Hepatitis Care

November 20, 2017

In a scathing ruling issued Friday, a federal judge found that Florida corrections officials have a “long and sordid history” of failing to treat inmates infected with the Hepatitis C virus and ordered the state to immediately come up with a plan to properly provide care.

U.S. District Judge Mark Walker found that the Department of Corrections and its health care contractors had for years refused to treat infected inmates with antiviral medications, known as “direct acting antiviral” drugs, because of the cost.

Between 7,000 and 20,000 of the state’s 98,000 prisoners are believed to be infected with Hepatitis C, but only 13 have been treated with the antiviral drugs since 2013, and three of those who received the treatment were plaintiffs in the lawsuit, according to court documents.

The treatment, which originally cost up to $75,000 when first released in 2013, now costs about $37,000 for a 12-week regimen and cures the virus 95 percent of the time.

But in a harshly worded 32-page order, Walker wrote that cost is no excuse for not providing the treatment, scolding the agency for being “deliberately indifferent” to the medical needs of inmates, a violation of their constitutional rights.

“Preventable deaths from HCV (Hepatitis C virus) are occurring within the prison system,” he wrote.

Walker ordered the department to update its Hepatitis C treatment policy and to formulate a plan to implement the policy by screening, evaluating, and treating inmates in line with directions and timelines set out by its expert witness.

And he told the corrections agency to come up with the plan “with alacrity,” writing in the order that “this court will not tolerate further foot dragging.”

Michelle Glady, a Department of Corrections spokeswoman, said in an email that the agency has asked the Legislature for $19 million “to expand the treatment for inmates with Hepatitis C” and that it contracts with the firm Centurion “to provide comprehensive health services to all inmates in Florida.”

“FDC (the Florida Department of Corrections) is absolutely committed to ensuring all inmates in our custody are provided medically necessary treatment that is in line with national standards and our constitutional responsibilities,” Glady said in the email.

Hepatitis C is usually contracted through intravenous drug use but can also be transmitted through tattooing or blood transfusions. The disease causes liver scarring, which can significantly impair liver function and ultimately lead to death.

The lawsuit was filed in May by the Florida Justice Institute on behalf of three inmates and a class of others infected with the virus. Walker also certified the case as a class-action lawsuit on Friday.

“We are very pleased with Judge Walker’s order, and we hope that it will result in thousands of inmates getting much-needed treatment so they will not die,” Randall Berg, executive director of the institute, told The News Service of Florida on Friday.

Corrections officials maintained that the case was moot because they had made several changes to their policy about treating infected inmates since the lawsuit was filed.

But even the most-recent revision — finalized a week before a five-day hearing in the case last month — is inadequate, Walker found.

“FDC needs to clear up the loosey-goosey language in its treatment policy so that it can no longer hide behind the consequences of its own obfuscations,” Walker wrote in a footnote.

The department’s latest policy doesn’t guarantee that inmates will be screened or receive treatment quickly enough, Walker found, based on testimony from the corrections department’s own expert.

The judge gave the department until Dec. 1 to come up with a new plan and ordered the agency to “increase its capacity and outline a timetable for doing so” because agency officials have maintained they do not have enough staff to start screening all inmates who could be at the highest risk of having advanced liver disease due to Hepatitis C.

“This court has no doubt that without a court-ordered injunction, FDC is unlikely to treat inmates in a constitutionally appropriate manner,” Walker wrote.

In a footnote, Walker wrote that funding issues could excuse some delay, but not to this extent.

“For instance, if DAAs (direct acting antivirals) were released yesterday, this court would not expect FDC to wave a magic wand and suddenly treat thousands of inmates overnight,” he wrote. “But that is not the case. FDC has had since late 2013 to respond to this problem, and it has only just recently started doing what it should have done years ago.”

by Dara Kam, The News Service of Florida

Pictured: The Medical Classification Unit inside the Century Correctional Institution.  NorthEscambia.com file photo, click to enlarge.

Comments

8 Responses to “Judge Blasts State Prisons Over Hepatitis Care”

  1. Chris on November 22nd, 2017 8:32 pm

    Argue all you want.
    The inmates will get it

  2. Alan on November 22nd, 2017 10:10 am

    @john….unfortunately, the courts don’t care. I believe supreme court precedent states prisons will provide health care for those incarcerated under their watch.

    In addition, while I have no issue with the death penalty in certain situations, once again a choice has to be made. Studies indicate it cost 3+ times more in Florida to sentence someone to life in prison than to execute them. Reason being, it takes 20+ years to get through the appeals process and as a Florida taxpayer, you get to pick up all the fees associated with that.

    From an article on the subject I stumbled across “Florida Spent Average of $3.2 Million per Execution from 1973 to 1988″. Like everything else, I promise you the cost has continued to rise.

    In other words, its not as easy at just saying, “kill them all”.

  3. john on November 22nd, 2017 6:35 am

    I don’t think the prison system should have to supply healthcare. If I fell on hard times and had to go live with my Aunt Bessie would she pay for my health insurance? absolutely not! She may feed me a meal or two, but anything other than that would be pushing it. What we are doing as a nation is unwittingly encouraging bad people to do crimes, because they know they will only go on vacation after they commit. What we should do with our prison system is this: execute all murderers, rapists, and child molester, drug dealers; then for all other offenders if you come to prison a third time then you get executed. End of story that will save billions.

  4. Donna on November 21st, 2017 6:25 am

    Sad that citizens that do not commit crimes and choose to go to work everyday . These citizen either can’t afford health care or have it and can’t afford out of pocket high deductibles to even get treatment . But yet out government wants us to keep paying taxes so these low life’s can have good free health care !!
    We live in a mixed up messed country I don’t know about you but a free country we are not ! The low life’s non working citizens are sucking us dry !!!!

  5. Dan on November 20th, 2017 7:48 pm

    I’m with you Alan.
    Private corporations have no business in the incarceration business. By the way, the schools to prison pipeline system is running well to guarantee long term occupancy rates.

  6. alan on November 20th, 2017 2:16 pm

    @Jason …. it does not matter how many of them would of pursued treatment on the outside nor does it matter what level of healthcare you believe they should receive. The judicial branch has concluded prisoners are wards of the State and as such, are required to give them adequate health care, including treatment for Hep-C.

    And unlike you, I am concerned about the taxes and fees I pay to house inmates. I believe there are other punishments beside excessive prison time, which is being used to enrich others, that would be just as successful.

  7. Jason on November 20th, 2017 11:59 am

    @Alan….. one of the simplest ways for an inmate to avoid all the issues you complain about, is not to commit any crimes and risk the chance of being incarcerated.

    Of the 7,000 people who might be Hep-C positive, how many do you think would actually be seeking treatment if they were outside the prison fence versus receiving their three hots and a cot? IMHO, the answer would be, “Not many if they had to fork over the money to pay for the medication”.

    As far as the new kiosk, they are a win/win for inmates, their families and for the institution. I could care less that its a “for profit” company doing the install and generating the sales of the service. The company takes all the risks – from install, servicing and repairs.

    The families no longer have the burden of vehicle travel to the institution to visit with those incarcerated. These fees charged for the visitation via the kiosk will be paid for by the families and its a whole lot cheaper than jumping in the car and riding to the institution. This type of visitation also eliminates the introduction or smuggling of contraband by visitors. It frees up staff to handle other issues versus babysitting visitation.

    IMHO, the prison system should be providing the very basic of health care. Here is a bandage and some peroxide if they are bleeding. If they need aspirin, let the inmates buy it from commissary. If they require a prescription, let the inmates pay for it. Why should the taxpayers subsidize a Cadillac plan of med care?Its not in the taxpayer best interest for an inmate doing life to live long-term in prison. No need to offer long-term healthcare option and medication to a “lifer” or those on death row. Those incarcerated didnt care about their actions while committing crimes, why should the taxpayer care about them as they rot away in prison?

    As far as expensive phone calls, who cares? The for profit system paid to install and maintain the phones. The institution gets a rebate which helps lower the cost of operations of the institution for us taxpayers. the cost of those phone calls are paid for by the inmates family. they dont have to accept the calls. Last time I checked they can still write a letter and send “snail mail” for 49 cents. No need to have daily or weekly or even monthly phone calls.

    Yep, no sympathy from this taxpayer. Despite the alleged horribleness of the prison lifestyle, so many folks dont seem to care while they are committing crimes or while re-offending once they have been released.

    Take your sob story elsewhere. The only ones sobbing with you are those incarcerated or their family.

  8. Alan on November 20th, 2017 7:43 am

    Just the simple math. 7,000 inmates, the low end of the estimate, times $37,000 dollars per treatment, is $259M. The upper end estimate of 20,000 inmates would come to $740M. The FDOC has asked for an additional $19M to help treat the epidemic. That is like putting out a forest fire with a thimble.

    Florida ranks at 8th in US incarceration rates, has some of the harshest minimum sentencing guidelines, requires 85% minimum time served, and has completely done away with parole. Florida puts more people in Prison and then ensures they stay there longer than just about any other State. Why? I am going to guess money.

    Could it be that companies make political contributions to Florida’s legislators who in turn pass laws to ensure there are plenty of prisoners:
    - who can be housed in privately run prisons at a guaranteed occupancy rate
    - requiring sub par healthcare provide by a private contractor
    - paying for overpriced phone calls provided by a private contractor
    - for the new kiosks system being installed as we speak which will provide video visitation and emails and the new tablets for games, news, music, movies, and games. Of course, also through a private for-profit company.

    And as soon as they figure out how to make more money on this Hep-C epidemic, treatment will happen and the FDOC budget will increase, all at a higher cost to the taxpayer for housing 110,000 prisoners.

    Oh well, what the he!! do I know.

Written by William Reynolds · Filed Under News