Suing for testing, treatment

With thousands of Michigan inmates infected with the hepatitis C virus and only a handful receiving treatment, students from the University of Michigan Clinical Law Program and their professor filed suit in federal district court Jan. 21 to get better health care for infected prisoners.

“It’s really a public health concern because more than 90-some percent of people who go to jail come out,” says program clinical-assistant professor David Santacroce.

“We’re not testing; we’re not treating; we’re letting these people back out into the population,” he says. “We’re going to have to pay for this anyway. It’s easier, cheaper and more successful to do it up front.”

Hepatitis C is the most common chronic blood-borne infection in the country. Estimates of the infection rate in prisons nationally is 30 percent to 40 percent. Michigan Department of Corrections officials agree that the state’s infected prison population could be 15,000 or higher. As of December, fewer than 50 were being given the standard medication needed to fight the chronic form of the disease.

“We were just amazed at the lack of treatment and the sheer volume,” Santacroce says.

The class-action lawsuit was filed with support from the American Civil Liberties Union of Michigan. It alleges that the Michigan Department of Corrections is in violation of the Eighth Amendment’s protections against cruel and unusual punishment for failure to treat the inmates for the hepatitis C virus, for which there is no vaccine. It seeks treatment for those prisoners who are likely to be cured through therapy with pegylated interferon and ribavirin. Untreated, hepatitis C often destroys the liver, leaving a transplant as the only viable medical alternative.

According to a study by the Philadelphia Inquirer, state corrections departments currently pay about $15,000 per inmate for testing, monitoring and treatment with the current hepatitis C medicines. The drugs cure about 60 percent of the patients to whom they are given.

Santacroce says it is money well spent.

“There was an actuarial study published not too long ago that said that for every dollar we spend now, we’re going to save four later.”

He says that not all of the infected prison population needs treatment, but that current identification and treatment policies are substandard. He says that it’s not a matter of choice by the Michigan Department of Corrections. It’s a matter of law.

“What we’re saying is that the [MDOC] policy on its face, and as applied to our plaintiffs, is deliberate indifference and you can’t be deliberately indifferent to a prisoner’s medical needs,” he says. “We certainly aren’t arguing that prisoners are entitled to extraordinary treatment that is above and beyond what is available to the poor person on the street through Medicaid or Medicare. We’re saying they deserve basic medical care for serious medical conditions.

“We’re not asking for the moon. We’re not asking for some crazy, fancy treatment. We’re asking for the standard protocol. If you think the pegylated interferon treatment is expensive, try a transplant.”

Hepatitis C sickens thousands, costs millions.
Should convicted felons be on organ transplant lists?
Tom Schram is co-chair of the National Writers Union of Southeast Michigan. E-mail [email protected]

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