An estimated 20% to 22% of U.S. prisoners are infected with hepatitis C, according to a 2002 report presented to Congress by the National Commission on Correctional Health Care. And the Centers for Disease Control and Prevention estimates that 1.3 million people with HCV were released from prison in 1996.
Reacting in January 2003 to an egregious lack of proper medical care in correctional facilities, the CDC recommended a host of improvements, including proper screening, treatment, and education. The Federal Bureau of Prisons subsequently adopted these guidelines, and some states, such as New Jersey and Montana, have also promised to shape up their act.
But just the same, medical care for the disease remains spotty at best, negligent at worst across the country. Furthermore, prisoners, not knowing they have hepatitis C or how to prevent its spread, often transmit the virus among themselves through drug use and tattooing'or to sex partners when they get out of prison.
'The protocols might look better on paper, but it doesn't mean that anyone's getting treated under them. It means they've got something to show to the press, basically,' says David Santacroce, a clinical law professor at the University of Michigan.
David is an appropriate name for the attorney, because he is part of the legal team battling Correctional Medical Services, a Goliath for-profit company that provides'or rather, denies, as advocates claim'health care to privatized correctional facilities in 27 states. Many blame such companies' ultimate concern with their bottom lines for the dismal state of health care in prisons, since treatment for HCV can cost up to $50,000 a year. And Phyllis Beck, director of the National Hepatitis C Prison Coalition, says lawsuits are the only effective way to slay the dragon.
According to Jack Beck, an attorney at the Prisoners' Rights Project at the Legal Aid Society in New York, about 10,000 of the state's 65,000 prisoners are HCV-positive. At any one time there are only about 100 to 150 of those people treated for the disease. Similar to many other states, New York establishes onerous roadblocks to keep prisoners from receiving medical care for hepatitis C. For example, any inmate who has any history of drug use must enroll in a drug treatment program, and the prisoners must have at least 15 months left before they are eligible for parole'even if they will probably not qualify for release.
