In­mates de­nied care

A suit ac­cuses the state of with­hold­ing hep C treat­ment be­hind bars.

The Denver Post - - NEWS - By Jen­nifer Brown

One in nine pris­on­ers in Colorado has hep­ati­tis C, the most deadly — though cur­able — in­fec­tious dis­ease in the na­tion, yet only a frac­tion of them re­ceives treat­ment.

Of the 2,280 pris­on­ers di­ag­nosed with the virus, the Colorado De­part­ment of Cor­rec­tions treats fewer than 70 per year, leav­ing the rest to suf­fer as vic­tims of a “cruel and ar­bi­trary” sys­tem, Amer­i­can Civil Lib­er­ties Union of Colorado ac­cused in a clas­s­ac­tion law­suit filed Wednes­day against the de­part­ment.

Be­fore a pris­oner is con­sid­ered for treat­ment, a blood test must show “sus­tained mea­sur­able liver dam­age” se­ri­ous enough to equate roughly to stage two liver dis­ease, which is mea­sured in stages zero through four. Then the pris­oner must com­plete al­co­hol or drug ther­apy, which can take more than two years de­pend­ing on pro­gram avail­abil­ity at the prison where the in­mate is held.

The chances of re­ceiv­ing po­ten­tially life-sav­ing an­tivi­ral med­i­ca­tion even af­ter those qual­i­fi­ca­tions are met is min­i­mal. A De­part­ment of Cor­rec­tions com­mit­tee that meets four times each year chooses a “se­lect few” pris­on­ers based on a yearly quota of up to 70 peo­ple, the law­suit says. A re­cent count found 735 pris­on­ers el­i­gi­ble for con­sid­er­a­tion by the com­mit­tee.

“We have al­ways been con­cerned with the de­liv­ery of med­i­cal care in the De­part­ment of Cor­rec­tions and this is a gi­ant health cri­sis in Colorado pris­ons and the na­tion’s pris­ons,” said Mark Silverstein, le­gal di­rec­tor for ACLU of Colorado. Also, when pris­on­ers don’t re­ceive treat­ment be­hind bars and are re­leased, it raises the pub­lic health risk of spread­ing the dis­ease, he said.

Cor­rec­tions spokesman Mark Fair­bairn said the sys­tem has treated 80 of­fend­ers with the new an­tivi­ral treat­ment since July 2015. In all but one case, the in­mates were cured, he said. “Al­though these new phar­ma­ceu­ti­cals are ground­break­ing and ef­fec­tive, we have de­vel­oped and im­ple­mented poli-

cy to as­sess treat­ment needs along­side ap­pro­pri­ated re­sources,” he said in an email.

It was not known how much it would cost the state to pro­vide treat­ment for all in­fected pris­on­ers or how much it has cost to treat those 80 of­fend­ers.

The ACLU filed a sim­i­lar law­suit in 2016 against the state Med­i­caid de­part­ment, ac­cus­ing Colorado of deny­ing treat­ment for needy Coloradans in­fected with the cur­able dis­ease.

Un­til 2013, the best treat­ment for hep­ati­tis C in­cluded toxic in­jec­tions that went on for a year, had an es­ti­mated cure rate of only 50 per­cent and had side ef­fects worse some­times than the dis­ease it­self — bone pain, mem­ory loss, de­pres­sion and nau­sea. So­valdi, ap­proved four years ago, is some­thing of a mir­a­cle drug, re­quir­ing three months of ther­apy with­out the ex­cru­ci­at­ing side ef­fects. Its cure rate is 90 per­cent.

But be­cause of the drug’s price tag — es­ti­mated at $40,000 for the 12-week reg­i­men — Med­i­caid placed stip­u­la­tions on who qual­i­fies for treat­ment. Those with the gov­ern­ment in­sur­ance must have enough liver dam­age to qual­ify as stage two.

That law­suit against the state Med­i­caid de­part­ment is on­go­ing.

The law­suit filed Wednes­day is brought by four pris­on­ers, in­clud­ing Robert Wieghard, a 61year-old Bent County Cor­rec­tional Fa­cil­ity in­mate. Wieghard has enough liver dam­age to qual­ify for treat­ment, but has been de­nied el­i­gi­bil­ity be­cause he has not com­pleted the re­quired al­co­hol and drug classes.

The law­suit says hep­ati­tis C has con­trib­uted to 18 deaths of Colorado pris­on­ers in the last three years. The virus is the most deadly in­fec­tious dis­ease in the United States, lead­ing to cir­rho­sis and liver fail­ure if not treated, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion.

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