Subject:Court rules inmates not entitled to hepatitis C treatment
Date: Wed, 5 Mar 2003 00:00:38 EST

Subject: Inmates not entitled to hepatitis C treatment - Local News - GreatFallsTribune. Saturday, March 1, 2003

Inmates not entitled to hepatitis C treatment
By ERIC NEWHOUSE
Tribune Projects Editor

A split Montana Supreme Court has refused immediate help for the state's 900 prison inmates who aren't being treated for hepatitis C. Inmate Keith A. Brown filed the petition seeking treatment of hepatitis C, one of the leading causes of liver disease in the United States. "We recognize the seriousness of the medical issue that Brown has raised,
but are unable to grant relief given the state of the proceeding before us," said a four-judge majority led by Chief Justice Karla Gray.

Justices Terry Trieweiler, James Nelson and William Leaphart dissented from
Tuesday's majority opinion.
"We ignore the state's statutory obligation to provide treatment; we enable
the violation of Brown's fundamental constitutional rights; and we demean
the notion that we live in a 'civilized' society," wrote Nelson and
Leaphart.
About 4 million Americans have been exposed to hepatitis C, or about 1.8
percent of the population.
That jumps to between 14 and 40 percent of the nation's prisoners, Dr. Anne
Spaulding of the Centers for Disease Control in Atlanta said in a telephone
interview Friday.
"We tend to house a lot of people with high risk-factor histories in our
prisons," explained Dr. Rob Lyerla, one of the authors of a recent CDC
report on preventing hepatitis in prisons.
The CDC said 25,000 to 40,000 new cases of hepatitis occur annually, and
that 60 percent of them are caused by injection drug use.

In Montana, about 30 percent of the state's 2,750 inmates have hepatitis,
said Dr. Liz Rantz, chief medical officer for the Department of Corrections.
There's no treatment provided for most of those 900 inmates, she said.
That's because there's no effective vaccine for hepatitis C.
It can be treated with interferon, she said, but there's only about a 40
percent success rate, the side effects can be awful, and a full year's
treatment can cost close to $20,000 an inmate.
"There's no way we could go to the Legislature and say we want to treat
every inmate with hepatitis C," said Rantz.
She said she currently is developing procedures to identify long-term
inmates who might be susceptible to treatment.
"We couldn't treat every inmate who just happened to be passing through the
system for a year or two," she said.
In his petition, Brown charged that he is dying a slow, painful death at the
regional prison in Missoula and asked the high court to either impose an
immediate death sentence, grant him a medical parole or order medical
treatment in prison.
"The factual uncertainty of this matter, including the nature of Brown's
diagnosis, his susceptibility to treatment, and the availability of
treatment, require factual resolution," said the majority.
"It is clear that this proceeding does not establish the necessary factual
basis for these issues," it added.
But Spaulding said the success rates have been better for a treatment that
combines pegylated interferon and ribavirin.
And she said some prison systems have gone to bulk buying, which can reduce
the cost.
But cost should not be a factor, said the Supreme Court.
"This court will not countenance the failure to provide appropriate
treatment for an infected inmate on the basis that the department has
insufficient resources to do so," said the majority opinion.
Justice Trieweiler dissented on the grounds that the majority didn't offer
any help since Brown is a prisoner, not a lawyer.
"To acknowledge that there are issues in this case which require litigation
and resolution by a trial court is to acknowledge that Brown has no remedy
at law," wrote Trieweiler. "It's to condemn him to death for the nonviolent
offense for which he was imprisoned.
"Worse than that, the court's order puts at risk one-third of the prison
population whose only hope now is that they can serve their sentence before
they die from a disease which, if untreated, gradually destroys their
livers."
Trieweiler concluded that the majority stance was hypocritical.
"Hepatitis C and the state's refusal to treat it is turning Montana's
prisons into potential death camps," he wrote.
He said this country fought a war to eliminate death camps and then severely
criticized the citizens of those societies for not doing more to end their
operation.
"It seems to me that as a society, we have too quickly put the lessons from
that experience behind us," concluded Trieweiler.

Ah thank you, Teb!

Bot Ken Connor and I tried to get this posted, but had no success!

I LOVE that final comparison to the Nazi Death Camps! Too bad it is an opinion from a dissenting judge. BUT, often if it is a ppealed to a higher court, the dissenting judge's opinion is what overturns the original ruling!

We can dream, eh?

Love,
Menolly

WELL HERE I GO WITH MY OPINIONS, DON'T INTEND TO OFFEND ANYONE, BUT, IF THE STATE OF NEBRASKA HAS TO PAY 200.000.00 DOLLARS FOR A LIVER TRANSPLANT FOR CAROLYN JOY IN CORRECTIONAL CENTER FOR WOMEN, SHE GOT A LIFE SENTENCE IN 1983, HER LIVER DAMAGE WAS DONE BEFORE SHE WENT INTO PRISON BECAUSE OF DAILY USE OF HEROIN AND ALCOHOL ABUSE OVER NINE YEARS, THE PRISON SYSTEM DID NOT HAVE ANYTHING TO DO WITH HER LIVER DESTRUCTION, SO THESE INMATES THAT HAVE BEEN SENT TO PRISON AND THEY CONTRACTED THE HEP C, WHILE IN PRISON WHY SHOULD THEY NOT GET THE MEDICAL TREATMENT THEY NEED? WHERE IS THE DIFFERENCE HERE? THEY SAY TREATMENT FOR ONE INMATE FOR 1 YEAR WOULD COST THE PRISON SYSTEM ABOUT 20,000.00, WELL COMPARE THAT TO 200.000.00. I THINK THE STATE, WHAT EVER STATE IT MAY BE, SHOULD BE RESPONSIBLE FOR EVERY INMATE THAT BECOMES SICK WITH A DISEASE THEY WERE EXPOSED TO WHILE IN PRISON, OR LET THE STATE TAKE ACTION TO TRY AND MAKE THE PRISONS A HEALTHER INVIORMENT TO KEEP THE INMATES LOCKED UP. SOME OF THESE INMATES MAY NOT HAVE LONG SENTENCES, AND IF THEY GET HEP C, WITH NO TREATMENT THEY OF COURSE WILL PROBABLY DIE FROM THIS DISEASE WHEN OR BEFORE THEY ARE RELEASED FROM PRISON. WELL THIS IS MY OPINION ON THIS SUBJECT. TAKE IT TO A HIGHER COURT AND NEVER GIVE UP TRYING TO MAKE IT BETTER AND GET THE BEST MEDICAL TREATMENT THAT IS AVAILABLE.

My sister died from HCV while in Texas TDCJ at the Carol Young Unit in Texas City on Sept. 16 2002, They refused to treat her due to her liver being "too far gone", I have found that the majority of HCV positive inmates aren't ever going to be treated because of the costs. It seems that TDCJ, would rather take an occasional lawsuit, for which they have smartly legislated a cap on awards of only 250,000 per case and have deep enough pockets to tie any suit up in court for years, there by nulifying any attorneys resources for the same time, thereby making in a no profit case therefore they won't take any cases to court because of the cap on the awards. It was a very smart peice of legislation by Texas to do that, they have put into law a way to kill these people and get away with it legally. This is legal murder, not even with a death penalty as a sentence!!!! Hooray for George W. the world is a much safer place now isn't it, all of these HCV prisoners will die, making it a cost savings to boot. By the grace of God will any of the HCV inmates get out in time to save themselves. But if they get a job and get benefits, they might be told that the benefits won't cover a pre-existing condition. It's a crule way to die. My sister basically bled to death from esphageal hemorraging(sp). There is evidence of a cover up at the unit that many inmates wrote to me and the attorney that was handling the case unitl he found no mal practice at the hospital, but there was malpractice at the unit level, because of no treatment, it's a vicous cycle that allows this to continue. TDCJ has a way to legally kill inmates with no death penalty, it's true, ask anyone of the inmates if they have recieved treatment for this, they will most likely tell you nope, they said my liver is too far gone. Granted there might be a very few that did get treatment, but I have yet to hear of any. This is insane!!!!

Goosebumps:

Alsolutely dear, THIS IS INSANE! That is why we started this forum, and hope to start making some noise that will in the end encourage some changes.

Part of what we have to do is make THE PUBLIC aware of what is going on, because in the end, it is TAXPAYERS who will be footing the bill, and caring for these dying people, AFTER they have been released!

Please read the "Welcome to the Hep C Family" post at the top of this forum. You will readily see that YOU ARE NOT ALONE in your suffering. All four of us moderators' lives have been cruelly hurt by this virus, and TWO of the moderators are presently fighting the battle to get treatment!

Do please feel at home here. You are amongst MORE than just friends. You are amongst FAMILY!

I send you the DEEPEST HUG for the pain you endure in the atrocious death of your sister! We may be small voices right now, but voices gathered get LOUDER, don't they.

Welcome, dear friend, to PTO and the Hep C forum!

All My Love,
Menolly

Thank you Menolly, it is very much appreciated.
As a bit of encouragement for the two moderators, I too, had HCV. I say "had" because I was lucky, I was allowed to have the rebetron combo therapy when it first became approved by the FDA, rather than intron A alone. (40+% efficacy vs. 20% efficacy) I have now been clear of the virus for going on three years this July. I truly dodged a bullet. Because I have had this success with this treatment, I believe my sisiter would have had the same success if given a chance, mainly due to us having the same genetics, we both had the same parents, as strange as that sounds, so many people, siblings don't these days it seems. I am also on a methadone maintanance program and you wouldn't believe the discrimination by freeworld doctors about that. They insist on being off the methadone just to do the treatment, for no reason other than they don't agree with opiate replacement therapy, so many of the people I know aren't allowed to have treatment because of this, but that's a whole other topic. I hope that something can be done about this tragedy of being incarcerated with HCV, it's a total crapshoot if you will make it through your sentence or not. I really hope that I can encourage some people to at least try the treatment and forget about the warnings about the treatment being worse than the disease, not true. If you could hear how my sisiter died, it would rip your heart out and scare you to death!!!. Not to mention the mistreatment by the co's there at the unit while she was waiting to die basically. She knew she wasn't going to make it out. She even told me this. If any one knows any one in TDCJ, be a strong and loud sane voice for that person and never give up, never let TDCJ talk over you. be loud and be heard by TDCJ and UTMB, it's the inmates ONLY voice!!! If I knew this when my sister was alive, I would have been able to help her, I feel. I just discovered how they run things inside TDCJ along side of UTMB, as I said you have to have a loud and persistant voice. Never settle for the word of any one at the unit level, go over their heads when ever you feel it's necessary. Tell every one,email every one that you can get a hold of an email address for within TDCJ/UTMB, the inmates have only your voice!!!! They are all perceived by the CO's and rank as being nothing but liars and con artists, but don't cry wolf either. Be real and keep a level head, take notes, have your friend inside get to look at their medical records, you'd be surprised of the stuff they forget they have in those records. Have them sign a medical info release for you so you can talk to the medical staff at the unit. Talk to every one you can, let them know who you are, let them know who you are supporting. Be a pain in their lives at work, they will do things for you. I have now a decent relationship, phone wise at least with my friends med staff at her unit now because I have made my and her name known by them inside the med department. This goes for ALL medical problems. My friend does not have HCV. But is with her that I learned how to work the system. Be loud!!!!! Remember TDCJ is seperate from UTMB, but they just happen to be in crime together.

Goose Bumps,

You DO know that methadone collects in your liver, right? Have you looked into BUPRENORPHINE as an alternative maintainance program? Not many doctors or clinics seem to know about it yet. Perhaps the doctor's are still wading through the special FDA paperwork, to be allowed to prescribe it. I DON'T know it's toxicity to the liver, but it is MUCH easier to kick, if you ever decide to stop everything completely, out of kindness to your liver.

In Canada, you must have 6 months PROVEN drug and alcohol free before a doctor will even consider you for Hep C treatment! Now, how do you PROVE you haven't had a beer in 6 months?

Thank you for your encouraging news. Do you know what genotype of Hep C you are?

I have to tell you a little anecdote. The very first day Ken got his Hep C diagnosis, I was at his house, in shock with him! I immediately contacted an old Hep C afflicted friend of mine in Australia, named Steve. SIX YEARS AGO, Steve was the FIRST person I ever heard who dared to say the word CURE for Hep C, instead of merely "in remission", or "sustained responder".

Steve immediately sent Ken and I such a hopeful letter, in which he told us that he has been cured for 3 and a half years now. (He's a genotype 3a.) AND STEVE IS ABOUT TO GET MARRIED!

Ken and I couldn't have heard more hopeful news that day! We hadn't even told a soul on PTO yet about his diagnosis, we were that paralyzed from the news! STEVE helped us breathe again!

So, you keep spreading your good news, (Mr/Ms??) Goose Bumps! People need to hear it so desparately!

All My Love,
Menolly

Menolly, I don't know what my genotype of HCV I am/was. I'm sorry I don't have that info. But really bottom line is that I know I've been clear of it for going on three years. You say that methadone collects in your liver, but from all the decades of tests with methadone,from all that I have read and researched there is nowhere that says it harms the liver. also, because I am not currently HCV positive, my liver enzymes are normal, so I'm not worried about any damage being done by the methadone. The alternative for me is what will kill me. Even though it's a synthetic opiate, there are no true opiates that harm or cause harm to your liver, it's all of the stuff that gets packaged with it. LOL, it's Mr. one day I will expose my real name.LMAO-ROTF

Dear MR. Goose Bumps:

Alternative ONE might kill you, dear.

BUT alternative THREE MIGHT BE Buprenorphine.

Do let me know if you ever do run across any research that speaks of it's liver toxicity.

Don't worry about exposing your real name. I've been here like... forever, yet only a very few people know my real name! And even fewer know exactly where I live. But my honey here, knows EVERYTHING about me!

This is the Internet, and even wonderful sites such as this one, can attract a weirdo or two. But we're usually pretty quick to spot them!

Love,
Menolly

I have read about Buprenorphine. I was extremely interested in getting on it. But when I need to do something, it wasn't available for anything other than trials. So I went with the government approved replacement. I do sometimes wish our government was a little more progressive in this area. But after all we have turned into a nation of PC correctness and the frame of thought if we don't like something lets make it illegal. But that's also another topic. If I do find what the liver toxicity factor is with methadone I will certainly let you know as I hope you will do the same for me.:-) I get home from work everyday about this time and I go straight to this site now, I am getting addicted =to it. I always do that with things I love, such as chocolate covered devils food donuts from Entenmenn's(sp). MMMMmm Chocolate, in Homer's voice, thank God for Dan Castalenata or what ever his name is, he is the greatest!!!

I live in NC, do all states deny treatment for inmates with Hepatitis C? My friend is incarcerated, and has been for 22 1/2 yrs. He was having stomach pains, they thought he had Hep. C and kept running test, kept coming back Neg. They finally done some test and found out he has a cancerous tumor on the head of his Pancreas. They went to remove it, but couldn't because it was wrapped up in his intestines and veins so they had to close him back up. They are supposed to start Radiation on him this week. But they done another test on him about two weeks ago for Hep. C and this time it came back Positive. I think they gave it to him. He said the prison hospital is nasty and stinks very bad. He also had to be given blood a couple times. He doesn't do drugs. He said he has no idea how he got it. But when I got a letter from him this past Monday, the way I understood him they aren't going to treat him because they aren't worried about it. I'm going to print him some stuff off of here and send it to him so he can read about it. THey done his surgery to remove the tumor on March 14th and still haven't started him Radiation. The prison system doesn't care. He comes up for another Custody review in Aug. and a Parole review in Oct. so we hope they will let him out this time so he can get treated. If it is left up to them they will let him set in there and die.

hello i have a brother in kilby correctional fauilty in mout meigs alabama. he has hipt c
will he get medical help for this while he is there.
pam

At the Hampton Roads Regional Jail (HRRJ), in Portsmouth, Virginia, they test for Hepatitis but do NOT provide treatment. The same is true for tuberculosis. HRRJ does not even isolate these type of ill inmates from the rest. Sick.

Its hard to get medical treatment for Hep C in prison. A friend of mine is being treated now for Hep C, while in prison, but it had to go to the top, the Ombudsman for investigation, and push.

Its wrong, cause people with life sentences could pay the ultimate, there life without treatment with Hep C. Its extremely unfair.