8-1-17 Florida:
ORANGE COUNTY, Fla. - The family of a man who died while an inmate at the Orange County Jail announced Monday that they were in the process of filing a federal lawsuit against the county, almost two years after Max Gracia II's death.
The family told Channel 9 that they worked to negotiate with the county, but said they didn't see enough change in policy that would keep the same type of death from happening in the future.
Gracia died four days after he was bitten by a police dog and taken to jail in August 2015.
About three months later, his death was ruled a homicide, which raised concerns about his treatment.
In December 2015, a report claimed Gracia was so sick that other inmates had to drag him on the floor to move him from cell to cell.
"If he did anything wrong, then that was between him and the court system. But he didn't get that opportunity," the victim’s mother, Willine Gracia, said in early 2016.
While announcing the lawsuit Monday, Willine Gracia said the court action was about making a change, not about making a dollar.
"It's not about the money," she said. "It's not.
"You can't treat a human being that way. It doesn't matter about color, race, none of that matters. My son screamed and laid there in agony and pain. Dying. My God." ..Continued..
August 1, 2017
Family announces federal lawsuit 2 years after Orange County inmate's death
Lawsuit Says Only Five Out Of Thousands Treated For Hepatitis C In Missouri Prisons
8-1-17 Missouri:
A lawsuit alleging the Missouri Department of Corrections systematically denies medical treatment to prisoners with chronic hepatitis C has taken a big leap forward after a judge certified it as a class action.
U.S. District Judge Nanette Laughrey last week ruled that the lawsuit, which was filed in December, meets all the requirements for class certification, including numerous plaintiffs and common issues of law and fact.
The ruling is significant because the class potentially includes thousands of inmates. At least 10 to 15 percent of the Missouri prison population is infected with hepatitis C, and the corrections department itself, in response to a Sunshine Act request, estimated last year that it had 5,200 inmates with hep C. The hepatitis C rate among the general population is about 1 percent.
"By not treating them, they're increasing the spread of the disease within this population," says Gillian Wilcox, a staff attorney with the ACLU of Missouri, which represents the plaintiffs. "Ninety-six percent of these people are coming back into communities." ..Continued..
Medical Problems of State and Federal Prisoners and Jail Inmates, 2011–2012
February 5, 2015 NCJ 248491:
Presents the prevalence of medical problems among state and federal prisoners and jail inmates, highlighting differences in rates of chronic conditions and infectious diseases by demographic characteristic. The report describes health care services and treatment received by prisoners and jail inmates with health problems, including doctor 's visits, use of prescription medication, and other types of treatment. It also explains reasons why inmates with health problems were not receiving care and describes inmate satisfaction with health services received while incarcerated. Data were from the 2011 –12 National Inmate Survey.
Highlights:
- In 2011 –12, an estimated 40% of state and federal prisoners and jail inmates reported having a current chronic medical condition while about half reported ever having a chronic medical condition.
- Twenty-one percent of prisoners and 14% of jail inmates reported ever having tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS).
- Both prisoners and jail inmates were more likely than the general population to report ever having a chronic condition or infectious disease. The same finding held true for each specific condition or infectious disease.
- Among prisoners and jail inmates, females were more likely than males to report ever having a chronic condition.
- High blood pressure was the most common chronic condition reported by prisoners (30%) and jail inmates (26%).
- About 66% of prisoners and 40% of jail inmates with a chronic condition at the time of interview reported taking prescription medication.
- More than half of prisoners (56%) and jail inmates (51%) said that they were either very satisfied or somewhat satisfied with the health care services received since admission.
..Source.. by BJS, Marcus Berzofsky, Dr. P.H., RTI International, Laura M. Maruschak, BJS Statistician, Jennifer Unangst, RTI International
May 12, 2017
Florida prisoners with hepatitis are at risk for worse, lawsuit claims
See also: Lawsuit Says State Refuses to Treat Prisoners for Hepatitis C, Letting Some Die5-11-17 Florida:
Thousands of Florida prison inmates who have hepatitis C are not getting adequate medication and treatment — leaving them at risk for liver failure, liver cancer and death, according to a lawsuit filed against the Florida Department of Corrections.
The case, brought on behalf of three state prison inmates who have the disease, alleges that up to 40,000 state inmates could have some form of the disease, which can potentially be spread — not only among the prison population — but to the general public if not treated by the time an inmate is released.
The lawsuit, filed by the Florida Justice Institute, seeks an immediate injunction forcing the state prison system to start treating inmates with the disease by providing medications that have been approved and recommended by the Centers for Disease Control and Prevention and the Federal Drug Administration since 2013.
“The FDC recognizes that hepatitis C is a serious disease that is easy to cure,” said Randall C. Berg Jr., FJI’s executive director. “Yet it routinely fails to provide lifesaving medication to people incarcerated in Florida.”
The Institute maintains that FDC’s treatment rate is among the lowest in the nation, and that as many as 40,000 of the state’s 99,000 inmates could be infected. ..Continued.. by JULIE K. BROWN
September 20, 2016
Health Law Expanded Coverage For Ex-Inmates, But Gaps Remain
Insurance expansion in the early stages of the Affordable Care Act’s implementation boosted coverage for ex-prisoners but still left substantial gaps among a population with high rates of mental illness and chronic diseases such as hepatitis and diabetes, new research shows.
As expected, the health law’s 2014 expansion of Medicaid coverage for the poor was linked to higher insurance rates among those on parole or probation, and others with recent involvement with the criminal justice system.
The large majority of ex-prisoners are eligible for Medicaid in states that opted to expand it, experts say.
Another portion of the health law was also associated with substantial, and perhaps surprising, increased coverage for released prisoners.Policymakers see the health law as a way to connect millions of ex-prisoners to care, cut recidivism and save money by reducing expensive visits to hospital emergency rooms, which are often the provider of last resort for the uninsured.
After 2010, when the law required employer medical plans to cover dependents up to age 26, the portion of young adult ex-inmates without insurance fell from 40 percent to 32 percent.
Presumably many of them got coverage through their parents’ job-based plans, said Dr. Tyler Winkelman, a researcher at the University of Michigan and the lead author of the study, published Monday in the Journal of General Internal Medicine.
“It’s a fascinating finding,” he said. “This could be a really important way that justice-involved individuals get insurance coverage, because so many of them are younger than 26.”
But coverage is still far from universal. Nineteen states haven’t expanded Medicaid. Among those that have, prisons and jails are doing a spotty job of enrolling released prisoners.
As of 2014, the first year of the Medicaid expansion, 30.7 percent of ex-inmates and other justice-involved people were still uninsured, according to the researchers’ analysis of a national survey on drug use and health. The rate had previously hovered around 40 percent.
Newer figures may show continued increases in coverage among released prisoners, Winkelman said.
Several states have expanded Medicaid since 2014. Plus, he said, “I would assume that as more jails and prisons are coming online with programs, they’ll enroll more people.” ..Source.. by Jay Hancock
September 6, 2016
Tennessee inmate asking for hepatitis C treatment dies
John Bilby knew he didn't have much time left. But, at least for a few days, it appeared as though the longtime Tennessee inmate and sufferer of hepatitis C might have some hope. Diane Douglas, Bilby's wife, said he was recently told he was at the top of the list to receive the best available treatment for his hepatitis C, a chronic disease that slowly destroys the liver.
Douglas said the day after Bilby told her this, he died. "He was a very strong man, strong minded. He realized he had done wrong, but with me and him and the chaplain, he realized God would forgive him for it," Douglas told The Tennessean. "I was with him for 16 years, and he finally made peace with that. He was changing his life around." ..Continued.. by Dave Boucher
September 5, 2016
Inmates with hepatitis C sue Tennessee prison officials for treatment
Tennessee inmates infected with hepatitis C filed a federal lawsuit against state prison officials late Monday, asking the court to force the state to start treating all inmates who have the potentially deadly disease.
The lawsuit, filed by attorneys with the American Civil Liberties Union and other advocates in U.S. District Court in Nashville, says the Tennessee Department of Correction officials knowingly denying inmates care for their hepatitis C, also known as HCV, constitutes cruel and unusual punishment. It alleges the department is denying care because the best available medication is too expensive.
"In reality, (department officials) ignore the medical needs of (inmates) and class members in order to save costs. (The department's) written policies for HCV diagnosis, assessment and treatment utilize outdated standards of care and normalize the practice of refusing treatment for unjust and medically unsound reasons," the lawsuit states.
Inmates Charles Graham, also known as Charles Stevenson, and Russell L. Davis are named as plaintiffs in the lawsuit. Attorneys representing the inmates include Thomas Castelli, the ACLU-TN legal director; Karla Campbell of Nashville-based law firm Branstetter, Stranch and Jennings; and Elizabeth Logsdon of advocacy organization Disability Rights Tennessee. No Exceptions Prison Collective, an inmate advocacy organization, also helped compile the lawsuit.
"Incarcerating people under conditions that erode their health, safety and human dignity amounts to cruel and unusual punishment, which not only has devastating long-term effects for those individuals, but which undermines the purported purpose of a rehabilitative criminal justice system," Castelli said in a news release.
They are seeking what's known as class-action status for the case: If successful, that would mean every inmate infected with hepatitis C also could be eligible to receive treatment in the future. The lawsuit names as defendants new department Commissioner Tony Parker, department Assistant Commissioner of Rehabilitative Services Dr. Marina Cadreche and department Medical Director Dr. Kenneth Williams.
In a statement, department spokeswoman Neysa Taylor defended the state's medical practices.
"The Tennessee Department of Correction is currently unaware of the referenced court filing but is confident the department is providing adequate medical care as determined by medical protocol," Taylor said in an email late Monday.
In the past, the department also has argued that it is adequately treating all inmates. But a Tennessean investigation earlier this year found that, as of March, nearly 3,500 inmates had hepatitis C while only eight were receiving treatment that could cure them. As of the end of June, the enormous disparity between those infected and those receiving treatment remains: There are 2,935 inmates with hepatitis C, while four are receiving the newest treatment, Taylor said. An additional inmate refused treatment, and three have completed the newest treatment, Taylor said.
Although infected inmates routinely leave and enter the Tennessee prison system, the change in number of inmates infected probably shows that at least several hundred inmates who remain infected have returned to their communities in the past few months. The department also doesn't test every inmate who enters the prison system. But of the 901 inmates tested in 2015, 424 tested positive for hepatitis C, Taylor previously told The Tennessean.
Advocates — including Jeannie Alexander, head of No Exceptions — say that means there are probably hundreds of other inmates with the disease who are not diagnosed.
"It is immoral and a violation of human rights and constitutional rights to knowingly refuse treatment to prisoners suffering from Hepatitis C when an effective treatment that has become the new standard of care is available," Alexander said in an emailed statement. ..Continued.. by Dave Boucher,
September 11, 2013
Man appeals HIV notification law conviction
An Iowa man with HIV sentenced to 25 years in prison for not telling a sex partner that he carried the virus appealed to the Iowa Court of Appeals on Wednesday.
Nick Rhoades, 39, met and had sex with a man he had chatted with on the Internet in 2008. He was convicted in 2009 and is currently on probation after his sentence was reduced a year later. He is required to register as a sex offender for the rest of his life unless the conviction is overturned.
Rhoades' attorneys say the conviction should be thrown out because his defense attorney did not fully understand the law and should have never advised him to plead guilty. Rhoades claims he was not properly questioned by the district court judge about whether he understood the law when he pleaded guilty. His attorneys also argued Rhoades did not violate the specific definition of the state's law.
"Even though Rhoades used a condom in the sexual encounter and even though he never intended to expose, and in fact did not expose, infectious bodily fluids to his partner he was advised to plead guilty," said Christopher Clark, an attorney with Lambda Legal, a national organization that fights for civil rights for lesbians, gay men, transgender people and those with HIV.
Iowa passed a law in 1998 that makes it a felony for someone with HIV to engage in intimate contact with another person. That is defined as the intentional exposure of the body of one person to a bodily fluid of another person in a manner that could result in the transmission of HIV. The law does not require that the other party become infected.
Clark argued that Rhoades, who lived in Plainfield when he was charged and now lives near Des Moines, did not intentionally expose the other man to bodily fluids in a way that could have transmitted HIV because he practiced safe sex by using a condom.
"This was a wildly inappropriate prosecution by the state and that's why we're here making our arguments today and challenging it," he said in an interview after Wednesday's hearing.
Assistant Attorney General Kevin Cmelik, who asked the court to uphold the conviction, said there are no facts to support Rhoades' claim that he didn't understand the plea. Cmelik also said the district court judge found that Rhoades' attorney had clearly informed him of the specifics of the law.
Cmelik said the appeal boils down to whether Rhoades' sex act violated the law.
"I would submit to the court the intentional exposure in this case is simply committing the act of having sexual contact," he said. The Legislature intentionally broadly defined exposure in the law, he said.
Since Iowa's law took effect, at least 27 people have been convicted.
Lambda Legal has worked with other organizations to revise HIV criminalization laws across the country. Currently 33 states have one or more HIV-specific criminal exposure laws, according to the U.S. Centers for Disease Control and Prevention.
Des Moines Democratic Sen. Matt McCoy has introduced bills in the past few years to reduce penalties and focus on people who purposefully try to infect others with the virus. He wants Iowa's law to sentence people convicted of intentional or attempted transmission of the virus to a maximum of five years in prison, putting HIV in the same criminal category as transmitting any other communicable disease, such as Hepatitis C. The current HIV law has a maximum penalty of 25 years.
McCoy also wants to end a requirement that people convicted must be placed on a sex offender registry for life. His bills have never advanced out of committee but he plans on trying again next year.
Clark said he hopes the court concludes the Iowa law as written does not cover safe sex.
"HIV positive individuals do have a right to have sexual lives and do that in a safe and responsible way," he said. "We're hoping for that outcome in this case." ..Source.. by DAVID PITT
April 1, 2012
Minnesota's million-dollar inmates
4-1-2012 Minnesota:
James Vogel knew he had it coming in 2009 when an Aitkin County judge sentenced him to five years in prison for his sixth drunken-driving conviction. What gave him pause was the mysterious lump in his gut -- a bulge the size of a football -- and who was going to take care of it.
The lump turned out to be a rare form of non-Hodgkins lymphoma. Terminal. Five years average life expectancy.
Yet, at the direction of the Minnesota Department of Corrections, Vogel soon started receiving the best medical care in America: a year of intensive chemotherapy, then a trip to the Mayo Clinic for nearly a month to receive a sophisticated bone-marrow transplant.
By the time he left Mayo in August 2010 and headed back to prison in Oak Park Heights, Vogel, now 52, was on his way to being what state corrections officials describe as a "million-dollar prisoner."
Vogel's treatment epitomizes a pair of forces bearing down on Minnesota's corrections system: Soaring medical costs and a rapidly aging prison population. More than one in 10 Minnesota inmates is now over age 50 -- a share that has doubled in the past decade -- and increasingly many of them need specialized treatment for costly illnesses such as cancer, diabetes and heart disease. More than 550 offenders are serving life sentences; at an average age of 40, most face at least 30 more years in prison before they have any chance of parole.
With a medical budget that has tripled in the past decade, to $68 million last year, the Corrections Department faces politically sensitive questions -- among them the matter of providing expensive, sophisticated medical care to offenders who have committed heinous crimes, at a time when many Minnesotans are struggling to afford basic care and health insurance.
"The aging curve in prison is crushing when it comes to costs, just like the one for the general public, and it won't get any better," said Sen. Tony Lourey, DFL-Kerrick, whose district includes a correctional facility and the secured treatment center for the state's sex offenders.
Nan Larsen, the Corrections Department's medical director, is often asked by legislators why prisoners are afforded care that those on the outside would find difficult to obtain. A direct, tough-minded administrator, she has an answer:
"Their punishment is that they are separated from us, from society and from their families -- but not from our care."
Besides, Larsen notes, inmates like Vogel have unique status. As a prisoner in the United States, he is a member of the only class of Americans with a constitutionally guaranteed right to health care, as determined by the U.S. Supreme Court.
Vogel, a construction worker from Grand Rapids, Minn., understands the paradox.
"I probably would not have gone to see a physician, or had the cancer found as soon as it was, if I hadn't been arrested," he said in an interview at Stillwater prison. "I'll admit that. So there's a level of gratitude over the treatment I've received."
Prisoners elderly at 50
When Vogel became a million-dollar inmate, he joined a select group of convicts who need highly specialized care -- at cost of more than $14 million just last year.
They've lived hard lives and pushed their bodies to the breaking point. In Minnesota, a prisoner at 50 is considered elderly, with the medical problems of someone 60 or older.
A snapshot of inmate health is sobering:
More than 80 percent are considered chemically dependent, and nearly 20 percent are estimated to be hepatitis C-positive. Decades of smoking, boozing and drug use have pushed their hearts, livers and kidneys to the edge of failure.
Obesity, hypertension and diabetes are common.
More than 20 percent of the men and nearly 70 percent of the women are on psychotropic medications.
Just to treat prisoners with cancer, the department has spent more than $14.4 million over the past five years. Four prisoners now await stem-cell transplants.
Cardiac care -- ranging from heart bypass grafts and stents to pacemakers -- has cost nearly $2 million over the past four years.
On a recent morning deep inside the maximum-security Oak Park Heights prison, 16 prisoners were laid out in a semi-circle with tubes needled into their arms. Some of the most violent men in the state were hooked up for thrice-weekly, three-hour dialysis sessions to cleanse their failed kidneys.
Although they're a comparatively small number of prisoners, their care costs have doubled in the past four years and will only go higher. Currently, the dialysis program costs more than $560,000 a year. The number of dialysis patients is expected to double by 2020 and cost $1.8 million.
Currently, nine prisoners with hepatitis-C are deemed candidates for a special drug that has shown remarkable success over a 12-week regimen. The Corrections Department says it would cost $40,000 per treatment, a total of $360,000 if each prisoner is givn the drug.
And finally, when prisoners are considered so ill that they must be hospitalized, the daily rate for a room and routine care is $5,000.
Price tag: $49 billion
Across the country, many states are struggling with the same burden. The nation's prison population has almost tripled in the past two decades, to nearly 1.6 million inmates, due mainly to tougher sentencing guidelines; overall corrections spending has grown fivefold, to $49 billion in 2008, according to the Pew Center on the States.
Nationally, the number of prisoners over age 65 nearly doubled in the past decade, reaching more than 26,000 in 2010, according to a recent study by Human Rights Watch. Medical costs for older inmates range from $8,500 to $11,000 per person per year, the report found.
"Prisons were never designed to be geriatric facilities," said Jamie Fellner, the report's author. "Yet, U.S. corrections officials now operate old age homes behind bars."
To control costs in Minnesota, the Department of Corrections contracts its prison care to a national, for-profit health provider called Corizon, formerly Correctional Medical Services. This year, DOC will pay Corizon $28 million to provide basic care to prison inmates, up $9 million from 2006.
Corrections officials say the relationship is saving taxpayers tens of millions of dollars; while public health care spending in Minnesota has increased an average of 8 percent annually over the past six years, the department says it has been able to keep its cost growth to about 5.5 percent using privatized care for prisoners. But inmates complain of long delays between the time their illnesses are diagnosed and when they get treatment.
Larsen notes that, while some inmates get the finest care available in Minnesota, others are denied services that are routinely covered by the health insurance of people on the outside.
By her count, there are more than 65 health insurance mandates for which the average citizen on private health insurance can receive coverage. They include certain kinds of cosmetic surgery, breast reconstructive surgery, wigs for hair loss and removal of port wine birth marks.
"The DOC does not provide this level of coverage," Larsen said.
Offenders, she added, receive a "community standard'' of care consistent with standards established by the state Board of Medical Practice.
"If an offender can live safely and participate in [prison] programming with a hernia, and it is not causing pain and not interfering with daily living, the [prison] doctor may not authorize treatment," Larsen said.
On borrowed time
..For the rest of this story: by StarTribune
