BY JERRY IANNELLI
Hepatitis C is not all that difficult to treat. A class of drug called direct-acting antivirals, or DAAs, has been proven at least 90 percent effective in curing the condition. Just 1 percent of the U.S. population typically lives with hep C — but that rate is far higher, up to 17 percent, among state and federal prisoners.
“Florida has the third-highest prison population, which brings some responsibilities to the Department of Corrections,” said Erica Selig, a lawyer for the nonprofit Florida Justice Institute, which filed the suit on behalf of three plaintiffs. “They can’t ignore this.”
According to the institute, just five of the 5,000 Florida inmates with diagnosed hepatitis C (also known as HCV) received DAA treatment. The suit says that because many inmates don’t know they have the illness, there are likely far more people with hepatitis serving time in the state prison system: There might be anywhere from 14,000 to 41,000 cases, the lawyers say.
According to the suit, at least 160 Florida inmates have died of liver problems since 2013. The Justice Institute warns that many likely suffered from hepatitis, whether they knew it or not.
“Since HCV is the most common cause of liver failure in the United States, it is likely that most of these deaths were due to chronic HCV,” the suit says. “Upon information and belief, past and current practices of the Defendant are resulting in deaths that could have been prevented through treatment of HCV.”
Updates & Related Articles
FJI Files Class Action Lawsuit Against Florida Department of Corrections for Not Providing Hepatitis C Treatment
The Florida Justice Institute (FJI) has filed a class action lawsuit against the Florida Department of Corrections (FDC) for failing to provide incarcerated people with life-saving medications for hepatitis C, resulting in thousands being left at risk for liver failure, liver cancer, and a very painful death. The case is brought on behalf of three prisoners—Carl Hoffer, Ronald McPherson, and Roland Molina—and seeks to certify a class of all FDC prisoners who have been, or will be, diagnosed with chronic hepatitis C. The lawsuit alleges that, although the FDC has a written policy addressing the treatment of hepatitis C, in practice it provides medications to almost no one. The lawsuit seeks an immediate injunction requiring the FDC to develop a plan to provide DAA medications to all prisoners with hepatitis C, consistent with the medical standard of care. “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 Complaint describes how treatment of hepatitis C was revolutionized in 2013 with the advent of direct-acting antiviral (DAA) drugs, which cure 90 – 95% of all hepatitis C patients, regardless of the form of the disease, with little to no side effects. Treatment with DAAs is a simple 12-week course of oral medications, whereas previous therapies were ineffective for most patients, had serious side effects, and required treatment for 6 months to a year.
Guidelines developed by respected medical societies, which are available at www.hcvguidelines.org and have been adopted by the Centers for Disease Control and Prevention (CDC), express the current medical standard of care: to provide DAA medications to all persons diagnosed with chronic hepatitis C. Even the State of Florida’s Department of Children and Families has recognized this standard, by approving Medicaid coverage for adults with chronic hepatitis C, regardless of the stage of the disease. “The FDC has a responsibility to provide adequate medical treatment to all the people in its custody,” said Erica Selig, an FJI attorney. “Withholding this simple treatment falls far short of that standard.”
The FDC states that roughly 5,000 prisoners have hepatitis C, but this understates the true number. National estimates suggest that 16% – 47% of all incarcerated people in North America have hepatitis C, meaning that there are likely 14,700 – 40,184 FDC prisoners with the disease. Yet, the FDC states that only 5 prisoners were given DAA medications as of July 2016. Treating all incarcerated individuals would have a profound public health impact by significantly reducing the spread of the disease in the general population, and saving costs in the long run by avoiding expensive care associated with advanced liver disease.
The case is Hoffer v. Jones, Case No. 4:17-CV-00214-MW/CAS, and has been assigned to U.S. District Judge Mark Walker in the Northern District of Florida. For more information, contact Randall C. Berg, Jr., RBerg@FloridaJusticeInstitute.org.
Florida prisoners with hepatitis are at risk for worse, lawsuit claims From the Miami Herald
BY JULIE K. BROWN
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 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.”
Hepatitis C is a blood-borne disease caused by the hepatitis C virus (HCV). The virus causes inflammation that damages liver cells, and is a leading cause of liver disease and liver transplants. The virus is transmitted by infected blood and sexual activity. Intravenous drug use is the most common form of transmission in the United States. An estimated 2.7-3.9 million people in the United States have chronic hepatitis C, according to the CDC. Most people do not know they are infected, and the virus is more prevalent in the prison population.
Standard treatment of the disease was revolutionized in 2013 which the advent of direct-acting antiviral (DAA) drugs, which cure 90-95 percent of patients, with little or no side effects, according to the CDC.
The complaint says that only five inmates were treated with the lifesaving medications.
Treating all inmates “would have a profound public health impact by significantly reducing the spread of the disease in the general population,” FJI said.
The Florida prison system maintains they have only about 5,000 inmates with the disease, but FJI disputes that figure because it claims that FDC doesn’t test inmates for the virus.
The FDC did not respond to a request for comment.
Amid Ongoing Lawsuit, Florida’s Prison Agency Asks For Millions To Treat Inmates With Hep C From WFSU
Ever heard of the drug, Harvoni? Classified as a “direct acting anti-viral drug,” it’s said to have a high rate of success in treating Hepatitis C.
Now, drugs, like Harvoni, are at the center of a lawsuit on behalf of Florida inmates who have the blood borne disease that can attack the liver. And, these inmates say they want the prisons to provide these drugs they say have fewer side effects.
Currently, the Florida Department of Corrections does not have any funding for the treatment of the Hepatitis C virus, also known as HCV. Kenneth Steely is the General Counsel for the prison agency.
“We were served with a class action lawsuit in May of this year, seeking to have testing for HCV for all inmates and to provide the direct acting antiviral drugs to all inmates,” speaking to a group lawmakers Tuesday. “Ya’ll are probably familiar with Harvoni commercials out there: ‘if you’re a baby boomer, come get tested for Hepatitis C.’ That’s what this litigation is about.”
Steely as well as the agency’s Chief Financial Officer Kim Banks spoke before a House Criminal Justice Budget committee Wednesday. Banks asked lawmakers for the funds to address treating Hepatitis C.
“The department is requesting $19.3 million to begin treatment of approximately 500 inmates with HCV,” she said.
DOC seeks funds for inmate ‘Hep C’ treatment From Florida Politics
The Florida Department of Corrections on Wednesday requested over $19 million to treat inmates who have the Hepatitis C virus, even as the state prisons agency is embroiled in a class-action lawsuit over that treatment.
The request was made before the House Justice Appropriations Subcommittee, as part of each state agency’s annual legislative budget request. Treatment for Hep C costs anywhere from $25,000-$50,000 per inmate, according to the department.
Kim Banks, the agency’s chief financial officer, told lawmakers that DOC estimates around 500 inmates have the virus.
Following the presentation to lawmakers detailing the state agency’s operating budget, which hovers around $2.4 billion each year, Rep. Patricia Williams, a Lauderdale Lakes Democrat, asked for an explanation of the need for Hep C treatment.
“What happens if we’re not funding this portion (Hep C treatment) of the budget,” Williams asked. “What’s the ramification?”
With an ongoing case looming over FDC, Banks was limited as to what she could say. She told Williams that FDC does not currently have funding for Hep C treatment, but could not speak to potential consequences.
Court Orders Treatment for Incarcerated People with Hepatitis C, Granting Preliminary Injunction Motion Court Also Grants Class Certification to Class of Florida Prisoners With Hepatitis C
In a 32 page order, U.S. District Court Judge Mark Walker in Tallahassee granted Plaintiffs’ Motion for Preliminary Injunction and ordered the Florida Department of Corrections (FDC) to submit a plan to treat incarcerated people with Hepatitis C, with Direct-Acting Antiviral (DAA) medications. The Court noted “that Defendant must move with ‘alacrity.’ This Court will not tolerate further foot dragging.” The Court found that the Department had failed to treat prisoners with Hepatitis C, despite the fact that curative medications had been available for years. The Court also found that the lack of treatment was due to financial issues.
The Court also granted Plaintiffs’ Motion for Class Certification, and certified a class of all current and future FDC prisoners who have been, or will be, diagnosed with Hepatitis C. This allows the case to proceed as a class action, so that FJI attorneys can represent all FDC prisoners with Hepatitis C on a class-wide basis.
In the first court order of its kind in the nation in a statewide prisoner Hepatitis C class action, it was ordered that the FDC must submit a plan by December 1 that cures the deficiencies noted by its own expert at the preliminary injunction hearing, and results in treatment being provided more quickly and to more people. Once the Court approves a plan for treatment, the Court will enter an injunction.
The Court concluded that “Preventable deaths from HCV are occurring within the prison system Most of the witnesses who testified before this Court, and even Defendant’s own expert, all but admitted that Defendant has been deliberately indifferent to Plaintiffs’ (and the class’s) serious medical needs.”
Florida Justice Institute attorneys originally brought this case in May of 2017. Click here for more information.
Judge Blasts State Prisons Over Hepatitis C Care From the News Service of Florida
THE CAPITAL, TALLAHASSEE, November 17, 2017……… In a scathing ruling issued Friday, a federal judge found that Florida corrections officials have a “long and sordid history” of failing to treat inmates infected with the Hepatitis C virus and ordered the state to immediately come up with a plan to properly provide care.
U.S. District Judge Mark Walker found that the Department of Corrections and its health care contractors had for years refused to treat infected inmates with antiviral medications, known as “direct acting antiviral” drugs, because of the cost.
Between 7,000 and 20,000 of the state’s 98,000 prisoners are believed to be infected with Hepatitis C, but only 13 have been treated with the antiviral drugs since 2013, and three of those who received the treatment were plaintiffs in the lawsuit, according to court documents.
The treatment, which originally cost up to $75,000 when first released in 2013, now costs about $37,000 for a 12-week regimen and cures the virus 95 percent of the time.
But in a harshly worded 32-page order, Walker wrote that cost is no excuse for not providing the treatment, scolding the agency for being “deliberately indifferent” to the medical needs of inmates, a violation of their constitutional rights.
“Preventable deaths from HCV (Hepatitis C virus) are occurring within the prison system,” he wrote.
Walker ordered the department to update its Hepatitis C treatment policy and to formulate a plan to implement the policy by screening, evaluating, and treating inmates in line with directions and timelines set out by its expert witness.
Read the full article.
Florida let hepatitis C go untreated in prisons. Now it may cost taxpayers millions. From the Miami Herald
The state of Florida may have to pay hundreds of millions of dollars in treatment costs to as many as 20,000 sick inmates after a federal judge ruled Friday that prison officials had failed to properly care for felons infected with the hepatitis C virus.
The ruling, by U.S. District Court Judge Mark Walker, requires the Florida Department of Corrections to immediately treat a significant portion of the state’s 98,000 inmates who test positive for the viral infection with direct acting antiviral drugs, a 12-week treatment that now costs about $37,000 per patient.
“FDC has a long and sordid history of failing to treat HCV-infected inmates,” Walker wrote in his 32-page ruling. “And this court finds as a matter of fact that FDC’s failure to treat was due to a lack of funding.”
The class action lawsuit was filed in May by three inmates who have been suffering for years from the ravages of hepatitis C but were denied treatment from both the state and the private companies contracted to provide medical care in the prison system.
Walker said the state was “deliberately indifferent to the serious medical needs” and noted that only 13 inmates of the more than 7,000 eligible had ever been given the antiviral drugs, and three of them were given treatment after being named plaintiffs in the case.
He ordered the department to “move with alacrity” and said the court “will not tolerate further foot dragging.” He then gave the agency until Dec. 1 to develop a plan and ordered that it treat the most severe cases first.
Federal order foreshadows possibility Tennessee must treat all inmates infected with hepatitis C From the Tennessean
A recent federal court order in Florida may foreshadow a local judicial decision on whether thousands of Tennessee inmates affected by the state’s hepatitis C epidemic will receive medication that could save their lives.
U.S. District Judge Mark Walker ruled Nov. 17 that the Florida Department of Corrections failed to meet constitutional requirements of treating inmates suffering from hepatitis C, as reported in the Tampa Bay Times.
Hepatitis C is a chronic liver disease also referred to as HCV which can damage the body for decades before possibly causing death.
“Here, FDC’s history of past misconduct leads this court to believe that future injury is imminent. Specifically, this court finds that FDC will not treat HCV-infected inmates in an appropriate and timely manner.” Walker wrote.
“If these inmates are not treated, they will undoubtedly suffer irreparable injury.”
Inmates and lawyers in Tennessee allege similar longstanding negligence by local prison officials.
Two inmates filed a lawsuit in summer 2016 after a USA TODAY NETWORK-Tennessee investigation revealed only eight of 3,487 inmates known to be infected with hepatitis C received life-saving treatment.
Court Enters Preliminary Injunction Requiring Evaluation and Treatment of Prisoners with Hepatitis C
Judge Mark Walker of the Northern District of Florida has entered a Preliminary Injunction requiring the Florida Department of Corrections to evaluate and treat prisoners with Hepatitis C with life-saving medications called direct-acting antiviral drugs. The Order also imposes deadlines for those evaluations and the initiation of treatment. The Court had previously granted Plaintiffs’ Motion for Preliminary Injunction, but required the FDC to submit a plan of treatment. After the FDC submitted its plan and the Court reviewed both parties’ comments on it, the Court entered the Preliminary Injunction Order.
More details about the case can be found in the related posts.
Friday Editorial: Florida’s Department of Corrections makes another costly blunder From the Florida Times-Union
Yet another bungle by the state’s Department of Corrections may cost taxpayers millions of dollars this year.
This time it’ll be a big “oops” for a dysfunctional state department that’s been called on the carpet for years for its treatment of inmates.