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.
And he told the corrections agency to come up with the plan “with alacrity,” writing in the order that “this court will not tolerate further foot dragging.”
Michelle Glady, a Department of Corrections spokeswoman, said in an email that the agency has asked the Legislature for $19 million “to expand the treatment for inmates with Hepatitis C” and that it contracts with the firm Centurion “to provide comprehensive health services to all inmates in Florida.”
“FDC (the Florida Department of Corrections) is absolutely committed to ensuring all inmates in our custody are provided medically necessary treatment that is in line with national standards and our constitutional responsibilities,” Glady said in the email.
Hepatitis C is usually contracted through intravenous drug use but can also be transmitted through tattooing or blood transfusions. The disease causes liver scarring, which can significantly impair liver function and ultimately lead to death.
The lawsuit was filed in May by the Florida Justice Institute on behalf of three inmates and a class of others infected with the virus. Walker also certified the case as a class-action lawsuit on Friday.
“We are very pleased with Judge Walker's order, and we hope that it will result in thousands of inmates getting much-needed treatment so they will not die,” Randall Berg, executive director of the institute, told The News Service of Florida on Friday.
Corrections officials maintained that the case was moot because they had made several changes to their policy about treating infected inmates since the lawsuit was filed.
But even the most-recent revision —- finalized a week before a five-day hearing in the case last month —- is inadequate, Walker found.
“FDC needs to clear up the loosey-goosey language in its treatment policy so that it can no longer hide behind the consequences of its own obfuscations,” Walker wrote in a footnote.
The department's latest policy doesn't guarantee that inmates will be screened or receive treatment quickly enough, Walker found, based on testimony from the corrections department's own expert.
The judge gave the department until Dec. 1 to come up with a new plan and ordered the agency to “increase its capacity and outline a timetable for doing so” because agency officials have maintained they do not have enough staff to start screening all inmates who could be at the highest risk of having advanced liver disease due to Hepatitis C.
“This court has no doubt that without a court-ordered injunction, FDC is unlikely to treat inmates in a constitutionally appropriate manner,” Walker wrote.
In a footnote, Walker wrote that funding issues could excuse some delay, but not to this extent.
“For instance, if DAAs (direct acting antivirals) were released yesterday, this court would not expect FDC to wave a magic wand and suddenly treat thousands of inmates overnight,” he wrote. “But that is not the case. FDC has had since late 2013 to respond to this problem, and it has only just recently started doing what it should have done years ago.”