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| Jail contractor to treat hepatitis C |
| By The Birmingham News |
| Published: 11/10/2003 |
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Medical costs in Alabama prisons are rising partly because the new medical contractor will treat hepatitis C, a virus that's epidemic in prisons but has been ignored even though it can lead to fatal liver disease. Ronald Cavanaugh, director of treatment for the Alabama Department of Corrections, said he's seen estimates as high as 40 percent for the rate of prisoners across the country infected with the virus. Most reports put the number at 17 percent to 30 percent of prisoners nationwide. No one knows the exact rate in Alabama. Most prisoners eventually get out, taking the contagious, untreated disease with them. It's created a growing public health concern. There is no vaccine for hepatitis C, and its often not diagnosed in early stages. In the general U.S. population, infection rates are about 1.8 percent, according to the Centers for Disease Control and Prevention. Monday, the state's three-year, $142 million contract with Prison Health Services takes effect. The Brentwood, Tenn.-based company will take over care previously provided by Birmingham-based Naphcare for about $29.5 million a year. Cavanaugh said the new contract will include greater accountability, better staffing and improved treatment in areas including HIV and hepatitis. The hepatitis C treatment and prevention portion alone will cost the department $3 million to $8 million a year, Cavanaugh said. It will be the first time Alabama prisons will offer hepatitis C treatment and will have a protocol for prevention and education, Cavanaugh said. Spread primarily by intravenous drug use and sexual contact, untreated hepatitis C can lead to cirrhosis of the liver and liver cancer. The right treatment during a window of opportunity in the early stages of liver inflammation usually cures patients for life. After that window closes, it's too late. The treatment costs about $25,000 per patient. Alabama prisons are facing at least four class-action lawsuits relating to adequacy of health care. The lawsuits allege that Naphcare and other providers did not adequately care for prisoners with chronic conditions such as HIV and diabetes. Many inmates contract hepatitis through high-risk lifestyles before incarceration. But the window for treatment comes while they're locked up. If care is not provided, the disease can progress and lead to a need for costly care once they are released, or it can become fatal, experts say. Prison health workers will start identifying patients who would be appropriate candidates for treatment. Cavanaugh estimated a couple hundred prisoners initially may be identified. |
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