ACLU sues North Carolina prisons over lack of Hepatitis C screening, treatment

Kim Caldwell was diagnosed with Hepatitis C in 2015, when he was screened upon his incarceration in a North Carolina state prison. He was told he needed a follow-up screening to determine if he required treatment. Caldwell never received that follow-up, and despite making requests, filing grievances, and transitioning facilities, he has still not received treatment for this disease.

Caldwell is one of three prisoners with Hepatitis C that are plaintiffs in a federal class-action lawsuit against North Carolina state officials. The suit was recently filed by the the ACLU of North Carolina and North Carolina Prisoner Legal Services. 

Caldwell, Lloyd Buffkin and Robert Parham’s lawsuit was filed on behalf of all people incarcerated in North Carolina with Hepatitis C, according to the ACLU press release. The lawsuit claims that North Carolina’s Department of Public Safety refuses to provide adequate, life-saving medical treatment to inmates with this disease. The plaintiffs are seeking proper screening and proper treatment for prisoners with Hepatitis C in North Carolina. 

Hepatitis C is a highly communicable disease that can be contracted through means such as intravenous drug use, unregulated tattoos or piercings, and needlestick injuries in healthcare settings. Left untreated, the disease can cause liver cancer or disease, and death. The Center for Disease Control, the American Association for the Study of Liver Disease, and the Infectious Diseases Society of America all recommended testing for incarcerated people. According to the National Hepatitis Corrections Network, correctional populations represent about 1/3 of total cases of Hepatitis C in the country. 

Emily Seawell, an attorney with the ACLU of NC, explained that in the state, universal screening of prisoners is not required. Experiences of prisoners vary depending on facilities and prison officials.

“Some prisoners get screened upon entry, some get screened shortly thereafter, and some are still awaiting additional screening and have never received any,” Seawell said. 

In an email, communications officer for DPS Jerry Higgins wrote, “The Department of Public Safety takes seriously screening and treatment of Hepatitis C (HCV) in its incarcerated population.” 

According to the lawsuit’s press release, “With very narrow exceptions, North Carolina DPS policy expressly forbids the treatment of prisoners whose Hepatitis C is caught early, when treatment would be most effective.”

For the majority of N.C. prisoners that have Hepatitis C, Seawell said there is no treatment option, and the treatment plan that does exist is haphazard and arbitrarily conducted. 

According to Seawell, the current policy in N.C. is treatment eligibility for prisoners who have been diagnosed with advanced stages of Hepatitis C, but it’s not required that prisons treat them.

“That’s handled on kind of a case-by-case basis. There’s no uniformity,” Seawell said.  

Additionally, Seawell said this treatment protocol is based on a misunderstanding of the disease itself. 

Higgins wrote in his email that treatment is provided to all inmates at stage F2 or higher, as well as screening for all at-risk inmates and also to those upon request for screening.

But according to Seawell, one can be diagnosed at stage 3 and then test at stage 1 a few months later. It’s not a progression, Seawell said. 

“Allowing it to advance only increases the time period these incarcerated people are suffering, and for no good reason,” Seawell said. 

According to Mandy Altman, this subsequently becomes a public health problem when these untreated prisoners are released. Altman pointed out, however, that N.C. is in large company with its practices. 

“There are a lot of states that have similar policies. The cure for Hep C didn’t come out until December of 2014, so it’s kind of a new thing that states are having to grapple with,” Altman said.

The original cost of the cure, according to Altman, was about $120,000. It’s since been reduced to about $20,000-30,000 since then. 

Altman said that the problem facing prisons is that they bear the disproportionate burden of this prevalence of Hepatitis C. Altman also pointed out that it as not a politically savvy for politicians to ask for funding for prisoner health care, as opposed to healthcare for children or the elderly.

But it’s still better to treat instead of wait, Altman said. The cost of treating someone with a lot of liver damage can be much higher. Altman added that, with the increasing trend of these kinds of lawsuits, it may be more cost effective to treat prisoners than face the large class-action costs of losing subsequent lawsuits.

The lawsuit filed by the three prisoners and the ACLU claims that the state’s actions and lack thereof violate both the Americans with Disabilities Act and the Eighth Amendment, which forbids cruel and unusual punishment.

Seawell said she has seen positive results in other similar cases around the country.

“I think within the next five years, all these lawsuits that are happening – which North Carolina is not unique in that at all – are going to start winning in favor of the people in prison and they will have to change the treatment protocol,” Altman said.