HEALTH CONCERNS
Investigation into HIV-meds distribution highlights ongoing problems with health care at the Allegheny County Jail {BY ALEX ZIMMERMAN} ASK ALEXANDRA Morgan-Kurtz about the quality of medical care at the Allegheny County Jail and there’s an uncharacteristic pause. “I’m trying to think of a polite way to say this,” says the staff attorney of the Pennsylvania Institutional Law Project. “Probably {PHOTO BY ALEX ZIMMERMAN} the worst health care in the state I’ve seen The ACLU is investigating the irregular distribution of HIV treatments at the Allegheny County Jail. when it comes to prisons and jails.” Problems related to health care at the contends, nor is the jail keeping tabs on the jail, says PATF has received complaints county jail are hardly new. But after a the levels of virus in the blood of infected about a lack of HIV medication. March 23 City Paper story revealed that inmates, providing sufficient “pre-release Testing and treatment are “really imthe state American Civil Liberties Union counseling,” or offering enough medication portant, especially when you’re talking had launched an investigation into the upon release. about a system where men are living toBut medication-delivery problems at gether in an enclosed environment day jail’s distribution of HIV medication to the jail aren’t HIV-specific: “I don’t after day,” Christen says. Missing doses inmates, fresh questions are being think HIV/AIDS patients are get- of HIV meds can lead to future drug reraised about why these probting some kind of uniquely sistance and higher levels of virus in the lems have persisted and who Follow bad care,” says state ACLU blood, which makes spreading the disis ultimately responsible for ents Legal Director Vic Walc- ease more likely, a problem for inmates finding solutions. developm ry o of this st ak zak. “It’s emblematic of as well as for the general public when “There’s not one person re as they b . what’s happening in the inmates are released. you can point to and say, on www r [jail] health-care-delivery ‘You made that decision; you Problems related to appropriate dee p a pghcityp system as a whole.” have to fix it,’” Morgan-Kurtz livery of medications and staffing levels .com Concerns about medica- were also part of a scathing says. “That’s a huge part of the tion delivery were echoed by ad- report released last Decemproblem. There is no one to hold vocates and outside providers who ber by Allegheny County the jail accountable.” According to the ACLU, jail medical staff consistently visit the jail. Controller Chelsa Wagner, Charles Christen, executive director of who told CP that the have not been providing HIV medication in a “timely and consistent way.” Regular the Pittsburgh AIDS Task Force, an orga- ACLU’s findings “certainly HIV testing isn’t being conducted, the ACLU nization that has worked with inmates at don’t surprise me.” But figuring out who is ultimately responsible is not a straightforward task. Jail health care is directly administered by Corizon Health, a company hired in September 2013 as part of an effort to control rising costs and improve care. (Corizon receives about $ 11.5 million per year from the county.) After refusing to grant an interview request, Corizon released a statement through a third-party public-relations firm that read, “We take seriously the concerns of patients, their families and the community related to clinical quality, especially when it comes to the treatment of HIV/AIDS … many of the allegations made in this article are untrue” — a reference to the ACLU’s claims. A spokesman would not elaborate on which claims they FARM believe are untrue. X A County spokeswoman Amie Downs Visit traxfarsm.com wrote, “Providing jail medical care is chal-
lenging and there will always be issues that will need to be addressed. That being said, the administration is working alongside its numerous stakeholders to constantly address and improve the provision of medical care, and will continue to do so.” Warden Orlando Harper declined comment via Downs, and the county would not answer specific questions about potentially inconsistent medication delivery. “In regards to your question on the HIV/ AIDS policy, you will need to contact Corizon directly as that is a medical-care policy question,” Downs wrote. But Marc Stern, a former assistant secretary for health care at the Washington State Department of Corrections, says municipalities can’t simply pass responsibility for poor health care to contractors. “A lot of places privatize because they don’t understand health care and … understand it’s a high-risk, high-cost part of their jail,” says Stern, now a correctional healthcare consultant and public-health professor at the University of Washington. “Many jail administrators misunderstand that you can’t contract away all your liability in providing constitutionally appropriate health care.” The county controller approved a position on Dec. 9 for a “Healthcare Contract Monitor,” according to the controller’s office, but it is no longer posted and the position was not filled. There can be good reasons to privatize, especially if a private company can offer more competitive salaries and attract talent, Stern says. But municipalities still have an obligation to make sure the terms of that contract are being met. And he says, “If you’re going to have that much expertise anyhow, I don’t think it’s a big leap to say, ‘Why not just operate it ourselves?’” The larger issue, according to Stern, is not whether medical care is provided by a private company. (Stern formerly worked for a company that later became part of Corizon.) It’s overall funding. “I think we focus on: ‘The company’s trying to make a profit.’ You get the outcome that you paid for; [municipalities are] not willing to put the money into correctional health care that it needs,” he says. But whatever the cause of the problems it alleges, the ACLU is continuing to investigate and could move in the direction of a lawsuit “if we don’t see any kind of improvement,” Walczak says. “We’re not talking about not getting your aspirin; this is a whole lot more serious than that.”
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PITTSBURGH CITY PAPER 04.01/04.08.2015
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