[O]ne lawmaker used the word “unbelievable.” Another called it “appalling.”
Both were reacting to a presentation Thursday afternoon revealing that few inmates in Vermont’s prison system are being treated for hepatitis C, despite a large number with the virus.
And, those lawmakers are still awaiting answers about where the money went that had been set aside to provide that care.
Mike Fisher, the chief health care advocate for Vermont Legal Aid, told the Joint Legislative Justice Oversight Committee at the Statehouse on Thursday that a public records request to the Vermont Department of Corrections resulted in some “troubling” numbers.
Those numbers showed that in 2017, DOC treated one person for hepatitis C out of 258 people in custody with the disease, according to the Fisher.
“Obviously, when I say that’s a red flag, that’s being generous,” Fisher said. “We really wanted to raise the public profile about this issue. Our goal here is to improve access to treatment for Vermonters.”
He added: “We bring this not with a conclusive statement that we know something bad is happening, but, wow, we have red flags in front of us that are very concerning.”
Also, according to Fisher, he looked at the “flow of dollars” paid by DOC to Centurion, a private company contracted by the department to provide health care, for “pharmaceuticals and off-site services, the areas we believe include most of the resources for HCV treatment.”
Those numbers showed:
• the state paid Centurion $2,719,719 for pharmaceuticals, and Centurion spent $1,785,926 in 2017.
• the state paid Centurion $2,113,727 for off-site medical services, and Centurion spent $833,203 in 2017.
• the DOC did not respond to his request for information about what happened to the unspent funds for both items, which totals a little more than $2.2 million.
“I’m surprised at the numbers,” Sen. Ginny Lyons, D-Chittenden, a committee member, said at the Thursday meeting, using the word “unbelievable” to describe the figures presented to the panel by Fisher.
Sen. Dick Sears, D-Bennington, who is also on the committee, expressed concern about what has happened to the unspent $2.2 million.
“I just find it appalling that you can’t account for $2 million,” Sears, who also is a member of the Senate Appropriations Committee, told corrections officials at the meeting.
And if Centurion did get that money, Sears said he wants it back.
“Or, if it’s still there, and we used it for bridge repair,” the senator added.
“I would ask for a full accounting of the approximately $2 million that’s not accounted for in this document at our next meeting,” Sears said. “Two million dollars is $2 million … I think there was some famous guy who said, “A million here and a million there, you start talking about real money.” (The quote is attributed to the late Illinois Sen. Everett Dirksen, though he spoke of “billions.”)
Vermont Deputy Corrections Commissioner Mike Touchette said after the meeting that he would work to provide the panel with that information.
“I don’t have that information right off,” Touchette said. “It sounds like there were a couple of different scenarios. I can’t speak specifically as to which scenario that funding stream went to.”
Ben Watts, the DOC’s director of health services, defended the department’s actions regarding the care of prisoners with hepatitis C. He talked of a prescription drug treatment regimen that runs at least eight weeks, and that is complicated by the variable stay behind bars for many inmates, he said.
Watts told the committee that he didn’t have exact numbers of how many of those inmates with hepatitis C were detainees, compared to those who are under sentence serving prison terms.
That cost of that eight-week drug treatment can reach up to $26,000, according to testimony before the committee Thursday.
Watts also told the panel that in order to prevent building up resistance to the drug treatment, it’s important that a person be able to complete that eight-week treatment process, and not stop and start it.
“Hepatitis C is complicated in the way that it progresses,” he said. “There is hepatitis C that can progress fairly rapidly, there is hepatitis C that can progress over the course of years, sometimes decades.”
Watts added, “It’s a complicated condition that’s really best addressed through regular monitoring and decisions made between the patient and the provider on a case-by-case basis.”
“How do we account for 1 out of 258 being treated?” Lyons asked him.
“I think looking at detained people and their length of stay would be very valuable,” he replied.
The number of people treated by corrections for hepatitis C tends to be variable from year to year, he told the panel. For example, Watts said, already in 2018, 10 people have been treated.
He spoke of the department’s treatment of prisoners with hepatitis C as the same as person would be provided out in the community.
Fisher told the panel he was pleased to see the number of inmates receiving treatment for hepatitis increases, but he still had questions.
The comparison to the standards of treatment of people in the community is the right question,” Fisher said. “We continue to have real concerns about whether they are taking the steps necessary to really achieve that and one person in 2017 is most glaring example.”
