Alabama Prison at Center of Suit Over AIDS Policy

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Sent: Wednesday, July 14, 2004 3:21 AM
Subject: Re: (no subject)

If we do not keep talking about his mysterious death, it will go slowly away like everything else they do. You see, Sherry does not let them forget Patrick, FMI does not let them forget the inmates. You cannot let the forget your loved ones. They all bank on people not caring enough about these type of issues. That is why I get so mad when it looks like family members do not want to step up to the plate and fight. Well, I am not going to let them forget Dr. Tabet. I am going to get the entire report he did on Alabama prisons and I am going to feature it on my show. I am going to show how much money Naphcare and the state of Alabama lost because of the report. Please click on some of the other cases the Southern Center for Human Rights has done in Alabama especially the one where they had to pay the inmate 90,000. The warden from the prison (Elmore) flat out lied. Please see attachment and click on center cases. 

Alabama Prison at Center of
Suit Over AIDS Policy

                          By ADAM LIPTAK
                          The New York Times
                          October 26, 2003

                         ARVEST, Ala.  Prisoners who need AIDS or H.I.V.
                          medication at the Limestone Correctional Facility here must
                          get up at 3 in the morning to stand in line for it. The wait can
                          take 45 minutes. Then they repeat the exercise at 10 in the
                          morning, and again at 3 in the afternoon.

                          Those who are too sleepy or sick to stand in line miss out, a
                          federal lawsuit maintains.

                          Whether convicted of shoplifting or murder, every male felon
                          in Alabama who has AIDS or H.I.V. is sent to this
                          medium-security prison near Huntsville. Here they live, eat,
                          sleep, exercise, see the doctor and wait in lines in a unit
                          strictly segregated from the rest of the prison.

                          Alabama is the only state to keep inmates with H.I.V. or AIDS
                          isolated from other prisoners  not only in its cells, but in all
                          prison programs.

                          This policy was meant, prison officials have said, to limit the
                          health and security problems posed by infected prisoners,
                          and the courts have endorsed it as a reasonable reaction to
                          the dangers of H.I.V. 

                          But its critics say that at least as practiced in Alabama, segregation is dangerous and inhumane to
                          those prisoners, subjecting them to shoddier health care, a greater risk of communicable diseases
                          and harsher living conditions than those of other inmates.

                          "Human beings who are H.I.V.-positive and incarcerated in Alabama have died of treatable
                          diseases, treatable in any country in this world and certainly treatable under even minimal medical
                          care offered in the United States," said David M. Lipman, a Miami lawyer who represents the
                          prisoners in the class-action lawsuit.

                          Mr. Lipman and other lawyers for Limestone's inmates with H.I.V. filed the suit in federal court in
                          Birmingham last November, contending that the prisoners' living conditions and medical care were
                          a form of cruel and unusual punishment. A medical expert for the plaintiffs, Dr. Stephen Tabet,
                          who specializes in infectious diseases at the University of Washington, concluded that being
                          admitted to Limestone with AIDS was akin to a death sentence.

                          The rate of AIDS-related deaths among Alabama prisoners in 2000 was more than twice the
                          national prison average, according to the Justice Department. Thirty-nine men with H.I.V. have
                          died at Limestone since 1999. A recent state-sponsored audit called the six AIDS deaths at the
                          prison in the first 10 months of 2002 a "remarkably high" number.

                          Until recently, the H.I.V.-positive prisoners were held in a vast converted warehouse filled with
                          row after row of beds  the perfect setting, the lawsuit says, for the spread of infections that can
                          be deadly among people with compromised immune systems. 

                          As of the end of 2000, the Justice Department says, there were slightly more than 25,000 inmates
                          in the nation's prisons who were known to be infected with H.I.V., accounting for more than 2
                          percent of all prisoners. Nearly half were in three states: New York, Florida and Texas.

                          But only 20 states, including Alabama, test all prisoners for H.I.V., so the number of infected
                          prisoners may be substantially higher. 

                          In approving Alabama's practice of segregation, the courts have noted that states that integrate
                          H.I.V.-positive inmates with the rest of the prison population see many more new H.I.V. infections
                          than does Alabama.

                          Alabama spends less money per prisoner than any other state, both as a general matter and for
                          medical care. Yet just the medicine for only one H.I.V.-positive inmate costs $8,000 to $12,000 a
                          year, according to the state audit. The sole doctor here, who is responsible for the care of 1,823
                          prisoners, including 237 with H.I.V., said this medication cost even more. The tension between
                          scant resources and great need has taken an enormous toll, the lawsuit says.

                          Prison officials declined to comment for this article, citing the pending suit, but in legal papers
                          they have denied the prisoners' claims. Naphcare, the company that until recently was under
                          contract to maintain medical services for the prisoners, defended its work.

                          "Naphcare provides quality, compassionate health care to Alabama inmates," said David Davis, a
                          spokesman for the company. Naphcare disputes the conclusions of the state audit and has sued
                          its authors for libel.

                          Dr. Tabet, the plaintiffs' expert, reviewed the medical files of 38 of the prisoners who died of
                          H.I.V.-related causes here in recent years, and issued a report critical of Limestone's patient care.

                          "Consistently, patients died of preventable diseases," said Dr. Tabet, whose review concluded
                          before a 39th inmate died in October. He noted many instances of pneumonia and wasting,
                          conditions associated with AIDS that he said should not have been fatal.

                          Dr. Tabet also said he had found that many patients did not get their medication or understand
                          the importance of taking it. Others told him that they could not tolerate the medicines on an empty
                          stomach early in the morning. 

                          The prison's medical director, Dr. Colette Simon, who served as an employee of Naphcare but may
                          remain here now that its contract has been canceled, disputed Dr. Tabet's conclusions.

                          "The standard of care is good," she said.

                          Dr. Simon, Limestone's only physician, a specialist in infectious diseases who has worked at
                          several New York City hospitals, is praised by all the parties to the suit. The plaintiffs dropped her
                          as a defendant in March, saying they had found her to be "well qualified and competent to
                          provide H.I.V./AIDS medical treatment." Naphcare remains a defendant, along with several state

                          Dr. Simon said she had turned down opportunities to work in smaller prisons that employ three or
                          four doctors. The need is greater here, she said, adding that inmates here received better care than
                          they would in the outside world. Obtaining the expensive medicine needed to control H.I.V. is
                          easier here, she added, than after they are released.

                          "Having more help would be good," she said, but "the care would still be the same." 

                          Dr. Simon took issue with Dr. Tabet's recommendation that prisoners be given quantities of
                          medicine to take as needed without supervision. She said this could lead to hoarding, barter and

                          "All they have to do is come when they are called," she said of the prisoners. "And people who
                          are so weak they cannot go to pill call are not in the dorm. They're in my infirmary."

                          Dr. Simon said that she tried to reason with and cajole prisoners in an effort to get them to take
                          their medicine, but acknowledged that she did not always succeed.

                          The state canceled Naphcare's contract in May without giving a reason, though the company has
                          said it suspects that the state audit was to blame. The company continued to provide services
                          while a new bidding process was completed. [On Oct. 17, the contract was awarded to another
                          company, Prison Health Services.]

                          It was only in early October that all 237 H.I.V.-positive inmates at Limestone were moved from the
                          former warehouse that had been their home for years. The lawsuit said the warehouse was often
                          too hot or cold and was infested with spiders, rats and birds. The new units, called dormitories by
                          prison officials, are customary cellblocks, with rows of two-man cells arranged on two levels
                          surrounding a common area.

                          The cellblocks are in some ways less appealing than the warehouse, which has high ceilings, a big
                          yard and more light and space, if less privacy. In the cellblocks, prisoners mill about and watch
                          television in the smaller common area. The warehouse, now occupied by other prisoners, is
                          reminiscent of a bare-bones military barracks.

                          Lawyers for the prisoners, who had been harshly critical of conditions in the warehouse, said the
                          recent move was a victory that would slow the spread of infectious diseases. But they said other
                          problems, like access to medicine, remained.

                          Segregating prisoners in order to focus on their health has its defenders. Anne S. De Groot,
                          associate professor of community health at Brown University and an editor of the H.I.V.
                          Education Prison Project Report, said programs in California and Texas "work well because prison
                          authorities can focus their H.I.V. treatment in one location."

                          "There is no reason to segregate prisoners except to centralize medical care," Professor De Groot
                          said. That, she added, is not the rationale offered by Alabama, whose care here she described as
                          "substandard even compared to the general standard in correctional systems."

                        The Center's Prison Cases in the News