CARSON CITY — With costs sharply down for treatment that cures hepatitis C, the state Department of Corrections has quietly moved to make testing for the blood-borne virus standard procedure for all new inmates.
The department plans to test the more than 12,000 existing prisoners under its supervision by February.
The effort, a significant policy change, also revises treatment and testing procedures for inmates just entering the system. The department has budgeted about $6.8 million this year and next for testing and treatment, including hiring of contract staff to help with getting all inmates tested over the next few months.
With treatments now boasting a better than 90 percent success rate, medical standards for testing have been expanded to cover all at-risk groups, including inmate populations. And testing an entire prison population is now logistically feasible, department officials told the Legislature’s Interim Finance Committee Friday.
In addition, “returning inmates to their communities cured of chronic (hepatitis C) is an invaluable step toward HCV elimination and successful community reintegration,” corrections department Deputy Director for Support Services John Borrowman wrote in a memo to the committee.
The department was not asking lawmakers for approval of the program or its funding. But committee members nonetheless chastised the cash-strapped department for not including the program in its budget request earlier this year and going deeper into the red to implement it now.
“I have concerns that given your previous budgetary problems, and the frustrations that this committee has had in managing those problems, why you chose to do this,” finance committee co-chair Rep. Maggie Carlson, D-Las Vegas, told Borrowman and other department officials Friday. “You keep digging a hole and instead of building a ladder you just get out another shovel.”
Borrowman said the corrections department didn’t budget for the program earlier because treatment options have evolved swiftly, costs have come down and more doctors have adopted the new treatment protocol.
“All of those things were yet undeveloped for agency request into the budget cycle,” he said.
Testing for the virus costs $8, while the cost of a new drug that cures the disease has declined from roughly $100,000 to $5,000. The department is bound to provide appropriate medical care to inmates.
“If they come in with diseases, we don’t get to say, ‘Well, those are choices you made before you got here.’ We are obligated to provide that medical care,” Borrowman said after the hearing.
Curing inmates also is part of preparing them to re-enter society after they leave prison. It comes with education to change the risky behaviors which led them to contract it, and likely avoids costlier health complications down the road.
“Hepatitis C is the first disease that I know of as a registered nurse that we can cure with just a pill,” said Theresa Wickham, the department’s chief of nursing. Inmates leaving prison are “going to go home and they’re going to be healthy individuals.
“And so the cost benefit is not only just in the actual treatment but also healthier public communities, she added. “It’s really a public health issue.”
Borrowman said the department will seek approval from the committee for a transfer of contingency funds to cover the program early next year.