Officials in Nebraska, South Dakota, Oklahoma begin to probe prisons’ hepatitis C treatment efforts

WASHINGTON — Members of Congress, state legislators, regulators, and legal advocates are calling on prisons to explain their poor hepatitis C treatment rates, after a STAT investigation revealing that more than 1,000 people had died from complications of the curable disease.

In South Dakota and Oklahoma, lawmakers have written to their respective departments of corrections about STAT’s reporting. In Nebraska, the state’s inspector general of corrections requested that the prison explain a policy, obtained by STAT, requiring that incarcerated people sign a consent form that misrepresents the benefits of available hepatitis C treatments. Lawmakers in other states are pledging broader probes into the issue, too.

In Congress, key lawmakers are pledging to work with the Biden administration to find a solution to the nationwide problem. And the White House is rallying support for a $10 billion national plan to eliminate the virus in the United States.

“As someone who has benefited directly from the remarkable advances in treatment for hepatitis in the past decade — particularly for hepatitis C — it’s shocking to see results of STAT’s in-depth investigation of preventable [hepatitis] C deaths in our prisons,” said Rep. Hank Johnson (D-Ga.), a co-chair of the House Hepatitis Caucus, who was cured of hepatitis C about a decade ago.

Rep. Grace Meng (D-N.Y.), the co-chair of the caucus, said it is “unacceptable that anyone including incarcerated individuals are needlessly dying because state prisons are not distributing a known cure for Hepatitis C.” She pledged to work with the administration to broaden access.

STAT’s investigation found that more than 1,000 individuals incarcerated in state prisons died of hepatitis C-related complications in the six years after curative drugs hit the market. It revealed that states around the country continue to ration these curative drugs to a fraction of their prison population with policies that deem most incarcerated people with the virus ineligible for treatment.

So far, at both the state and federal level, Democrats have mainly taken the lead on pushing prisons to account for their behavior. The House Hepatitis Caucus, for example, has no Republican members. STAT also reached out to more than a dozen GOP state-level lawmakers on health care and criminal justice committees in Nebraska, Oklahoma, and South Dakota. None offered an immediate comment.

In four of the eight states STAT described as doing the worst job addressing the virus — Nebraska, South Dakota, Oklahoma, and Illinois — officials have already pledged to investigate the issue.

Doug Koebernick, the independent Nebraska inspector general for corrections, sent an inquiry to the state prison system earlier this week requesting information about a deceptive consent form STAT uncovered that prisoners must sign before being treated for the virus.

“It is concerning to me that patients may be being misled by the department,” said Koebernick. “I’d like to get a better grasp of why they did this and what they’re doing to address it.”

A spokesperson for the Nebraska Department of Correctional Services told STAT the department is updating the consent form. They said similar before STAT’s report published.

Other lawmakers and advocacy groups in Nebraska are raising alarms over the prison systems’ lackluster progress treating hepatitis C. The state treated just nine people for the virus in 2021, STAT reported — just over 3% of the people it knew to carry the virus.

“This is shocking to me,” said Sen. Wendy DeBoer, a Democrat who serves on the state’s Judiciary Committee. DeBoer told STAT she was unaware of the hepatitis C issue prior to STAT’s reporting.

“This is something that just somehow fell through the cracks,” said DeBoer, who pledged that the legislature would look into the issue.

Sen. Terrell McKinney, a Democrat who also serves on the Judiciary Committee, pledged in an interview to bring the issue up directly with leadership of the corrections department once a new commissioner is named.

“There’s no reason that this should be happening,” said McKinney. “It’s definitely not acceptable.”

The ACLU of Nebraska, which called STAT’s findings “unacceptable and inhumane,” is also considering litigation to force the state to ramp up treatment.

“We don’t have the complaint drafted or anything like that, but we’re definitely not taking that off the table at this point,” said Mindy Rush Chipman, the Nebraska ACLU interim executive director.

Independent legal experts in the state told STAT that incarcerated people would have a good case if they chose to challenge the policy in court.

“It’s pretty clear that a lot of the people in Nebraska who need this lifesaving medical care for [hepatitis] C have a viable claim under the Eighth Amendment,” said Danielle Jefferis, an assistant professor of law at the University of Nebraska College of Law who specializes in prisoner rights.

Ronald Reagan, a retired state district court judge who served in Nebraska for more than 30 years, was even more definitive: “I don’t think there’s any question that it could put the state in legal jeopardy.”

“What a stain that is on our correctional system,” he added.

Policymakers in other states are also beginning to raise concerns with their prisons’ handling of the hepatitis C virus as well.

South Dakota Rep. Jennifer Keintz, a retiring Democrat who sits on the health and human services committee, said it was “extremely concerning” that the state treated just seven people last year for the virus and enacted policies that restricted access to only the sickest prisoners, as STAT reported.

South Dakota Sen. Linda Duba, a Democrat on the joint appropriations committee, told STAT she contacted the state’s new commissioner of corrections directly about the report. Duba told STAT that the secretary, Kellie Wasko, already responded and “will address this issue.”

“The Secretary and her staff have new protocols they will implement,” Duba told STAT in an email. “She has over 30+ years of corrections experience and is a nurse.”

Oklahoma Sen. George Young, a Democrat who sits on the state’s judiciary and health committees, has reached out to the department of corrections there for more information on the high number of deaths from hepatitis C in the state’s prisons. Hepatitis C played a role in at least 84 deaths from 2014 to 2019 in Oklahoma — the third highest tally of any state in STAT’s reporting.

“You have alerted me to something that I think is very significant and important,” Young said. “I don’t know how they’ve gotten away with me not seeing about the hep C numbers but that kind of slipped by me.”

Young plans to ask the Department of Corrections to provide an accounting of how all people in Oklahoma prisons have died and an estimate of how much it would cost to ramp up treatment for the virus in the state.

Illinois Rep. La Shawn Ford, a Democrat who is active on criminal justice issues in the state, also pledged to advocate for better hepatitis C treatment for incarcerated people in the coming legislative session.

“I’m going to make this an issue,” Ford told STAT. “I’m going to lift this up.”

Illinois failed to treat any people in six of its prisons last year, STAT reported. At one facility housing more than 2,000 people, Illinois treated just one person for the virus.