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Battle to ensure constitutional care
On May 28, 2004, the parties signed a settlement agreement requiring improvements in almost every area of the provision of medical care at St. Clair Correctional Facility. Plaintiffs in the class action alleged numerous problems at the facility - from inadequate staffing to the delay or denial of treatment for life-threatening illnesses like cancer, hemophilia, and hepatitis C ("HCV").

The suit alleged that the Alabama Dept. of Corrections' actions caused plaintiffs to suffer a "serious risk of harm ... including death."

In fact, after the original complaint was filed, three of the eleven named plaintiffs died as a result of their illnesses. Jerry Baker, suffering from lung disease, died in May 2003; Johnny DeFries, suffering from cirrhosis and testicular cancer, died in September 2003; and Roosevelt Youngblood, also suffering from cirrhosis, died in early 2004.

One of the most significant improvements resulting from the settlement is that Alabama will, for the first time, test and treat inmates with HCV, a blood-borne disease infecting between 16 and 41% of the prison population.

Because the annual treatment cost is expensive - $25,000-$35,000 per prisoner - states have historically denied treatment. Left untreated, HCV can eventually cause death. With its new policy, Alabama becomes one of the few states in the country to adequately treat this deadly disease.

Among the other provisions agreed to in the settlement:

• The ADOC must develop and implement guidelines that are reasonably-based on nationally-accepted guidelines for treatment of serious illnesses including hypertension, asthma, HIV, MRSA, and tuberculosis.
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• The ADOC must provide increased levels of staffing at the facility, including 40 hours per week of on-site physician care, 40 hours per week of a mid-level practitioner such as a nurse practitioner, and at least 16 hours of RN coverage in every 24-hour period.
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• Referrals to outside specialists will be accomplished as medically necessary but will take no longer than 60 days.
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• An inmate will be seen at sick call within 36 hours of the request, or 72 hours on weekends, and sick call will not be conducted between 11 PM and 6 AM. Any inmates presenting to the nurse more than two consecutive times for the same symptoms, with deterioration or no improvement, will be referred to a higher-level practitioner.
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• Diabetics, seizure patients, HIV-positive inmates, cardiac patients, and inmates at risk for periodontal disease will receive a dental cleaning on an annual basis. All other inmates will have the opportunity for a cleaning at least once every 24 months.

The settlement lasts for two years. During that time-period, a medical doctor will visit the facility four times each year to evaluate compliance with the agreement.

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