New York's Commission of Corrections, a watchdog group over state prisons and local jails, is charged with establishing minimum health care standards for inmates. All inmates are screened upon entering prison for tuberculosis and hepatitis C, and they can request HIV testing, according to corrections spokesperson James Flateau. Critics say health safeguards need to be in place so that sick inmates do not pose a public health hazard when they are released. Roughly 67,000 inmates are spread out in 70 prisons across New York, and some 29,000 inmates are released to the community each year.

About 15 percent of inmates are hepatitis C-infected, and about 9 percent are HIV-positive, say prison officials. Since 1995, medical spending for prisoners increased more than 50 percent, from $149 million to $229 million this year, said Flateau. CDC estimates that of the more than 4 million Americans with chronic hepatitis C, 39 percent were once in prison. The disease is commonly spread through intravenous drug use, unprotected sex and sharing items like razors.

About 1 percent of HCV-infected inmates in New York are receiving treatment, advocates and prison officials say. Advocates believe the number should be higher, but officials insist that all those who qualify for treatment receive it. Some inmates are temporarily ineligible because of past drug use or preexisting medical conditions. In other cases, CDC guidelines advise that year-long antiviral treatment should not be started if there is less than a year remaining on an inmate's sentence.

A package of bills passed by the Assembly Health Committee would extend Department of Health oversight to reviewing AIDS and hepatitis C care in prison and mandate that the corrections commissioner implement programs statewide for guards and inmates to prevent the spread of HIV, hepatitis C and STDs. Similar efforts in the past have failed, mainly because the bills lacked a majority sponsor in the Republican-dominated Senate.

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