September 18, 2009
Federal judges recently found health care in California's prison system so poor as to be unconstitutional. Lacking any other solution, they ordered a reduction in the prison population. Over the next two years, tens of thousands of state prison inmates may be released -- including many who have hepatitis C, tuberculosis or HIV and are likely to encounter major barriers to accessing care in the outside world.
"It's almost set for failure to just release people with no resources," said Jessica Flintoft, a policy director for re-entry in San Francisco.
"We want to prevent them from spreading diseases to anyone else," said Marianne Gallagher, supervisor of the Neil A. Christie Living Center, an HIV/AIDS service provider in San Jose. "It's not a popular population. But they are probably the most vulnerable."
"In a paradoxical way, they do much better in jail than they do at home," said Dr. Dean Winslow of the PACE Clinic in San Jose. "Because they're not actively doing drugs, they're eating three meals a day, and they're usually under less stress in jail than on the outside."
PACE is waiting to find out exactly when and how many inmates will be released under the court order before developing a service strategy that targets them. Of PACE's 1,100 patients, an estimated 20 percent have been incarcerated within the last couple of years, said Dena Dickinson, PACE's health center manager.
Failure to adhere to treatment regimens and to access care upon release can have devastating consequences. "People are not controlling the virus in their own system, then they're passing on viruses that are already resistant to other people," said Dickinson.