When an inmate has HIV, hepatitis C or both, the gaps, slipups and discrepancies can be devastating. After 10 years of freedom, Mary Robinson got high and tried to rob a bank in 2006. She landed back in the system, where she got to see firsthand how infectious disease care had gotten better – and also how it hadn’t. Before Robinson was arrested, she was on a cocktail of HIV medication that had successfully suppressed her virus for several years. When she went into the Rikers Island jail, there was a delay in getting her medical records, and then the jail’s pharmacy didn’t have her prescriptions in stock. She says she went untreated for six days – long enough for her virus to develop a resistance to the therapy she’d been on. She had to start a new round of drugs, which brought weeks of vomiting, diarrhea, headaches and lethargy.
Prison also gave her a chance to get clean and sober and to reevaluate. When she was released, Robinson started working as an advocate for inmates with HIV and hepatitis C. She counts the new Department of Health oversight law as her first major victory – as one contributor to the efforts led by the Correctional Association and joined by the Osborne Association and other groups.
The law requires the health department to go into jails and prisons once a year, evaluating every policy and practice that relates to care and treatment of the two infectious diseases. Advocates say it will bring accountability into a process that for too long has been shielded from public view by the corrections department. “Until now, DOCS has been the only provider of medical care in New York that is allowed to operate without outside oversight,” says state Senator Tom Duane of Manhattan, who sponsored the law.
Spokespeople for DOCS and the Department of Health say they don’t yet know what implementation of the new law will look like, but both departments lobbied against the bill before it passed. Erik Kriss, the main spokesperson for DOCS, argues that the new system will actually direct money into bureaucracy and away from an inmate care system that, he says, is already working well. “We have always worked with the Department of Health to establish high standards of care,” says Kriss. “The best way I’ve heard it put is this: Have you ever had a co-worker who became your boss?”
Advocates say that’s an attitude that is going to have to change. “This bill is part of a movement to bring a great deal more oversight into the prison system,” says Jack Beck of the Correctional Association. “Prison walls are meant to keep people inside. Too often, they’ve been used to keep public scrutiny out.”
