By: Marcus J. Hopkins, Blogger
Iowa’s Department of Corrections (IDOC) has put in a request for additional funding for the 2019 fiscal year (FY19) in anticipation of potential upticks in new HIV and Hepatitis C (HCV) infections within Iowa’s jails, prisons, and youth correctional facilities as a result of increased abuse of prescription opioids and heroin. Jerome Greenfield, Health Services Administrator for IDOC, has requested an addition $1 million budget increase to accommodate increased pharmaceutical costs for the treatment of HIV and HCV (Pfannenstiel, 2017).
For each year from 2010 to 2015, between 12%-14% of Iowa’s incarcerated population tested positive for HCV, though these data account only for the individuals incarcerated at any given point in time, and do not account for the movement in and out of IDOC facilities (Iowa Department of Public Health, 2017). Of those entering into the IDOC system and who warranted screening, over 91% were screened for HCV in FY14, with a 5.6% testing positive; in 2015, over 78% were screened, and 4.5% tested positive. While the number of positive tests results decreased in 2015, that may be a result of fewer inmates being screened.
The budget request comes at a time when the state is grappling with a potential $75 million budget shortfall as a result of lower-than-expected revenue returns during the last fiscal year that ended June 30th, 2017. The IDOC, itself, suffered a $5.5 million budget cut in FY17, and a $1.6 million cut for FY18, making the likelihood of this request being fulfilled dubious, at best. For its part, IDOC officials believe that, should any more cuts be implemented, they will have to reduce staffing in order to deal with those losses. This means fewer correctional employees, which can create a hostile environment, leave inmate needs and concerns unmet, and foment distrust and enmity between inmates and correctional facility staff. As we saw in Delaware, earlier this year, this type of environment can lead to prisoners protesting and/or rioting (Oh, 2017).
Iowa’s also dealing with an explosion of new HCV diagnoses, which have more than quadrupled since 2009 among people between 18 and 30 (Carver-Kimm, 2017). For those from whom data were collected, over 51% reported Injection Drug Use (IDU) as a risk factor (Iowa Department of Public Health, 2017). The state is also making considerable inroads to combating the HCV epidemic within the state with seven local health departments and one Federally Qualified Health Center (FQHC) that administer HCV testing and Hepatitis A and B immunizations. These agencies, known as Counseling, Testing, and Referral (CTR) sites, are located in the state’s most populous counties, test only people who have ever injected drugs, and offer free HCV screening for anyone who reports having ever injected drugs.
In 2016, former Iowa Governor, Terry Branstad, signed a bill expanding access to Naloxone, a drug that reverses or blocks the effects of opioid medications. While advocates cheer the move as an excellent tool to save the lives of People Who Inject Drugs (PWID), they are also pushing the Iowa state legislature to legalize Syringe Services Programs (SSPs – Needle/Syringe Exchanges). Research consistently shows that SSPs lead to reduced rates of HIV, HCV, and HBV infections among PWID, as well as those who are sexually involved with PWID.
- Carver-Kimm, P. (2017, February 13). IDPH Releases Report on Hepatitis C Infection in Iowa. Des Moines, IA: Iowa Department of Public Health: Behavioral Health: Infectious Disease Prevention: IDPH News. Retrieved from: https://idph.iowa.gov/News/ArtMID/646/ArticleID/158153/IDPH-Releases-Report-on-Hepatitis-C-Infection-in-Iowa-2131
- Iowa Department of Public Health. (2017, February). Epidemiological Profile of Hepatitis C in Iowa. Des Moines, IA: Iowa Department of Public Health: Bureau of HIV, STD, and Hepatitis. Retrieved from: http://www.idph.iowa.gov/Portals/1/userfiles/40/Iowa Hepatitis C Epidemiological Profile Feb 2017 Version -FINAL.pdf
- Oh, A. (2017, September 01). Gov. Carney Releases Final Report On Deadly Prison Riot In Delaware. New York, NY: CBS Local Media: CBS Philly. Retrieved from: http://philadelphia.cbslocal.com/2017/09/01/del-deadly-prison-riot-final-report/
- Pfannenstiel, B. (2017, September 17). Iowa prisons brace for possible uptick in HIV, hepatitis C cases as opioid epidemic swells. Des Moines, IA; The Des Moines Register. Retrieved from: http://www.desmoinesregister.com/story/news/politics/2017/09/17/iowa-prisons-brace-possible-uptick-hiv-hepatitis-c-cases-opioid-epidemic-swells/661663001/
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.