The Maine Department of Corrections has agreed to expand access in state prisons to a curative treatment for hepatitis C.

That commitment is part of a settlement in a federal class-action lawsuit filed last year. The lead plaintiff is Mathiew Loisel, who is serving a 30-year sentence for murder at the Maine State Prison in Warren. The agreement will eventually allow all infected prisoners to receive a costly but highly effective medication to treat a progressive disease that infects a large portion of the state’s prison population.

“Hepatitis C is a serious public health issue,” Commissioner Randy Liberty said in a department press release. “We recognize that among the inmate population, the impact of HCV on health and wellness can be significant. We’re pleased to have reached an agreement to expand access to medication to all current inmates with chronic HCV over the next four years. It is the right thing to do.”

Miriam Johnson, one of the attorneys who represented Loisel, said he cared deeply about accessing the medication for everyone in Maine prisons, not just himself.

“That was his end goal,” Johnson said. “He made it very clear to me that he was not going to quit until the department agreed to provide this life-saving medication to all people in custody.”

Andy Schmidt, another attorney from Loisel’s legal team, said the case could be a model for other states. Kaiser Health News reported in 2018 that almost no inmates in state prisons were receiving treatment for hepatitis C. Schmidt said inmates are prevailing in similar lawsuits across the county, which will set legal precedents.

“But hopefully our cooperative approach will become the common sense precedent for other states,” he said. “Because in the end this is not only the moral thing to do, it is the fiscally responsible thing to do. Why wait until the inmates are freed from custody and need liver transplants? Why allow a communicable disease to spread when you will have to treat those that contract it?”

Maine currently has 1,775 adults in state prisons. A spokeswoman for the Department of Corrections did not respond to an email asking how many of those people currently have the disease. She also did not answer questions about the anticipated cost of the treatment or the timeline for rolling out the treatment. The press release said the medical provider in state prisons, Wellpath LLC, began to expand access to the treatment in October 2019.

Court documents included the response to a public records request in 2017, which said that 580 prisoners had been diagnosed with the disease as of October of that year. But medical staff were treating only three of those people with the medication to cure hepatitis C, and one was receiving the drug because he was already in the midst of treatment when he went to prison.

The settlement does not apply to county jails, where more than 1,400 people are in custody, either awaiting trial or serving shorter sentences.

Hepatitis C is a blood-borne viral infection of the liver. The U.S. Centers for Disease Control and Prevention estimated that 2.4 million people in the United States were living with the disease in 2016. While public health officials believe the disease is significantly underreported, the number of diagnoses have increased in recent years. Maine had the ninth highest rate of acute hepatitis C in the country in 2018. It is typically transmitted when people share needles during substance use or otherwise come into contact with an infected person’s blood.

While some people only suffer a short illness, public health officials estimate that more than half of the people who contract hepatitis C will develop a chronic version that was believed to be incurable. It can result in serious health problems and is the most common reason for liver transplants in the United States. But in 2011, drug makers released a new treatment that can completely cure 90 percent of cases and reduce a patient’s risk of developing serious complications later.

Loisel’s attorneys said medical experts advise administering that medication to all people with chronic hepatitis C, even in early stages. The treatment comes in a pill form and is taken daily for eight to 12 weeks. But it is also expensive, often costing tens of thousands of dollars.

The complaint said Loisel was diagnosed with hepatitis C in 2014. He alleged that medical staff repeatedly refused to provide the cure because the disease had not done enough damage to his liver yet. He also said one treatment provider at the Maine State Prison told him during a consultation in January 2018 that “the costs of these drugs is just too high” and that the prison “cannot possibly treat everybody.”

His attorneys argued that response violated the Americans with Disabilities Act, as well as Loisel’s constitutional right to protection from cruel and unusual punishment.

“The agreement we were able to reach with the state brings our corrections system in line with the community standard of medical care and the state’s obligations under the Constitution,” Johnson said.

Johnson said people who are incarcerated have a higher rate of hepatitis C, and providing treatment in prison will reduce the risks of transmission when those people are released.

“When we talk about finally providing this standard of care within the prison system, that is something that certainly benefits those individuals but also benefits the rest of the population as well,” she said.

Loisel filed the lawsuit in February 2019 in the U.S. District Court of Maine. The parties filed a joint motion in July that indicated they reached an agreement that would take time to implement, and they asked to stay the proceedings. The motion did not include any details about the agreement. The judge agreed to put the case on hold and asked for a status report in December.

A team of four attorneys from two firms collaborated to represent Loisel. They are Berman & Simmons and Andrew Schmidt Law PLLC. The Maine Attorney General’s Office represented the state and deferred to the Department of Corrections for comment on the settlement.


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