Ask Alexandra Morgan-Kurtz about the quality of medical care at the Allegheny County Jail and there's an uncharacteristic pause.
"I'm trying to think of a polite way to say this," says the staff attorney of the Pennsylvania Institutional Law Project. "Probably the worst health care in the state I've seen when it comes to prisons and jails."
Problems related to health care at the county jail are hardly new. But after a March 23 City Paper story revealed that the state American Civil Liberties Union had launched an investigation into the jail's distribution of HIV medication to inmates, fresh questions are being raised about why these problems have persisted and who is ultimately responsible for finding solutions.
"There's not one person you can point to and say, 'You made that decision; you have to fix it,'" Morgan-Kurtz says. "That's a huge part of the problem. There is no one to hold the jail accountable."
- Photo by Alex Zimmer
- The ACLU is investigating the irregular distribution of HIV treatments at the Allegheny County Jail.
According to the ACLU, jail medical staff have not been providing HIV medication in a "timely and consistent way." Regular HIV testing isn't being conducted, the ACLU contends, nor is the jail keeping tabs on the levels of virus in the blood of infected inmates, providing sufficient "pre-release counseling," or offering enough medication upon release.
But medication-delivery problems at the jail aren't HIV-specific: "I don't think HIV/AIDS patients are getting some kind of uniquely bad care," says state ACLU Legal Director Vic Walczak. "It's emblematic of what's happening in the [jail] health-care-delivery system as a whole."
Concerns about medication delivery were echoed by advocates and outside providers who consistently visit the jail.
Charles Christen, executive director of the Pittsburgh AIDS Task Force, an organization that has worked with inmates at the jail, says PATF has received complaints about a lack of HIV medication.
Testing and treatment are "really important, especially when you're talking about a system where men are living together in an enclosed environment day after day," Christen says. Missing doses of HIV meds can lead to future drug resistance and higher levels of virus in the blood, which makes spreading the disease more likely, a problem for inmates as well as for the general public when inmates are released.
Problems related to appropriate delivery of medications and staffing levels were also part of a scathing report released last December by Allegheny County Controller Chelsa Wagner, who told CP that the ACLU's findings "certainly don't surprise me."
But figuring out who is ultimately responsible is not a straightforward task. Jail health care is directly administered by Corizon Health, a company hired in September 2013 as part of an effort to control rising costs and improve care. (Corizon receives about $11.5 million per year from the county.)
After refusing to grant an interview request, Corizon released a statement through a third-party public-relations firm that read, "We take seriously the concerns of patients, their families and the community related to clinical quality, especially when it comes to the treatment of HIV/AIDS ... many of the allegations made in this article are untrue" — a reference to the ACLU's claims. A spokesman would not elaborate on which claims they believe are untrue.