CURING HCV in prison: The new Community Standard of Care.

"Q: Will we be able to wipe out hepatitis C entirely?

A: In contrast to HIV, we do have the capability of doing that - essentially curing everyone who got infected. While we have made tremendous progress against HIV, we still don't have a cure, we still don't have a vaccine. The situation for HCV is dramatically different. A cure is achievable. Someday soon, the cure using an interferon-free cocktail is going to be routine...."

 ----------

Until now, I thought it was likely that this disease would kill not only my imprisoned friend Davon, sick as a dog on interferon right now, but also my big brother, who hasn't been able to get treatment - both I feared would die very painfully, at an early age. 

This news gives me hope, though. We have the capability to wipe out this disease and cure those who are ill right now - the question remains: do we have the collective will? That much, I still don't know.

Nearly 6,000 AZ state prisoners have tested positive for the Hepatitis C virus, but only a fraction are deemed eligible for a miserable course of interferon treatment because it costs so much and takes such a toll on body and mind. Many drop out from the side effects, having to face debilitating and fatal liver disease instead. Most public health estimates put the jail/prison population at being over 50% HCV+. Imagine how hard it is already to see loved one do time and maybe even make amends for their crimes in prison, and come home only to find that they were sentenced to die from an infectious disease, as well. 


For those who don't care about prisoners, though, think about this: since 95% of then return to the free world eventually, that means there's already an epidemic in communities with high rates of poverty, unemployment, homelessness, felonization, incarceration, uninsured persons, IV drug addiction, HIV/AIDS, and other compromised populations. It also disproportionately affects people of color, the LGBTQ communities, and Baby Boomers. That's a huge public health problem that no one in Arizona likes talking about - why are they so silent now, I wonder? Surely they've heard this by now.

It sounds like it's time for the AZ DOC and Wexford to re-write their Hep C treatment protocols, in any case, in order to assure that the standard of care they provide to prisoners with the virus (HCV) is consistent with the community's new standard. Otherwise, they can both expect to be named in a new class action lawsuit soon, I'm sure. I'd think the public at large could even sue the state for having an infected population unleashed on us - uneducated, untreated, unsupported, uninsured, and unwell.

remembering those we have already lost...

  

we must accelerate the fight for the living.

Fight the spread of HEP C today: 

support PHRO (Phoenix Harm Reduction Organization)

Phoenix Art Museum: Art of Resistance

Prisoners' Justice Day Guerilla Installation

August 10, 2012

--------from the San Francisco Chronicle----------

Hepatitis C fight - 'watershed moment'

Erin Allday / San Francisco Chronicle

Tuesday, September 11, 2012

Earlier this year, an editorial in the New England Journal of Medicine declared that the world was in a "watershed moment" in the history of treatment for hepatitis C, a virus that is believed to infect roughly 180 million people globally. Dr. Warner Greene, director of the Gladstone Institute of Virology and Immunology in San Francisco, agrees wholeheartedly - and believes that with recent advances in treatments and a cure, the world could be on the cusp of nearly wiping out the virus.

Q: What does the hepatitis C virus do to the body?

A: This is an RNA virus that infects hepatocytes, cells in the liver. That's why you ultimately get hepatitis, or inflammation in the liver, and that can progress on to cirrhosis. About 20 percent of people spontaneously clear the hepatitis C virus, and of the rest, about 20 to 25 percent will progress to cirrhosis, and eventually end-stage liver disease. Hepatitis C is the leading reason behind liver transplants in the United States.

Q: For many years, hepatitis C has been treated with interferon. What is interferon?

A: Interferon is a type of protein called cytokine. It normally triggers an antiviral response in the body. It inhibits key steps in the (hepatitis C) virus life cycle that allow it to replicate. But it's doing it at a cost. Cytokine is pretty toxic. It makes patients very sick.

Q: Last year the Food and Drug Administration approved new drugs to treat hepatitis C. How do they work?

A: It's just like with HIV - you're attacking multiple, key proteins needed for the hepatitis C virus lifecycle. Now you have these small molecules that are attacking the virus itself, as opposed to trying to induce an antiviral response, like with interferon.

These drugs are proving to be just dynamite. We're very close to being able to cure everybody of hepatitis C. The natural history of hepatitis C virus infection has been fundamentally changed.

Q: Why has hepatitis C been so hard to treat historically?

A: One thing that limited progress was the lack of an infectious molecular clone to use in the laboratory to test drugs. It was only in the last few years that an infectious molecular clone came out of Japan. Before that, none of them fully replicated (in the lab). When the molecular clones came along progress just took off at light speed.

Then the blueprint for working on HIV became very informative - protease inhibitors, polymerase inhibitors, they were all targeted very quickly, by multiple pharmaceuticals. Many of the pharmaceuticals just moved their HIV discovery teams into HCV. Progress has been made so rapidly here because the trail had been blazed by all of the HIV drugs.

Q: Will we be able to wipe out hepatitis C entirely?

A: In contrast to HIV, we do have the capability of doing that - essentially curing everyone who got infected. While we have made tremendous progress against HIV, we still don't have a cure, we still don't have a vaccine. The situation for HCV is dramatically different. A cure is achievable. Someday soon, the cure using an interferon-free cocktail is going to be routine.

Then it becomes more of an implementation issue - how you distribute these drugs, what you charge for them. There are 180 million people infected worldwide, five to six times the size of the HIV epidemic, and many are living in resource-poor settings. We're going to have to figure out how to deal with the developing world.

Hepatitis C drugs offer hope for cure

Erin Allday / San Francisco Chronicle

Updated 4:09 p.m., Wednesday, September 12, 2012

Scientific breakthroughs, one piled on top of another at breakneck speed over the past few years, have put medical researchers on the cusp of curing almost everyone who suffers from hepatitis C, if not wiping out the disease entirely.With 180 million people in the world thought to be infected with the virus - 12,000 of them in San Francisco alone - that's potentially a huge public health coup, doctors and scientists say.

In a little more than a decade, a virus that was once almost untreatable could be made nearly extinct.
"It is just a remarkable moment in the history of hepatitis C," said Dr. Warner Greene, director of the virology and immunology division at the Gladstone Institute in San Francisco. "I think hepatitis C and its sequela - liver cancer, cirrhosis, liver transplants - can largely be gone in the future. We just won't have to worry about it."

In the past year, new treatments have come out that already have doubled the number of people who can be cured of hepatitis C. Now the race is on among drug developers to market the first medical cocktails that would cure almost everyone on the planet, and do it safer and faster than the best treatments currently available.

New treatments - both those already available and those expected to be approved in the next five or so years - were a large part of the reason the U.S. Centers for Disease Control and Prevention recommended this summer that all Baby Boomers get screened for hepatitis C.

That generation is thought to have the largest number of undiagnosed cases of the disease, with so many of them potentially exposed to the virus in the wild, drug-friendly hippie years of the '60s and '70s. Until recently it wasn't practical to screen millions of people for possible cases of hepatitis C because few good treatments were available.

Hepatitis C's spread

Hepatitis C is a virus transmitted through the blood, similar to HIV. It's often spread through shared needles used by intravenous drug abusers. Decades ago, and even still in some developing parts of the world, people were exposed to hepatitis C through unsterilized equipment used for tattoos or surgical procedures. Also, the U.S. blood supply wasn't screened for hepatitis C until the early 1990s, so people sometimes became infected from a blood transfusion or organ transplant.

In roughly 20 percent of hepatitis C cases, the body's immune system fights off the virus without any medical intervention and probably without the individual ever being aware of having it. The remaining cases develop into chronic hepatitis C.

In some of those cases, the virus may lie dormant for decades, or even a lifetime, but in about 1 in 5 chronic cases, the virus will attack the liver, scarring it and causing cirrhosis, and potentially leading to liver cancer and liver failure. The infection causes about 10,000 deaths a year in the United States, and it's the leading reason for liver transplants. Hepatitis C is especially prevalent in people who also have HIV infections; in fact, HIV-positive patients are more likely to die of hepatitis-caused liver disease than of AIDS or HIV.

Antiviral drugs

It's only in the past seven years or so that doctors and scientists discovered the first antiviral drugs that can stop the virus, giving the body's natural immune system a chance to fight it off. The cure rate with those drugs is 75 to 80 percent, but they require that patients also take interferon, a toxic medication that can cause disabling side effects for a year.

In the next five years, researchers expect to develop even more potent antiviral medications - drugs that will cure more than 90 percent of patients, and do it in half the time and without the interferon.

"There's no question that with these new treatments, cure is going to be the rule and not the exception," said Dr. Brad Hare, medical director of the HIV/AIDS ward at San Francisco General Hospital, who studies HIV and hepatitis C co-infections. "It's more important than ever to identify people with hepatitis C, because we have something even better to offer them."

That said, Hare added, it's unlikely that the virus will ever be eradicated. There will always remain a pocket of people who don't respond to drug therapy or aren't able to take it for some reason. Those who have been cured can be reinfected.

And getting new medications to the tens of millions of people affected by hepatitis C won't be easy, especially because the drugs will almost definitely be expensive.

Strains on the system

Just screening the millions of Baby Boomers in the United States, and getting those who test positive for hepatitis C into treatment, could be an overwhelming strain on the health care system, public health experts say. Drugs in development could ease some of that burden if they're easier to take and more effective than the current treatments.

Hepatitis C was discovered in the late 1980s, although scientists had known for years that a virus existed that was causing inflammation in the liver and that wasn't the hepatitis A or B viruses.

The U.S. Food and Drug Administration approved the first treatment for hepatitis C - the chemotherapy drug interferon - in 1991, and added a second drug, ribavirin, in 1998. Those two medications were considered a breakthrough therapy for a virus that had previously been untreatable, but the treatment itself was rough and not all that effective.

The ribavirin comes in pill form, but the interferon has to be given intravenously three times a week for 48 weeks. Both drugs, especially the interferon, often come with awful side effects - major depression and, sometimes, suicidal thoughts, plus fatigue, nausea and flu-like symptoms.

And the worst of it is that the treatments lead to a cure only roughly half the time - less than half for patients with the most common strain of hepatitis C.

"A lot of us didn't have bad symptoms before we went on treatment," said Daniel Berrner, a San Francisco resident who was diagnosed with both HIV and hepatitis C in 2005, and underwent successful treatment for the latter in 2009. "People maybe feel some fatigue, but that's it. So to convince them to feel awful for a year when they're not feeling that bad to begin with is a really hard thing to do."

Because treatment was, for many people, tougher to endure than the virus itself, many doctors over the years have "triaged" patients by performing liver biopsies or blood tests to determine if hepatitis C was causing severe enough damage to treat even at the risk of failure. If patients weren't experiencing acute symptoms and their livers seemed relatively healthy, they'd often postpone treatment.

More seek treatment

Whether to get treatment for hepatitis C is still a personal decision and best made after a thoughtful conversation with a primary care doctor or a liver expert, doctors said. But increasingly patients are being encouraged to get treatment, even if their infection isn't particularly virulent.

"I still try to triage based on the risk of end-stage liver disease. But now more patients are willing to be treated," said Dr. Natalie Bzowej, a liver disease specialist at California Pacific Medical Center.

Bzowej helped lead national research into one of the first antiviral treatments that targeted hepatitis C, a protease inhibitor called telaprevir made by Vertex Pharmaceuticals, which was approved by the FDA in June 2011. A similar drug, boceprevir from Merck, also won FDA approval last year.

Remarkable success

In clinical trials, about 80 percent of patients with the most common strain of hepatitis C who took one of those drugs, plus the usual interferon and ribavirin combination, were cured. That was a remarkable improvement over the previous 40 to 50 percent cure rate.

Also encouraging: Most of the patients who were cured were able to stop taking the medications after just 24 weeks, cutting the treatment time in half.

The reason for the difference is that the new drugs single out the hepatitis C virus specifically, whereas the interferon and the ribavirin essentially just give a boost to the body's natural immune system. For many people, the immune system is not strong or fast enough on its own to fight off the virus.

Protease inhibitors are best known as a class of drugs used to treat HIV infection. They work by attacking specific enzymes, or proteases, in a virus that are a key part of the replication process. By inhibiting those enzymes, the virus is unable to reproduce and eventually dies off.

Now, scientists are looking for the next line of drugs to attack other points of the hepatitis life cycle. The pharmaceutical industry is racing toward clinical trials - companies battling to be the first to get new drugs, especially those that would make interferon obsolete, to the market.

Multidrug attack

Doctors and scientists alike expect the first of the new wave of drugs to be available in four or five years. Part of the reason not everyone can be cured of hepatitis C is that, like many viruses, it mutates so quickly and becomes immune to drugs. So ideally, doctors will have at their disposal several drugs - maybe dozens - that will attack the virus on several fronts at once.

If those drugs are strong and fast enough, they could cure patients without the need for interferon. Protease inhibitors and other antiviral drugs aren't without side effects, but the symptoms are much less severe than those from interferon, and the newest classes of drugs may work in as little as 12 weeks, or about half the time it takes telaprevir, the protease inhibitor, to do the job.

"I feel like we are glimpsing the beginning of the end for hepatitis C," said Dr. Cami Graham, vice president of global medical affairs at Vertex. "We really are beginning to see what that path to eradication is going to look like."

Long incubation period

Both drug developers and doctors alike said they are advising patients not to raise their hopes too high. Almost all of the clinical trials are in their earliest stages, and for the Baby Boomers especially, patients with decades-old infections may not have even a few years to wait for new treatments.

"What we have now is better than anything we've had in a long time," said Dr. Joanna Ready, chief of gastroenterology at Kaiser Santa Clara. "What will be even better is interferon-free therapies, and the early studies have been very, very, very promising. But the disease has such a long incubation period and damages the liver over decades, so we really need to be following people over time.
Still, Ready said, she's hopeful.

"If we don't wipe out hepatitis C entirely, we can probably make it go away like polio, where you haven't gotten rid of it but you've really beaten it down," she said. "The science behind these treatments is improving every day. And the more we know, the better we are at treating it."

Erin Allday is a San Francisco Chronicle staff writer. E-mail: eallday@sfchronicle.com 

---------------------

FIGHT THE SPREAD OF HEP C TODAY. 

 Phoenix Harm Reduction Organization (PHRO)

UPDATE: ASPC-Lewis Hep C exposure incident.

excellent report by Craig Harris at the AZ Republic is at the bottom.

 --------------------

Bury Hep C, Not People.... 

Wexford Health Sources, Phoenix (JULY 2012)

Wexford connection for prisoner health information:

toll free 1-855-890-6307, or email your request to azcorrections@wexfordhealth.com. 

This media release comes to us this afternoon from Wendy Halloran at KPNX Channel 12 News. They will be covering the story tonight at 5pm and 6pm. Wendy was recently nominated for an Emmy for her investigation of the highly preventable suicide of Tony Lester.

Hep C is already a leading killer in our state prisons. Nearly 6,000 prisoners are already diagnosed with it, and another 20-30% of the prison population likely have it but don't know it yet...

From: LAMOREAUX, BILL [mailto:BLAMOREA@azcorrections.gov]
Sent: Tuesday, September 04, 2012 11:35 AM
To: Halloran, Wendy
Subject: RE: MEDIA REQUEST FROM WENDY HALLORAN AT 12 NEWS

Ms. Halloran:

On August 27, 2012, a potential exposure event occurred at the Arizona State Prison Complex – Lewis while administering medication. A vial of medication, which may have been compromised with a previously used syringe, was subsequently used to treat additional inmates.

Review of this event determined the potential exposure to Hepatitis C and involved up to 105 inmates. As a result, these inmates were notified and are currently being screened for infectious diseases as per protocol in such an exposure event. An independent laboratory, under contract with Wexford, will provide continued medical monitoring and testing of these potentially exposed inmates over the next several months. All patients will be informed of the results of the testing.

The medical protocols related to this potential exposure have been reviewed to ensure that subsequent events do not occur. The initial event remains under review by Wexford Health, the contracted provider responsible for inmate health care.

The nurse who violated the basic infection control protocols is an employee of a staffing agency under contract with Wexford Health. Wexford has banned the nurse from working under any of its contracts and has also requested that the individual be referred to the State Board of Nursing for investigation.

Regards,

Bill

---------from the AZ Republic------------

Prison nurse tied to hepatitis C exposure

by Craig Harris - Sept. 4, 2012 11:12 PM
The Republic | azcentral.com

A nurse for the new medical provider for Arizona prisons may have exposed 103 inmates at the Buckeye state prison to hepatitis C by contaminating the prison's insulin supply, and state and local health officials were not alerted for more than a week.

Officials with the state and Maricopa County health departments, who confirmed to The Arizona Republic on Tuesday that they had not been informed by Wexford Health Sources Inc. of the problem, said they will launch investigations into the incident.

Official notification of the Aug. 27 error only came late Tuesday afternoon, hours after an inmate's family member had told 12 News of the potential health risk.

State rules require health-care providers and correctional facilities to notify health departments within five business days of a hepatitis C diagnosis, treatment or detection.

Wexford said it suspended the nurse on Aug. 27, immediately after learning the person "had violated basic infection-control protocols while administering medication that day."

"In talking with the Department of Health Services, they believe it should have been reported first to the county," Corrections Director Charles Ryan said late Tuesday. "That is a question we will have of Wexford -- as to the lack of notification or an explanation as to why that did not occur.

"The department has concerns about this issue, and we will be having further discussions with Wexford in terms of this requirement and some other issues as well."

Ryan said the incident occurred when a diabetic inmate who also has hepatitis C was administered a routine dose of insulin by the nurse on Aug. 27. The needle used on that inmate was inserted into another vial to draw more insulin for the same inmate.

Ryan said the contaminated needle was inserted into a vial which was then put back among other vials in the prison's medication refrigerator. It got mixed up with other vials used throughout that day to administer insulin injections to more than 100 other diabetic inmates. Later that day, Ryan said, officials realized that the vial that potentially had been tainted with hepatitis C may have been used to dose other inmates.

At that point, the nurse in question was suspended and prison officials sought to determine how many inmates may have been exposed.

All the vials of medicine were destroyed after the discovery.

Wexford spokesman Larry Pike on Tuesday minimized the potential exposure of other inmates. He said that the company acted "expeditiously" to identify those who were potentially affected and that the company believes the potential for their exposure was small.

Though corrections officials and Wexford declined to name the nurse, the Arizona State Board of Nursing identified her as Nwadiuto Jane Nwaohia. She has been under state investigation since June 2012 for unsafe practice or substandard care, but the board would not provide additional information on the nature of the previous problem.

Corrections officials first acknowledged the matter Tuesday morning after 12 News asked about the incident at the Arizona State Prison Complex-Lewis, which houses 5,382 inmates in minimum- to maximum-security facilities.

Hepatitis C is the leading cause of liver transplants and causes liver cancer. Seventy-five to 85 percent of people with hepatitis C develop a chronic infection, according to the U.S. Centers for Disease Control and Prevention.

Shoana Anderson, head of the state Office of Infectious Disease Services, said one of the biggest dangers for those infected with hepatitis C is "it sits in the liver quietly, and 20 years later, a person can develop severe liver disease."

Anderson and Jeanene Fowler, a spokeswoman for the Maricopa County Department of Public Health, said Wexford should have notified them of the issue.

"It's extremely disturbing that something like this could happen. It calls for a thorough investigation to determine all of the surrounding causes of the mistake or the negligence," said Don Specter of the Prison Law Office, a prison watchdog group based in Berkeley, Calif.

Ken Kopczynski, executive director of the Private Corrections Working Group in Tallahassee, Fla., called the incident "scary" and said it shows a lack of oversight by corrections officials.

"This is a problem with privatization," Kopczynski said. "They are just accepting who Wexford will hire."

Wexford, which has previously lost contracts for poor service in other jurisdictions, this spring won a $349 million, three-year contract to provide health care for Arizona inmates. The company began providing services for nearly 40,000 Arizona inmates on July 1.

In a written statement, the Pittsburgh-based company said it suspended the nurse immediately upon learning she "may have compromised a vial of medication by placing it in contact with a previously used syringe."

Wexford, in its statement, said a local staffing agency assigned the nurse to the prison complex. The company said that at no time was the same syringe and needle used on more than one patient and that no staff members were exposed.

Wexford said it reported the nurse to the state nursing board for investigation, but that did not occur until late Tuesday afternoon, after the news had been reported. The company also banned the nurse from working under any of its contracts in the future. Wexford provides health-care services nationwide to roughly 124,000 inmates and other residents at more than 100 institutions.

The state said inmates exposed were notified and are being screened for infectious diseases. An independent laboratory under contract with Wexford will provide continuing medical monitoring and testing of the potentially exposed inmates over the next several months, the state said. All patients will be informed of their results, though Ryan noted that some inmates may previously have been exposed to hepatitis C.

Before the problem at the Buckeye prison, Wexford had issues in other states. Clark County, Wash., declined to renew a contract with Wexford in 2009 at its county jail and juvenile-detention center after complaints that Wexford was not dispensing medications to inmates in a timely fashion.

SOS Cecil Ash: Please Send Help.

July 2011 Artwalk display
(with Cougar)
1009 N. 1st. St. / Phoenix

This is how easy it can be to help us convene legislative hearings next session on the violence, suicides, and poor health care in the prisons. The AZ House Health and Human Services ' Committee is chaired by Cecil Ash, a truly decent man, and seems to be the best place to hold such hearings. Following Stan's letter requesting this is Representative Ash's response.

I understand that Representative Ash is still focusing his energies on sentencing reform - which we desperately need - but in the meantime people are continuing to die unnecessarily inside. If Ash doesn't want to spend political capital using his chairmanship of the HHS committee (as opposed to the Judiciary Committee), for something directly related to health and human services, then he needs to cultivate another legislator who will do that in the next session that we can lobby.

Until Representative Ash can identify that person for us - or until someone else steps forward to lead the charge on this matter - please keep sending these kinds of letters and emails to him, folks. And send me what you're willing to let me post for others to learn from, as my buddy Stan did for us...

This letter, by the way, was a beautiful gift for Dana's mom on that difficult day. Thanks, Stan, from all of us.

-----------------------------------

From: Stan Hemry
Sent: Thursday, July 07, 2011 11:05 AM
To: Cecil Ash
Subject: Dana Seawright's unsolved murder

Good morning Rep. Ash,

I am a resident of Phoenix for more than 10 years. Today is the 1st anniversary of this young man's death. I writing to draw your attention to the murder of Dana Seawright, who refused to give up his cell in prison with a man of another race. One was black the other, Hispanic. Dana's gang ordered him to prove his loyalty to the gang. Dana was subsequently killed for a fake attack on another man of the same race as his cell mate. 10 of Dana's gang members were given enough leeway within the prison facility to enter his cell and beat him to death for not delivering the beat down ordered by his gang.

Now, I know that this sounds like typical gang activity, but Dana was standing up for the freedom of association. Something the gangs and guards, apparently, do not allow. This type of violently-enforced segregation underscores the divisions that are routinely encouraged within the prison community.

Guards and prison people both manifest the divisions as they see racial tensions played out in tragic ways. Scenes, like the one of Dana's murder while under guard, re-enforce segregation and violently punishes prison people, who do not abide within the artificially-created, racial divides.

Dana's murder is a harsh wake up call to take action to examine what is happening. This could have easily been me, or possibly you, Rep. Ash, given the same circumstances. I would have done what he did and probably be murdered too.

Racially-segregated gangs monitor and enforce divisions among the prison people. Why can't there be a program to gradually de-segregate the prison community? Train the guards to understand that we are all equal in frailty, love and life. Give the prison people adequate mental and physical health care.

If there is any justice left in the system, I hope you will convene hearings into the rapidly rising murder and suicide rates in the Department of Correction. Understanding the circumstances surrounding the tragedy of Dana's death could help to reform the training received by prison guards and lower the tension levels among the prison people.


Respectfully,


Stan Hemry
PHX 85004

--

Contact me if you are an educator and want to screen Arlington West in your school.



-------to contact Representative Ash------



----------reply from Representative Ash--------

From: Cecil Ash
Date: Fri, Jul 8, 2011 at 3:06 PM
Subject: RE: Dana Seawright's unsolved murder
To: Stan Hemry

Dear Mr. Hemry:

Thank you for your email. There are a great many problems in the prison system. You have identified some of them in your email. You are correct, given the same set of circumstances, you or I might have done the same thing.

I am not indifferent or unaware of the many problems in the D.O.C. However, to have hearings this next session would jeopardize some of the sentencing reforms I've been working on for the last three years. Before undertaking hearings on your issue, I need to get some of the sentencing changes enacted. Then I will proceed to look at health issues (both physical and mental) in the prison system. If we could stop so many people from getting in there in the first place, we might have the resources to do a better job with a smaller population.

I will put you on my email list to be informed of our efforts in this area.

Again, thank you for email, and my condolences to Dana's family.


Sincerely,



Cecil Ash

State Representative

District 18

Hitting Home: International Women's Day.

"Thank you Neuro ICU: We Heart Mom."

Those of you who get these blogs automatically fed to them will recognize that this is a revision of an earlier post. I'm still working this stuff out, and just wanted to clarify where I'm at these days...


This was the thank you that I left on the sidewalk last night at Scottsdale Healthcare's campus on Osborn, where my mother is being treated for an extremely aggressive form of brain cancer. We thought she may have had one or more stroke last month because she suddenly lost her vision in her left eye and began falling a lot, but the CT scan in the ER at the time barely even showed the shadow that consumed her right occipital lobe within just weeks; Mom was diagnosed with a sinus infection and put on antibiotics instead of being sent for an MRI.


Had she not fallen and incurred a new head injury last week, Mom's tumor may not have been discovered in time to do surgery. It has yet to be seen whether or not the surgery was in time to save her life or prevent her from prolonged misery. Because this particular cancer is so devastatingly quick to kill, they're starting her on both radiation and chemo even though they removed all visible traces. I guess no matter how good your surveillance, people and equipment are, by the time you see it again it's generally too late. This is what killed Ted Kennedy.


Some folks may be wondering why I'm still running around protesting and chalking the town while my mom may well be dying - I think I'm just trying to hold on to normal life as best I can through this; I'm afraid that if I put it down I may not be able to pick it up again for a long time. Besides, Mom isn't dying - she's fighting for her life. One of the reasons is so she can continue to be a part of mine. That means I need to keep living it.


My art and politics are a part of me, anyway, not activities I do in my free time. I won't be able to maintain my same level of activism, though - or prisoner support. My mail is flowing again, and I'm back up to my neck in letters from people in trouble. I'll write a post begging the community for more help on that count soon - after which, my blogs may well fall silent for awhile. If you try to contact me from here on out with little initial success, just be persistent. I've got my hands full now, but I'm not planning on going anywhere; I'll still help if I can do so, however this turns out. Mom would want me to.


In the meantime, if you have any good energy to send into the universe for Mom and the people treating her, please do. She's not only a primary source of my own social conscience and fire, but she's generously supported my unpopular causes over the years, even when she barely had enough to live on herself. She's the person that my prisoner friends ought to be thanking and praying for the most today - she helps keep me going when I risk succumbing to both poverty and despair, so that I in turn can be there for them. She is who makes most of my work possible. She saved my life, in fact.


So, my mom, Jean Boatman, is my Woman of the Year. She's a retired teacher from Fountain Hills, and a member of the current school board there. She's actually a registered Republican and has been an officer of the Mayflower Society (yes, I'm a Pilgrim) - but don't let that fool you. She's really an insurgent liberal and lives somewhat vicariously through my radical politics (which the people who love and respect her know already, so her "cover" isn't really blown). Please think good things for us - and do something pro-active to stand up for collective bargaining, public education, and health care rights this week.


Finally, I hope it dawns on Mom's community as they learn of her extraordinary medical needs that if the Republican and Tea Parties had their way right now, she would have been left to die like those AHCCCS transplant patients - and all the other Medicaid patients the state wants to cut off of medical care (but is more than willing to shell out $20,000+/year to imprison). Mom's life would be no less worth saving if she had no health insurance than it is now. Why is anyone else's?


Send that message to the the chair of the Az House Death Panels - also known as the Appropriations Committee - if you're a friend of my mom's. He's the man that Fountain Hills chose to represent their interests: John Kavanagh. Since most teachers are struggling to survive out there - and a lot of kids are hurting, too - I'd say he's doing a lousy job of representing anyone but the rich in that town.


He can be reached at:


John Kavanagh
AZ House of Representatives
1700 W. Washington
Room 114
Phoenix, AZ 85007
Phone Number: (602) 926-5170
Fax Number: (602) 417-3108
jkavanagh@azleg.gov

"Give my Taxes to AHCCCS:
Health care is a human right."

Get well card for Mom/1st Amendment lesson for AZ students.
Arizona State Capitol/Wes Bolin Plaza.

The Tea Party Legislature now in Session.

From Protecting Arizona's Family Coalition (PAFCO):

---------------------

AZ Legislature starts to heat up with many bills dropped and AHCCCS hearings next week.



· AHCCCS is scheduled for informational budget hearings on February 1 and February 2. No budget bills dropped yet for these hearings, but this preliminary hearings will outline the Governor’s budget proposals. Details and agenda are listed below.

· These are opportunities to be present, provide testimony, and show our opposition to the Governor’s budget proposals and clearly outline the type of transparency and accountability measures required when such critical decisions.

· The Governor’s proposals include eliminating 280,000 people from AHCCCS, resulting in the loss of thousands of high paying health care jobs, and crippling the health care system capacity --- potentially comprising the general health care system and cost shifting to private health care plans.

· Such monumental human, economic and health care system decisions must be vetted completely in the light of day with lots of citizen and expert input.

· The past week, a coalition of major health care provider organizations led by the Arizona Hospital and Health Care Association held an educational session with legislators laying out the human, economic and system costs of the Governor’s health care proposals. Clearly the Governor’s choices take a tremendous human and economic toll and must be rejected. For details on the Arizona Hospital Association analysis and study go to: http://www.azhha.org/advocacy/

· Alternatives exist, including a new proposal for raising revenue through a hospital bed tax and health care premium tax. Other alternatives include raising the beer and liquor tax to national average or eliminating tax exemptions and taxing various services. See the article below from ASU economist listed whose analysis indicates at this point revenue increases have a better economic impact that budget cuts. Arizona tax boost better than budget cuts, economist says (www.azcentral.com - http://www.azcentral.com/arizonarepublic/local/articles/2011/01/28/20110128arizona-budget-tax-boost.html?utm)_



AHCCCS BUDGET HEARINGS – FEBRUARY 1 IN THE SENATE AND FEBRUARY 2 IN THE HOUSE



· Tuesday February 1 at 2pm AHCCCS Budget hearing - State Senate Appropriations agenda http://www.azleg.gov/FormatDocument.asp?inDoc=/agendas/02010154102%2Edoc%2Ehtm . This presentation is first round presentation. No budget bill has been introduced.

· Here is link to AHCCCS budget presentation. http://www.azahcccs.gov/reporting/Downloads/Legislation/Presentations/1-12househealth.pdf

· Wednesday February 2 at 2pm AHCCCS Budget hearing – House Appropriations agenda --- http://www.azleg.gov/FormatDocument.asp?inDoc=/agendas/02020101102%2Edoc%2Ehtm




Children’s Action Alliance has released a detailed analysis: Read/download the user-friendly chart here and share with your colleagues.

As CAA comments: This budget --- also ignores the next funding cliff when the temporary state sales tax dollars go away - education and health care remain exposed to more major misery. The budget moves resources from the classroom to the prison cell and promises a weaker workforce. Large cuts are proposed for K-12 and universities, key elements in a sustainable economy, workforce, and reduction of poverty, hunger, homelessness, and family violence.

Arizona: Mercy, Mercy Me...

Davon's clemency board hearing was yesterday - the decision to turn him down was clearly made before we walked into the room, however. The chair made only passing reference to the thick stack of mail that had arrived in support of Davon's application, and cut me off when I was speaking on his behalf. He made a special point of reading things into the record to justify their determination against him. The county attorney's office can be expected to oppose such applications, but they went out of their way, it seems, to damn him - which was precisely what the board needed and asked for. Not that I'm accusing them of any impropriety - I'm sure they did what they felt was right - just as I'm doing. We just come from different places, and they don't know Davon like I do. As evidenced by their decision yesterday, They don't know him at all.


Pardons in Arizona have nothing to do with mercy or grace, by the way - or even justice for that matter, even when sincere people try to deliver it. Look at what our good governor did to Bill Macumber, the innocent man who has already spent 35 years in prison for murder and may well die there. Convinced beyond any doubt that his conviction was based on perjured testimony and manufactured evidence, the Arizona Board of Executive Clemency unanimously recommended him for a full pardon, which would have gone into effect if Brewer had simply left it alone for 90 days. Instead she quashed it, in the interest of her kind of "justice". Affirming Bill's innocence would have implied his ex-wife's guilt. As she worked for the Maricopa County Sheriff's office at the time she framed him, I suspect Brewer was doing someone with history there a favor. But what do I know?



Sadly, despite his story saturating the media across the country before November 2, the voters in Arizona elected that woman anyway.



As for Davon: the outcome of his hearing was no surprise, really - probably least of all to him - but it was still a disappointment; his little sister left the room abruptly in tears. We did, however, raise awareness about the prosecution of the seriously, mentally ill for their symptoms rather than their criminality, and built a network for prisoners with Hep C and their families. We also entered our objections to the prison industrial complex into the public record (that was the part I think they didn't want to hear). One of our legislators even turned out to corroborate Davon's mom's assertion that Arizona's prisoners aren't getting the medical care they need in there - and that came from a self-described "conservative Republican". I suspect he will pay a price for having done that, which is why I won't name him here. I doubt he would endorse my own take on the system, but he's still one of the few politicians I've ever met with real integrity. I can't think of a single Democrat in this state who would put themselves on the line like that for a convicted violent, crazed felon seeking mercy - much less another Republican.



I'm convinced that clemency boards exist largely to reinforce the illusion that the system we have of doling out punishment in our country is a "just" one that serves the best interests of society at large. By allowing room for pardons and commutations, we suggest that the legal system we live under, as a rule, delivers justice to criminals and victims alike, and that any abuse of power or injustice perpetrated by the state in the process is an exception that needs to be dealt with on a case-by-case basis. If that was the reality, however, our prisons would not be packed almost exclusively with the poor - most of whom have the least ability to do great harm. In a truly just and morally evolved society it is the money-lenders, warmongers and rogue sheriffs of this land who would be doing time for exploitation, mass murder, and kidnapping - not making the rules the rest of us have to live by. They certainly wouldn't be retiring with honors and drawing down our collective dime.



But ours is neither a just nor a moral society - it isn't even a democracy. It is a capitalist republic in which the wealth and power of the few still depends on their ability to co-opt, terrorize, and restrain the many. We literally replaced our plantations with prisons when overt slavery went out of style. America's governments exploit and injure far more innocent and vulnerable people than all our lone criminals combined do. We've even made the perpetuation of victimization and crime an attractive, acceptable industry from which savvy investors can profit.



Thanks, everyone, for all your support through this. Stay with us, please - this fight is much bigger than one young man, and has only just begun. Keep an eye on what's happening with Davon for awhile longer - he went further out on a limb in the interest of prisoner rights and health care than any of the rest of us had to - and risks paying a much higher price now than the one extracted from him at sentencing. We'll see if he's allowed to keep his good time - and make it successfully through the 4 years of probation he has yet to serve -in light of his and his mother's public defiance. I guess we'll also see if the Arizona State Legislature shows any mercy for the honesty and courage of one of their own.