HOFFER et al v. JONES
| CARL HOFFER, RONALD MCPHERSON and ROLAND MOLINA |
| JULIE L JONES |
| 4:2017cv00214 |
| May 11, 2017 |
| US District Court for the Northern District of Florida |
| Tallahassee Office |
| Leon |
| MARK E WALKER |
| CHARLES A STAMPELOS |
| Prison Condition |
| 42 U.S.C. ยง 1983 |
| None |
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Filing
465
ORDER ON CROSS-MOTIONS FOR SUMMARY JUDGMENT. The parties' cross-motions for summary judgment, ECF No. 270 and ECF No. 342 , are GRANTED in part and DENIED in part, as described in this order. The preliminary injunction en tered in this case, ECF No. 185 , which was subsequently modified and renewed, see, e.g., ECF No. 437 , is hereby dissolved. No later than 5/20/2019, the parties must confer and file a jointly proposed briefing schedule regarding the entitl ement to and determination of attorney's fees and costs. The Clerk is directed to provide a copy of this order to inmate Steven A. McLeod. The Clerk is directed to enter judgment stating: a. Defendant must ensure that the Florida Department of Corrections ("FDC"), FDC's employees, and FDC's agents comply with FDC's Hepatitis C Virus ("HCV") policy, HSB 15.03.09 Supplement #3, as it is revised. b. Defendant must ensure that FDC's HCV policy, HSB 15. 03.09 Supplement #3, is not modified absent this Court's instruction. c. Defendant must ensure that, no later than May 20, 2019, FDC's HCV policy, HSB 15.03.09 Supplement #3, is modified as follows: i. The policy must be modified to refl ect that treatment must be initiated for F0 and F1 inmates within two years of staging. ii. A section must be added to the policy requiring an explanation to anyone who refuses staging or treatment of, at least, (1) the consequences of HCV, (2) the availability, lack of side effects, and efficacy of the new medications, (3) the staging process, and (4) whether and when they will receive treatment. iii. The policy must be modified to reflect that (1) patients must be initially staged using a F ibroSure test within 30 days of confirming they have chronic HCV; (2) patients who need ultrasounds must receive an ultrasound within 90 days of confirming they have chronic HCV; (3) if a patient needs to be restaged as a result of an ultrasound, t he restaging must take place within 5 days of receiving the ultrasound results; and (4) staff must rely on the test, exam, or study indicating the highest fibrosis level for staging. iv. The policy must be modified to reflect that deadlines are manda tory. v. The policy must be modified to reflect that staff have the discretion to restage inmates sooner than scheduled. vi. The exclusion for time remaining on an inmate's sentence must be modified such that (1) it no longer refers to "p re-treatment evaluation"; (2) it no longer refers to "post treatment SVR assessment"; (3) it no longer includes a "12-18 months" estimate; and (4) it reflects that an inmate-who has already been staged and evaluated-simply ne eds to have "sufficient" time remaining on their sentence to complete a course of treatment. vii. The exclusion for high-risk behaviors must be modified to reflect that (1) high-risk behaviors only warrant a delay if there is a "medi cal reason" to delay treatment and (2) it only provides for temporary ineligibility, not permanent exclusion. viii. Section J.3., which refers to "chronic disciplinary issues," must be amended to reflect that chronic disciplinary is sues, in and of themselves, are not sufficient to render an inmate ineligible for treatment; rather, treatment may only be delayed for medical reasons. ix. Section P, which governs referrals for liver transplants, must be modified as follows: (1) de compensation must be defined as "the presence of encephalopathy, ascites, bleeding varices, or jaundice"; (2) it must be clarified to reflect that patients will be referred if they have any one of the listed items; (3) referrals must be ini tiated within 30 days of any one of the triggering events; (4) it must provide that FDC must promptly comply with the transplant center's request for records and other information, and to promptly transport the inmate to and from the transplant center; and (5) it must be clarified that for individuals who have been scheduled to receive DAA medication, are undergoing DAA treatment, or who have finished DAA treatment, a referral must be made only if the post-treatment MELD score is over 15. x. Section A.2., which refers to risk factors, must be modified to include "being born between 1945 and 1965, previous incarceration, and HIV" as risk factors. d. Defendant must ensure that FDC initiates treatment for all known chronic-HC V inmates who are currently staged F0 or F1 within two years of the date of this order. e. Defendant must ensure that FDC either (1) adopts a system of opt-out testing along with an aggressive notice campaign or (2) adopts a system of opt-in testing paired with peer education. FDC must make its choice and Defendant must inform this Court of FDC's decision no later than 5/20/2019. f. Defendant must ensure that FDC forms a definite plan to make elastography available to its medical staff within a reasonably immediate timeframe. Defendant must file its proposed plan with this Court no later than 5/20/2019. g. Defendant must ensure that-for inmates who were known to have chronic HCV in December 2017, who have fibrosis st age 2, and who are eligible for treatment-FDC initiates treatment no later than December 31, 2019. Beginning on 6/3/2019, and on the first day of each month thereafter, Defendant must file with this Court a status report reflecting FDC's progress in complying with this Court's injunction. That status report must include: i. A certification regarding FDC's compliance with the applicable deadlines for prisoners known to have chronic HCV in December 2017. ii. Information re garding the total number of inmates who: 1. have been screened/tested for HCV, 2. have been identified as having chronic HCV, 3. have been identified as having chronic HCV and have been staged (which must be further broken down by stage, including F0 , F1, F2, F3, F4, decompensated cirrhosis, and those with HIV), 4. have been submitted to the Hepatitis C Committee for evaluation (which must be further broken down by stage, including F0, F1, F2, F3, F4, decompensated cirrhosis, and those with HIV) , 5. have begun treatment with DAAs, 6. have completed treatment with DAAs, 7. have achieved a sustained virologic response (SVR), 8. have not achieved SVR, and 9. have been deemed (temporarily or permanently) ineligible for treatment with DAAs along with the specific reason for ineligibility. Signed by CHIEF JUDGE MARK E WALKER on 4/18/2019. (kjw) **Order mailed to inmate McLeod as directed.**
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