Four Vermont inmates have died while or shortly after being incarcerated at Camp Hill state prison in Pennsylvania. One of them was denied treatment or palliative care for lung cancer in circumstances that could reasonably be described as tantamount to torture. This outrageous situation is one reason why prison reform advocates urge Vermont to end the practice of incarcerating inmates out of state. Developments of the past week, however, call into serious question whether the health care provided to inmates in Vermont facilities is itself adequate.

Lawmakers on the Joint Legislative Justice Oversight Committee heard testimony from Michael Fisher, chief health care advocate for Vermont Legal Aid, suggesting that the Department of Corrections is failing to treat many prisoners who have the hepatitis C virus. Fisher told the panel that in 2017, the DOC treated just one of the 258 people in its custody who had the disease. So far this year, the number is 10.

Moreover, the department is apparently unable to account for $2.2 million of the $4.8 million that the state paid for pharmaceuticals and off-site medical services to Centurion, the private company that holds the contract to provide health care in the prison system. Centurion spent only about $2.6 million of that amount.

“Appalling,” said state Sen. Dick Sears, D-Bennington. “Unbelievable,” said Sen. Ginny Lyons, D-Chittenden. Of the two characterizations, we prefer the one by Sears. Unfortunately, this information is all too believable.

Hepatitis C is an infection that, according to the Vermont Department of Health, “can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness that can lead to chronic liver disease, liver cancer and sometimes death.” It is transmitted primarily through blood-to-blood contact resulting from contaminated needles used to inject drugs intravenously, but sexual transmission is also possible.

The health department also reports that significant advances in treatment have been made in recent years, and that 90 percent or more of cases are now curable, although the prescription drug regimen is expensive.

Given the relationship to illicit drug use, it’s not surprising that studies show that the disease is more prevalent among inmates than in the general population. Thus prisons are a key arena in which to combat hepatitis C. Moreover, the courts have ruled that prisoners are entitled to medical care comparable to that offered in the community at large.

Deputy Corrections Commissioner Mike Touchette told VtDigger that he would get back to the committee with information about what happened to the money that is unaccounted for, citing a couple of possible scenarios. Seven Days, the alternative weekly, reports that Ben Watts, the department’s health services director, conceded that Centurion got to keep the money under the provisions of its contract, which has now been changed to cap corporate overhead and profit. If that’s the case, taxpayers are entitled to be outraged.

Meanwhile, Watts claims that the department does offer inmates treatment equivalent to that provided in the community, an assertion that seems far-fetched given the small number of inmates being treated. The problem, according to Watts, is that many of the inmates who have the disease are detainees who are not in custody long enough to complete the eight-week prescription drug regimen. He did not provide numbers, however, and it’s reasonable to ask why the DOC could not coordinate with the state health department so that prisoners who start treatment while in custody could finish it back in the community.

Combined with the well-documented long-term problems with the DOC’s approach to housing inmates out of state, this troubling information strongly suggests that a change of leadership in the department is urgently needed. Absent that, lawmakers must step up their scrutiny of all its operations.