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STD testing at jail may cost county either way
Currently suspended, the program costs county $800,000, but if lawsuits prevail, it could mean millions

Sunday, February 18, 2007
Daily Herald
by Rob Olmstead

Of all the political footballs in this year’s Cook County budget, few have been more contentious than that of testing prisoners for sexually transmitted diseases.
County Board President Todd Stroger has proposed eliminating the program — in fact, as of January, the program was suspended — while an alternative budget proposal by county commissioners would keep it in place.
Public health advocates say the program is a vital link in the health system and a way to catch a significant percentage of STD cases in Cook County.
Dr. Robert Simon, the chief of county’s bureau of health, doesn’t dispute that but says it’s a matter of prioritization.
Why, he asks, should prisoners get screened for STDs when most people going to an actual doctor’s office — private or public — don’t get that high level of care.
“Nobody screens us (unless we have symptoms),” Simon said. “So let’s look at them (prisoners) as regular citizens. Regular citizens don’t get screened when they go to a doctor.”
While those mainstay arguments on the program are hardly new, missing so far from the debate has been the role of several lawsuits against the program.
Former prisoners say they are tested against their will — that deputies line them up in cattle-call fashion and make them sign consent waivers whether they want to or not. Given the invasive nature of the test, it has inspired several prisoners to take legal action.
Even a lawyer, Lawrence Thompson, who once was detained at the jail when a judge got mad at him, has said the consent is forced, and sometimes consent cards are even signed after the test has been administered.
In December, a federal judge certified a lawsuit — Jackson v. Sheahan — against the STD testing of males at the jail for class action status, meaning that it now applies to any male who has been tested for STDs at the jail, within certain parameters.
Another lawsuit, applying to female detainees — Young v. Sheriff of Cook County — has been filed and is seeking class-action status. A ruling on the class action issue is due in April.
So far, defending against the lawsuits hasn’t broken the county’s bank. Taxpayers have paid out $29,094 to private attorneys in the Jackson lawsuit, and $33,271 in the Young case to defend the county, according to county finance committee records.
But with a dozen or so plaintiffs in Jackson seeking $100,000 each and whatever compensation a judge sees fit for the rest of the class, if the county loses the lawsuit, it could be facing a multimillion judgment for a program that costs the county just about $800,000 a year to run.
“The class is so large, you could have a very substantial result,” said Patrick Driscoll, chief of the Cook County State’s Attorney’s civil division, and the man ultimately responsible for defending the county.
The lawsuits could be a problem, but why not just fix the way the program is run rather than eliminating it, said Charlie Fasano, director of the prisons and jails program for the John Howard Association.
“Would it be problematic? Yeah. But does that mean that they should say forget it? No,” said Fasano, who monitors the jail to make sure prisoners are treated humanely and in accordance with court decrees.
Fasano said ending the testing of prisoners would end up costing the county more in the long run, as prisoners who aren’t diagnosed go back into the community to spread the disease, and then all of them show up at county health facilities.
“These people who are going back (from jail) to every part of the city or suburbs — the questions are, are they going back infected, likely to infect someone else?” Fasano asked.
Sheriff Tom Dart agreed, noting that 80 percent of people booked at the jail get back out, at least temporarily, while only about 20 percent go on directly to prison.
Kenneth Flaxman, one of the lawyers who brought the Jackson v. Sheahan lawsuit, said he thinks the program can be done in a humane way — with actual “real” consent, for example.
“But when people are tested at the jail, they don’t have a choice. The men are told drop your shorts and pull out your, well, they use a slang word that’s not fit for a family newspaper.”
All Flaxman is asking is that jail inmates get treated humanely, he said.
Dorothy Murphy-Swallows, director of the county’s STD testing program, declined an interview, saying she did not have permission from her county bosses.
But in a deposition she gave under subpoena, Murphy-Swallows noted that at one point, diagnoses at the jail accounted for one-third of all cases of certain types of STD cases in Cook County.
And, she noted, 20 percent of the men 25 and younger who are tested at the jail come back positive for some type of STD.
Simon acknowledges the program is a good one, and if he had unlimited resources, he would fund it.
But with limited resources, he has to prioritize. Even without the threat of a multimillion dollar lawsuit hanging over his head, he said, he would cut it in favor of breast cancer screenings, MRIs and colonoscopies for working poor who show up at Stroger Hospital. Right now, he noted, he has a backlog of 200 people who need hip replacements.
And as for the lawsuits?
The ever-candid Simon could barely contain his anger.
“I think it is incredible. Where’s the class-action lawsuit that represents the average citizen?”
County officials will meet several times this week to hash out a budget compromise. A vote is scheduled for Thursday.


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