Allegheny County Chief Executive Rich Fitzgerald’s proxy attended Thursday’s Jail Oversight Board (JOB) meeting to cast a vote that killed a proposal to expand Medication Assisted Treatment (MAT) at the Allegheny County Jail.
The proxy, Barbara Parees, left at the beginning of the meeting and did not appear until the final five minutes to participate in the vote. She voted despite the fact that Fitzgerald is not permitted to send a designee in his place to JOB meetings according to Pennsylvania state law, as reported by the Current.
Allegheny County Councilor-At-Large Bethany Hallam and Allegheny County Controller Chelsa Wagner, both JOB members, voted in favor of expanding the use of medications to assist incarcerated individuals who are dependent on opioids, or who already have a prescriptions for MAT. Joining Parees in the opposition was board member Gayle Moss. Board member Terri Klein and Kevin Kraus representing County Sheriff William Mullen abstained.
One day after Fitzgerald’s designee voted not to expand MAT at the jail, Governor Tom Wolf passed an expansion of the Pennsylvania state prison system’s Medication Assisted Treatment program. In a press release announcing the Governor’s 14th signed renewal of the opioid disaster declaration, Wolf said PA’s prison MAT program is a “a model program for other states.”
“The opioid and heroin epidemic is an ongoing public health crisis, one that requires immense coordination of staff and resources to save lives and promote healing,” said Wolf. “Public health emergencies like this one are complex disasters that require a concerted, sustained response from the state.”
Hallam introduced the motion to expand MAT at the Allegheny County Jail after the Current reported that Jerome Maynor, a 71-year-old man currently housed at the ACJ, was being denied methadone treatment and forced into withdrawal. The Pennsylvania Institutional Law Project and the Abolitionist Law Center sent a letter to Allegheny County Jail Warden Orlando Harper about their concerns for Maynor’s well-being and sobriety after forced withdrawal. Maynor is currently in jail for a probation violation and the court ruled for him to remain detained.
Allegheny County Jail currently does not permit individuals in custody to receive methadone or buprenorphine to treat opioid use disorder, unless the incarcerated person is pregnant. The motion Hallam had submitted suggested expanding that treatment to every incarcerated person at the ACJ, “who has been legally prescribed those treatments, as directed by a physician or other licensed medical provider.”
Tadiso, Inc, has entered into an agreement with the jail to provide methadone treatment for the pregnant women on a weekly basis. In its contract with the county, Tadiso is designated to provide methadone treatments for “inmates of the Allegheny County Jail.” This contract would allow for the expansion of treatment to men and non-pregnant women or persons.
Former Allegheny County Jail nurse practitioner Jodi Lynch said as of August 2020, there were no opioid or medicine assisted treatments at the jail, other than for pregnant women. “Every script I’ve written for suboxone, it is all female, not male,” she said.
Lynch said persons transferred to the jail from another facility would have their prescriptions continued, but persons on suboxone, methadone, or heroin coming in “off the street” would be forced into withdrawal as is the case with Jerome Maynor.
“There is no treatment. None. None. They only provide comfort meds, as far as diarrhea and vomiting” Lynch said,” They’re going to have a hard time saying they treat anyone for addiction.”
Lynch described doing detox visits with men where patients vomited and appeared pale or sweaty. Symptoms of detox include nausea, pain, difficulty eating, difficulty sleeping, diarrhea, tremors, and an inability to focus.
The AP reported in 2018 that, according to a lawsuit filed by the American Civil Liberties Union of Massachusetts, a Massachusetts jail’s policy of denying inmates access to MAT violates constitutional rights and the Americans with Disabilities Act.
The AP reported, “The ACLU argues that denying Pesce his doctor-prescribed methadone violates the U.S. Constitution’s Eighth Amendment, which protects against cruel and unusual punishment, as well as the Americans with Disabilities Act, which prohibits discrimination against people with substance use disorder.”
Lynch said her concerns aren’t just for the people currently incarcerated. She’s just as worried for the people who have been released after forced withdrawal.
“If you don’t treat it, there’s a high risk of relapse or overdose. There’s a high risk of coming back,” said Lynch.