Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, March 31, 1992 TAG: 9203310397
SECTION: VIRGINIA PAGE: B3 EDITION: METRO
SOURCE: BONNIE V. WINSTON STAFF WRITER
DATELINE: RICHMOND LENGTH: Medium
Alex Velazquez, who has asked to be released from the Powhatan Correctional Center so that he can die in the care of relatives in New York, is now close to defenseless against infection, said Dr. B.L. Kapil, chief physician for the state Corrections Department.
Velazquez, 28, who was convicted in Virginia Beach of possessing cocaine with the intent to distribute it, already has lost more than 25 pounds since he was diagnosed with the deadly virus in November 1990. Chemotherapy has temporarily halted his Kaposi's sarcoma, the purplish, cancerous bumps that stretch along his arms. He has had two bouts with MAI, Mycobacterium avian intracellularis, a cousin to tuberculosis associated with a suppressed immune system. And he is on 10 different medications.
Kapil said last week that 182 inmates, or about 1 percent of the state's 17,000 prisoners, have tested positive for the AIDS virus.
But the numbers are growing exponentially, along with the health and financial problems facing the state associated with their care. Wilder's consideration of Velazquez' request for release - the first associated with AIDS - underscores the growing seriousness of the AIDS crisis in Virginia's prisons and the sensitive humanitarian, financial and public safety questions that go with it.
Velazquez' family, in Virginia last week from New York, say they are prepared to take over for the state, and care for Velazquez at home in New York until his death. They are awaiting word from Wilder, expected any day now.
Last year, 12 Virginia inmates died of AIDS. By the end of this year, Kapil expects more than 500 to have tested positive for the HIV-virus. And by decade's end, the numbers are expected to grow to more than 3,100, or twice the number now held in the largest state prison.
"The general public absolutely has no inkling of the extent of the problem," Kapil said. "I am exasperated. I don't know what we're going to do. We know what the budget situation is. We know nobody wants to raise taxes. But I don't know how we can care for all these people unless we have more money."
The department only now is starting to break out the cost of care for AIDS patients in the prison medical system. Until there is more complete data, Kapil said, the actual cost of caring for the infected inmates will not be known.
Twenty-six of the 182 already have full-blown AIDS. The 14 sickest, including Velazquez, are being cared for in the infirmary at Powhatan Correctional Center west of Richmond. Twelve others have been stabilized and are in the regular prison population.
"For drugs alone, to keep someone on AZT for a year, to do lab tests and pay consultants' fees, costs about $6,000," Kapil said.
Generally, he continued, the cost can range from several hundred dollars annually for lab tests to monitor a single inmate with the virus but no symptoms of the disease, to $50,000 to $60,000 for the intensive care necessary in the last year of life of an inmate with full-blown AIDS.
The cost, Kapil said, are "entirely borne by the department. Medicaid doesn't cover this. The federal government won't pay anything. So it is entirely paid for by the state."
Releasing inmates, such as Velazquez, who have AIDS, would save the state considerable sums, Kapil acknowledged. "That is the effect," he said, "but certainly not the motive" for releasing anyone. "Public safety is a big aspect of it."
Kapil argued that, public safety considerations aside, from a "medical, humanitarian and compassionate point of view," Velazquez and other terminally ill AIDS patients should be released from prison to die "provided they have a loving, caring family to go to."
In that sense, Velazquez is lucky, Kapil said. "I have known a couple of AIDS patients who were eligible for parole, but their families were not interested in taking care of them."
In another instance, an inmate was abandoned by his family when they found he had AIDS. The man, in his early 30s, died in prison.
"My guess would be, yes, if he [Velazquez] gets released, it will encourage others to apply," Kapil said.
\ AIDS IN PRISON
NUMBER OF VIRGINIA PRISONERS WHO HAVE TESTED POSITIVE FOR HIV:
1985 4
1986 11
1987 14
1988 16
1989 46
1990 69
1991 151
1992 182 (so far)
1993 528 (projected)
2000 3,147 (projected)
- Source: State Corrections Department chief physician
by CNB