Californians are locked into contributing to the cost of treating state inmates sickened by valley fever.
Since 2006, the state prison system has tried but failed to reduce the disease's impact and price tag.
California Correctional Health Care Services foots an annual bill of about $23 million for sending inmates with valley fever to hospitals outside the prison, guarding these patients, and for their antifungal treatments. That's about what it costs to build a new school in Fresno County.
Not included in that sum are the costs the state prison system racks up treating valley fever within the prison walls and the costs attributed to expensive, long-term care for patients with complications of valley fever, such as meningitis.
Most of those expenses stem from the high rates of valley fever at eight institutions located in areas of the San Joaquin Valley rife with the fungus that causes the disease. Among those is Pleasant Valley State Prison in Coalinga where, in 2005, the prison's valley fever rate was 600 times the rate of Fresno County.
That Pleasant Valley outbreak prompted the prison health system to take preventive steps, following recommendations from the California Department of Public Health.
Inmates most vulnerable to the disease – including those with HIV and chronic lung disease requiring oxygen therapy – were sent to prisons outside the region. Inmates were educated about the symptoms of the disease. And plans for new construction at Pleasant Valley State Prison in Coalinga were canceled.
Despite those changes, the rate of valley fever among inmates has continued to climb, mirroring an increase in cases throughout the state. The rate of valley fever at Pleasant Valley dropped from 2006 to 2008, then pitched up sharply through 2010; the rate of disease at Avenal State Prison in Kings County steadily climbed from 2006 to 2010, according to a 2012 report from the prison health care system that found that "additional measures" were needed to stem the rising costs and cases.
Those costs are not confined to the state prison system.
Last month, the U.S. Department of Justice awarded a settlement of $425,000 to Arjang Panah, who contracted valley fever while serving a drug sentence at Taft Correctional Institute in Kern County. "He will require lifetime treatment," said attorney Ian Wallach, who represented Panah.
Former state Sen. Roy Ashburn (R-Bakersfield) often cited the financial costs of the disease when persuading fellow lawmakers to fund vaccine research. A key component of his argument focused on the prisons: The costs of treating valley fever among inmates and prison guards exceeds the state's contribution to a cure.
"That's an issue that made it pretty convincing," Ashburn said. "On a cost-benefit basis, it made sense to contribute $1 million a year."
But after Ashburn left office, state lawmakers looking for short-term ways to balance the budget stopped funding the vaccine effort.