Blasting the Florida Department of Corrections’ “long and sordid history of neglecting” inmates who have hepatitis C infections, and citing a “risk of such deliberate indifference reoccurring in the future,” a federal judge ordered Thursday evening that the state must treat all inmates with the disease.

The order is the result of a class-action lawsuit begun by three Florida inmates nearly two years ago. According to the order, the truth uncovered at earlier hearings was “crystal:” that the Florida Department of Corrections did not treat inmates with this infection because the drugs used to cure it, called “direct-acting antivirals,” were too expensive.

In an order that “recast” his earlier findings into a permanent injunction, U.S. District Court Judge Mark Walker instructed the department to screen and treat all inmates for hepatitis C. In his earlier preliminary injunction filed in late 2017, the department was required to treat prisoners by certain deadlines depending on the severity of the disease, but did not require treatment at the early stages.

PREVIOUS COVERAGE: Florida let Hepatitis C go untreated in prisons. Now it might cost taxpayers millions.

Hepatitis C is a viral infection that’s most often contracted through intravenous drug use, but it can also be transmitted through tattooing or blood transfusions. If it’s not treated, it can lead to liver infection, liver cancer, bleeding, bloating and a painful death.

Walker’s 68-page ruling will likely prove very costly to the state, which is now finalizing its budget in the last two weeks of the legislative session. The direct-acting antiviral drugs can cost tens of thousands of dollars per patient, and it’s estimated that at least 20,000 prisoners may have hepatitis C.

A press release by the Florida Justice Institute, which represented the three inmate plaintiffs, celebrated the win as a “victory for public health in Florida” that would save inmates from more preventable deaths. The institute noted that one of the three plaintiffs, Carl Hoffer, died waiting for a liver transplant as this case was pending.

Their chief lawyer, Randall Berg Jr., also died last week, according to the release.

Walker wrote that the department had made “progress” treating inmates within the past 15 months, but it doesn’t erase the past wrongs.

Department spokeswoman Michelle Glady said in a statement that they are “thoroughly” reviewing the order.

“The Florida Department of Corrections is committed to ensuring all inmates in our custody are provided medically necessary treatment that is in line with national standards and our constitutional responsibilities,” she said.

Julie Jones was secretary of the Department of Corrections until February, when she resigned. Gov. Ron DeSantis appointed Mark Inch to the position. The Department of Corrections uses a vendor to provide healthcare for about 100,000 inmates.

The order requires the department, starting in June, to file a monthly status report to the court that lists how many inmates have been screened for having hepatitis C, how many have it and at which stages, and how many are receiving treatment.