After examining the parties’ briefs and the record, we 

have concluded that oral argument is unnecessary. Thus, the

appeal is submitted on the briefs and the record. See FED. R.

APP. P. 34(a)(2)(C).

In the

United States Court of Appeals

For the Seventh Circuit

No. 11-2903

PETER POOLE III,

Plaintiff-Appellant,

v.

DEBBIE ISAACS, et al.,

Defendants-Appellees.

Appeal from the United States District Court 

for the Southern District of Illinois.

No. 09-1070-GPM—G. Patrick Murphy, Judge.

SUBMITTED NOVEMBER 29, 2012 —DECIDED DECEMBER 28, 2012 

Before EASTERBROOK, Chief Judge, and WOOD and

SYKES, Circuit Judges.

WOOD, Circuit Judge. Peter Poole, an Illinois prisoner,

firmly believes that a required $2 co-payment for

dental care furnished at the Big Muddy River Correctional Center violates his rights under the Eighth Amend-
2 No. 11-2903

ment to the federal Constitution. After a lengthy period

during which he refused to make the payment, he

finally capitulated and promptly received the necessary

care. Later, however, he filed this case under 42 U.S.C.

§ 1983 against several prison officials, asserting that

his constitutional rights had been violated. Poole’s complaint frivolously accuses the defendants of “committing

strong arm robbery” against a “captive market of inmates.”

After screening the complaint as required by 28 U.S.C.

§ 1915A, the district court dismissed Poole’s claims

against several defendants with prejudice, but it allowed

the action to proceed against Debbie Isaacs, the healthcare administrator at Big Muddy, because Poole alleged

that he “didn’t have any money” for the co-payment.

That allegation was false, and thus after discovery

the district court granted summary judgment for Isaacs.

Poole appeals.

Most of the material evidence presented with the summary judgment motions was undisputed. At the time

Poole was incarcerated at Big Muddy, he had serious

dental problems. He had a routine examination with

a dentist on September 17, 2007. Ordinarily he would

have had to wait two years for a new exam, but on July 29,

2008, he was examined by Dr. Malcharek, who is a

dentist employed by Wexford Health Services, a private

company that furnishes healthcare services at the

prison. Dr. Malcharek (who was not named as a defendant) noted from Poole’s dental chart that on an earlier

occasion a colleague had recommended extracting one

tooth and filling two others. Dr. Malcharek offered to

schedule those procedures, but Poole balked when

told that he first had to authorize withdrawal of the
No. 11-2903 3

$2 co-payment from his inmate trust account. Poole

complained to healthcare administrator Isaacs about the

need to pay; Isaacs was responsible for monitoring

Wexford’s compliance with administrative directives

governing medical care. In Poole’s opinion, the July 2008

visit should have been categorized as a follow-up to

the September 2007 appointment; if that were correct,

the 2008 visit would have been exempt from the co-payment requirement. See 730 ILCS 5/3-6-2(f) (2006). Issacs,

however, agreed with Dr. Malcharek that the 2008 visit

was not a follow-up and that payment was required.

Poole had more than enough money in his trust account

to cover that modest sum, but rather than pay, he

declined treatment and filed a grievance against Isaacs

and the Wexford dentists. By refusing to provide free

dental care, Poole argued, they had caused him to

suffer headaches as well as extreme tooth pain that

made eating difficult. His grievance was denied, and

the decision was upheld through both levels of administrative appeal.

The grievance process was complete in April 2009,

but after that, Poole restarted the cycle. In July 2009 he

was examined by Dr. Dennis Meyers, who agreed with

Dr. Malcharek that work needed to be done, and also

that it could not proceed without a co-payment. Poole

still had adequate funds in his trust account, but for

several months he continued stubbornly to maintain

that he was exempt from the co-payment. Finally, in

October 2009, he authorized the withdrawal of the $2

and received treatment.

Poole then sued. He named as defendants not only

Isaacs but also Wexford, the warden at Big Muddy, and
4 No. 11-2903

the director of the Department of Corrections. (Poole

also named Dr. Meyers but voluntarily dismissed him.)

The district court recruited counsel to assist Poole in

litigating his claim against Isaacs, but it dismissed the

other defendants because Poole failed to allege their

personal involvement in the alleged denial of care. Later

the district court granted summary judgment to Isaacs,

reasoning that the co-payment plan was not unconstitutional, and even if it was, Isaacs was entitled to qualified immunity because she acted reasonably given the

law at the time.

Under the regulation in force during the relevant

period, the Department of Corrections typically required

a $2 co-payment (now $5) from inmates whose trustfund balance was $2 or greater either at the time

medical services were provided or during the preceding

60 days (“or since arrival at the offender’s current

facility, whichever occurred most recently”). See 730 ILCS

5/3-6-2(f) (2006); 730 ILCS 5/3-6-2(f) (2010); ILL. ADMIN.

CODE, tit. 20, § 415.30(g)(3) (2007). Poole concedes

that he was able to pay that amount. He also seems to

acknowledge that the Eighth Amendment does not

compel prison administrators to provide cost-free

medical services to inmates who are able to contribute

to the cost of their care.

In fact, that proposition is by now well established.

In City of Revere v. Massachusetts General Hospital, 463 U.S.

239 (1983), the Supreme Court looked at one aspect of

the question. The specific issue before the Court was

whether a state entity (there a municipality) could be
No. 11-2903 5

compelled to reimburse the provider of emergency

medical services. The state supreme court held that the

answer was yes; otherwise, it feared, persons in police

custody might be denied necessary services in violation

of the Eighth Amendment. The Supreme Court began

by noting that the relevant constitutional provision for

this situation was the Due Process Clause, not the

Eighth Amendment. Ultimately it held that “as long as

the governmental entity ensures that the medical care

needed is in fact provided, the Constitution does not

dictate how the cost of that care should be allocated as

between the entity and the provider of the care.” 463

U.S. at 245. In a footnote, the Court reserved the

question now before us: “Nothing we say here affects

any right a hospital or governmental entity may have

to recover from a detainee the cost of the medical

services provided to him.” Id. n. 7.

Other courts have taken the next step, however. For

example, in Reynolds v. Wagner, 128 F.3d 166 (3d Cir.

1997), the Third Circuit squarely rejected the argument

that “a program that requires that inmates with

adequate resources pay a small portion of their medical

care” automatically violates the Constitution. Id. at 174;

accord, Tillman v. Lebanon Cnty. Corr. Facility, 221 F.3d

410, 418-19 (3d Cir. 2000). See also Shapley v. Nevada Bd. of

State Prison Comm’rs, 766 F.2d 404, 408 (9th Cir. 1985);

Negron v. Gillespie, 111 P.3d 556, 558-59 (Colo. Ct. App.

2005); Mourning v. Correctional Med. Servs., (CMS) of

St. Louis, Mo., 692 A.2d 529, 539 (N.J. App. Div. 1997). In

our view, these cases are well reasoned and consistent

with the general rationale of City of Revere. We thus join
6 No. 11-2903

our fellow courts in holding that the imposition of a

modest fee for medical services, standing alone, does

not violate the Constitution. To the extent that Poole is

arguing for some form of per se unconstitutionality, we

reject his position. And this is not a case in which the

required payment exceeds the inmate’s resources. In

fact, had Poole been truly indigent, he would have

been exempt from the requirement. The Illinois statute

contains a number of exemptions from the co-payment

requirement, including one for people with chronic

illnesses, one for follow-up visits, one for those meeting

the statute’s definition of indigency, and one for juvenile

offenders. 730 ILCS 5/3-6-2(f). We have no occasion

either to comment on these particular exemptions or to

speculate whether others might be needed. It is enough

to say that Poole was not deprived of dental services

for reasons beyond his control. 

Poole does, however, urge that he should have been

given the benefit of one of those exemptions: the one for

a follow-up visit ordered by a physician. But that is just

a state-law question that cannot be pursued under

§ 1983. E.g., Allison v. Snyder, 332 F.3d 1076, 1078-79 (7th

Cir. 2003) (citing Pennhurst State Sch. & Hosp. v. Halderman,

465 U.S. 89, 106 (1984)); McMullen v. Maple Shade Twp.,

643 F.3d 96, 101 (3d Cir. 2011).

Isaacs did not deny dental care for Poole, nor is she

to blame for the delay in treatment. Poole had sufficient

funds in his trust fund account but opted to refuse treatment rather than part with his money. Even though he

was in pain until he received treatment, the delay in
No. 11-2903 7

receiving care was of his own making. For that reason

the district court correctly ruled that Isaacs was entitled

to summary judgment in her favor and that Poole failed

to state a claim against the other defendants.

We have reviewed Poole’s remaining arguments, and

none has merit. Indeed, both the original lawsuit and

this appeal are so lacking in merit that they warrant the

imposition of two strikes under 28 U.S.C. § 1915(g). The

judgment of the district court is AFFIRMED.

12-28-12