Source: http://centerjd.org/content/faq-civil-justice-and-prison-health-care
Timestamp: 2019-04-26 01:51:53+00:00

Document:
Do sick and injured inmates have a right to health care while incarcerated?
Yes. The U.S. Supreme Court has long recognized that prisoners have a constitutional right to adequate health care through the Eighth Amendment’s ban on “cruel and unusual” punishment. To constitute an Eighth Amendment violation, prison personnel must act with “deliberate indifference to serious medical needs of prisoners.” However, like any patient, inmates have the right to be treated in a non-negligent manner. In other words, even if inadequate health care does not rise to the level of a constitutional violation, state negligence standards still may be violated. Enforcing these rights in court, however, can be very difficult for inmates.
How does a prisoner receive health care?
1) The prison is government-run, with the government providing health care.
2) The prison is government-run, with the government outsourcing health care to a private contractor. As reported by Prison Legal News, “Around 20 states outsource all or some of the medical services in their prison systems,”while the federal government outsources some aspects of health-care operations in its facilities.
3) The prison is corporate-run, with a private company operating the inmate health care system. As of 2013, private prisons held 19 percent of federal prisoners and 7 percent of state prisoners. This population is increasing. From 2000-2013, the number of state and federal prisoners in private prisons rose by more than 46 percent (from 90,815 in 2000 to 133,000 in 2013). When looking solely at federal prisoners in private prisons, the numbers more than doubled, going from 15,524 in 2000 to 41,159 in 2013.
Why would governments turn to private prison companies to provide health care services?
Cost Savings. State and federal budgets are being strained by the exploding prison populations. This rapid growth is often attributed to “a series of ‘get tough’ policies enacted in the 1980s and into the 1990s, such as truth in sentencing laws, mandatory minimums, mandatory drug sentences, life sentence without possibility of parole, and the three-strikes law.” Along with prison population growth comes the accompanying cost of providing health care for inmates (many of whom enter prison with chronic illnesses, infectious diseases and other health problems). In addition, the number of inmates over the age of 55 is rising, increasing 234 percent between 1999 to 2013. The cost to treat these patients is, on average, at least 2-3 times that of other inmates.
Outsourcing health care to private prison health care companies, which are predicated on a cost-cutting model to boost profits, may sound appealing to cash-strapped governments despite what it might mean for the quality of care provided. Some contracts require specific cuts in health care costs, such as the five-year contract between Florida’s Department of Corrections (FDOC) and Corizon, the nation’s largest for-profit prison health care provider, where the company agreed to provide the current quality of medical care to Florida state prisoners for 7 percent less than it cost the FDOC.
Can private health care be unsafe for prisoners?
Yes. Whether it is due to cost cutting or simple disregard for inmates’ well-being, health care for prisoners is often abysmal and can be deadly. This problem permeates every part of the country.
For example, from January 2013 through May 2014 in Illinois, there were “significant lapses in care” in an “unacceptably high” 60 percent of the cases in which state prisoners died of natural causes. This was the finding of an independent report submitted by medical experts in connection with a class action lawsuit that alleged unsafe medical care at the state’s prisons, care provided to roughly 50,000 inmates by Wexford Health under a 10-year, $1.36 billion contract. The report uncovered serious problems with treatment of ordinary illnesses, such as a doctor stopping a diabetic patient’s insulin treatment “after his blood sugar levels were found to be normal while he was on the insulin,” an inmate’s foot being amputated after a “grossly mismanaged” ulcer and a prisoner who was sent to the hospital two weeks after a “rapidly progressive paralysis of the lower half of his body,” leaving him in a wheelchair.
A recent investigation in Arizona uncovered “disturbing cases of inadequate treatment” by private prison health care companies Corizon and Wexford Health Sources in state prisons. According to a former Corizon patient care technician, staffing levels left dementia patients unfed, incontinent inmates sitting for hours in their own feces and other prisoners dead. In one case, a pregnant inmate in jail on drug charges was forced to have a cesarean delivery and quickly moved back to her cell where her wound re-opened. She alerted prison staff but was refused medical attention. When she was finally able to see medical staff two weeks later, they then treated her with a “wound vacuum” and table sugar – an antiquated treatment used before the invention of antibiotics.
What can a prisoner do legally if he or she has been provided unsafe health care?
Before harmed federal inmates can even file a lawsuit, they must first jump through administrative hurdles established by the Prisoners Reform Litigation Act (PLRA). Many states have passed versions of the PLRA, which similarly obstruct state court access. Once those obstacles are overcome, an inmate’s legal options depend on three main factors: 1) whether s/he is in local, state or federal prison; 2) whether the health care is provided by the government or a private company; and 3) the degree of harm inflicted.
What if an inmate is provided inadequate health care in a federal facility?
If the harms committed against the inmate do not rise to the level of a constitutional violation the inmate may still be able to bring a malpractice claim under the Federal Tort Claims Act (FTCA). The FTCA allows federal prisoners (without regard to citizenship status) assigned to publicly-run prison facilities to file a tort claim against the United States when a federal employee has injured them. Before a claim can be filed under the FTCA, the inmate must exhaust administrative remedies by first filing a complaint with the Bureau of Prisons. There are also strict limits on the kinds of damages they may recover.
Health care provided by a private company. If a federal inmate happens to be housed in a privately-run federal prison, or his or her health care is provided by a private contractor, his or her rights completely change. The Supreme Court has said that Bivens actions are not available to federal inmates in private prisons as long as state tort law provides an alternative remedy, irrespective of how sufficient that remedy may be. In addition, federal prisoners held at privately-run facilities cannot sue under the FTCA because contractors are not federal employees for purposes of the Act. However, as the Supreme Court has suggested, remedies against private companies may still be available under state tort law.
What if an inmate is provided inadequate health care in a state or local facility?
If a state or local inmate’s harm is caused by “deliberate indifference to a serious medical need,” this mistreatment may violate the U.S. Constitution’s Eighth Amendment prohibition against cruel and unusual punishment. In that case, inmates can pursue a civil rights action in federal court under 42 U.S.C Sec. 1983. While a state government cannot be sued under Section 1983, state and local officials can be sued. (If found liable, the state will usually indemnify their employee.) In addition, private health care contractors and their employees can be sued under Section 1983. In fact, a state official and private contractor may be jointly liable for causing harm.
If a claim does not rise to the level of a constitutional violation, a private prison official may be liable under state medical malpractice law. Cases against the state are more difficult because of sovereign immunity issues. Most states have some kind of state tort claims act modeled on the FTCA, waiving sovereign immunity to some extent and allowing some claims to proceed. However, these laws typically have administration requirements and contain liability limits.
What additional obstacles do prisoners face in accessing the civil justice system and what are the ramifications?
Because civil lawsuits may be the only means to hold private prison operators, private health care contractors and their employees and government officials accountable for providing dangerous medical care, the scarcity of lawsuits has likely led to even worse conditions. Lawsuits are often the only means for the public and government regulators to learn about unsafe medical practices in the nation’s prisons. This is especially true for private contractor-operated prisons, which, in contrast to government-run federal and state facilities, are under no obligation to be transparent about the level and quality of prisoner health care. Sometimes it takes repeated litigation and the accompanying publicity to push a legislature to act or force a government agency to implement stronger regulations, exercise greater oversight or terminate a prison health care contract.
 As the Court explained in Estelle v. Gamble, 429 U.S. 97 (1976), “An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical ‘torture or a lingering death,’ the evils of most immediate concern to the drafters of the Amendment. In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose”[case citation omitted]. This right was recently re-affirmed by the Court in Brown v. Plata, 131 S.Ct. 1910 (2011)(“Prisoners retain the essence of human dignity inherent in all persons. Respect for that dignity animates the Eighth Amendment prohibition against cruel and unusual punishment. ‘The basic concept underlying the Eighth Amendment is nothing less than the dignity of man.’ To incarcerate, society takes from prisoners the means to provide for their own needs. Prisoners are dependent on the State for food, clothing, and necessary medical care. A prison’s failure to provide sustenance for inmates ‘may actually produce physical ‘torture or a lingering death.’ Just as a prisoner may starve if not fed, he or she may suffer or die if not provided adequate medical care. A prison that deprives prisoners of basic sustenance, including adequate medical care, is incompatible with the concept of human dignity and has no place in civilized society”) [cases and book citation omitted].
 Greg Dober, “Corizon Needs a Checkup: Problems with Privatized Correctional Healthcare,” Prison Legal News, March 15, 2014, https://www.prisonlegalnews.org/news/2014/mar/15/corizon-needs-a-checkup-problems-with-privatized-correctional-healthcare/.
 Yana Kunichoff, “Private Prison Health-care Industry Grows as States Cut Costs, Bringing in Millions of Dollars,” Prison Legal News, May 15, 2012, https://www.prisonlegalnews.org/news/2012/may/15/private-prison-health-care-industry-grows-as-states-cut-costs-bringing-in-millions-of-dollars/.
 U.S. Department of Justice, Bureau of Justice Statistics, “Prisoners in 2013” (September 2014), http://www.bjs.gov/content/pub/pdf/p13.pdf.
 U.S. Department of Justice, Bureau of Justice Statistics, “Prisoners in 2011” (Appendix: Table 15) (December 2012), http://www.bjs.gov/content/pub/pdf/p11.pdf.
 U.S. Department of Justice, Bureau of Justice Statistics, “Prisoners in 2013” (Table 12) (September 2014), http://www.bjs.gov/content/pub/pdf/p13.pdf.
 See, e.g., Bill Cotterell, “Florida Prison System’s Problems Blamed on Budget Cuts.” Reuters, February 2, 2015, http://www.reuters.com/article/2015/02/03/us-usa-florida-prisons-idUSKBN0L706G20150203; PEW Charitable Trusts, “Managing Prison Health Care Spending,” May 15, 2014, http://www.pewtrusts.org/en/research-and-analysis/reports/2014/05/15/managing-prison-health-care-spending; Chris Kirkham, “Private Prison Corporation Offers Cash In Exchange For State Prisons,” Huffington Post, February 14, 2012, http://www.huffingtonpost.com/2012/02/14/private-prisons-buying-state-prisons_n_1272143.html.
http://www.pewtrusts.org/en/about/news-room/news/2014/10/03/prison-population-continues-to-age; PEW Charitable Trusts, “Managing Prison Health Care Spending,” May 15, 2014, http://www.pewtrusts.org/en/research-and-analysis/reports/2014/05/15/managing-prison-health-care-spending; Niraj Chokshi, “State Spending on Health Care is Exploding. Here is Why,” Washington Post Gov Beat Blog, October 30, 2013, http://www.washingtonpost.com/blogs/govbeat/wp/2013/10/30/state-spending-on-prison-health-care-is-exploding-heres-why/.
 PEW Charitable Trusts, “Managing Prison Health Care Spending,” May 15, 2014, http://www.pewtrusts.org/en/research-and-analysis/reports/2014/05/15/managing-prison-health-care-spending.
 PEW Charitable Trusts, “Prison Population Continues to Age,” October 3, 2014, http://www.pewtrusts.org/en/about/news-room/news/2014/10/03/prison-population-continues-to-age.
 See Gabrielle Canon, “Here’s the Latest Evidence of How Private Prisons Are Exploiting Inmates for Profit,” Mother Jones, June 17, 2015, http://www.motherjones.com/mojo/2015/06/private-prisons-profit; Greg Dober, “Corizon Needs a Checkup: Problems with Privatized Correctional Healthcare,” Prison Legal News, March 15, 2014, https://www.prisonlegalnews.org/news/2014/mar/15/corizon-needs-a-checkup-problems-with-privatized-correctional-healthcare/; Nicole Flatow, “How Private Prison Firms Use Quotas to Fill Cells and Coffers.” Think Progress, September 20, 2013. http://thinkprogress.org/justice/2013/09/20/2658701/private-prison-firms-quotas-cells-coffers/; In the Public Interest, Criminal: How Lockup Quotas and “Low-Crime Taxes” Guarantee Profits Guarantee Profits (September 2013), http://www.inthepublicinterest.org/wp-content/uploads/Criminal-Lockup-Quota-Report.pdf.
 Michael Sandler, “Illinois prison contractor paid $3.1 million to resolve complaints over five years,” Modern Healthcare, May 20, 2015, http://www.modernhealthcare.com/article/20150520/NEWS/150529989; Beth Kutscher, “Rumble over jailhouse healthcare,” Modern Healthcare, August 31, 2013, http://www.modernhealthcare.com/article/20130831/MAGAZINE/308319891.
 David Royse, “Medical battle behind bars: Big prison healthcare firm Corizon struggles to win contracts,” Modern Healthcare, April 11, 2015, http://www.modernhealthcare.com/article/20150411/MAGAZINE/304119981.
 See, e.g., Bruce Rushton, “Horrific health care: In Illinois prisons, getting sick can be a death sentence,” Illinois Times, June 25, 2015, http://illinoistimes.com/article-15777-horrific-health-care.html; Beth Kutscher, “Rumble over jailhouse healthcare,” Modern Healthcare, August 31, 2013, http://www.modernhealthcare.com/article/20130831/MAGAZINE/308319891; Thomas Prohaska, “Niagara County to privatize jail medical services,” Buffalo News, September 17, 2012, http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20120917/CITYANDREGION/120919216/1010.
 See, e.g., Bruce Rushton, “Horrific health care: In Illinois prisons, getting sick can be a death sentence,” Illinois Times, June 25, 2015, http://illinoistimes.com/article-15777-horrific-health-care.html.
 “Warning of Poor Prison Care Deserves Closer Look,” Chicago Sun-Times, June 7, 2015, http://chicago.suntimes.com/opinion/7/71/666351/editorial-warning-prison-health-care-needs-closer-look; Jason Meisner, “Independent Experts Blast Quality of Medical Care in Illinois Prisons,” Chicago Tribune, May 19, 2015, http://www.chicagotribune.com/news/ct-illinois-prison-medical-care-met-20150519-story.html.
 Jason Meisner, “Independent Experts Blast Quality of Medical Care in Illinois Prisons,” Chicago Tribune, May 19, 2015, http://www.chicagotribune.com/news/ct-illinois-prison-medical-care-met-20150519-story.html.
Al Jazeera America, May 28, 2014, http://america.aljazeera.com/watch/shows/america-tonight/articles/2014/5/27/whistleblower-arizonainmatesaredyingfrominadequatehealthcare.html.
 Pat Beall, “Privatizing prison healthcare leaves inmates in pain, sometimes dying,” Palm Beach Post, September 26, 2014, http://www.mypalmbeachpost.com/news/news/privatized-prison-health-care-in-florida-deadly-pa/nhWkX/.
 Dan Christensen, “Florida Prison Healthcare Providers Sued Hundreds of Times,” Miami Herald, October 2, 2013, http://www.miamiherald.com/news/state/article1955813.html.
 Michael Winerip and Michael Schwirtz, “New York City to End Contract With Rikers Health Care Provider,” New York Times, June 20, 2015, http://www.nytimes.com/2015/06/11/nyregion/report-details-failings-of-corizon-rikers-island-health-provider.html.
 SeeAELE Law Enforcement Legal Center, “Prison Litigation Reform Act: Similar State Laws,” http://www.aele.org/law/Digests/jail187.html(viewed July 2, 2015). See, e.g., 42 Pa.C.S.A. §6601; WI Stat §814.25; Texas Inmate Litigation Act, V.T.C.A. Civil Practice & Remedies Code Secs. 14.002(a) and 14.005(a, b); MCL 600.5507(Michigan). See also, Sasha Volokh, “Suing public and private prisons: the role of the Prison Litigation Reform Act,” Washington Post, February 20, 2014, https://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/02/20/suing-public-and-private-prisons-the-role-of-the-prison-litigation-reform-act/.
 See, e.g., Sasha Volokh, “The Surprising Truth About Suing Private Prisons,” Washington Post, February 19, 2014, http://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/02/19/the-surprising-truth-about-suing-private-prisons/; ACLU National Prison Project, “Know Your Rights: Medical, Dental, and Mental Health Care” (July 2012), https://www.aclu.org/files/assets/know_your_rights_--_medical_mental_health_and_dental_july_2012.pdf; Center for Constitutional Rights and The National Lawyers Guild, “Section 1983 Lawsuits” and “Federal Tort Claims Act (FTCA),” Jailhouse Lawyer’s Handbook (2010), http://jailhouselaw.org/section-1983-lawsuits/ and http://jailhouselaw.org/federal-torts-claims-act/, respectively; Columbia Human Rights Law Review, “Your Right to Adequate Medical Care,” A Jailhouse Lawyer’s Manual ((2009), http://www3.law.columbia.edu/hrlr/jlm/Chapter_23.pdf. See also, Minneci v. Pollard, 132 S. Ct. 617 (2012).
 ACLU National Prison Project, “Know Your Rights: Medical, Dental, and Mental Health Care” (July 2012), https://www.aclu.org/files/assets/know_your_rights_--_medical_mental_health_and_dental_july_2012.pdf.
 Bivens v. Six Unknown Named Agents of Federal Bureau of Narcotics, 403 U.S. 388 (1971).
Estelle v. Gamble, 429 U.S. 97 (1976). See also, Carlson v. Green, 446 U.S. 14 (1980).
 Farmer v. Brennan, 511 U.S. 825 (1994). See also, Center for Constitutional Rights and The National Lawyers Guild, “BivensActions & Federal Injunctions,” Jailhouse Lawyer’s Handbook (2010), http://jailhouselaw.org/bivens-actions-federal-injunctions/.
 See 28 U.S.C. Sec. 1346(b), 1402(b), 2401(b), 2671-2680.
 Center for Constitutional Rights and The National Lawyers Guild, “Federal Tort Claims Act (FTCA),” Jailhouse Lawyer’s Handbook (2010), http://jailhouselaw.org/federal-torts-claims-act/.
 Sasha Volokh, “The Surprising Truth About Suing Private Prisons,”Washington Post, February 19, 2014, http://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/02/19/the-surprising-truth-about-suing-private-prisons/.
 Minneci v. Pollard, 132 S. Ct. 617 (2012).
9 AELE Mo. L. J. 301 (September 2007), http://www.aele.org/law/2007JBSEP/2007-09MLJ301.pdf.
 See, e.g.,Nick Daum, “Section 1983, Statutes, and Sovereign Immunity,”112 Yale L.J. 353 (2002), http://www.yalelawjournal.org/comment/section-1983-statutes-and-sovereign-immunity.
 See, e.g., Memorandum and Order, Fox v. Barneset al, No. 09 C 5453(N.D. Ill. May 15, 2013); Bruce Rushton, “Horrific health care: In Illinois prisons, getting sick can be a death sentence,” Illinois Times, June 25, 2015, http://illinoistimes.com/article-15777-horrific-health-care.html.
 See National Conference of State Legislatures, “State Sovereign Immunity and Tort Liability,” http://www.ncsl.org/research/transportation/state-sovereign-immunity-and-tort-liability.aspx.
 Wren Abbott, “Incarcerated Care; Prisoners find little recourse for health care complaints,” Santa Fe Reporter, March 2, 2011, http://www.sfreporter.com/santafe/article-5946-incarcerated-care.html.
 Bruce Rushton, “Horrific health care; In Illinois prisons, getting sick can be a death sentence,” Illinois Times June 25, 2015, http://illinoistimes.com/article-15777-horrific-health-care.html.
 Citizens for Responsibility and Ethics in Washington, “New CREW Report Calls for More Disclosure from Private Prison Profiteers,” February 18, 2014, http://www.citizensforethics.org/press/entry/report-calls-for-foia-disclosure-from-private-prison-profiteers; Matt Stroud, “Private Prisons Are Exempted From Federal Disclosure Laws,” Forbes.com, February 7, 2013, http://www.forbes.com/sites/mattstroud/2013/02/07/private-prisons-are-exempted-from-federal-disclosure-laws-advocates-say-that-should-change/.
 For recent examples that illustrate the importance of civil lawsuits, see David Royse, “Medical battle behind bars: Big prison healthcare firm Corizon struggles to win contracts,” Modern Healthcare, April 11, 2015, http://www.modernhealthcare.com/article/20150411/MAGAZINE/304119981; Dara Kam, “Florida prisons chief to seek revamp of health care contracts,” News Service of Florida, February 20, 2015, http://www.tampabay.com/news/politics/stateroundup/florida-prisons-chief-to-seek-revamp-of-health-care-contracts/2218522; Craig Harris, “Judge approves Arizona inmate health-care settlement,” Arizona Republic, February 19, 2015, http://www.azcentral.com/story/news/local/arizona/2015/02/19/judge-approves-arizona-inmate-health-care-settlement/23657207/; Carimah Townes, “Largest Wrongful Death Settlement In California History For Inmate Who Didn’t Get Proper Treatment,” ThinkProgress, February 11, 2015, http://thinkprogress.org/justice/2015/02/11/3621551/corizon-wont-get-away-with-medical-neglect-in-california/; American Civil Liberties Union, “ACLU Urges D.C. Council to Oppose Corizon Contract,” December 16, 2014, http://aclu-nca.org/news/aclu-urges-dc-council-to-oppose-corizon-contract, citing Dan Christensen, “Florida prison officials didn’t ask, companies didn’t tell about hundreds of malpractice cases,” BrowardBulldog.org, October 2, 2013, http://www.browardbulldog.org/tag/wexford-health/; Dani Kass, “Settlement reached in Fluvanna women’s prison health care lawsuit,” Daily Progress, November 29, 2014, http://www.dailyprogress.com/news/local/settlement-reached-in-fluvanna-women-s-prison-health-care-lawsuit/article_46896b32-7811-11e4-9a5d-2f625656c65a.html; Aviva Shen, “Doctors Say Arizona Prisons Mocked Sick Inmates, Left Stroke Victims In Soiled Diapers For Weeks,” ThinkProgress, September 11, 2014, http://thinkprogress.org/health/2014/09/11/3566347/doctors-arizona-prison-health-care-abuse/.

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