Opinion ID: 2650096
Heading Depth: 2
Heading Rank: 2

Heading: Morris’s Substantive Constitutional Claims

Text: Morris asserts that the health care services fee violates the Eighth Amendment’s ban on cruel and unusual punishment. We construe his claim as asserting that he is being denied medical care, or in the alternative, that the fee requires him to decide between obtaining medical care or basic necessities. We conclude that his complaint does not state sufficient facts to support an Eighth Amendment claim under either theory of relief. Since “[p]rison walls do not form a barrier separating prison inmates from the protections of the Constitution,” the “federal courts must take cognizance of the valid constitutional claims of prison inmates.” Turner v. Safley, 482 U.S. 78, 84 (1987). “The Eighth Amendment, which applies to the States through the Due Process Clause of the Fourteenth Amendment, prohibits the infliction of ‘cruel and unusual punishments’ on those convicted 9 Case: 12-50848 Document: 00512495684 Page: 10 Date Filed: 01/10/2014 No. 12-50848 of crimes.” Wilson v. Seiter, 501 U.S. 294, 296–97 (1991) (internal citation omitted). In Estelle v. Gamble, 429 U.S. 97 (1976), the Supreme Court explained that the principles behind the Eighth Amendment “establish the government’s obligation to provide medical care for those whom it is punishing by incarceration.” Id. at 103; see also Wilson, 501 U.S. at 297. In City of Revere v. Massachusetts General Hospital, 463 U.S. 239 (1983), the Court considered whether the Constitution affects the allocation of costs for medical care. 6 The Court explained 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. That is a matter of state law.” Id. at 245. The Court stated that “[n]othing 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. at n.7. From this, the lower courts have concluded that there is “no general constitutional right to free health care.” Reynolds v. Wagner, 128 F.3d 166, 173 (3d Cir. 1997); see Poole v. Isaacs, 703 F.3d 1024, 1026 (7th Cir. 2012) (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”); Bihms v. Klevenhagen, 928 F. Supp. 6 In City of Revere, police officers shot and wounded a suspect, whom they brought to Massachusetts General Hospital’s (“MGH”) emergency room for medical treatment. 463 U.S. at 240–41. MGH sent the Chief of Police of Revere a bill for the cost of the medical services it rendered the suspect, and subsequently sued Revere in state court to recover on the unpaid bill. Id. at 241. The Massachusetts Supreme Judicial Court had held that the Eighth Amendment required that “Revere be liable to the hospital for the medical services rendered.” Id. The Supreme Court reversed, explaining that “the injured detainee’s constitutional right is to receive the needed medical treatment; how the city of Revere obtains such treatment is not a federal constitutional question.” Id. at 245. Even though City of Revere concerned a pretrial detainee’s due process rights, the Court noted that “the due process rights of a person in [the wounded suspect’s] situation are at least as great as the Eighth Amendment protections available to a convicted prisoner.” Id. at 244. 10 Case: 12-50848 Document: 00512495684 Page: 11 Date Filed: 01/10/2014 No. 12-50848 717, 718 (S.D. Tex. 1996) (“As [plaintiff] was obliged to pay court costs, he may be obliged to pay his medical costs.”). In the medical context, “to state a cognizable [Eighth Amendment] claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. It is only such indifference that can offend ‘evolving standards of decency’ in violation of the Eighth Amendment.” 7 Estelle, 429 U.S. at 106. Since Estelle said that “only the ‘unnecessary and wanton infliction of pain’ implicates the Eighth Amendment, a prisoner advancing such a claim must, at a minimum, allege ‘deliberate indifference’ to his ‘serious’ medical needs.” Wilson, 501 U.S. at 297 (internal citation omitted). The Court explains the test as follows: [A] prison official violates the Eighth Amendment only when two requirements are met. First, the deprivation alleged must be, objectively, “sufficiently serious”; a prison official’s act or omission must result in the denial of “the minimal civilized measure of life’s necessities”[.] . . . The second requirement follows from the principle that “only the unnecessary and wanton infliction of pain implicates the Eighth Amendment.” To violate the Cruel and Unusual Punishments Clause, a prison official must have a “sufficiently culpable state of mind.” In prison-conditions cases that state of mind is one of “deliberate indifference” to inmate health or safety . . . . Farmer v. Brennan, 511 U.S. 825, 834 (1994) (internal citations omitted). We conclude that Morris has not alleged facts that exhibit deliberate indifference. “[T]he deliberate indifference standard of Estelle does not 7 The Supreme Court endorsed the use of the deliberate indifference test for Eighth Amendment challenges in prison conditions cases in Wilson, 501 U.S. at 297, and other courts considering prison medical copayment statutes and policies have likewise applied a deliberate indifference analysis. See Reynolds, 128 F.3d at 174; Shapley v. Nev. Bd. of State Prison Comm’rs, 766 F.2d 404, 408 (9th Cir. 1984) (“The complaint alleges no facts which the court could construe as deliberate indifference under Estelle[, 429 U.S. at 106–07].”); Breakiron v. Neal, 166 F. Supp. 2d 1110, 1116 (N.D. Tex. 2001) (“Deducting payments from [prisoner’s] inmate trust account does not of itself exhibit deliberate indifference by [defendant].”). 11 Case: 12-50848 Document: 00512495684 Page: 12 Date Filed: 01/10/2014 No. 12-50848 guarantee prisoners the right to be entirely free from the cost considerations that figure in the medical-care decisions made by most non-prisoners in our society.” Wagner, 128 F.3d at 175; see also Farrakhan v. Johnson, 2009 WL 1360864, at  (E.D. Va. May 13, 2009) (unpublished) (“Inmates are not entitled to free medical care, and an inmate’s displeasure at having to pay such co-payment does not present a constitutional claim.”). Morris has not alleged that he is denied medical care. He also has not pled sufficient facts to show that the health care services fee acts as a functional denial of medical care, by requiring him to obtain either medical care or basic necessities. The Eighth Amendment requires prison officials to provide inmates with “adequate food, clothing, shelter, and medical care.” Farmer, 511 U.S. at 832. Although Morris alleges that “TDCJ does not provide all hyg[ie]ne necessities,” he does not identify any necessities, hygienic or otherwise, that he is denied. His assertion that he should be permitted a “modest balance” in his trust fund account “to buy the simple personal commodities like toiletries available at the commissary” is similarly unavailing. See Shapley, 766 F.2d at 408 (“Pro se complaints must be liberally construed, but [plaintiff] alleges no facts revealing how the $3 fee requirement affected him.” (citation omitted)). Thus, while we are cognizant of the concern expressed in Collins v. Romer, 962 F.2d 1508 (10th Cir. 1992), that a statute not “force[] the Plaintiffs to choose between basic medical care or basic hygiene necessities,” id. at 1510– 11, Morris has not alleged that he faced any such choice. See also Wagner, 128 F.3d at 178 (“It is apparent that the Berks County Prison Program does not force inmates to choose between necessary medical care and other essentials.”). 12 Case: 12-50848 Document: 00512495684 Page: 13 Date Filed: 01/10/2014 No. 12-50848 Accordingly, Morris fails to allege that any deprivation is sufficiently serious to constitute deliberate indifference. See Iqbal, 556 U.S. at 678. 8 Importantly, § 501.063 provides that TDCJ will not deny any inmate medical care because of an inmate’s inability to pay. Tex. Gov’t Code § 501.063(c). As in Wagner, the program here “does not ‘condition the provision of needed medical services on an inmate’s ability to pay.’ Under the program, no inmate is ever denied medical care for lack of money.” 128 F.3d at 174; see also Breakiron, 166 F. Supp. 2d at 1116 (“[Plaintiff] has not alleged, moreover, that he was denied medical treatment because of any inability to pay for the medical treatment.”); McCall v. Johnson Cnty. Sheriff’s Dep’t, 71 F. App’x 30, 31 (10th Cir. 2003) (unpublished) (“It is clearly constitutionally acceptable to charge inmates a small fee for health care where, as here, indigent inmates are guaranteed service regardless of ability to pay. Despite [plaintiff’s] claim, it appears that penurious prisoners have a debit placed on their prison account balance. As such, [plaintiff] does not allege that he was denied access to medical care due to any inability to satisfy the copayment requirement . . . .”). As noted, Morris does not allege that he was denied access to medical care because of his inability to pay the fee, or that provision of medical care was delayed as a result of his inability to pay. Rather, he admitted in his objection to the report and recommendation that his account was debited a $100 fee in November 2011, and that he was provided with medical care. Moreover, § 501.063 creates a system under which only fifty percent of the monies deposited into the trust fund accounts of indigent inmates are credited against any negative balance. See Tex. Gov’t Code § 501.063(a)(3). 8Because Morris fails to allege the denial of medical care or the forced choice between medical care and basic necessities, we are not called upon to determine which specific items may constitute basic necessities for purposes of the Eighth Amendment. 13 Case: 12-50848 Document: 00512495684 Page: 14 Date Filed: 01/10/2014 No. 12-50848 The other fifty percent remains available for an inmate’s use for other means, such as to pay court fees or purchase items from the commissary. Finally, for the same reasons we outline above, “[t]o the extent that [defendant] is arguing for some form of per se unconstitutionality, we reject his position.” Poole, 703 F.3d at 1027; see also Breakiron, 166 F. Supp. 2d at 1115– 1116 (“Charging inmates for medical care, furthermore, is not per se unconstitutional. . . . Deducting payments from a prison trust account does not of itself violate the Eighth Amendment’s prohibition against cruel and unusual punishment.”); McCall, 71 F. App’x at 31; Bihms, 928 F. Supp. at 729. 9 We are not persuaded by the statement in Department of Corrections v. Sisters of St. Francis, 836 S.W.2d 719, 725 (Tex. App.—Hous. [1st Dist.] 1992, no writ), that “[t]he right of an incarcerated prisoner to free medical care is recognized both under Texas statute and under the United States Constitution.” The court cites Estelle for this proposition, but Estelle offers no support, simply stating that the Eighth Amendment requires the government “to provide medical care for those whom it is punishing by incarceration.” 429 U.S. at 103. Additionally, Sisters of St. Francis did not concern copayment obligations by inmates (or even an Eighth Amendment challenge), but the State’s liability to a private medical facility that provided care for an inmate on emergency medical reprieve. For these reasons, we find the Sisters of St. Francis court’s statement about prisoner access to medical care inapplicable. 9Morris also argues that the district court applied the wrong standard of review in using Turner, 482 U.S. at 89. We are doubtful that the legitimate penological interest test from Turner applies here, since Turner concerned a prison regulation, not a statute, and dealt with impingement on inmates’ First Amendment rights, not with Eighth Amendment issues. However, even if the test applies, we conclude that § 501.063 is related to a legitimate penological interest because the statute seeks to control the prison budget, and we have recognized that budgetary considerations may be a valid penological concern. See Moussazadeh v. Tex. Dep’t of Crim. Justice, 703 F.3d 781, 795 (5th Cir. 2012); Baranowski v. Hart, 486 F.3d 112, 122 (5th Cir. 2007). 14 Case: 12-50848 Document: 00512495684 Page: 15 Date Filed: 01/10/2014 No. 12-50848 The fact that the prison regulations and statutes analyzed by other courts in similar cases impose smaller fees than that in § 501.063 is not dispositive. All inmates are guaranteed medical care regardless of ability to pay, and half of all deposits into inmates’ trust fund accounts is reserved for their use, even if there is a negative balance due to payment of a health care services fee. Further, Morris has not adequately alleged that he is forced to choose between paying for medical care and paying for basic necessities. We conclude that Morris has not pled an Eighth Amendment violation.
Morris next argues that the district court erred in denying him relief on his procedural due process claim. “To state a Fourteenth Amendment due process claim under § 1983, a plaintiff must first identify a protected life, liberty or property interest and then prove that governmental action resulted in a deprivation of that interest.” Gentilello v. Rege, 627 F.3d 540, 544 (5th Cir. 2010) (internal quotation marks and citation omitted). In procedural due process claims, “the deprivation by state action of a constitutionally protected interest in life, liberty, or property is not in itself unconstitutional; what is unconstitutional is the deprivation of such an interest without due process of law.” Zinermon v. Burch, 494 U.S. 113, 125 (1990) (internal quotation marks omitted). A government decision depriving an individual of his right to “life, liberty or property” must, at a minimum, be preceded by notice and an opportunity for the individual to be heard. Mullane v. Cent. Hanover Bank & Trust Co., 339 U.S. 306, 313 (1950). We assume arguendo that inmates have a protected property interest in the funds in their prison trust fund accounts, entitling them to due process with respect to any deprivation of these funds. Rosin v. Thaler, 417 F. App’x 15 Case: 12-50848 Document: 00512495684 Page: 16 Date Filed: 01/10/2014 No. 12-50848 432, 434 (5th Cir. 2011) (per curiam) (unpublished); see Eubanks v. McCotter, 802 F.2d 790, 793 (5th Cir. 1986). 10 Morris argues that the notice was inadequate, and he also seems to argue that the prison provides inadequate post-deprivation process for challenging incorrect fee assessments. Specifically, Morris contends that TDCJ staff do not give notice to prisoners “at each visit,” and he argues that the posted notice is inaccurate because it states that inmates “will not be charged” for certain health care visits, even though § 501.063 does not contain any exemptions. Importantly, Morris’s attack is on the statute itself: his claim is that § 501.063 is unconstitutional. He does not attack the regulation that the prison adopted, AD-06.08, or the regulation’s effect on him. 11 As such, the regulation is relevant to this appeal only insofar as Morris’s complaint about notice implicates the regulation. We conclude that the notice provided was constitutionally adequate. Morris admitted that TDCJ posted notices about the statute in the prison. The notice informs inmates that under § 501.063, inmates will be charged a $100 fee for health care visits effective September 2011, which “covers all health care visits that you request for one year.” AD-06.08, which TDCJ promulgated the following March, includes additional provisions for notice to offenders. 12 10See also Breakiron, 166 F. Supp. 2d at 1114; Abdullah v. State, 211 S.W.3d 938, 943 (Tex. App.—Texarkana 2007, no pet.); Wagner, 128 F.3d at 179; Mahers v. Halford, 76 F.3d 951, 954 (8th Cir. 1996); Quick v. Jones, 754 F.2d 1521, 1523 (9th Cir. 1985). 11Morris did not amend his complaint to add a claim challenging the prison regulation as applied. 12 Specifically, AD-06.08 provides: