Healthcare for Prisoner’s Legal Rights and the COVID-19 Impact


Just over an hour-and-a-half drive from New York City, depending on traffic, a medium-security federal correctional institution released a notorious but nonviolent inmate in late May 2020. In 2018, the former personal lawyer of the nation’s then-current president, Michael Cohen, received a three-year sentence after pleading guilty to various political and financial offenses, contravening campaign finance laws and lying to the US Congress. The Otisville correctional facility at which he was serving his sentence released him early due to the COVID-19 outbreak that was then ravaging the state, including in penal institutions. 

What happened with Cohen was not an isolated incident. In federal correctional facilities throughout the country, the Justice Department allowed over 23,800 inmates to serve the balance of their time in home detention because of the pandemic. Detention facilities had to look more closely at how they provided healthcare to inmates, with many correctional facilities deciding to release thousands of nonviolent prisoners early. Behind these releases were a couple of cases that came before the US Supreme Court concerning healthcare for prisoners, legal rights for those who encouraged these early releases.  

Legal Access to Medical Care for Prisoners
About 2.3 million people are held in various local, state and federal correctional or other detention facilities throughout the United States, more per capita than any other nation in the world. While incarcerated, the facilities in which these people are held have certain obligations to care for those they incarcerate, including providing healthcare for prisoners. Legal rights to medical care for prisoners have been cemented as constitutional rights in the last half-century, especially due to two cases decided in the US Supreme Court.

Estelle v. Gamble
In 1973, a several-hundred-pound cotton bale fell on a prisoner on a work assignment in Texas, J. W. Gamble. Though Gamble continued working for several more hours, he later requested a pass to the unit’s hospital, who checked for a hernia before sending him back to his cell. When his pain increased, he returned to the hospital, where a nurse gave him two pain pills. The next day, a different doctor prescribed him painkillers and confined Gamble mostly to his cell, though later concluded he could engage in light work. 

Prison administrators later placed Gamble in “administrative segregation” – effectively solitary confinement – when he refused to work because of intense back pain. Over the course of the next few months, prison staff repeatedly disciplined him for not working, though doctors only diagnosed him with high blood pressure. When Gamble began to experience chest pains regularly, the prison treated and hospitalized him, but refused further medical care after treating him on a total of 17 occasions. 

In February 1974, Gamble signed a complaint that alleged the prison subjected him to cruel and unusual punishment, which is banned by the Eighth Amendment and applies to all states due to the Fourteenth Amendment. Though a district court dismissed his claim, the Fifth Circuit of the US Court of Appeals reversed this, stating that the prison had failed to diagnose Gamble’s back injury by not giving him an x-ray, providing him no real treatment while keeping him in solitary confinement. 

Gamble Supreme Court Decision
While the US Supreme Court decided in an 8-1 decision in 1974 that Gamble’s treatment did not constitute cruel and unusual punishment, Justice Thurgood Marshall acknowledged that under the Eighth and Fourteenth Amendments that the Texas government must provide healthcare for prisoners, legal rights that were then made constitutionally relevant due to this decision. Unfortunately for Gamble, the Court also decided these breaches by the prison were inadvertent, though the case established that deliberate failure to provide medical care to inmates violated their civil rights against cruel and unusual punishment.  

Helling v. McKinney
More directly relevant to the coronavirus pandemic is the establishment of legal responsibility for correctional facilities not to expose inmates to conditions that could endanger their future health. In 1993, the Supreme Court extended requirements concerning healthcare for prisoners. Legal rights were established when William McKinney, a prisoner in Nevada whose cellmate smoked five packs per day, asked to be housed in an environment free from second-hand smoke. 

McKinney Supreme Court Decision
Though McKinney suffered no deleterious effects, the Supreme Court found 7-2 that the claims of damage to his future health had merit, raising a valid Eighth Amendment claim. Justice Byron White, when writing this decision, rejected the government’s argument and found that prisons’ responsibilities applied to healthcare beyond current medical conditions. The decision also found that deliberate indifference was shown towards McKinney by allowing him to be exposed to second-hand smoke, which posed a serious threat to his future health. By ignoring this threat to McKinney’s health, the prison showed deliberate indifference to his health, thus entitling McKinney to relief even though no ailments resulted from the prison’s inaction. 

Legal Rights to COVID-19 Treatment
These two decisions confirmed that penal institutions’ responsibilities extended beyond just providing healthcare, for prisoners’ legal rights also included keeping them safe from unhealthy conditions. This brings us back to the coronavirus pandemic. 

The first case of COVID-19 at the Riker’s Island detention facility happened in mid-March 2020. Within two weeks, doctors diagnosed more than 200 people in New York City’s main jail complex with the disease, despite trying to control the extent of infections. Many other jails and prisons across the country reported similar outbreaks among both inmates and staff.  

Release of Prisoners Due to COVID-19
As infrastructure in detention facilities keeps inmates from adequately social distancing from each other or prison staff, detainees were inevitably at higher risk of exposure. To contain the disease, many state and local correctional facilities around the country released prisoners, with populations dropping by 170,000 in the spring of 2020, according to a Reuters survey.

In March 2020, a Washington sheriff stopped imprisoning people charged with most nonviolent misdemeanors, dropping the population in detention by a third. Wisconsin’s Dane County also saw a similar decline of over 34% in its jail population from February to mid-May 2020. New York City too accelerated efforts to find alternatives to imprisonment for those in Rikers serving time for minor offenses like disorderly conduct, drug possession, petty theft or trespassing. Los Angeles County even put a measure on November 2020 ballots, which passed, to support programs that provided alternatives to incarceration, including employment and mental health services

The Bail System
Advocates have long lobbied for bail reform, but the pandemic made the judicial system focus on the bail system nationwide. Nearly half a million people awaiting trial – who according to the US Constitution are presumed innocent – sit in jails because they cannot afford to pay bail. This is about two-thirds of the total jail population. 

One factor driving this is the commercialization of the country’s bail system. The American Bar Association (ABA) condemns the current bail system for discriminating against those unable to pay, which disproportionately affects certain minorities and penalizes the poor. Both the International Association of Chiefs of Police and the National Association of Counties have asked for alternatives. Many jails throughout the country saw substantial population drops, due in part to temporary changes concerning bail. 

Denied Healthcare
Certain detention facilities did not release prisoners and saw significant coronavirus outbreaks. Georgia’s Clayton County Detention Center received complaints from inmates in the spring of 2020 regarding overcrowding, unsanitary conditions and mask shortages, resulting in a class-action lawsuit filed by the Southern Center for Human Rights (SCHR) and the American Civil Liberties Union (ACLU). 

The lawsuit accused the sheriff of contributing to the outbreak, which resulted in over a hundred inmates testing positive by May 2020. This included a 72-year-old inmate who exhibited shortness of breath and headaches, common symptoms of coronavirus infection, but who stated in sworn testimony that the prison never administered a COVID-19 test nor did he see a doctor. Though he survived, another inmate died in June 2020.

How Laufer Law Group Can Help
Our experienced lawyers can help if you or someone you love has concerns about access to healthcare for prisoners, legal rights regarding medical care or threats to health during incarceration. The Laufer Law Group can also assist by urging the court to allow a personal recognizance bond due to healthcare concerns for those awaiting trial. Please contact the Laufer Law Group for more information so that we can establish whether your civil rights have been violated and seek compensation for you according to the law.

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