8th amendment
oddly absent 1219
equal protection?
not nec nsa but interesting to check:
https://www.alternet.org/2019/12/how-some-alabama-county-sheriffs-force-their-inmates-into-medical-debt
no lnx
How some Alabama county sheriffs force their inmates into medical debt
Written by ProPublica December 26, 2019
This article was produced in partnership with AL.com, which is a member of the ProPublica Local Reporting Network.
In Alabama, the county in which you’re arrested could be the deciding factor in who will be financially responsible for your medical bills behind bars.
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In Baldwin County, known for its white-sand Gulf Coast beaches and waterfront communities, the sheriff’s office ensures that inmates in the county jail do not have to pay anything more than a $15 copayment for medical care.
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“Inmates are not billed for the full cost of any medical care either inside or outside” the jail, Sheriff Hoss Mack said in an email. “Alabama Code Title 14 assigns financial responsibility of inmates’ medical treatment to the department where they are being held.”
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Just across the bay in Mobile County, home to one of the busiest ports in the U.S. and the eponymous city of nearly 200,000 people built around it, Sheriff Sam Cochran takes a different tack: Some of his inmates are personally on the hook for the full cost of medically necessary care they receive from outside doctors while incarcerated, even if they are awaiting trial.
The difference between the two sheriffs’ approaches demonstrates the unique power Alabama sheriffs have to set their own rules and answer only to voters.Legal experts and civil rights advocates say sheriffs like Cochran are likely violating both state law and the Eighth Amendment of the U.S. Constitution, which prohibits cruel and unusual punishment and excessive fines.
It’s not just happening in Mobile County. In multiple instances confirmed by AL.com and ProPublica, inmates have had medical bills sent to collections while they were still behind bars, damaging their credit and putting pressure on their family members to pay up to ensure the care continued.
Brandon DeLaFosse is among them. He was arrested on domestic violence, burglary and robbery charges and booked into the Mobile County Metro Jail in November 2018, three months after he underwent surgery on his inner ear. Since then, he has received bills totaling thousands of dollars for necessary follow-up appointments and tests, some of which have gone to collections while he remains behind bars.
“He keeps getting bills in the mail,” said Alicia DeLaFosse, Brandon’s mother, who has paid hundreds of dollars for care he has received while in custody. “It’s all money he owes from going back and forth to the doctor.”
Like many inmates, DeLaFosse doesn’t have significant income or access to public or private insurance in jail.
Alabama law is clear: If an “inmate develops a medical condition which requires immediate treatment at a medical-care facility outside the county jail, the department shall be financially responsible for the cost of the treatment of the inmate.”
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But Cochran said when the jail’s doctors determine inmates need care that goes beyond what in-house medical staff and contracted outpatient providers can handle, they are often taken to private medical professionals who do not have contracts with the jail. And he allows those medical providers to bill at least some of those inmates directly.
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Most jails and prisons across Alabama and the U.S. either have doctors and nurses on staff or contract with outside companies to provide medical care in their lockups. It’s not uncommon for inmates to be charged low copays — typically less than $20 — for medications and medical services.
But requiring inmates to foot the bill for their health care takes that practice to another level.
That’s “like charging them for their own food,” said John Lentine, a Birmingham criminal defense attorney and adjunct law professor at Samford University’s Cumberland School of Law and the Birmingham School of Law. “To me it’s a basic human rights kind of thing.”
Michele Deitch, a senior lecturer at the University of Texas at Austin’s School of Law and Lyndon B. Johnson School of Public Affairs, said the practice is “absolutely” unconstitutional.
“There is a constitutional obligation to provide health care that meets the serious medical needs of people who are incarcerated,” said Deitch, who co-wrote the American Bar Association’s Standards on Treatment of Prisoners. “That’s not negotiable.”
The tactic is another way in which sheriffs across Alabama are avoiding financial responsibility for inmate medical care. AL.com and ProPublica reported in September that many sheriffs in Alabama and across the country are finding ways to release inmates from jail just before they incur expensive hospital bills, a tactic known as “medical bond.”
In several recent cases, incarcerated people around the country have successfully challenged policies restricting their access to free medical care in prison.
Last year, a federal court ruled that transgender inmates in Missouri’s state prisons have a right to receive hormone therapy free of charge while incarcerated, regardless of whether they were already receiving the treatments when they were taken into custody. And this year, prisoners in Minnesota reached a settlement with the state’s Department of Corrections that requires the prison system to provide prisoners who have Hepatitis C with expensive drugs that often cure the infection.
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