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Abstract: 

Fred Cohen, who passed away in 2022, was one of the country’s leading authorities on correctional law, and specifically the rights of prison and jail inmates to health and mental health care. This article, “The Legal Framework for Correctional Health Care Law,” was written after more than fifty years of experience as a law school professor, author, and legal consultant on health and mental health for the Ohio and California departments of corrections. It summarizes the principal legal standards of care, as established by the courts and Congress, every correctional health professional should know and be guided by. The “Framework” places the responsibilities of health care staff in the context of the constitutional duties expressed in the Eighth Amendment, as established by the federal courts and the U.S. Supreme Court in a series of rulings that began with the monumental decision in Estelle v. Gamble in 1976, and by a succession of federal statutes, including the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA). We present this “Framework” in two parts: in this issue, Part I explains the underlying legal theory that established a constitutional right to health care for inmates, the legislative void this constitutional theory filled, and subsequent legislative efforts to better define, and sometimes limit, the right to health care. It defines the critical concepts of “serious medical condition” and “deliberate indifference,” concepts that determine the success or failure of almost every legal action brought against prison or jail administrators and providers over the provision of health care. It lays out the mandated standards of care providers must meet, including adequate staffing, bed space, and access to care. Part II will address issues of informed consent, confidentiality, HIPAA, the use of solitary confinement and bodily restraints, suicide liability, and the impact of the Prison Litigation Reform Act (PLRA).

Keywords: Affordable Care Act; Eight Amendment; Estelle v. Gamble; Constitutional Right to Health Care; Serious Medical Condition; Deliberate Indifference

Affiliations:  1: Co-Founder, Correctional Law Reporter.