"Wearing contact lenses is not a constitutional right," Martynick said, adding that if it comes to inmates' having to make a choice between smoking and wearing contacts, so much the better for learning about real life.
County Commissioner Andrew Dinniman, who is also on the prison board, said adopting the policy was part of a plan to encourage financial responsibility on the part of the incarcerated, as well as to save county taxpayers a few bucks.
"The (prison) staff believes that half the people who go on sick call are not really sick," Dinniman said. "So if you go there and you are not sick, then you have to pay a fee to cover the costs."
Truly sick prisoners, he said, will not be charged the $3 to $5 fee. Nor will the policy apply, he said, to indigent inmates or to emergencies, standard medical and dental examinations, laboratory tests, psychiatric care, or care for chronic medical problems.
Inmates' accounts will be docked for the new costs as they are now for such commissary items as candy and cigarettes.
With the policy's adoption, Chester County has joined Berks County in an attempt to teach inmates financial responsibility while, at the same time, trying to recover some of the costs of imprisonment. In addition to charging for medical costs, Berks County bills inmates $10 a day and up for room and board.
The medical component of the Berks County policy is being challenged in federal district court by the Institutional Law Project. And Chester County lawyer Samuel Stretton said he expected to file a similar suit over the room- and-board fees within 30 days.
"I've been very upset with what I've seen in Berks County," said Stretton, the Democratic candidate for Chester County district attorney. "It is my position that it is wrong and does nothing in terms of rehabilitation."
Stretton contends that Berks County's policy is punitive and violates the due-process clause of the Constitution. Martynick said she believed the policy met all the tests of recent court decisions.
The intent, she insisted, is to make prisoners start taking responsibility for their health and welfare.
"I think we are on the right path here," Martynick said. "And I don't think in any way do we violate the prisoners' rights."
Dinniman said the policy is a two-phase effort. During the next 30 to 60 days, both prison staff and inmates will receive educational materials about the new program.
They will be taught, among other things, the difference between a common cold, whose symptoms can be helped with cough drops and liquids, an allergy that needs medical treatment, and a bacterial infection that may require treatment with an antibiotic.
Said Martynick: "We will be providing the inmates information about their own health, which they may not have had in the past, so they can distinguish between a routine problem and a serious problem. But at no time will a prisoner be denied emergency or necessary medical care."