California now limits medical parole to people on ventilators


FILE – An inmate in a wheelchair himself passes a checkpoint at the California Medical Facility in Vacaville, Calif., April 9, 2008. California prison officials have begun limiting medical parole to inmates so ill they are under fans. They cite a federal rule change as the reason inmates with quadriplegia or other severe permanent disabilities can no longer be placed in nursing homes. (AP Photo / Rich Pedroncelli, file)


A new California policy could return dozens of quadriplegic, paraplegic, or otherwise permanently incapacitated inmates from nursing homes to state prisons.

Prison officials say a change in federal rules has caused them to limit medical parole to inmates so sick they are hung on ventilators to breathe, meaning their movements are so restricted they do not constitute a public danger. The state previously included a much wider range of permanent disabilities allowing inmates to be cared for in nursing homes outside prison walls.

Steve Fama, an attorney with the nonprofit Prison Law Office, said the court-appointed federal office that controls health care in California prisons told him the change could affect about 70 of the 210 inmates approved for a medical parole in the current system, started in 2014..

“It would be a shame if these people were sent back to prison,” Fama said. “It has been proven that these patients did not need a prison environment given their state of health. “

The policy change comes as the state has reduced its prison population due to the coronavirus pandemic, as well as more general pressure from voters and lawmakers to release older and disabled inmates who are less likely to commit new crimes.

California officials say they have no choice as part of a new approach to enforcing federal nursing home licensing requirements by the Centers for Medicare & Medicaid Services. It is a division of the US Department of Health and Human Services headed by former California Attorney General Xavier Becerra.

The federal agency has taken the position that parole officers cannot impose any conditions on inmates at community medical facilities, according to the state. This includes a rule that inmates do not leave without permission from their parole officer – a restriction state officials say is necessary to ensure public safety.

In response, only those on ventilators are placed in the community, Corrections spokesperson Dana Simas said.

Federal officials disagree that revoking medical parole and putting incapacitated inmates behind bars is the state’s only option.

They say California could leave inmates in nursing homes without a ban on leaving them, or place them in facilities that are not federally regulated – “assisted living facilities or non-certified qualified facilities that” a state may wish to allow parolees to serve who have additional health care needs.

Simas responded that sending offenders to such uncertified facilities “would require a whole new program to be put in place to monitor and audit the care provided in these facilities.” The health care provided to offenders in existing institutions is controlled by the federal receiver’s office and several outside agencies.

The state’s decision affects incapacitated inmates who are deemed to still need some sort of supervision, but it does not affect compassionate releases approved by a court and without any conditions. Inmates can apply for compassionate release if they are diagnosed with an illness that could lead to their death in 12 months or less and it is a health condition they did not have at the time. of their conviction.

Several other states have had to deal with the same problem, although federal officials cannot immediately say which, when, and how they complied.

Almost all states allow parole for prisoners with serious health conditions, which is commonly referred to as medical parole, according to the National Conference of State Legislatures. But the organization said in a 2018 review that such laws are rarely used.

Researchers from the Vera Institute of Justice, a national nonprofit research and advocacy group, said obstacles include limited eligibility criteria and difficulty applying for release. Their 2017 report found that Alabama released 39 people on medical parole over eight years, while Texas approved 86 of the more than 2,000 applications in 2016. The legislative body said those states had some of the highest release rates.

California has eclipsed those releases by approving 210 medical releases and denying 110 applications since 2014, though that’s only a tiny fraction of the nearly 100,000 inmates currently in jail in the most populous state.

California Assembly Member Phil Ting, who heads the powerful Assembly Budget Committee, is pushing a bill to expand the criteria and create an easier process for placing inmates with disabilities in facilities. community health.

“Limiting it to those who use ventilators is arbitrary and not based on medical science,” he said. “Public safety is not improved by taking such an unnecessarily narrow view of this policy. “

Ting’s bill would include those who are eligible for hospice care or who suffer from debilitating pain or a debilitating illness. Instead of leaving the decision to the state parole board, which is made up largely of law enforcement officials, it would create a new medical parole board in each prison, made up of caregivers. health. It would also keep patients in outside facilities even if they no longer meet the criteria for medical parole.

It was originally worn by former Assembly Member Rob Bonta, now state attorney general, and cleared the Assembly before stagnating in the Senate last summer. Ting plans to try again next year.

Those sentenced to death, life without parole, or for the murder of police officers are not eligible under California law, and that would not change according to Ting’s proposal.

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Julio V. Miller