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SACRAMENTO, Calif. \u2014 California has halted a court-ordered medical parole program, opting instead to send its most incapacitated prisoners back to state lockups or release them early.<\/p>\n
The unilateral termination is drawing protests from attorneys representing prisoners and the author of the state\u2019s medical parole legislation, who say it unnecessarily puts this vulnerable population at risk. The move is the latest wrinkle in a long-running drive to free those deemed so ill that they are no longer a danger to society.<\/p>\n
\u201cWe have concerns that they cannot meet the needs of the population for things like memory care, dementia, traumatic brain injury,\u201d said Sara Norman, an attorney who represents the prisoners as part of a nearly three-decade-old federal class-action lawsuit<\/a>. \u201cThese are not people who are in full command and control of their own surroundings, their memories \u2014 they\u2019re helpless.\u201d<\/p>\n Caring for a rapidly aging<\/a> prison population is a growing problem across the United States. It is twice as expensive to imprison older people than those younger, according to Johns Hopkins University researchers<\/a>, and prisoners 55 and older are more than twice as likely to have cognitive difficulties as non-incarcerated older adults.<\/p>\n Medical parole is reserved for the sliver of California\u2019s 90,000 prisoners who have a \u201csignificant and permanent condition\u201d that leaves them \u201cphysically or cognitively debilitated or incapacitated\u201d to the point they can\u2019t care for themselves, according to the state parole board<\/a>. Prisoners who qualify \u2014 excluded are those sentenced to death or life without parole \u2014 can be placed in a community health care facility instead of state prison.<\/p>\n Attorneys said the roughly 20 parolees the state has returned to lockup need significant help performing basic functions of daily life, with some in wheelchairs or suffering from debilitating mental or physical disabilities. They say outside facilities have the capacity to provide more compassionate and humane care to very ill prisoners.<\/p>\n Kyle Buis, a California Correctional Health Care Services spokesperson, characterized the program as \u201con pause\u201d as patients return to in-prison facilities and as officials anticipate increasing their use of the compassionate release program. Prisoners granted compassionate release have their sentences reduced and are released into society, while those on medical parole remain technically in custody.<\/p>\n \u201cThere were multiple considerations that went into this decision,\u201d Buis said. \u201cOur growing ability to support those with cognitive impairment inside of our facilities was one factor.\u201d Democratic Gov. Gavin Newsom also cited \u201celiminating non-essential activities and contracts\u201d to save money.<\/p>\n \n\t\tSubscribe to KFF Health News’ free Morning Briefing.\t<\/p>\n<\/div>\n While nearly every state<\/a> now has a medical parole law, they are rarely used<\/a>, according to the National Conference of State Legislatures. One common reason is eligibility. Texas, for instance, screened more than 2,600 prisoners in 2022 but approved just 58 people. Officials also often face procedural hurdles, according to the Vera Institute of Justice, a national nonprofit research and advocacy group.<\/p>\n Some states, however, have tried to expand medical parole programs. Michigan did so<\/a> because an earlier version of the law proved too difficult to use, resulting in the release of just one person. New York has some of the nation\u2019s broadest criteria<\/a> for release but is among states struggling to find nursing home placements<\/a> for parolees.<\/p>\n California\u2019s first effort to free prisoners deemed so incapacitated that they are no longer dangerous began in 1997 with a little-used process that allowed corrections officials to seek the release of dying prisoners. But that program resulted in the release of just two prisoners in 2009. The medical parole program was officially created by a state law<\/a> that took effect in 2011 and was expanded in 2014 to help reduce prison crowding so severe that federal judges ruled it was harming prisoners\u2019 physical and mental health.<\/p>\n Nearly 300 prisoners had been granted medical parole since July 2014, state officials reported<\/a>. The average annual cost per medical parolee was between about $250,000 and $300,000 in 2023, Buis said. And despite lawmakers\u2019 expectations<\/a> when they started the program, he said, Medi-Cal \u2014 California\u2019s Medicaid program, which is partly funded by the federal government \u2014 did not reimburse the state for their care because they were still considered incarcerated.<\/p>\n California has had a rollercoaster relationship<\/a> with its sole nursing home contractor for medical parolees. The state ended its contract with Golden Legacy Care Center<\/a> in Sylmar at the end of 2024, Newsom reported in January in his summary of the state\u2019s 2025-26 budget<\/a>.<\/p>\n In 2021, prison officials said they were sending dozens of paralyzed and otherwise disabled prisoners back to state prisons and limiting medical parole<\/a>, blaming a federal rule change that barred any restrictions on prisoners in such facilities. The move came after state public health inspectors fined Golden Legacy for handcuffing an incapacitated patient\u2019s ankle<\/a> to the bed in violation of state and federal laws.<\/p>\n Golden Legacy did not return repeated telephone and email requests for comment. Buis said state officials \u201ccontinuously monitored care at Golden Legacy, and we never had concern for the quality of care provided.\u201d<\/p>\n Attorney Rana Anabtawi, who also represents prisoners in the class-action suit, toured Golden Legacy\u2019s medical parole building with Norman in November and saw caregivers offering memory care patients special art classes and a \u201chappy feet\u201d dance party.<\/p>\n She felt it \u201cwas a much better place for our patients than being in prison \u2014 there appeared to be regular programming aimed at engaging them, there were no officers walking around, the patient doors were open and unlocked, patients had general freedom of movement within their building.\u201d<\/p>\n Over the past several years, the California Department of Corrections and Rehabilitation has built up its capacity to service those with severely compromised health. The state created two of its own memory care units in men\u2019s prisons, a 30-bed unit in the California Health Care Facility in Stockton in 2019 and a 35-bed unit in the California Medical Facility in Vacaville in 2023. The Central California Women\u2019s Facility in Chowchilla provides up to 24-hour skilled nursing care for women with life-limiting illnesses including dementia.<\/p>\n Yet Norman fears the in-prison facilities are a poor substitute.<\/p>\n \u201cThey\u2019re nowhere near enough and they are inside prisons, so there\u2019s a limit to how compassionate and humane they can be,\u201d she said.<\/p>\n In addition to the 20 returned to state prisons when the contract expired, Buis said, one was paroled through the standard process, while 36 were recommended for compassionate release. Of those, 26 were granted compassionate release, eight were denied, and two died before they could be considered.<\/p>\n The use of compassionate release increased under a law<\/a> passed in 2022 that eased the criteria<\/a>, including by adding dementia patients. Last year<\/a>, 87 prisoners received compassionate release. By contrast, during the six years before the new law, just 53 were freed. Officials expect about 100 prisoners each year will qualify for compassionate release, Buis said.<\/p>\n Compassionate release would allow them to \u201csort of die with dignity,\u201d said Daniel Landsman, vice president of policy for the criminal justice advocacy group FAMM, previously known as Families Against Mandatory Minimums<\/a>, and ensure \u201cthat the California prison system is not turning into a de facto hospice or skilled nursing facility.\u201d<\/p>\n Mark Leno, who authored California\u2019s medical parole law when he was a Democratic state senator, criticized prison officials for ending their use of the law without legislative approval and instead just terminating the Golden Legacy contract. He also railed against returning very ill patients to prisons, a decision he called \u201cperfectly inhumane.\u201d<\/p>\n \u201cIs it just cruel punishment and retribution or is this thoughtful execution of the law put in place by the legislature?\u201d he said.<\/p>\n This article was produced by <\/em>KFF Health News<\/em><\/a>, which publishes <\/em>California Healthline<\/em><\/a>, an editorially independent service of the <\/em>California Health Care Foundation<\/em><\/a>.<\/em>\u00a0<\/p>\n<\/p><\/div>\n\n\t\t
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