Tuesday, March 30, 2010

CA considers medical parole as solution to rising prison health costs

Over at Sentencing Law & Policy, Doc Berman notices that California is considering medical parole to reduce health care costs, excerpting an article that holds up Texas' example: "36 other states have a version of medical parole, including Texas, which is putting about 100 to 170 inmates a year into that status," says a Golden State legislator pushing the idea. In California, according to the Sacramento Bee:
the prison system could save $213 million over five years by paroling just 32 inmates identified as severely incapacitated. Twenty-one of those 32 inmates are in nursing facilities or hospitals outside prisons, which requires spending for expensive guard time – including overtime – as well as huge health care costs.

These 21 inmates' average annual health care and guard costs total more than $1.97 million apiece – a total of $41.4 million a year for 21 individuals, said Kelso aide Luis Patiño. "These people are not even capable of realizing they're being punished," Patiño said. "Society becomes the victim, because it's paying the cost."

I mentioned in the comments to Berman's post that, while Texas began using medical parole more frequently in response to similar stories of high-cost inmates, there is still more savings to be had on this front than we've so far achieved from the policy. "The last number I heard: Only about 10% of those recommended for medical parole are approved by the parole board. Many TX offenders recommended for medical release pass away before the parole board gets around to their case. Around 40 inmates per month die in Texas prisons, a number which has been going up along with healthcare costs as the prison population gets older."

State Sen. John Whitmire in committee hearings has cited data (which I've never seen) suggesting Texas' most expensive inmates cost the state upwards of $1 million per year in medical bills. And TDCJ has said Texas could save up to $49 million per year by using parole more aggressively for older, nonviolent offenders with high healthcare costs.

From state government's perspective, medical parole makes a lot of sense. States pay 100% of prisoners' healthcare costs. On the outside, if a parolee is indigent the state pays just 1/3 of Medicaid costs, including hospice, etc.. And if they're 65 or older and Medicare eligible, state government can unload their whole healthcare bill on the feds. From taxpayers' perspective at 30,000 feet, that's a distinction without a difference: It all ultimately comes from their wallets. But for state governments trying to balance their budgets, the strategy makes a lot of sense.

UPDATE/CLARIFICATION: I spoke this morning with Larance Coleman at the Texas Senate Criminal Justice Committee who told me that the estimate by a California legislator of 100-170 Texans receiving medical parole each year is way too high. Perhaps, he said, over the life of the program that many have been released. Coleman said he gets monthly reports that include the number of medical releases approved by the parole board, and generally they average around 2 per month. I'm guessing the 100-170 number is how many TDCJ recommends, but the board turns down 90% of them.

MORE: From California Corrections Crisis.


Anonymous said...

One wonders how many of these inmates would not be ill or dying if they received proper medical attention in the first place or if they received their medications on a regular basis. Imagine how the risks rise for an inmate with a heart condition or diabetes after days have gone by without their meds because the prison is on lockdown. The inmate who is given aspirin for a cut that's gone septic or a bacterial infection who does not receive proper treatment until after it becomes a matter that needs hospitalization. The inmate who goes in with the state knowing they have cancer but cannot get the needed treatment until the cancer has become a death sentence.

Correct me if I'm wrong, but didn't the Hair just give a posthumous pardon to an innocent man who died in prison from asthma? If he had received proper medical attention would he have died ?

How much could be saved if we didn't impose ridiculously long sentences for every crime under the sun.

We have the nerve to criticize other countries for their policies and treatment of prisoners, but the reality is that in places we are no better than those countries we hold up as evil for their actions. Given that we're talking about the Texas parole board, I'm shocked that even the 10% of those recommended are given parole. The question is how many are bounced right back in because their illness causes them to violate that parole in some manner?

Marie T said...

At the House Corrections Committee meeting the El Paso Rep asked Rissie Owens why the 85 year old father of one of her constituents who it dying of cancer was still in prison. Rissie told her to call her office and they would talk about it. This should be a no-brainer as you say. The Rep is new to the committee and she like you wondered why there was even a question about paroling him. Even if he is the worst of the worst, how can a dying man be a danger to the public especially when he has a family who wants to take care of him. Of course we are preaching to the choir here and to the House Committee. How in the world can we get changes when the appointed remain in charge?

PirateFriedman said...
This comment has been removed by the author.
PirateFriedman said...

Good strategy, shift costs to the feds.

sunrays wench said...

This is one of the simplest, easiest, quickest, most sensible ways to reduce TDCJ inmate numbers and budget, and the only people that really stand in the way of all those things are the BPP members.

In a state that has harsh laws against the mistreatement of the elderly, and with a state prison system which is one of the few that officially designates inmates as elderly when they reach 55, surely I'm not the only one who can see a giant paradox when inmates are not paroled when they are sick or old?

Anonymous said...

Some of the old and sick can victimize the children in the family when they are released. Shift the medical burden to the feds? Where do the feds get their money? Look in the mirror.

PirateFriedman said...

Anon, you miss my point. If California can shift costs to the feds then that's a good strategy for them because they don't pay 100% of the taxes which go into the federal budget.

But there is nothing moral about this. This is socialism, every group trying to manipulate the system for their own advantage.

Would be nice if we could bar ex cons from Medicaid, Medicare and allow doctors in the ER room to turn away care to former rapists and bank robbers, etc? Unfortunately, that’s not the society we live in.

sunrays wench said...

I am told that the majority of the inhabitants in TX are Republicans. As I understand it, Republicans are in favour of personal responsibility, low state interference in citizens' lives and basically only looking after yourself and paying for what you use.

If that is the case, how about this for a radical solution: when you vote in your leaders, your cross on the ballot paper is also used to indicate your acceptance that whatever your chosen leaders decide to do with inmates, you will be taxed accordingly because you are giving them the power to make those decisions for you.

After the election, all of those who voted for candidates who support keeping people incarcerated for longer periods and who do not agree that paroling medically ill and elderly inmates, pay a specific tax to fund those decisions. Those who support candidates who advocate paroling inmates and diversion & rehab projects are taxed directly to fund those.

That way, everyone knows what they are paying for, no smoke screens and full responsibility.

PirateFriedman said...

Sunray, sounds like a cool idea. Those of us who support the Libertarian party would pay the least, that's for sure!

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Anonymous said...

I agree stongly with medical parole, and I also agree that inmates are mis-managed medically in TDCJ and all too often left to die.

However, I would agree with the remark by Anonymous 12:32, who stated that even the sick and elderly can abuse children in the home.

My own father, who had sexually abused me as a child back in the 70's (he was never charged or prosecuted), ended up in a nursing home with Alzheimers. The last time I saw him, as a woman in my 40's, he was bedridden and confused, but that did not stop him from making lewd sexual gestures and nasty sexual remarks to me, his caregivers, and anyone else in shouting distance. He did this right up until his death.

Unless they are in a coma, sexual predators can still be dangerous.

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