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.