Wednesday, April 07, 2010

Texas' medical parole process praised: Recommendations are timely, but parole board fails to act

Having recently discussed the Texas parole board's failure to act on 90% of medical releases recommended by TDCJ, I was interested to see via Doc Berman that the Vera Institute just published a new study titled, "Aging Prisoners, Increasing Costs, and Geriatric Release" (pdf), which includes a discussion of Texas' program.

According to the Vera Institute, "In the years following its creation [in 1991], few elderly inmates were released." A 2002 audit critical of the program sparked reform, after a fashion, inspiring the Texas Correctional Office for Offenders with Mental or Medical Impairments to contract with
the Department of Aging and Disability Services (DADS) for case management services. The DADS staff conduct all pre-release interviews, handle federal entitlement applications, and coordinate post-release services, including placement in nursing homes, hospices, or at other facilities.40 To ensure that staff make timely referrals for offenders with terminal illnesses or long-term care needs, TCOOMMI also made unit physicians responsible for initiating referrals. (Previously, TCOOMMI would request medical summaries for any referral received from internal or external sources, a process that typically had unit medical staff completing paperwork for offenders whose conditions were not deemed clinically appropriate for early release.) The streamlined referral process helps target appropriate inmates for release and reduces paperwork and processing times.
So Texas is now recommending medical releases in a timely fashion, according to Vera. What they fail to add is that most of those prisoners are still not released and ultimately die in prison. The bottleneck occurs at the parole board. They simply don't act on medical parole cases quickly enough and most of those recommended for release expire before a decision is ever made.

Vera recommends that:
  • States that look to geriatric release as a cost-saving measure must examine how they put policy into practice. For instance, they should review the release process to address potential and existing obstacles.
  • More analysis is needed to accurately estimate overall cost savings to taxpayers—and not just costs shifted from departments of corrections to other agencies.
  • More effective monitoring, reporting, and evaluation mechanisms can improve assessments of the policies’ impact.
  • Creative strategies allowing older individuals to complete their sentences in the community should be piloted and evaluated.
  • Finally, to protect public safety, states should consider developing relevant risk- and needs-assessment instruments, as well as reentry programs and supervision plans, for elderly people who are released from prison.


Jennie said...

So I don't get this. You release them to save the State of Texas money? Who then foots the bill? I mean someone has to pay for the nursing home and medical bills. Isn't this kind of like passing the buck onto the Federal Government?

Anonymous said...

Yes, Jennie. It's a joke.

sunray's wench said...

Not always.

There are plenty of families who would gladly have their elderly or ill inmate home again, perhaps with a tag or on house arrest, and add them to their medical insurance payments.

Although of course, if you had a better sytsem of healthcare that didn't rely on paying at point of delivery, the question wouldn't be an issue.

The BPP are the ones at fault. They are incapable of thinking for themselves, so they say "no" to just about everything sensible put before them. This is TDCJ advising that these inmates should be paroled and yet still the BPP think they know better that the professionals.

That's the joke, Anon 5.24.

Gritsforbreakfast said...

Jennie, I'd written this on that question in an earlier post:

"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."

Anonymous said...

With the aging population of offenders, this needs to be addressed asap. In other words the BBB needs to get their head out and parole these offenders.This will save TDCJ in the long run! Also seems like the BBB could bre better ran!

PirateFriedman said...

Outsanding observation Jennie.