Streamlining Medical Parole to Ensure Public Safety and Protect Taxpayers

Louisiana legislators have an opportunity to make sensible changes to medical parole laws through HB210

► There is a Need for Medical Parole. There are some 125,000 inmates 55 or older, a figure that has risen 1,300 percent since the 1980’s.^[i] The nation’s older inmate population is expected to increase exponentially again over the next decade, with associated health costs spiraling higher. Geriatric inmates have three times the medical costs of non-geriatric inmates and in Texas one inmate several years ago consumed $1 million in health care costs in one year alone.^[ii] About two-thirds of states have a medical parole process, including Louisiana, but Louisiana’s medical parole law could be improved.^[iii]

► Current Louisiana Law is Too Restrictive. Current law excludes anyone with a contagious disease, which according to a medical encyclopedia encompasses some 215 diseases, ranging from chicken pox and measles to gonorrhea and lyme disease. Given that inmates placed on medical parole would continue to receive medical care, often in a nursing home or hospice, these diseases can be managed in those settings just as effectively, if not more so, than in prison. In addition to removing the contagious disease exclusion, HB210 clarifies the current requirement of permanent physical incapacitation so as to also include those who are so permanently mentally or physically disabled that they are unable to engage in any gainful activity or have a terminal illness. For example, someone with advanced Alzheimer’s disease will have such severe dementia, limited muscle mass, and loss of speech that they are cannot perform basic tasks or actively seek the assistance required to stay alive, but at the same time they may not completely physically incapacitated in the sense that can still move some parts of their body to some degree.

► HB210 Preserves Integrity of Sentencing Laws. This bill continues existing law requiring that inmates be at least 45 to be eligible and that they have served at least 20 years of at least a 30-year sentence. Also, although it would require a miracle given the criterion in this bill of being permanently mentally or physical disabled such that the person is capable of no gainful activity or has a terminal illness, theoretically if the offender recovered while on medical parole, he could still be recommitted to prison under existing law.

► Geriatric Inmates Pose Little Risk to the Public. Studies have shown that offenders over 60 have a minimal recidivism rate.^[iv] For example, since Oklahoma adopted a medical parole law in 2000, 135 inmates have been released with only two being re-arrested due to possessing a controlled substance.^[v] A 2013 study by the U.S. Department of Justice Inspector General found an overall 41 percent re-arrest rate for discharged federal inmates, compared with a 3.5 percent re-arrest rate for those placed on compassionate release, a standard which is far broader than this medical parole bill proposes.^[vi]

► Medical Parole Includes Strict Conditions. Those on medical parole can be required to meet numerous conditions, such as house arrest. They may also be placed in a nursing home or hospice. While medical parolees are often paraplegic, comatose, or otherwise unable to move around, electronic monitoring can be used to ensure they remain in that setting. Even though their health care costs will typically continue to be subsidized because they are indigent and elderly, federal funds through Medicaid will generally pay at least two-thirds of the cost and, for the 10 to 15 percent who are veterans, their full costs can be paid with federal funds.

► Share of Savings Should Be Reinvested. Due to the accumulation of many seriously ill inmates, savings during the first few years could be significant. The Legislature should allocate a fixed percentage of savings to fund a pilot program that would provide incentive funding that parishes could voluntarily apply for if they pledge to reduce the number of low-level offenders they send to prison and use the funds for proven alternatives such as drug courts.