Sunday, March 28, 2010

Receiver Advocates Medical Parole

Clark Kelso encourages voters to endorse medical parole for chronically ill inmates as a measure for significantly reducing expenditures on the prison health system. This morning's Sac Bee reports:

"I am keenly aware, as are the courts," Kelso said, "that a dollar that we can save in the prison health care program is a dollar that can be spent on other important priorities for the state, such as education, money for children, the elderly, other health care programs."

An aide in Kelso's office said that, conservatively, 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 PatiƱo.

The bill was introduced by Mark Leno. Interestingly, the bill would do something else that reverses a 40-year trend: it would give parole boards some of their power and discretion back. Medical releases would depend on a parole board determination that the inmate no longer poses a danger to society due to his or her medical condition.

As I told my students last week, one of the most significant implications of the shift from indeterminate to determinate sentencing was a shift in power within the system. The most noticeable effect of this change was the transfer of power from judges to prosecutors and legislators; determinate sentencing "locked" the defendants into a sentence based on the charge, and therefore awarded prosecutors a powerful bargaining chip in deciding which offense to charge. However, these changes were accompanied by "truth in sentencing" laws, requiring that inmates serve the majority of their sentence, stripping the parole board from its previously immense power to assess rehabilitation and risk.

It seems that the new proposal would reinfuse parole boards with some of that discretion, but keep it within reasonable boundaries. The concern about disparities and inconsistent criteria for release is significantly narrowed when the parole board has to hear evidence from doctors about the extent to which a certain inmate might be incapacitated due to his or her illness. This seems to be a not-unreasonable assessment, especially since much of the argument against early releases has to do with the concern about putting violent, dangerous people back on the streets. If someone's illness renders him or her non-dangerous, the only argument remaining for keeping them behind bars is retribution. And the question is whether we can afford pure retribution, as things stand today.


Michael Mutalipassi said...

But will this actually ease costs on the state? Someone will need to pay for the end of life care for those inmates, and it seems unlikely that those people will have an opportunity to provide for their own health care at this point. Shifting end of life costs from one state agency to another does not seem to do much good.

It's not that I am not behind allowing for more leeway in sentencing and parole decisions. It's just that this particular law does not seem to be solving the problem it pro-ports to solve. It's seems more like slight of hand.

Hadar Aviram said...

That's a good point, Michael. Also, I wonder whether the new healthcare bill would be more hospitable to folks released from prison with tons of preexisting conditions.