What should California do with state prison inmates who are bedridden and immobile? Or who have dementia and are incapable of independent movement, speech, or bladder control? Or who have end-stage disease and are too weak to exist outside of a skilled nursing setting?
One clear answer: California no longer can afford to do what it is doing. It is keeping these inmates, who pose no threat to public safety, within the prison system at huge cost to taxpayers.
For example, California has 21 inmates who are comatose, in a persistent vegetative state or at end-stage Alzheimer’s disease. They require care in nursing facilities or hospitals outside of prison at an average per-year cost of $1,973,252 each. That is more than $41 million from the state’s general fund.
A lot of that cost comes from rules that require prison guards to double-guard these incapacitated inmates who pose no threat to anybody – 24 hours a day, seven days a week.
Here’s just one example from 2008: The six-month cost for a prisoner in a persistent vegetative state was $421,000 for medical care and $410,000 for double-guarding him as he lay immobile in his hospital bed.
Just whom does this serve? Do Californians, struggling to figure out how to pay for schools, roads and parks, benefit? No. Do crime victims benefit when the state pays two guards to stand over an incapacitated prisoner in a community hospital? Or from having an immobile prisoner shackled to a prison medical bed? No.
This is utterly irrational and unjustifiable given the state’s dire budget situation.
There is a better option: medical parole. Federal prison health care receiver J. Clark Kelso is sponsoring such a bill, Senate Bill 1399. Lawmakers and the governor should get behind it.
This would not be a “release,” but placement in a specific medical facility under supervised parole. It could be revoked if the prisoner became a threat to public safety. Third-strikers, death-row inmates or those sentenced to life without parole would not be eligible.
Not only would medical parole save the cost of guarding incapacitated prisoners who pose no threat to the public, it would allow the state to tap federal funds for Medicare and Medi-Cal health services.
This provides fiscal savings without reducing public safety.
Under the bill, Department of Corrections and Rehabilitation doctors would refer a prisoner to the parole board for medical parole if two conditions were met:
• A prisoner had a “significant and permanent condition, disease or syndrome” that makes him or her “physically or cognitively debilitated or incapacitated.”
• The prisoner posed no threat to public safety.
Sen. Mark Leno, chairman of the Senate Public Safety Committee and the bill’s author, says his intention is the board would be required to grant parole if a prisoner met the two conditions.
Corrections officials are analyzing 750-plus inmates who cost more than $100,000 a year for medical care who would potentially be eligible for parole under the bill.
The bill’s language, however, is weak. Though it says prisoners “shall be granted medical parole” if they meet the two conditions, how will that be enforced? Previous laws attempting to require the Board of Parole Hearings to release terminally ill and permanently incapacitated prisoners have been a dismal failure.
It should be a no-brainer to identify the costliest infirm inmates who no longer pose a danger to society and place them on parole. But a law will need teeth – or the same expensive nonsense will continue.