California now limits medical parole to those on ventilators
SACRAMENTO >> A new California policy could send dozens of quadriplegic, paraplegic or otherwise permanently incapacitated inmates from nursing homes back to state prisons.
Prison officials say a change in federal rules led them to limit medical parole to inmates so ill they are hooked to ventilators to breathe, meaning their movement is so limited they are not a public danger. The state previously included a much broader range of permanent incapacities allowing inmates to be cared for in nursing homes outside prison walls.
Steve Fama, an attorney with the nonprofit Prison Law Office, said the courtappointed federal office that controls health care in California prisons told him the change could affect about 70 of the 210 inmates approved for medical parole under the current system, started in 2014.
“It’d be an awful shame if those people were returned to prison,” Fama said. “Those patients have been proven not to need a prison setting given their medical conditions.”
The policy shift comes as the state has been reducing its prison population due to the coronavirus pandemic, as well as a more general push from voters and legislators to free older and infirm inmates who are less likely to commit new crimes.
California officials say they have no choice under a new approach to the enforcement of federal licensing requirements for nursing homes by the Centers for Medicare & Medicaid Services. That’s a division of the U.S. Department of Health and Human Services headed by former California Attorney General Xavier Becerra.
The federal agency has taken the position that parole officials can’t impose any conditions on inmates in community medical facilities, the state says. That includes a rule that inmates not leave except with permission from their parole agent — a restriction state officials said is necessary to ensure public safety.
In response, only those on ventilators are being placed in the community, corrections department spokeswoman Dana Simas said.
Federal officials disagree that revoking medical parole and putting incapacitated inmates back behind bars is the state’s only option.
They say California could leave the inmates in nursing homes with no prohibition on their leaving, or put them in facilities that aren’t regulated by the federal government — “assisted living or non-certified skilled facilities that a state may wish to license to serve parolees who have additional health care needs.”
Simas responded that sending offenders to such non-certified facilities “would require establishing an entirely new program to monitor and audit the care provided at these facilities.” Health care provided to offenders at the current facilities is checked by the federal receiver’s office and several outside agencies.
The policy change came after just one facility in Los Angeles County was informed following an inspection ending in early July that it was violating its licensing requirements, but state officials said the federal agency told them it will be enforced at all skilled nursing facilities.
The federal agency is citing a 2016 guidance memo that it says reiterated conditions under which parolees may remain in nursing facilities.
The state’s decision affects incapacitated inmates who are deemed to still need some sort of supervision, but it does not affect compassionate releases that are approved by a court and have no strings attached. Inmates can seek compassionate release if they are diagnosed with an illness that is deemed likely to cause their death in 12 months or less and is a medical condition they did not have when sentenced.