The Massachusetts Senate passed criminal justice reform legislation S. 2415, An Act relative to medical placement of terminal and incapacitated inmates, sponsored by Senator Patricia Jehlen (D-Somerville). The legislation creates a process for the Department of Correction (DOC) and the county sheriffs to place terminally ill and permanently incapacitated prisoners who are no longer a threat to the public in settings outside of state prisons and county jails, allowing eligible inmates to receive end-of-life care at nursing homes or in hospice care.

“With the passage of this bill, the Senate is continuing its strong commitment to reforming our criminal justice system,” said Senator Jehlen. “By putting a system in place that allows eligible inmates access to more suitable and medically appropriate care is not only a compassionate act, but a fiscally smart one as well. I am hopeful that Massachusetts will implement a medical release process and join the many states across the nation that already have a similar procedure in place.”

Other states and the federal government have been using medical placement systems to reduce corrections costs for decades. For instance, over the past decade Texas released almost 1,000 inmates with nearly every single one dying within a year, saving the state large amounts of money without affecting public safety. Currently, Massachusetts is one of only 5 states without a medical placement process.

Placing terminally ill and incapacitated inmates in these alternative settings shifts health care costs from DOC and the sheriffs to public or private health insurers, who can provide the care more efficiently and for a lower cost. Most inmates will be eligible for Medicaid upon release, resulting in significant federal reimbursement.

This bill is a necessity because of the aging prison population and the high cost of incarcerating an older prisoner. On average, it costs over $100,000 a year to incarcerate an elderly person, about double what it costs to incarcerate a non-elderly inmate. In 1980, the United States only had about 9,500 prisoners over age of 55. By 2008, that number reached 94,800 (1000% increase). In Massachusetts in 2015, there were 1,707 state prisoners aged 50-59 and 845 over the age of 65.

“I want to thank Senator Jehlen for her continued leadership on this growing public health issue impacting the criminal justice system,” said Middlesex Sheriff Peter J. Koutoujian. “Sheriff’s offices are not equipped to care for the significant medical needs associated with terminally ill individuals who are unable to pose a threat to public safety given the severity of their condition. Adoption of this legislation will allow us to place carefully screened individuals to appropriate facilities, while ensuring they remain under the jurisdiction of the Parole Board.”

Only inmates who are no longer a public safety risk will be eligible for medical placement. To ensure this, the legislation imposes three layers of review before moving inmates out of a correctional facility, followed by supervision on parole. First, a medical professional must determine that a person is terminally ill or permanently incapacitated and that their condition has debilitated them to the point that they are no longer a threat to public safety. Second, the sheriff or the superintendent of the correctional facility where the inmate resides reviews the petition.  Third, if the sheriff or superintendent recommends medical parole, the Parole Board would make a final decision. If the application is approved, the person remains under parole supervision and can be returned to prison if they violate parole or miraculously recover.

The bill now goes to the House of Representatives for a vote.