Fewer than 10% of applicants have been granted medical parole, frustrating some Mass. lawmakers

A group of state lawmakers on Monday visited a health care unit inside a state-run prison after receiving multiple complaints of understaffing, unsanitary conditions and inadequate medical treatment.

Several of the lawmakers, along with some prisoner advocates, said issues at the health care unit inside MCI-Norfolk raised questions about the state's medical parole law. The critics say the Department of Correction is too reluctant to approve the release of seriously ill prisoners as the law intended. The law increasingly has become the subject of legal and legislative battles.

After Monday's visit to the 16-bed critical stabilization unit (CSU), state Sen. Jamie Eldridge compared the medical wing to a movie.

"It reminded me of 'One Flew Over the Cuckoo's Nest,' " said Eldridge, a Democrat whose district includes Middlesex and Worcester. "It was incredibly outdated and cramped and just not ideal for providing health care to prisoners in their 70s and 80s."

MCI-Norfolk holds some of the oldest, sickest prisoners in Massachusetts — a state ranked second-highest in the nation for its number of elderly people who are incarcerated.

More than 15% of Massachusetts prisoners are older than 55, according to the Prison Policy Initiative, a research and advocacy group focused on criminal justice reform. The average age of a prisoner at Norfolk is 48; the oldest person incarcerated there is 88, according to statistics from the state's Department of Correction (DOC). About 1,100 men are housed at MCI-Norfolk.

State Sen. Becca Rausch, whose district includes the prison, said she had received numerous complaints about conditions and health care. She planned to look further into what she saw and heard during the visit.

"There are inconsistencies between what we're hearing from some of the administrators, and what what we're hearing from the folks who are living in the CSU," Rausch, a Democrat, said. "That needs some investigating to figure out what's really going on."

The CSU is one of three medical care units in state prisons. The Department of Correction said it is committed to delivering appropriate care for prisoners through the private vendor Wellpath.

"Qualified medical professionals employed by our medical service provider, Wellpath, approach all clinical decisions with compassion and are guided by their expertise," a DOC spokesman said in an emailed statement.

Wellpath acknowledged that staffing is a problem it is trying to address in various correctional facilities.

“The nation is in the midst of an unprecedented crisis in nursing and mental health staffing, which has been exacerbated by the Covid pandemic," Wellpath spokeswoman Judith Lilley said in an emailed statement. "Wellpath is closely following changes in applicable regulations and orders that waive or alter requirements with respect to the practice of nursing to ensure sufficient staffing levels to provide quality patient care.”

Who Seeks Medical Parole

Many of the people housed in prison medical units like Norfolk's CSU apply for medical parole or so-called "compassionate release." Under a law passed four years ago with the state's landmark criminal justice reform act, release is allowed for prisoners "if they are permanently incapacitated, either physically or cognitively, or if they are terminally ill with less than 18 months to live."

According to DOC data, 270 people applied for medical parole in the fiscal year ending in June 2020. Of those, 26 were granted medical parole. The data also show a total of 56 people have been granted medical parole since the law passed.

"During the COVID era, you would think that the number of people released through the law would have increased. But, in fact, very few  were released ..."

State Sen. Jamie Eldridge

Prisoners Legal Services of Massachusetts, an advocacy group, said an 82-year-old prisoner held at CSU and seeking medical parole died Tuesday, just days after he was transferred to an outside hospital.

"PLS believes that most, if not all, CSU residents are eligible for medical parole," the group said in a statement. "Many have sought medical parole, but none have been successful."

During the coronavirus pandemic, at least two men died within a day of being granted medical parole. Because they were no longer officially in DOC custody, their deaths were not counted in the total number of prisoners who died of COVID-19.

"During the COVID era, you would think that the number of people released through the law would have increased," state Sen. Jamie Eldridge said. "But, in fact, very few  were released, and I think that's really troubling and a sad commentary on the administration's lack of commitment to fully following the spirit of the criminal justice reform law."

The DOC has said it has followed public health guidelines throughout the pandemic, and people have been released in accordance with the law.

Legislation Aimed At Changing Medical Parole

Advocates have also raised questions about policies for releasing prisoners once they're granted medical parole. While some may be allowed to go to private homes of loved ones, others have been required to go to certain facilities approved by the DOC. Some prisoners granted medical parole died before they were set free.

Susan Neuber, a registered nurse, testified in September in support of legislation aimed at removing some of the obstacles to granting medical parole. Among other provisions, the bill would permit a health care proxy to help with the process and would allow for post-release placement in a facility overseen by the Department of Public Health.

For more than a decade, Neuber served as medical proxy for 61-year-old Daniel Prunty, who was held in the infirmary unit at Souza Baranowski Correctional Center. Prunty had various health issues including liver cancer, kidney failure and hepatitis C. Neuber said Prunty was unable to walk, care for himself or communicate effectively. She testified that his medical care in prison was inadequate, and he needed intensive medical treatment and hospice care.

"Dan's care was not even borderline," Neuber said. "It was horrific. These places are just not set up to care for people who are terminally ill."

"Dan's care was not even borderline. It was horrific. These places are just not set up to care for people who are terminally ill.

Susan Neuber, registered nurse

After three denials, DOC Commissioner Carol Mici approved Prunty's petition for medical parole, but on the condition he be sent to a secure facility. That facility was never located. Prunty died of liver cancer a few days after his petition was granted, and before he was released.

Supporters of the bill argue that granting medical parole would be less expensive than providing health care in correctional settings, which often includes the cost of transporting prisoners to hospitals where they are guarded by correction officers. Many of them also estimate the health costs for severely ill prisoners are two to three times higher than the average $70,000 a year cost to incarcerate someone.

"It really does benefit the state and all of the taxpayers when we use our money wisely and take advantage of the resources the state already has available, rather than trying to create end-of-life care within a house of correction, which was really not its intended purpose," said state Rep. Lindsay Sabadosa, a Democrat from Northampton and co-sponsor of the bill.

The DOC said it has updated some medical parole regulations in response to the proposed legislation and state Supreme Judicial Court rulings. A department spokesman said after a public hearing in December, the Executive Office of Public Safety and Security further revised the regulations and expects them to be "promulgated shortly." Neither department specified what changes were made.

Today, dozens of medical parole appeals making their way through the courts allege the Department of Correction arbitrarily denies petitions and does not follow the law.

Attorney Michael Nam-Krane is currently appealing the denial of medical parole to James Keown, who is among those held in the Norfolk CSU.

Keown has several health issues, including ALS or Lou Gehrig's Disease, a progressive nervous system disorder that affects the muscles, making it difficult to move or speak — and eventually to breathe. There is no cure for ALS, and prison medical specialists estimate that the 47-year-old will die within three years. The DOC denied Keown's petition for medical parole, saying that "within three years" is not "terminally ill."

"The Legislature specifically intended for people — even murderers — to be let out on compassionate release because it's the human thing to do ..."

Michael Nam-Krane, attorney

"When you visit him, he's in a wheelchair and his legs and hands don't really work," said Nam-Krane. "He definitely is permanently incapacitated such that he's not a danger to anybody, but we are still getting a lot of resistance from the DOC."

Keown was sentenced to life in prison in 2008 after he was convicted of murdering his wife by poisoning her with antifreeze. His wife's family opposes his release. But Nam-Krane argues that the nature of a prisoner's crime should not be a factor in granting medical parole. He points out that most of the elderly people in prison have been there for a long time for committing terrible crimes.

"It's not even a legal argument to say they don't think someone should get out because he did a terrible thing," Nam-Krane said. "The Legislature specifically intended for people — even murderers — to be let out on compassionate release because it's the human thing to do, and because sadly, people like my client cost more money to keep in that kind of setting."

But some lawmakers say the nature of some crimes should prevent certain prisoners from ever being released. State Rep. Brian Ashe, a Democrat from Longmeadow, said he has spoken with several of his House colleagues and prosecutors who support legislation he plans to refile this year that would bar those convicted of first-degree murder from gaining medical parole.

"It's very difficult to get a murder one conviction. And to get one means the person has done something so heinous ... that the judge and jury deemed that they should be in jail for the rest of their lives ..."

State Rep. Brian Ashe

"It's very difficult to get a murder one [first-degree] conviction," Ashe said. "And to get one means the person has done something so heinous, something so terrible that the judge and jury deemed that they should be in jail for the rest of their lives. To have them get out for whatever reason really just spits in the face of victims and their families."

Ashe acknowledged he is personally affected. Sixty-two-year-old John Stote was convicted of the 1997 killing of Ashe's relative John "Jackie" Regan. Stote's medical parole was revoked last April, after he appeared to be recovering from COVID-19. Stote was again granted medical parole in December, but he remains incarcerated at MCI-Shirley.

Stote's attorney, Mark Bluver, is still arguing in court for Stote's release. He's requested an opinion from the state Supreme Judicial Court.