Analysis	
  of	
  United	
  States	
  Compassionate	
  and	
  Geriatric	
  Release	
  Laws:	
  
Towards	
  a	
  Rights-­‐Based	
  Response	
  for	
  Diverse	
  Elders	
  and	
  Their	
  Families	
  and	
  Communities	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  

	
  
	
  

A	
  ‘Just	
  Aging’	
  Shadow	
  Report	
  by:	
  	
  	
  

Be	
  the	
  Evidence	
  International	
  in	
  Collaboration	
  with	
  International	
  CURE	
  

	
  
	
  

	
  
Published	
  by:	
  	
  
Be	
  the	
  Evidence	
  Press	
  
New	
  York,	
  New	
  York	
  
May	
  9,	
  2015	
  

Authored	
  by:	
  	
  
Tina	
  Maschi,	
  PhD,	
  LCSW,	
  ACSW	
  
Alexandra	
  Kalmanofsky,	
  MSW	
  
Kimberly	
  Westcott,	
  PhD,	
  JD,	
  MSW	
  
Lauren	
  Pappacena,	
  MSW	
  	
  	
  	
  
Fordham	
  University	
  Be	
  the	
  Evidence	
  International	
  
Guest	
  Contributor:	
  	
  
Ron	
  Levine,	
  Ron	
  Levine	
  Photography	
  
	
  

	
  
Suggested	
  Citation:	
  Maschi,	
  T.,	
  Kalmanofsky,	
  A.,	
  Westcott,	
  K.,	
  &	
  Pappacena,	
  L.	
  (2015).	
  An	
  Analysis	
  of	
  United	
  States	
  
Compassionate	
  and	
  Geriatric	
  Release	
  Laws:	
  Towards	
  a	
  Rights-­‐Based	
  Response	
  for	
  Diverse	
  Elders	
  and	
  Their	
  Families	
  and	
  
Communities.	
  New	
  York,	
  NY:	
  Be	
  the	
  Evidence	
  Press,	
  Fordham	
  University.	
  Available	
  at:	
  www.beetheevidence.org	
  

	
  

An	
  Analysis	
  of	
  United	
  States	
  Compassionate	
  and	
  Geriatric	
  Release	
  Laws:	
  
Towards	
  a	
  Rights-­‐Based	
  Response	
  For	
  Diverse	
  Elders	
  and	
  Their	
  Families	
  and	
  Communities	
  
	
  

Table	
  of	
  Contents	
  

	
  

Executive	
  Summary…………….…………….…………….…………….…………….…………….…………….…………….…….	
  	
  	
  3	
  
Introduction.…………….…………….…………….…………….…………….…………….…………….…………….………………	
  	
  	
  4	
  
Methods…………….…………….…………….…………….…………….…………….…………….…………….……………………	
  	
  	
  	
  7	
  
Summary	
  of	
  Findings…………….…………….…………….…………….…………….…………….…………….…………….…	
   	
  	
  8	
  
Physical	
  and	
  Mental	
  Health…………….…………….…………….…………….…………….……………………..	
   10	
  
Age…………….…………….…………….…………….…………….…………….…………….…………….………………	
   12	
  
Pathway	
  to	
  Release	
  Decision…………….…………….…………….…………….…………….………….………	
   13	
  
Post	
  Release	
  Support………….……….…………….…………….…………….…………….…………….……………	
  14	
  
Personal	
  and	
  Criminal	
  Justice	
  History…………….…………….…………….…………….…………….………	
   15	
  
Style	
  of	
  Review…………….…………….…………….…………….…………….…………….…………….…………	
   16	
  
Case	
  Study	
  Example;	
  Review	
  of	
  NY	
  Release	
  on	
  Medical	
  Parole…………….…………….…………….………	
  

16	
  

Discussion	
  and	
  Recommendations…………….………………….…………….…………….…………….…………….…	
   18	
  
Legal	
  References…………….…………….…………….…………….…………….…………….…………….…………….……	
  

25	
  

Additional	
  References	
  and	
  Bibliography…….……….…………….…………….…………….…………….…………..	
  

26	
  

Appendices…………….…………….…………….…………….…………….…………….…………….…………….……………	
  

31	
  

Appendix	
  A-­‐Compassionate	
  and	
  Geriatric	
  Release	
  Worksheet…………….…………….…………….………	
  	
  	
  	
  	
  	
  32	
  
Appendix	
  B-­‐Releasing	
  Their	
  Stories:	
  Awareness-­‐Building	
  Activity….…………….…………….………………	
   33	
  
Appendix	
  C-­‐To	
  Release	
  or	
  Not	
  to	
  Release:	
  Critical	
  Dialoguing	
  Activity…………………………………………	
   34	
  
Appendix	
  D-­‐About	
  Be	
  the	
  Evidence	
  International	
  (BTEI)…………………………………………………………….	
   38	
  
LIST	
  OF	
  TABLES	
  
Table	
  1;	
  Compassionate	
  or	
  Geriatric	
  Release	
  Parole	
  Laws	
  in	
  the	
  United	
  States…………………………..	
  	
   	
  9	
  
Table	
  2;	
  Characteristics	
  of	
  Laws	
  that	
  Specify	
  the	
  Conditions	
  that	
  Warrant	
  Release…………………….	
   10	
  
Table	
  3;	
  Legal	
  Considerations	
  for	
  Release…………….…………….…………….…..…………….…………….……….	
   11	
  
Table	
  4;	
  States	
  Including	
  Language	
  around	
  Age	
  as	
  a	
  Factor	
  for	
  Early	
  Release………………………………	
   12	
  
Table	
  5;	
  The	
  Process	
  for	
  Determination	
  of	
  Release…………….…………….…………….…………………………..	
   13	
  
Table	
  6;	
  Post	
  Release	
  Support	
  in	
  Place	
  for	
  Release…………….…………….…………….…………………………..	
   14	
  
Table	
  7;	
  Type	
  of	
  Crime	
  Considered	
  for	
  Early	
  Release…………….…………….…………….…………………………	
  16	
  

	
  

	
  
	
   2	
  

An	
  Analysis	
  of	
  United	
  States	
  Compassionate	
  and	
  Geriatric	
  Release	
  Laws:	
  

Towards	
  a	
  Rights-­‐Based	
  Response	
  For	
  Diverse	
  Elders	
  and	
  Their	
  Families	
  and	
  Communities	
  
	
  
	
  

EXECUTIVE	
  SUMMARY	
  
	
  

The	
   purpose	
   of	
   this	
   report	
   was	
   to	
   conduct	
   a	
   content	
   analysis	
   of	
   the	
   laws	
   and	
   regulations	
  
pertaining	
   to	
   the	
   early	
   release	
   or	
   furlough	
   of	
   incarcerated	
   people	
   within	
   the	
   United	
   States	
   in	
  
connection	
   to	
   advanced	
   age	
   and/or	
   illness.	
   The	
   review	
   of	
   52	
   federal	
   and	
   state	
   corrections	
  
systems	
  (50	
  states,	
  Washington	
  D.C,	
  and	
  Federal	
  Corrections)	
  demonstrate	
  47	
  have	
  some	
  legal	
  
procedure	
   or	
   precedent	
   for	
   incarcerated	
   people	
   or	
   their	
   families	
   to	
   petition	
   for	
   early	
   release	
  
based	
  on	
  advanced	
  age	
  or	
  health.	
  Five	
  corrections	
  systems	
  (e.g..	
  Illinois,	
  Massachusetts,	
  South	
  
Carolina,	
  South	
  Dakota,	
  and	
  Utah)	
  do	
  not	
  have	
  explicit	
  legal	
  mechanisms	
  for	
  early	
  release,	
  and	
  
therefore	
  there	
  is	
  no	
  obvious	
  legal	
  pathway,	
  with	
  a	
  clear	
  set	
  of	
  actions,	
  to	
  acquire	
  early	
  release	
  
for	
  incarcerated	
  people	
  in	
  these	
  jurisdictions	
  based	
  on	
  health	
  or	
  advanced	
  age.	
  	
  
Among	
   the	
   47	
   systems	
   with	
   early	
   release	
   or	
   furlough,	
   some	
   common	
   circumstances	
  
were	
  observed	
  that	
  helped	
  to	
  determine	
  release	
  criteria.	
  These	
  areas	
  of	
  consideration	
  include,	
  
but	
   are	
   not	
   limited	
   to:	
   type	
   of	
   crime	
   committed,	
   level	
   of	
   incapacity	
   or	
   illness,	
   anticipated	
  
survival	
   time,	
   a	
   clearly-­‐detailed	
   process	
   for	
   application	
   and/or	
   appeal,	
   level	
   of	
   supervision	
   or	
  
support	
  in	
  place	
  upon	
  release,	
  and	
  potential	
  impact	
  or	
  opinion	
  of	
  the	
  victim	
  and/or	
  their	
  family.	
  
Though	
   there	
   is	
   some	
   consistency	
   in	
   the	
   criteria	
   considered	
   for	
   early	
   release,	
   there	
   is	
   little	
  
consistency	
  across	
  systems	
  in	
  which	
  distinct	
  processes	
  assess	
  and	
  determine	
  advanced	
  age	
  or	
  
failing	
  health.	
  	
  As	
  the	
  prison	
  population	
  in	
  the	
  US	
  grows,	
  and	
  the	
  cost	
  to	
  incarcerate	
  is	
  impacted	
  
by	
  medical	
  care,	
  it	
  is	
  important	
  to	
  understand	
  if	
  and	
  how	
  various	
  systems	
  address	
  the	
  likelihood	
  
of	
  treating	
  incarcerated	
  people	
  who	
  are	
  older	
  and/or	
  who	
  have	
  a	
  serious	
  or	
  terminal	
  illness.	
  	
  
	
  
	
  

This	
  content	
  analysis	
  prompts	
  additional	
  questions	
  and	
  offers	
  guidance	
  on	
  how	
  human	
  
rights	
  standards	
  can	
  be	
  used	
  to	
  construct	
  policies,	
  laws,	
  and	
  practice	
  that	
  respect	
  and	
  honor	
  the	
  
dignity	
   of	
   the	
   person,	
   promote	
   the	
   political,	
   civil,	
   social,	
   economic,	
   and	
   cultural	
   rights	
   of	
   all	
  
citizens,	
   and	
   ensure	
   nondiscrimination,	
   transparency,	
   and	
   accountability	
   on	
   the	
   part	
   of	
  
governments.	
   	
   Future	
   research,	
   evaluation,	
   and	
   monitoring	
   recommendations	
   should	
   include	
  
an	
   assessment	
   of	
   the	
   following:	
   (1)	
   the	
   extent	
   to	
   which	
   existing	
   policies	
   meet	
   human	
   rights	
  
standards;	
   (2)	
   how	
   frequently	
   incarcerated	
   people	
   are	
   released	
   following	
   the	
   submission	
   of	
   a	
  
request	
  for	
  early	
  release	
  and	
  whether	
  such	
  requests	
  monitored;	
  (3)	
  the	
  nature	
  of	
  the	
  barriers	
  
within	
   each	
   system	
   that	
   inhibit	
   the	
   development	
   and	
   operation	
   of	
   a	
   consistent	
   and	
   orderly	
  
review	
   process;	
   (4)	
   the	
   attitudes	
   of	
   the	
   public	
   and	
   lawmakers	
   concerning	
   	
   early	
   release	
   for	
  
eligible	
   incarcerated	
   persons	
   and	
   the	
   ways	
   in	
   which	
   they	
   influence	
   the	
   development	
   and/or	
  
amendment	
  	
  of	
  laws;	
  (5)	
  whether	
  	
  cost	
  of	
  care	
  should	
  be	
  a	
  consideration	
  for	
  release;	
  (6)	
  how,	
  if	
  
at	
   all,	
   wishes	
   of	
   the	
   families	
   of	
   victims	
   and	
   incarcerated	
   persons	
   should	
   be	
   taken	
   into	
  
consideration;	
  and	
  (7)	
  	
  the	
  most	
  successful	
  supports	
  for	
  incarcerated	
  persons	
  post-­‐release?	
  	
  	
  
	
  

Treatment	
   of	
   the	
   aging	
   and	
   ailing	
   population	
   within	
   prisons	
   constitutes	
   a	
   moral,	
  
economic,	
  social,	
  legal,	
  and	
  human	
  rights	
  issue.	
  	
  Therefore	
  it	
  is	
  important	
  to	
  understand	
  how	
  
aging	
  and	
  ailing	
  incarcerated	
  people	
  are	
  perceived	
  by	
  ourselves	
  and	
  within	
  the	
  prison	
  system	
  
before	
  communities	
  can	
  meaningfully	
  respond	
  to	
  their	
  aging,	
  seriously	
  ill,	
  and	
  dying	
  members	
  
and	
  offer	
  support	
  to	
  their	
  families.	
  	
  	
  
	
  
	
   3	
  

	
  
An	
  Analysis	
  of	
  United	
  States	
  Compassionate	
  and	
  Geriatric	
  Release	
  Laws:	
  
Towards	
  a	
  Rights-­‐Based	
  Response	
  For	
  Diverse	
  Elders	
  and	
  Their	
  Families	
  and	
  Communities	
  
	
  
INTRODUCTION	
  
In	
   America,	
   about	
   200,000	
   adults	
   aged	
   55	
   and	
   above	
   are	
   behind	
   bars,	
   many	
   of	
   which	
  
have	
  a	
  complex	
  array	
  of	
  health,	
  social	
  service,	
  and	
  legal	
  needs	
  that	
  all	
  too	
  often	
  go	
  unaddressed	
  
prior	
  to	
  and	
  after	
  their	
  release	
  from	
  prison	
  (HRW,	
  2012).	
  The	
  large	
  number	
  of	
  older	
  people	
  in	
  
prison	
  is	
  partially	
  attributed	
  to	
  the	
  passage	
  of	
  stricter	
  sentencing	
  laws,	
  such	
  as	
  “Three	
  Strikes	
  
You’re	
   Out”	
   and	
   subsequent	
   longer	
   prison	
   terms	
   (ACLU,	
   2012;	
   HRW,	
   2012).	
   These	
   restrictive	
  
policies	
   have	
   created	
   a	
   situation	
   in	
   which	
   many	
   sentenced	
   to	
   long-­‐term	
   prison	
   sentences	
   will	
  
reach	
  old	
  age	
  and	
  may	
  even	
  die	
  while	
  in	
  prison	
  or	
  shortly	
  after	
  their	
  release.	
  
According	
   to	
   the	
   United	
   Nations	
   (UNODC,	
   2009),	
   older	
   prisoners,	
   including	
   those	
   with	
  
mental	
  and	
  physical	
  disabilities,	
  and	
  terminal	
  illnesses,	
  are	
  a	
  special	
  needs	
  population	
  and	
  are	
  
given	
   special	
   health,	
   social,	
   economic	
   practice	
   and	
   policy	
   considerations	
   (UNODC,	
   2009).	
   The	
  
age	
  at	
  which	
  individuals	
  are	
  defined	
  as	
  ‘older’	
  or	
  ‘elderly’	
  in	
  the	
  community	
  often	
  differs	
  from	
  
the	
  definition	
  of	
  'elderly'	
  applied	
  in	
  corrections.	
  Many	
  social	
  welfare	
  systems,	
  including	
  in	
  the	
  
United	
  States,	
  commonly	
  view	
  adults	
  as	
  older	
  when	
  they	
  reach	
  the	
  age	
  of	
  65	
  because	
  that	
  is	
  
when	
  most	
  individuals	
  are	
  eligible	
  to	
  receive	
  full	
  pension	
  or	
  social	
  security	
  benefits.	
  However,	
  
although	
  it	
  varies	
  among	
  states,	
  incarcerated	
  persons	
  in	
  the	
  United	
  States	
  may	
  be	
  classified	
  as	
  
“older	
  adult”	
  or	
  “elderly”	
  as	
  early	
  as	
  age	
  50	
  (HRW,	
  2012).	
  	
  
Incarcerated	
   people	
   have	
   been	
   shown	
   to	
   have	
   an	
   accelerated	
   aging	
   process	
   in	
   which	
  
their	
  biological	
  age	
  or	
  health	
  status	
  is	
  more	
  advanced	
  than	
  their	
  chronological	
  age	
  by	
  about	
  ten	
  
to	
   fifteen	
   years	
   (Aday,	
   2003).	
   That	
   is,	
   a	
   50-­‐year-­‐old	
   person	
   in	
   prison	
   often	
   has	
   the	
   health	
   status	
  
of	
  a	
  60	
  to	
  65-­‐year-­‐old	
  person	
  in	
  the	
  ‘free’	
  community.	
  This	
  accelerated	
  aging	
  process	
  in	
  prison	
  
is	
   often	
   attributed	
   to	
   a	
   combination	
   of	
   high-­‐risk	
   personal	
   histories	
   (e.g.,	
   substance	
   abuse,	
  
smoking,	
   poor	
   health	
   histories,	
   traumatic	
   brain	
   injury)	
   coupled	
   with	
   the	
   stressful	
   social	
  
environmental	
   conditions	
   of	
   confinement	
   (Aday,	
   2005;	
   Maschi	
   et	
   al.,	
   2012;	
   Williams	
   et	
   al.,	
  
2010,	
   2011).	
   About	
   7	
   out	
   of	
   10	
   older	
   adults	
   in	
   prison	
   report	
   some	
   type	
   of	
   medical	
   problem,	
  
	
   4	
  

including	
   serious	
   and	
   terminal	
   illnesses,	
   such	
   as	
   cancer	
   and	
   HIV/AIDS	
   (Anno	
   et	
   al.,	
   2004;	
  
Maruschak,	
   2008).	
   They	
   often	
   have	
   comorbid	
   physical	
   and	
   mental	
   health	
   symptoms,	
   for	
  
example,	
   symptoms	
   of	
   physical	
   and	
   mental	
   decline	
   accompany	
   with	
   dementia	
   (Fazel,	
   Hope,	
  
O’Donnell,	
  &	
  Jacoby,	
  2001).	
  	
  
Older	
   people	
   in	
   prison	
   often	
   have	
   histories	
   of	
   trauma	
   and	
   experience	
   post	
   traumatic	
  
symptoms	
   that	
   are	
   associated	
   with	
   combat	
   exposure	
   or	
   family,	
   peer,	
   community,	
   and	
   prison	
  
violence,	
  which	
  also	
  puts	
  a	
  significant	
  toll	
  on	
  their	
  physical	
  and	
  mental	
  health	
  (Maschi,	
  Dennis,	
  
et	
   al.,	
   2011;	
   Maschi,	
   Morgen,	
   Zgoba,	
   2011).	
   Official	
   statistics	
   suggest	
   gender	
   and	
   racial	
  
disparities	
  among	
  the	
  aging	
  prison	
  population.	
  Most	
  older	
  incarcerated	
  people	
  are	
  male	
  (93%)	
  
and	
   disproportionately	
   minorities,	
   such	
   as	
   African	
   Americans	
   (32%),	
   Hispanics	
   (14%),	
   and	
   those	
  
with	
  histories	
  of	
  poverty	
  and	
  other	
  social	
  determinants	
  of	
  health	
  and	
  justice	
  disparities	
  (Maschi	
  
&	
  Aday,	
  2014;	
  Maschi,	
  Viola,	
  &	
  Sun.,	
  2012;	
  Sabol	
  &	
  Couture,	
  2008;	
  Shimkus,	
  2004).	
  
Community	
  reintegration	
  of	
  elders	
  from	
  prison	
  is	
  another	
  significant	
  consideration.	
  
Yearly	
  estimates	
  show	
  that	
  about	
  700,000	
  individuals	
  of	
  varying	
  ages	
  are	
  released	
  from	
  prison.	
  
About	
  two	
  out	
  of	
  five	
  adults	
  recidivate	
  and	
  return	
  to	
  prison	
  for	
  parole	
  violations	
  or	
  new	
  
convictions	
  (BJS,	
  2014).	
  Age	
  is	
  an	
  important	
  determinant	
  of	
  who	
  will	
  return	
  to	
  prison	
  and	
  who	
  
will	
  not.	
  Research	
  suggests	
  that	
  adults	
  aged	
  55	
  and	
  older	
  are	
  less	
  likely	
  to	
  recidivate	
  than	
  their	
  
younger	
  counterparts	
  (0-­‐2%	
  and	
  43%,	
  respectively).	
  That	
  is,	
  official	
  statistics	
  consistently	
  show	
  
that	
  the	
  public	
  safety	
  risk	
  for	
  crimes	
  committed	
  by	
  released	
  inmates	
  is	
  much	
  lowers	
  for	
  those	
  
55	
  and	
  older	
  compared	
  to	
  their	
  younger	
  counterparts	
  (Jhi	
  &	
  Joo,	
  2009;	
  Lansing,	
  2012).	
  	
  
Evidence	
  suggests	
  that	
  there	
  is	
  a	
  positive	
  association	
  between	
  age	
  and	
  desistance	
  from	
  crime,	
  
adults	
  aged	
  55	
  and	
  older	
  pose	
  a	
  low	
  risk	
  to	
  public	
  safety.	
  A	
  growing	
  body	
  of	
  literature	
  also	
  
documents	
  the	
  complex	
  legal,	
  health,	
  and	
  social	
  care	
  needs	
  of	
  older	
  people	
  in	
  prison	
  of	
  which	
  
in	
  many	
  states	
  like	
  New	
  Jersey,	
  the	
  majority	
  will	
  be	
  released	
  over	
  the	
  next	
  five	
  years	
  (e.g.,	
  HRW,	
  
2012;	
  Maschi,	
  Viola,	
  &	
  Morgen,	
  2014).	
  
A	
  growing	
  body	
  of	
  research	
  suggests	
  that	
  there	
  are	
  barriers	
  and	
  factors	
  that	
  facilitate	
  
the	
  reintegration	
  of	
  aging	
  and	
  seriously	
  ill	
  people	
  in	
  prison.	
  Incarcerated	
  elders,	
  especially	
  those	
  
with	
  serious	
  illness	
  who	
  are	
  poised	
  for	
  release,	
  have	
  complex	
  age-­‐related	
  health,	
  mental	
  health,	
  
social/environmental	
  and	
  legal	
  needs	
  that	
  the	
  current	
  fragmented	
  care	
  systems	
  are	
  not	
  
	
   5	
  

adequately	
  prepared	
  to	
  address.	
  Care	
  transitions	
  assessment	
  and	
  planning	
  often	
  include	
  
identifying	
  linkages	
  to	
  housing,	
  health,	
  and	
  social	
  services,	
  including	
  Medicare	
  and/or	
  Medicaid	
  
benefits	
  (Maschi	
  et	
  al.,	
  2012;	
  Mesurier,	
  2011;	
  NCCH,	
  2002;	
  Williams	
  et	
  al.,	
  2010,	
  2011).	
  Many	
  
community	
  service	
  providers,	
  such	
  as	
  assisted	
  living	
  or	
  skilled	
  nursing	
  facilities	
  and	
  hospices,	
  
often	
  deny	
  placement	
  to	
  formerly	
  incarcerated	
  people	
  with	
  serious	
  and	
  terminally	
  illnesses	
  
often	
  because	
  of	
  their	
  offense	
  histories,	
  leaving	
  them	
  to	
  linger	
  in	
  prisons	
  past	
  their	
  official	
  
release	
  date	
  (Maschi,	
  Viola,	
  &	
  Sun,	
  2012).	
  The	
  aging	
  and	
  seriously	
  ill	
  population	
  in	
  prison	
  poses	
  
a	
  significant	
  challenge	
  for	
  care	
  transition	
  planning	
  that	
  corrections	
  and	
  community	
  services	
  do	
  
not	
  adequately	
  address	
  (Maschi	
  et	
  al.,	
  2013,	
  2014;	
  Williams	
  and	
  Abradles,	
  2007).	
  Transitional	
  
care	
  planning	
  is	
  often	
  problematic	
  in	
  states	
  with	
  large	
  aging	
  prison	
  populations,	
  such	
  as	
  New	
  
York,	
  where	
  a	
  sizable	
  number	
  are	
  racially	
  and	
  ethnically	
  diverse	
  elders	
  and	
  have	
  served	
  long	
  
term	
  sentences	
  for	
  violent	
  offenses	
  (NYDOCCS,	
  2013).	
  	
  
The	
  High	
  Cost	
  of	
  Incarcerating	
  the	
  Aging	
  and	
  Seriously	
  and	
  Terminally	
  Ill	
  
Housing	
  aging	
  and	
  seriously	
  ill	
  people	
  in	
  prison	
  comes	
  at	
  a	
  great	
  financial	
  cost	
  to	
  society.	
  
A	
  2012	
  Human	
  Rights	
  Watch	
  report	
  estimates	
  that	
  institutionalizing	
  and	
  providing	
  care	
  for	
  the	
  
American	
  prison	
  population	
  over	
  the	
  age	
  of	
  fifty-­‐five,	
  costs	
  state	
  and	
  federal	
  governments	
  an	
  
annual	
  sum	
  of	
  $2.1	
  billion,	
  which	
  is	
  three	
  times	
  the	
  amount	
  it	
  costs	
  to	
  accommodate	
  a	
  younger	
  
prisoner.	
   Beginning	
   around	
   the	
   1970’s,	
   compassionate	
   and	
   geriatric	
   policies,	
   such	
   as	
   medical	
  
parole	
   and	
   compassionate	
   release	
   laws	
   and	
   programs	
   for	
   mostly	
   non-­‐violent	
   terminally	
   ill	
  
incarcerated	
  people,	
  have	
  been	
  implemented	
  in	
  an	
  effort	
  to	
  transition	
  aging	
  and/or	
  serious	
  or	
  
terminally	
   ill	
   incarcerated	
   people	
   to	
   community-­‐based	
   care	
   (Maschi,	
   Marmo,	
   &	
   Han	
   2014;	
  
Williams	
  et	
  al.,	
  2011).	
  	
  In	
  theory,	
  these	
  laws	
  are	
  a	
  possible	
  cost-­‐efficient	
  option	
  for	
  the	
  release	
  
of	
   persons	
   with	
   serious	
   and/or	
   terminal	
   illness	
   in	
   prison.	
   	
   However,	
   states	
   often	
   do	
   not	
   use	
  
these	
   laws,	
   including	
   New	
   York,	
   often	
   due	
   to	
   bureaucratic	
   red	
   tape	
   and	
   negative	
   public	
  
attitudes	
  towards	
  more	
  compassionate	
  approaches	
  to	
  criminal	
  justice	
  (Chiu,	
  2010).	
  	
  
The	
  Purpose	
  of	
  this	
  Report	
  
To	
   date	
   there	
   has	
   not	
   been	
   a	
   comprehensive	
   comparative	
   analysis	
   of	
   the	
   legal	
  
provisions	
   of	
   the	
   existing	
   compassionate	
   and	
   geriatric	
   release	
   laws	
   in	
   the	
   United	
   States.	
  
Therefore,	
   the	
   purpose	
   of	
   this	
   content	
   analysis	
   is	
   to	
   fill	
   this	
   knowledge	
   gap	
   by	
   examining	
   the	
  
	
   6	
  

applicable	
   legal	
   provisions	
   in	
   the	
   US	
   to	
   determine	
   the	
   characteristics	
   of	
   compassionate	
   and	
  
geriatric	
  release	
  laws	
  in	
  the	
  US	
  and	
  the	
  extent	
  to	
  which	
  they	
  meet	
  human	
  rights	
  standards.	
  	
  
This	
   review	
   was	
   guided	
   by	
   the	
   following	
   research	
   questions:	
   (1)	
   what	
   are	
   the	
  
characteristics	
   of	
   compassionate	
   and	
   geriatric	
   release	
   laws	
   in	
   the	
   United	
   States?	
   (2)	
   To	
   what	
  
extent	
  are	
  existing	
  compassionate	
  and	
  geriatric	
  release	
  laws	
  consistent	
  with	
  core	
  principles	
  of	
  a	
  
human	
   rights	
   framework?	
   The	
   results	
   of	
   this	
   review	
   have	
   implications	
   for	
   developing	
   or	
  
improving	
   social	
   responses	
   to	
   the	
   treatment	
   of	
   aging	
   and	
   seriously	
   ill	
   people	
   involved	
   in	
   the	
  
criminal	
   justice	
   system.	
   Gaining	
   a	
   better	
   understanding	
   of	
   the	
   similarities	
   and	
   differences	
   of	
  
these	
   state	
   laws	
   can	
   help	
   to	
   develop	
   or	
   refine	
   existing	
   laws	
   that	
   address	
   the	
   complexity	
   of	
  
issues	
   faced	
   by	
   aging	
   and	
   seriously	
   ill	
   people	
   released	
   from	
   prison	
   as	
   well	
   as	
   the	
   issues	
  
confronting	
   their	
   families.	
   This	
   information	
   also	
   can	
   be	
   used	
   to	
   better	
   prepare	
   communities,	
  
especially	
  correctional	
  and	
  community	
  service	
  providers,	
  that	
  can	
  facilitate	
  the	
  release	
  process,	
  
smooth	
   care	
   transitions,	
   and	
   provide	
   community	
   placement	
   of	
   aging	
   and	
   seriously	
   ill	
   people.	
  
Advocates	
  and	
  policy	
  makers	
  also	
  can	
  be	
  made	
  more	
  aware	
  of	
  how	
  to	
  craft	
  responsive	
  laws	
  and	
  
policies,	
  amend	
  existing	
  legislation,	
  monitorand	
  evaluate	
  their	
  implementation,	
  and	
  take	
  action	
  
to	
  galvanize	
  public	
  support.	
  
METHODS	
  
In	
   order	
   to	
   identify	
   all	
   of	
   the	
   compassionate	
   and	
   geriatric	
   release	
   laws	
   in	
   the	
   United	
  
States,	
  the	
  research	
  team	
  conducted	
  a	
  comprehensive	
  search	
  of	
  the	
  Lexis	
  Nexus	
  database	
  using	
  
the	
  Fordham	
  University	
  online	
  research	
  database	
  portal.	
  The	
  following	
  key	
  word	
  search	
  terms	
  
were	
  used:	
  compassionate	
  release,	
  medical	
  parole,	
  geriatric	
  prison	
  release,	
  elderly	
  (or	
  seriously	
  
ill)	
  and	
  prison.	
  Identified	
  laws	
  were	
  included	
  in	
  the	
  sample	
  if	
  they	
  met	
  the	
  following	
  criteria:	
  (1)	
  
identified	
   aging	
   or	
   seriously	
   ill	
   people	
   in	
   prison	
   and	
   (2)	
   were	
   a	
   law	
   or	
   policy	
   that	
   contained	
  
provisions	
   governing	
   prison	
   release.	
   Two	
   trained	
   research	
   assistants	
   reviewed	
   the	
   laws	
   and	
  
coded	
   the	
   data.	
   	
   The	
   team	
   met	
   weekly	
   for	
   a	
   six-­‐month	
   period	
   with	
   the	
   lead	
   researcher	
   until	
  
100%	
   consensus	
   was	
   reached	
   for	
   all	
   categories	
   of	
   data	
   extracted.	
   As	
   shown	
   in	
   Table	
   1,	
   the	
  
search	
   located	
   52	
   federal	
   and	
   state	
   corrections	
   systems	
   (50	
   states,	
   Washington	
   D.C,	
   and	
   the	
  
Federal	
   Corrections).	
   Of	
   the	
   52,	
   47	
   have	
   some	
   legal	
   procedure	
   or	
   precedent	
   for	
   incarcerated	
  
people	
   or	
   their	
   families	
   to	
   petition	
   for	
   early	
   release	
   based	
   on	
   advanced	
   age	
   or	
   health.	
   There	
  
	
   7	
  

was	
   no	
   evidence	
   of	
   any	
   applicable	
   law	
   or	
   provision	
   found	
   in	
   five	
   corrections	
   systems	
   (Illinois,	
  
Massachusetts,	
  South	
  Carolina,	
  South	
  Dakota,	
  and	
  Utah).	
  	
  
Data	
  Analysis	
  Methods	
  
Interpretive	
  content	
  analysis	
  strategies	
  as	
  outlined	
  by	
  Drisko	
  and	
  Maschi	
  (in	
  press)	
  were	
  
used	
   to	
   analyze	
   the	
   compassionate	
   release	
   laws	
   from	
   the	
   United	
   States.	
   Interpretive	
   content	
  
analysis	
  is	
  a	
  systematic	
  procedure	
  that	
  codes	
  and	
  analyzes	
  qualitative	
  data,	
  such	
  as	
  the	
  content	
  
of	
  published	
  articles	
  or	
  legal	
  laws.	
  A	
  combination	
  of	
  deductive	
  and	
  inductive	
  approaches	
  can	
  be	
  
used,	
  and	
  this	
  strategy	
  was	
  used	
  in	
  the	
  current	
  review.	
  	
  Deductive	
  analysis	
  strategies	
  were	
  used	
  
to	
  extract	
  the	
  data	
  by	
  constructing	
  pre-­‐existing	
  categories	
  for	
  the	
  criteria	
  commonly	
  found	
  in	
  
compassionate	
   and	
   geriatric	
   release	
   laws	
   (e.g.,	
   age,	
   health	
   status,	
   length	
   of	
   sentence,	
   and/or	
  
type	
   of	
   offense).	
   Counts	
   of	
   these	
   textual	
   variables	
   found	
   in	
   each	
   category	
   were	
   then	
   calculated	
  
to	
  identify	
  frequencies	
  and	
  percentages	
  of	
  each	
  identified	
  category	
  (Drisko	
  	
  &	
  Maschi,	
  in	
  press).	
  	
  	
  
Inductive	
  analysis	
  strategies	
  were	
  used	
  to	
  analyze	
  any	
  emerging	
  or	
  new	
  categories	
  that	
  
could	
  not	
  be	
  classified	
  in	
  existing	
  categories.	
  Tutty	
  and	
  colleagues'	
  (1996)	
  four-­‐step	
  qualitative	
  
data	
   analysis	
   strategies	
   were	
   utilized	
   to	
   analyze	
   this	
   data.	
   Step	
   one	
   involved	
   identifying	
  
‘meaning	
   units’	
   (or	
   in-­‐vivo	
   codes)	
   from	
   the	
   data.	
   For	
   example,	
   the	
   assignment	
   of	
   ‘meaning	
  
units’	
   included	
   the	
   assigning	
   codes.	
   In	
   step	
   two,	
   second	
   level	
   coding	
   and	
   first	
   level	
   ‘meaning	
  
units’	
   were	
   sorted	
   and	
   placed	
   in	
   their	
   emergent	
   categories.	
   Meaning	
   unit	
   codes	
   were	
   arranged	
  
by	
   clustering	
   similar	
   codes	
   into	
   a	
   category	
   and	
   separating	
   dissimilar	
   codes	
   into	
   separate	
  
categories.	
  The	
  data	
  was	
  then	
  analyzed	
  for	
  relationships,	
  themes,	
  and	
  patterns.	
  In	
  step	
  three,	
  
the	
   categories	
   were	
   examined	
   for	
   meaning	
   and	
   interpretation.	
   In	
   step	
   four,	
   conceptually	
  
clustered	
  matrices	
  (or	
  tables)	
  were	
  constructed	
  to	
  illustrate	
  the	
  patterns	
  and	
  themes	
  found	
  in	
  
the	
  data	
  (Miles	
  &	
  Huberman,	
  1994).	
  
SUMMARY	
  OF	
  FINDINGS	
  
As	
  shown	
  in	
  Table	
  1,	
  out	
  of	
  50	
  states	
  plus	
  Washington,	
  DC	
  and	
  a	
  Federal	
  Law	
  (totaling	
  52	
  
jurisdictions),	
  4	
  states	
  do	
  not	
  have	
  any	
  publicly	
  available	
  records	
  of	
  compassionate	
  or	
  geriatric	
  
release	
  laws	
  (i.e.,	
  IL,	
  SC,	
  SD,	
  UT).	
  However,	
  46	
  states	
  were	
  found	
  to	
  have	
  a	
  compassionate	
  or	
  
geriatric	
   release	
   law,	
   as	
   well	
   as	
   Washington,	
   DC	
   and	
   the	
   Federal	
   Government.	
   After	
   a	
   review	
   of	
  
legal	
  documentation	
  from	
  48	
  systems	
  in	
  the	
  United	
  States	
  (47	
  separate	
  US	
  states/D.C.	
  and	
  one	
  	
  
	
   8	
  

Table	
  1:	
  	
  List	
  of	
  State	
  and	
  Federal	
  Compassionate	
  or	
  Geriatric	
  Release	
  Parole	
  Laws	
  in	
  the	
  
United	
  States	
  
Abbreviation	
  

1. AL	
  
2. AK	
  
3. AZ	
  
4. AR	
  
5. CA	
  
6. CO	
  
7. CT	
  
8. DE	
  
9. FL	
  
10. GA	
  
11. HI	
  
12. ID	
  
13. IL	
  
14. IN	
  
15. IA	
  
16. KS	
  
17. KY	
  
18. LA	
  
19. ME	
  
20. MD	
  
21. MA	
  
22. MI	
  
23. MN	
  
24. MS	
  
25. MO	
  
26. MT	
  
27. NE	
  
28. NV	
  
29. NH	
  
	
  

Compassionate	
  
or	
  
Geriatric	
  
Release	
  Law	
  
(Y=Yes,	
  N=No)	
  

State/	
  Territory	
  
Name	
  

Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
N	
  
Y	
  
Precedent	
  
Y	
  
Y	
  
Y	
  
Precedent	
  
Y	
  
N	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  
Y	
  

Alabama	
  
Alaska	
  
Arizona	
  
Arkansas	
  
California	
  
Colorado	
  
Connecticut	
  
Delaware	
  
Florida	
  
Georgia	
  
Hawaii	
  
Idaho	
  
Illinois	
  
Indiana	
  
Iowa	
  
Kansas	
  
Kentucky	
  
Louisiana	
  
Maine	
  
Maryland	
  
Massachusetts	
  
Michigan	
  
Minnesota	
  
Mississippi	
  
Missouri	
  
Montana	
  
Nebraska	
  
Nevada	
  
New	
  Hampshire	
  

Abbreviation	
  

Compassionate	
  
or	
  
Geriatric	
  
Release	
  Law	
  
(Y=Yes,	
  N=No)	
  

State/Territory	
  
Name	
  

30.	
  NJ	
  
Y	
  
New	
  Jersey	
  
31.NM	
  
Y	
  
New	
  Mexico	
  
32.	
  NY	
  
Y	
  
New	
  York	
  
33.	
  NC	
  
Y	
  
North	
  Carolina	
  
34.	
  ND	
  
Y	
  
North	
  Dakota	
  
35.	
  OH	
  
Y	
  
Ohio	
  
36.	
  OK	
  
Y	
  
Oklahoma	
  
37.	
  OR	
  
Y	
  
Oregon	
  
38.PA	
  
Y	
  
Pennsylvania	
  
39.	
  RI	
  
Y	
  
Rhode	
  Island	
  
40.	
  SC	
  
N	
  
South	
  Carolina	
  
41.	
  SD	
  
N	
  
South	
  Dakota	
  
42.	
  TN	
  
Y	
  
Tennessee	
  
43.	
  TX	
  
Y	
  
Texas	
  
44.	
  UT	
  
N	
  
Utah	
  
45.	
  VT	
  
Y	
  
Vermont	
  
46.	
  VA	
  
Y	
  
Virginia	
  
47.	
  WA	
  
Y	
  
Washington	
  
48.	
  WV	
  
Y	
  
Wyoming	
  
49.	
  WI	
  
Y	
  
Wisconsin	
  
50.	
  WY	
  
Y	
  
Wyoming	
  
51.Federal	
  	
  
Y	
  
US	
  Federal	
  
52.	
  DC	
  	
  
Y	
  
Washington	
  DC	
  
Note:	
  	
  Out	
  of	
  50	
  states	
  plus	
  Washington,	
  DC	
  and	
  
a	
  Federal	
  Law	
  (totaling	
  52),	
  46	
  states	
  were	
  
found	
  to	
  have	
  a	
  compassionate	
  or	
  geriatric	
  
release	
  laws	
  as	
  well	
  as	
  Washington,	
  DC	
  and	
  
Federal	
  Government.	
  Four	
  states	
  do	
  not	
  have	
  
any	
  public	
  records.	
  

Federal	
  law),	
  some	
  basic	
  structural	
  consistencies	
  are	
  present	
  that	
  impact	
  the	
  determination	
  and	
  
allowance	
  for	
  early	
  release	
  or	
  furlough	
  from	
  prisons	
  in	
  the	
  case	
  of	
  physical	
  or	
  mental	
  incapacity	
  
or	
   advanced	
   age.	
   In	
   order	
   to	
   evaluate	
   the	
   factors	
   that	
   impact	
   potential	
   release	
   and	
   thereby	
  
evaluate	
   various	
   systems	
   as	
   a	
   whole,	
   it	
   is	
   useful	
   to	
   break	
   down	
   the	
   key	
   drivers	
   into	
   five	
  
	
   9	
  

categories:	
   (1)	
   physical/mental	
   health,	
   (2)	
   age,	
   (3)	
   pathway	
   to	
   release	
   decision,	
   (4)	
   post	
   release	
  
support,	
  (5)	
  personal	
  and	
  criminal	
  justice	
  history,	
  and	
  (6)	
  stage	
  of	
  review.	
  Stage	
  of	
  review	
  is	
  the	
  
initial	
   ground-­‐level	
   investigation	
   and	
   does	
   not	
   mean	
   to	
   imply	
   which	
   choices	
   made	
   by	
   various	
  
governing	
   bodies	
   are	
   more	
   successful	
   or	
   prolific	
   in	
   their	
   relationship	
   with	
   early	
   release	
   or	
  
furlough	
  for	
  health-­‐associated	
  reasons.	
  These	
  issues,	
  as	
  noted	
  later,	
  need	
  further	
  investigation	
  
in	
  future	
  research	
  studies.	
  	
  
Physical	
  and	
  Mental	
  Health	
  
Table	
  2.	
  Characteristics	
  of	
  Laws	
  that	
  Specify	
  the	
  Conditions	
  that	
  Warrant	
  Release	
  	
  
	
  
Illness	
  is	
  Terminal	
  or	
  Incapacitating	
  
Mental	
  Health	
  
Age	
  +/-­‐	
  Disability	
  
Consideration	
  
	
  
	
  
	
  
With	
  a	
  lifespan	
  
Without	
  a	
  
time	
  limit	
  
lifespan	
  time	
  
limit	
  
Number	
  of	
  
17	
  
19	
  
17	
  
14	
  
	
  
	
  
	
  
	
  
states	
  
Abbreviations	
   AK,	
  AR,	
  DC,	
  HI,	
   AL,	
  CT,	
  FL,	
  GA,	
  ID,	
   AK,	
  AL,	
  AR,	
  DE,	
  
AL,	
  CT,	
  DC,	
  LA,	
  MO,	
  
KS,	
  KY,	
  MO,	
  MT,	
   IN,	
  KS,	
  LA,	
  MD,	
  
KS,	
  MD,	
  MI,	
  MS,	
   NC,	
  NM,	
  OR,	
  TX,	
  US	
  
NC,	
  NJ,	
  NM,	
  NV,	
   MN,	
  NE,	
  NH,	
  NY,	
   NH,	
  NJ,	
  RI,	
  TN,	
  
FED,	
  VA,	
  WA,	
  WI,	
  
PA,	
  RI,	
  TN,	
  US	
  
OH,	
  OK,	
  OR,	
  TX,	
  
TX,	
  US	
  FED,	
  WI,	
   WY	
  
FED,	
  WY	
  
VT,	
  WI	
  
WV,	
  WY	
  
	
  
All	
  parole	
  or	
  furlough	
  opportunities	
  have	
  some	
  measurements	
  by	
  which	
  they	
  determine	
  if	
  the	
  
incarcerated	
   person	
   will	
   be	
   eligible	
   for	
   release	
   due	
   to	
   medical	
   infirmity,	
   age,	
   and/or	
  
psychological	
   or	
   mental	
   facility	
   (See	
   Tables	
   2	
   and	
   3).	
   While	
   some	
   states	
   are	
   somewhat	
   vague	
  
about	
  what	
  may	
  be	
  considered	
  a	
  condition	
  viable	
  for	
  parole	
  or	
  furlough,	
  others	
  are	
  very	
  specific	
  
about	
  what	
  constitutes	
  consideration	
  for	
  release.	
  Some	
  consider	
  the	
  inmate’s	
  potential	
  threat	
  
to	
  society,	
  while	
  others	
  focus	
  on	
  the	
  high	
  cost	
  of	
  treatment	
  and	
  some	
  present	
  a	
  combination	
  of	
  
factors	
  to	
  consider.	
  There	
  is	
  little	
  consistency,	
  or	
  even	
  clarity,	
  concerning	
  attitudes	
  toward	
  the	
  
well	
  being	
  of	
  the	
  incarcerated	
  person	
  and	
  his/her	
  family	
  included	
  in	
  the	
  documentation.	
  
When	
  determining	
  if	
  the	
  incarcerated	
  person’s	
  medical	
  health	
  warrants	
  potential	
  early	
  
parole	
   or	
   furlough,	
   36	
   laws	
   make	
   mention	
   of	
   terminal	
   illness	
   for	
   consideration.	
   Of	
   those,	
   17	
  
include	
  a	
   maximum	
  anticipated	
  survival	
  period	
  or	
  time	
  limit	
   for	
  patient	
  life	
  expectancy.	
   The	
  US	
  
	
  10	
  

Federal	
   law	
   includes	
   a	
   time	
   limit	
   of	
   18	
   months	
   for	
   the	
   patient	
   to	
   survive	
   in	
   order	
   to	
   be	
  
considered	
  for	
  parole,	
  but	
  the	
  state	
  documents	
  that	
  include	
  a	
  limit	
  for	
  patient	
  life	
  expectancy	
  
most	
  frequently	
   cite	
  either	
  6-­‐	
  or	
   12-­‐months	
  to	
  live.	
  In	
  one	
  state,	
  Kansas,	
  the	
   period	
   	
   	
  is	
   only	
   30	
  
days	
  life	
  expectancy.	
  In	
  the	
  19	
  cases	
  where	
  states	
  do	
  not	
  specify	
  the	
  time	
  period	
  for	
  patient	
  life	
  
expectancy,	
   terminal	
   illness	
   is	
   included	
   as	
   a	
   potential	
   factor	
   for	
   early	
   release,	
   as	
   are	
   terms	
   such	
  
as	
  “imminent	
  peril	
  of	
  death”	
  or	
  “illness	
  from	
  which	
  the	
  inmate	
  will	
  not	
  recover,”	
  or	
  simply	
  	
  
	
  “terminal	
  illness.”	
  	
  	
  
Table	
  3.	
  Legal	
  Considerations	
  for	
  Release	
  	
  
	
  
	
  

Number	
  of	
  
States	
  
Abbreviations	
  

Considerations	
  for	
  early	
  release	
  for	
  incapacitated	
  or	
  terminally	
  Ill	
  patients	
  
included	
  in	
  legal	
  language	
  	
  
No	
  Threat	
  to	
   Incapacitated	
  so	
  
Cost	
  to	
  treat	
   General	
  Healthcare	
  
Society	
  
cannot	
  care	
  for	
  self	
  	
  
is	
  too	
  high	
  
to	
  be	
  qualitatively	
  
assessed	
  
15	
  
27	
  
4	
  
16	
  
	
  
	
  
	
  
	
  
CT,	
  DC,	
  LA,	
  
AK,	
  AL,	
  AR,	
  CA,	
  CT,	
  
AK,	
  GA,	
  RI,	
  
AL,	
  AR,	
  CO,	
  DE,	
  FL,	
  
MD,	
  MN,	
  MT,	
   DC,	
  GA,	
  ID,	
  KS,	
  KY,	
  
WA	
  
HI,	
  IN,	
  MI,	
  MN,	
  MS,	
  
NM,	
  NC,	
  NV,	
   MI,	
  MN,	
  MO,	
  NC,	
  NE,	
  
ND,	
  NH,	
  NJ,	
  OH,	
  PA,	
  
OK,	
  TN,	
  TX,	
  
NJ,	
  NM,	
  NV,	
  NY,	
  OR,	
  
WV	
  
US	
  FED,	
  VT,	
  
TN,	
  TX,	
  US	
  FED,	
  VT,	
  
WY	
  
WA,	
  WI,	
  WY	
  

	
  
When	
   considering	
   mental	
   or	
   psychological	
   health	
   as	
   a	
   consideration	
   for	
   early	
   release,	
   17	
   states	
  
include	
  mental	
  health	
  capacity	
  as	
  an	
  factor	
  to	
  consider	
  for	
  early	
  release	
  as	
  well.	
  All	
  make	
  note	
  
that	
   any	
   mental	
   or	
   psychological	
   infirmity	
   must	
   result	
   in	
   incapacity	
   to	
   care	
   for	
   oneself,	
   or	
  
render	
  the	
  person	
  bedridden,	
  and/or	
  incapable	
  of	
  caring	
  for	
  his	
  or	
  her	
  activities	
  of	
  daily	
  living	
  
(ADL).	
  All	
  require	
  evaluation	
  by	
  both	
  medical	
  and	
  mental	
  health	
  care	
  professionals.	
  	
  Only	
  one	
  
state,	
   Texas,	
   mentions	
   mental	
   retardation	
   as	
   a	
   potential	
   consideration	
   for	
   parole.	
   The	
   US	
  
Federal	
  prison	
  system	
  is	
  quite	
  specific	
  in	
  defining	
  cognitive	
  impairment	
  associated	
  with	
  either	
  
brain	
  injury	
  or	
  disease,	
  such	
  as	
  Alzheimer’s.	
  
When	
   reviewing	
   general	
   health	
   conditions	
   that	
   may	
   be	
   factors	
   for	
   early	
   release	
   or	
  
furlough,	
   many	
   laws,	
   27	
   use	
   language	
   that	
   indicates	
   the	
   incarcerated	
   person	
   is	
   incapacitated	
   in	
  
such	
   a	
   way	
   that	
   he	
   is	
   incapable	
   of	
   performing	
   activities	
   of	
   daily	
   living,	
   or	
   is	
   incapacitated	
   in	
  
general.	
  	
  Other	
  issues	
  are	
  also	
  mentioned.	
  For	
  instance,	
  15	
  of	
  the	
  laws	
  state	
  as	
  a	
  precondition	
  
	
  11	
  

for	
  early	
  release	
  that	
  the	
  incarcerated	
  person	
  must	
  be	
  incapacitated	
  -­‐	
  either	
  due	
  to	
  age,	
  mental	
  
health	
  or	
  illness	
  –	
  and	
  are	
  no	
  longer	
  a	
  threat	
  to	
  society.	
  Under	
  some	
  circumstances,	
  threat	
  to	
  
society	
  is	
  the	
  only	
  factor	
  that	
  the	
  medical	
  staff	
  must	
  evaluate	
  before	
  making	
  an	
  application	
  to	
  
the	
   parole	
   board.	
   In	
   other	
   instances,	
   the	
   cost	
   of	
   the	
   healthcare	
   to	
   the	
   prison	
   system	
   is	
   a	
  
consideration	
  for	
  early	
  release.	
  	
  
Interestingly	
  many	
  laws	
  that	
  identify	
  criteria	
  for	
  early	
  release	
  simply	
  use	
  terms	
  such	
  as	
  
“serious	
   medical	
   syndrome”	
   or	
   “needing	
   medical	
   attention.”	
   Many	
   of	
   the	
   states	
   that	
   include	
  
vague	
  language	
  around	
  what	
  constellation	
  of	
  factors	
  amount	
  to	
  the	
  likelihood	
  of	
  early	
  release	
  
seem	
  to	
  have	
  fewer	
  transparent	
  processes,	
  leaving	
  the	
  decision	
  to	
  the	
  parole	
  board’s	
  discretion	
  
on	
  a	
  case-­‐by-­‐case	
  basis.	
  A	
  better	
  understanding	
  of	
  how	
  broader	
  discretion	
  affects	
  the	
  prospects	
  
for	
   early	
   release	
   among	
   eligible	
   incarcerated	
   persons	
   in	
   those	
   states	
   should	
   be	
   ascertained	
  
through	
  further	
  study.	
  	
  
Age	
  	
  
Table	
  4.	
  States	
  Including	
  Language	
  Around	
  Age	
  as	
  a	
  Factor	
  for	
  Early	
  Release	
  
States	
  including	
  language	
  around	
  age	
  as	
  a	
  factor	
  for	
  early	
  release	
  
State:	
  
Alabama	
  
Connecticut	
  
Louisiana	
  
Missouri	
  
North	
  Carolina	
  
New	
  Mexico	
  
Oregon	
  
Texas	
  
Virginia	
  
Washington	
  
Wisconsin	
  
Wyoming	
  
US	
  Federal	
  Law	
  

Age	
  Specification:	
  
55+	
  
65	
  or	
  “advanced”	
  
45+	
  and	
  serving	
  at	
  least	
  20	
  years	
  of	
  a	
  30+	
  sentence	
  
“Advanced”	
  
65+	
  
65+	
  
No	
  specification	
  
No	
  Specification	
  
60+	
  
No	
  specification	
  
No	
  specification	
  
65+	
  
65+	
  and	
  dependent	
  on	
  %	
  of	
  time	
  served	
  

	
  
Table	
  4	
  shows	
  the	
  states	
  that	
  use	
  age	
  as	
  a	
  factor	
  in	
  decision-­‐making	
  around	
  early	
  release.	
  Of	
  
the	
   47	
   laws,	
   only	
   13	
   have	
   regulations	
   that	
   consider	
   age	
   a	
   determining	
   factor	
   for	
   potential	
   early	
  
	
  12	
  

parole	
  (12)	
  or	
  furlough	
  (1).	
  	
  In	
  each	
  scenario,	
  age	
  itself	
  is	
  not	
  the	
  sole	
  determinant	
  for	
  release,	
  
but	
   age	
   in	
   association	
   with	
   some	
   degree	
   of	
   being	
   unable	
   to	
   care	
   for	
   oneself,	
   or	
   an	
   indication	
   of	
  
some	
  lack	
  of	
  capability	
  in	
  terms	
  of	
  performing	
  activities	
  of	
  daily	
  living.	
  Most	
  states	
  do	
  not	
  define	
  
“elderly”	
   but	
   some	
   do,	
   and	
   usually	
   define	
   aging	
   as	
   65+.	
   Three	
   states	
   and	
   the	
   Federal	
  
government	
   limit	
   how	
   long	
   an	
   incarcerated	
   elder	
   must	
   have	
   served	
   prior	
   to	
   considering	
  
advanced	
  age	
  as	
  a	
  factor	
  for	
  early	
  release.	
  	
  
The	
   age	
   of	
   the	
   applicant	
   is	
   almost	
   always	
   considered	
   a	
   determinant	
   factor	
   only	
   in	
  
conjunction	
   with	
   a	
   medical	
   or	
   cognitive	
   condition.	
   	
   The	
   elderly	
   incarcerated	
   are	
   not	
   considered	
  
a	
   subset	
   of	
   incarcerated	
   people	
   that	
   justify	
   release	
   in	
   their	
   own	
   right	
   without	
   concomitant	
  
ailments.	
  The	
  few	
  exceptions	
  include	
  Alabama	
  and	
  Louisiana,	
  which	
  consider	
  age	
  as	
  a	
  reason	
  in	
  
it	
  to	
  release	
  an	
  incarcerated	
  person	
  early	
  without	
  incapacity,	
  though	
  the	
  incarcerated	
  person’s	
  
life	
   history	
   and	
   crimes	
   are	
   considered	
   heavily	
   when	
   determining	
   release.	
   Oregon	
   is	
   the	
   only	
  
state	
  whose	
  law	
  recites	
  language	
  on	
  the	
  humane	
  treatment	
  of	
  the	
  aging	
  population,	
  and	
  states	
  
that	
  without	
  the	
  release	
  of	
  the	
  prisoner	
  at	
  the	
  advanced	
  age/infirmity,	
  their	
  incarceration	
  may	
  
be	
   considered	
   “cruel	
   or	
   inhumane.”	
   All	
   other	
   states	
   require	
   that	
   an	
   incarcerated	
   person	
   of	
  
advanced	
  age,	
  as	
  defined	
  by	
  each,	
  have	
  some	
  incapacity	
  that	
  either	
  is	
  permanent	
  and	
  costly,	
  or	
  
renders	
  the	
  incarcerated	
  person	
  unable	
  to	
  physically	
  harm	
  society	
  in	
  any	
  way.	
  	
  
Table	
  5.	
  The	
  Pathway	
  and	
  Process	
  for	
  Determination	
  of	
  Release	
  
	
  

Process	
  for	
  Determination	
  of	
  Release	
  

	
  

More	
  malleable	
  
Clearly-­‐defined	
  
decision-­‐process	
  for	
   process	
  and	
  rules	
  
release	
  
for	
  release	
  
Number	
  of	
  States	
  
28*	
  
17	
  

Clearly-­‐written	
  rules	
  around	
  
physician	
  documentation	
  

Abbreviations	
  

AK,	
  AL,	
  AZ,	
  CA,	
  MO,	
  NC,	
  NJ,	
  
NY,	
  TX,	
  WI,	
  WY	
  

AK,	
  AZ,	
  CO,	
  CT,	
  DE,	
  
FL,	
  GA,	
  HI,	
  IN,	
  KY,	
  
LA,	
  MD,	
  MI,	
  MN,	
  
ND,	
  NE,	
  NH,	
  NM,	
  
OH,	
  OK,	
  OR,	
  PA,	
  US	
  
FED,	
  VA,	
  VT,	
  WA,	
  
WV,	
  WY	
  

AL,	
  AR,	
  CA,	
  DC,	
  ID,	
  
KS,	
  MO,	
  MS,	
  MT,	
  
NC,	
  NJ,	
  NV,	
  NY,	
  RI,	
  
TN,	
  TX,	
  WI	
  

*IA	
  and	
  ME	
  have	
  
precedent	
  for	
  early	
  parole	
  
but	
  no	
  law	
  in	
  place	
  

	
  13	
  

11	
  

Pathway	
  to	
  Release	
  Decision	
  
As	
   shown	
   in	
   Table	
   5,	
   as	
   with	
   the	
   incarcerated	
   person’s	
   mental	
   and	
   physical	
   health	
  
determinations,	
   the	
   pathways	
   to	
   release	
   decisions	
   vary	
   from	
   state	
   to	
   state.	
   Only	
   18	
   of	
   the	
  
states	
  seem	
  to	
  have	
  very	
  specific,	
  strictly	
  defined	
  pathways	
  and	
  regulations	
  to	
  follow	
  for	
  parole	
  
decisions.	
   The	
   more	
   specific	
   rules	
   include	
   the	
   mechanism,	
   such	
   as	
   who	
   makes	
   the	
   final	
  
determination.	
   In	
   addition,	
   11	
   states	
   have	
   very	
   clearly	
   written	
   rules	
   governing	
   physician	
  
documentation,	
  how	
  many	
  or	
  which	
  physicians	
  may	
  be	
  considered	
  for	
  review,	
  and	
  what	
  factors	
  
must	
  be	
  included	
  in	
  their	
  medical	
  letter.	
  	
  
Though	
  all	
  applications	
  are	
  subject	
  to	
  official	
  parole	
  board	
  review,	
  the	
  series	
  of	
  steps	
  in	
  
order	
  to	
  reach	
  the	
  parole	
  board	
  and	
  the	
  supporting	
  documentation	
  varies.	
  The	
  above-­‐
mentioned	
  17	
  states	
  often	
  have	
  clearly-­‐written	
  review	
  procedures;	
  most	
  provide	
  for	
  a	
  deputy	
  
warden	
  in	
  conjunction	
  with	
  the	
  prison	
  medical	
  director	
  reviewing	
  all	
  documentation	
  prior	
  
making	
  a	
  submission	
  to	
  the	
  parole	
  board.	
  Often,	
  the	
  prisoner	
  or	
  his	
  advocate	
  –	
  either	
  family	
  or	
  
legal	
  advocate	
  –	
  will	
  petition	
  directly.	
  The	
  medical	
  director	
  can	
  also	
  petition	
  for	
  early	
  release	
  if	
  
the	
  prisoner	
  cannot.	
  The	
  29	
  states	
  that	
  have	
  fewer	
  procedures	
  written	
  into	
  their	
  laws	
  and	
  
applicable	
  regulations	
  that	
  provide	
  that	
  parole	
  review	
  boards	
  consider	
  all	
  information	
  prior	
  to	
  
rendering	
  a	
  final	
  decision.	
  At	
  least	
  3	
  states	
  have	
  requirements	
  that	
  the	
  parole	
  board	
  must	
  
review	
  the	
  request	
  for	
  early	
  parole	
  within	
  a	
  certain	
  number	
  of	
  days	
  (e.g.,	
  30	
  days),	
  while	
  most	
  
assume	
  the	
  case	
  will	
  be	
  heard	
  in	
  a	
  timely	
  manner	
  or	
  be	
  reviewed	
  by	
  the	
  next	
  meeting	
  of	
  the	
  
parole	
  board.	
  	
  
Post	
  Release	
  Support	
  
Table	
  6.	
  Post	
  Release	
  Support	
  in	
  Place	
  for	
  Release	
  
	
  
Post-­‐Release	
  Support	
  in	
  Place	
  
	
  
Medical	
  facilities	
  
Financial	
  
vetted	
  
Coverage	
  
Number	
  of	
  States	
  
18	
  
11	
  
	
  
	
  
Abbreviations	
  
AK,	
  DC,	
  ID,	
  IN,	
  KS,	
  
AK,	
  AL,	
  CO,	
  ID,	
  
MD,	
  MN,	
  MO,	
  NC,	
   KS,	
  MO,	
  MT,	
  
NE,	
  NJ,	
  NM,	
  NY,	
  TN,	
   NY,	
  TN,	
  US	
  FED,	
  
TX,	
  US	
  FED,	
  VT,	
  WY	
   WY	
  
	
  14	
  

Holistic	
  support	
  
system	
  	
  
5	
  
	
  
ID,	
  MN,	
  NC,	
  NJ,	
  
NY	
  

Family	
  or	
  Support	
  
conditions	
  	
  
9	
  
	
  
ID,	
  LA,	
  MD,	
  MN,	
  MT,	
  
NC,	
  NJ,	
  NY,	
  US	
  FED	
  

	
  
When	
   presenting	
   to	
   the	
   review	
   board,	
   submission	
   of	
   a	
   post-­‐release	
   plan	
   is	
   customary	
   	
   (See	
  
Table	
   6).	
   Issues	
   such	
   as	
   where	
   the	
   incarcerated	
   person	
   will	
   receive	
   medical	
   care	
   or	
   enter	
  
hospice	
   is	
   vetted	
   by	
   the	
   medical	
   staff	
   of	
   the	
   prison,	
   while	
   case	
   managers	
   or	
   social	
   work	
  
professionals	
   identify	
   other	
   issues.	
   Eighteen	
   of	
   the	
   laws	
   note	
   that,	
   prior	
   to	
   release,	
   the	
   medical	
  
hospital	
   or	
   hospice	
   –	
   or	
   family	
   home	
   with	
   healthcare	
   professionals	
   –	
   must	
   be	
   vetted	
   prior	
   to	
  
release	
  to	
  ensure	
  both	
  safety	
  and	
  proper	
  healthcare.	
  In	
  addition,	
  11	
  of	
  the	
  laws	
  mention	
  that	
  
the	
  incarcerated	
  person	
  must	
  have	
  financial	
  resources	
  to	
  cover	
  healthcare,	
  such	
  as	
  Medicaid,	
  in	
  
place	
  prior	
  to	
  early	
  release.	
  Five	
  of	
  the	
  laws	
  mention	
  a	
  holistic	
  style	
  of	
  care,	
  including	
  emotional	
  
support	
  for	
  the	
  incarcerated	
  person	
  and	
  family,	
  as	
  well	
  as	
  reintegration	
  support.	
  	
  Of	
  the	
  states	
  
that	
   allow	
   for	
   the	
   patient	
   to	
   live	
   in	
   the	
   home	
   with	
   medical	
   care,	
   9	
   states	
   cite	
   	
   "family	
  
conditions"	
  or	
  "support	
  for	
  the	
  family	
  as	
  caregivers"	
  as	
  factors.	
  
Interestingly,	
   many	
   states,	
   including	
   the	
   federal	
   system,	
   also	
   require	
   that	
   the	
   released	
  
person	
   be	
   monitored	
   by	
   a	
   parole	
   or	
   medical	
   officer	
   consistently	
   to	
   ensure	
   that	
   the	
   released	
  
person’s	
   physical	
   health	
   does	
   not	
   improve;	
   if	
   the	
   incarcerated	
   person’s	
   condition	
   should	
  
improve	
   to	
   the	
   point	
   they	
   can	
   function	
   to	
   perform	
   activities	
   of	
   daily	
   living	
   or	
   are	
   no	
   longer	
  
terminally	
   ill,	
   the	
   incarcerated	
   person	
   must	
   be	
   returned	
   to	
   prison	
   to	
   complete	
   their	
   full	
  
sentence.	
  
Personal	
  and	
  Criminal	
  Justice	
  History	
  
As	
   shown	
   in	
   Table	
   7,	
   most	
   states/Federal	
   prisons	
   exclude	
   some	
   incarcerated	
   people	
   –	
  
regardless	
   of	
   their	
   overall	
   health	
   –	
   from	
   potential	
   early	
   release.	
   Most	
   provide	
   	
   that	
   to	
   get	
   early	
  
parole	
  or	
  furlough,	
  the	
  incarcerated	
  person	
  must	
  be	
  convicted	
  of	
  an	
  offense	
  with	
  potential	
  for	
  
parole	
  (25).	
  	
  Some	
  jurisdictions	
  	
  also	
  specify	
  that	
  the	
  incarcerated	
  person	
  may	
  not	
  have	
  been	
  
convicted	
  of	
  murder,	
  either	
  1st	
  or	
  2nd	
  degree	
  (7).	
  However,	
  most	
  exclusions	
  are	
  focused	
  upon	
  
the	
  incarcerated	
  person	
  who	
  has	
  committed	
  a	
  Class	
  A,	
  B	
  or	
  C	
  felony.	
  
In	
  addition,	
  11	
  of	
  the	
  states/Federal	
  laws	
  and	
  regulations	
  exclude	
  incarcerated	
  persons	
  
convicted	
  of	
  offenses	
  of	
  a	
  sexual	
  nature.	
  For	
  those	
  incarcerated	
  persons	
  who	
  are	
  considered	
  for	
  
early	
  release	
  or	
  furlough	
  that	
  committed	
  such	
  crimes,	
  a	
  psychologist	
  or	
  psychiatrist	
  must	
  also	
  
investigate	
  and	
  determine	
  potential	
  harm	
  to	
  society.	
  Finally,	
  9	
  states	
  (KS,	
  KY,	
  MD,	
  MT,	
  NC,	
  NV,	
  
	
  15	
  

NY,	
  TN,	
  WI)	
  have	
  included	
  in	
  their	
  laws	
  that	
  the	
  victims	
  or	
  their	
  families	
  must	
  be	
  notified	
  of	
  an	
  
upcoming	
   case	
   for	
   parole	
   or	
   furlough,	
   and	
   may	
   participate	
   in	
   the	
   hearing,	
   if	
   there	
   is	
   one,	
   or	
  
submit	
  a	
  letter	
  or	
  an	
  opinion	
  concerning	
  the	
  potential	
  release	
  of	
  the	
  prisoner.	
  
	
  

Table	
  7.	
  Type	
  of	
  Crime	
  Considered	
  for	
  Early	
  Release	
  
	
  
	
  

Number	
  of	
  
States	
  
Abbreviations	
  

Type	
  of	
  Crime	
  Considered	
  for	
  Early	
  Release	
  
Ability	
  for	
  Parole	
  
Excluding	
  
Consider	
  %	
  of	
  
and/or	
  without	
  
Murder	
  	
  
time	
  served	
  
	
  
sentence	
  of	
  death	
  
25	
  
7	
  
8	
  
	
  
	
  
	
  
AK,	
  CA,	
  CT,	
  DC,	
  FL,	
   AL,	
  DC,	
  LA,	
   CT,	
  DE,	
  IN,	
  MO,	
  
ID,	
  KY,	
  LA,	
  MD,	
  
NJ,	
  NM,	
  
MS,	
  NC,	
  NY,	
  OH	
  
MO,	
  MS,	
  MT,	
  NC,	
   NY,	
  OR	
  
NE,	
  NH,	
  NJ,	
  OR,	
  RI,	
  
TN,	
  TX,	
  US	
  FED,	
  
VA,	
  WA,	
  WI,	
  WY	
  

Excluding	
  Sexually	
  
Oriented	
  Crimes	
  
11	
  
	
  
AK,	
  AL,	
  AR,	
  CO,	
  ID,	
  
KY,	
  MS,	
  NC,	
  NJ,	
  TX,	
  
WI	
  

	
  
Style	
  of	
  Review	
  
As	
   noted	
   earlier,	
   there	
   seems	
   to	
   be	
   a	
   difference	
   in	
   style	
   from	
   state	
   to	
   state,	
   and	
  
determination	
   of	
   release	
   can	
   vary	
   from	
   strictly	
   regulated	
   to	
   very	
   discretionary	
   release	
  
determinants	
   	
   –	
   such	
   as	
   a	
   state’s	
   ability	
   to	
   grant	
   medical	
   release	
   if	
   the	
   governor	
   or	
   Deputy	
  
Warden	
  “deem	
  it	
  beneficial,”	
  either	
  for	
  reasons	
  of	
  cost	
  or	
  overcrowding.	
  
Without	
  further	
  investigation	
  from	
  state	
  to	
  state,	
  it	
  is	
  unclear	
  whether	
  a	
  less-­‐regulated,	
  
more	
  malleable	
  system	
  of	
  review	
  affords	
  a	
  more	
  holistic	
  and	
  individual	
  evaluation,	
  or	
  if	
  the	
  lack	
  
of	
  regulation	
  makes	
  the	
  outcome	
  more	
  difficult	
  for	
  the	
  prison	
  review	
  boards	
  to	
  determine.	
  	
  
CASE	
  STUDY:	
  Review	
  of	
  NY	
  Release	
  on	
  Medical	
  Parole,	
  McKinney’s	
  Executive	
  Law	
  §	
  259-­‐r	
  
The	
   state	
   of	
   New	
   York	
   tends	
   toward	
   more	
   specific	
   and	
   clearly	
   defined	
   guidelines	
   for	
  
consideration	
   of	
   early	
   parole	
   based	
   on	
   an	
   inmate’s	
   physical	
   or	
   cognitive	
   impairment,	
   or	
  
terminal	
   illness.	
   That	
   is,	
   incarcerated	
   persons	
   are	
   eligible	
   for	
   consideration	
   if	
   they	
   have	
   a	
  
terminal	
  condition	
  –	
  without	
  limits	
  to	
  the	
  amount	
  of	
  time	
  prognosticated	
  to	
  death	
  –	
  or	
  have	
  a	
  
permanent	
  syndrome	
  or	
  disease	
  that	
  is	
  not	
  terminal,	
  but	
  is	
  physically	
  or	
  cognitively	
  disabling	
  to	
  
the	
  point	
  that	
  they	
  no	
  longer	
  pose	
  any	
  threat	
  to	
  society.	
  	
   	
  
	
  16	
  

The	
  state	
  of	
  New	
  York	
  has	
  one	
  of	
  the	
  more	
  specifically	
  outlined	
  courses	
  of	
  action	
  prior	
  
to	
   and	
   post	
   release.	
   However,	
   merely	
   outlining	
   the	
   steps	
   on	
   paper	
   does	
   not	
   ensure	
   a	
  
completely	
  comprehensive	
  care	
  plan,	
  timely	
  process	
  of	
  the	
  release	
  decision,	
  or	
  implementation	
  
of	
  the	
  process	
  to	
  the	
  point	
  of	
  release	
  for	
  petitioners.	
  	
  The	
  request	
  for	
  parole	
  can	
  be	
  made	
  at	
  
any	
   time	
   during	
   the	
   sentence,	
   and	
   the	
   incarcerated	
   person	
   or	
   someone	
   on	
   his	
   or	
   her	
   behalf	
  
may	
  make	
  the	
  request	
  for	
  consideration.	
  Once	
  that	
  request	
  is	
  made,	
  the	
  Office	
  of	
  Classification	
  
and	
  Movement	
  decides	
  if	
  the	
  patient	
  is	
  eligible	
  based	
  on	
  their	
  sentence.	
  Once	
  that	
  incarcerated	
  
person	
  is	
  potentially	
  eligible,	
  a	
  state-­‐licensed	
  physician	
  will	
  evaluate	
  the	
  incarcerated	
  person’s	
  
condition,	
   prognosis	
   and	
   provide	
   a	
   description	
   of	
   the	
   incarcerated	
   person’s	
   capabilities,	
  
including	
  the	
  performance	
  of	
  activities	
  of	
  daily	
  living,	
  ambulation	
  and	
  “predictions	
  concerning	
  
duration	
   of	
   incapacity.”	
   All	
   medications,	
   services,	
   future	
   needs	
   and	
   recommendations	
   on	
  
medical	
  facility/environment	
  are	
  included	
  as	
  well.	
  
Once	
   the	
   medical	
   evaluation	
   is	
   forwarded,	
   the	
   Deputy	
   Commissioner	
   or	
   Chief	
   Medical	
  
Officer	
   offers	
   a	
   recommendation	
   within	
   seven	
   working	
   days	
   to	
   be	
   forwarded	
   to	
   the	
   Parole	
  
Board	
  to	
  consider.	
  At	
  that	
  point,	
  a	
  search	
  for	
  a	
  potential	
  victim	
  associated	
  with	
  the	
  incarcerated	
  
person	
  is	
  conducted,	
  and	
  if	
  one	
  is	
  located,	
  that	
  victim	
  or	
  family	
  will	
  be	
  notified	
  that	
  the	
  case	
  is	
  
up	
   for	
   parole	
   based	
   on	
   medical	
   request.	
   	
   Once	
   all	
   steps	
   are	
   complete,	
   the	
   parole	
   board	
   will	
  
consider	
  the	
  case.	
  	
  
The	
   state	
   also	
   requires	
   a	
   complete	
   evaluation	
   of	
   how	
   and	
   where	
   the	
   incarcerated	
  
person	
  will	
  be	
  discharged	
  and	
  under	
  what	
  circumstances.	
  Reports	
  are	
  created	
  to	
  describe	
  and	
  
evaluate:	
   the	
   level	
   of	
   care	
   the	
   incarcerated	
   person	
   will	
   require;	
   where	
   that	
   care	
   will	
   be	
   located	
  
(potentially	
   taking	
   into	
   account	
   the	
   area	
   of	
   the	
   incarcerated	
   person’s	
   support	
   system);	
  
identification	
   of	
   a	
   surrogate	
   to	
   speak	
   for	
   the	
   incarcerated	
   person	
   if	
   he	
   or	
   she	
   is	
   cognitively	
  
incapacitated;	
  creation	
  of	
  a	
  home-­‐care	
  supervision	
  plan	
  if	
  appropriate;	
  and	
  assessment	
  of	
  the	
  
status	
  of	
  institutional	
  placement.	
  	
  
In	
  addition,	
  either	
  private	
  or	
  public	
  medical	
  financial	
  assistance	
  will	
  be	
  documented	
  and,	
  
if	
  necessary,	
  the	
  Offender	
  Rehabilitation	
  Coordinator	
  will	
  file	
  appropriate	
  paperwork	
  to	
  obtain	
  
Medicaid/SSI/Public	
   Assistance.	
   Also	
   important,	
   a	
   description	
   of	
   ancillary	
   support	
   needed	
   for	
  
the	
   incarcerated	
   person	
   and/or	
   caregiver	
   will	
   be	
   documented.	
   The	
   type	
   of	
   support	
   or	
  
	
  17	
  

definitions	
   of	
   caregiver	
   are	
   not	
   provided,	
   but	
   this	
   leads	
   to	
   potential	
   assistance	
   for	
   the	
   family	
   of	
  
the	
  incarcerated	
  person	
  to	
  be	
  afforded	
  some	
  support.	
  	
  
Incarcerated	
   persons	
   are	
   not	
   eligible	
   for	
   early	
   medical	
   parole	
   if	
   they	
   are	
   serving	
   a	
  
sentence	
  for	
  murder	
  in	
  the	
  1st,	
  attempted	
  murder	
  or	
  conspiracy	
  to	
  commit	
  murder	
  in	
  the	
  1st,	
  or	
  
have	
  served	
  less	
  than	
  half	
  the	
  minimum	
  sentence	
  for	
  committing	
  or	
  attempting	
  murder	
  in	
  the	
  
2nd,	
  manslaughter	
  in	
  the	
  1st,	
  and	
  any	
  offense	
  defined	
  in	
  Article	
  130	
  of	
  the	
  Penal	
  Law.	
  
DISCUSSION	
  AND	
  RECOMMENDATIONS	
  
This	
   review	
   was	
   designed	
   to	
   describe	
   and	
   analyze	
   the	
   compassionate	
   and	
   geriatric	
  
release	
  laws	
  in	
  the	
  United	
  States.	
  As	
  noted	
  in	
  the	
  findings	
  section,	
  the	
  legal	
  provisions	
  across	
  
the	
  states	
  and	
  the	
  federal	
  government	
  varied.	
  These	
  variations	
  included,	
  but	
  are	
  not	
  limited	
  to:	
  
type	
   of	
   crime	
   committed,	
   level	
   of	
   incapacity	
   or	
   illness,	
   anticipated	
   survival	
   time	
   or	
   life	
  
expectancy,	
   a	
   clearly-­‐defined	
   process	
   for	
   application	
   and/or	
   appeal,	
   level	
   of	
   supervision	
   or	
  
support	
  in	
  place	
  upon	
  release,	
  and	
  potential	
  impact	
  upon	
  or	
  opinions	
  of	
  the	
  victim	
  and/or	
  their	
  
family.	
  	
  
Ratified	
   in	
   1948	
   as	
   a	
   response	
   to	
   the	
   atrocities	
   of	
   World	
   War	
   II,	
   the	
   Universal	
  
Declaration	
  of	
  Human	
  Rights	
  (UDHR;	
  UN,	
  1948)	
  provides	
  the	
  philosophical	
  underpinnings	
  and	
  
relevant	
   articles	
   to	
   guide	
   our	
   response	
   to	
   the	
   aging	
   and	
   seriously	
   ill	
   in	
   prison.	
   The	
   UDHR	
  
preamble	
  underscores	
  the	
  norm	
  of	
  ‘respect	
  for	
  the	
  inherent	
  dignity	
  and	
  equal	
  and	
  inalienable	
  
rights’	
  of	
  all	
  human	
  beings,	
  which	
  in	
  this	
  case	
  includes	
  older	
  adults	
  in	
  prison.	
  	
  Of	
  the	
  30	
  articles,	
  
two	
   of	
   them	
   (article	
   3	
   and	
   5)	
   are	
   of	
   fundamental	
   importance	
   to	
   responding	
   to	
   the	
   release	
   of	
  
aging	
  and	
  seriously	
  ill	
  persons	
  in	
  prison.	
  Article	
  3,	
  which	
  states,	
  “Everyone	
  has	
  the	
  right	
  to	
  life,	
  
liberty,	
   and	
   the	
   security	
   of	
   person”	
   and	
   Article	
   5,	
   which	
   states,	
   “no	
   one	
   shall	
   be	
   subjected	
   to	
  
torture	
   or	
   to	
   cruel,	
   inhuman	
   or	
   degrading	
   treatment	
   or	
   punishment”	
   (UN,	
   1948,	
   p.	
   3).	
   The	
  
articles	
  provide	
  a	
  broad	
  blueprint	
  for	
  designing	
  and	
  implementing	
  policies	
  and	
  legal	
  standards	
  
that	
  protect	
  older	
  adults,	
  especially	
  for	
  the	
  right	
  to	
  freedom,	
  safety	
  and	
  security,	
  and	
  humane	
  
health	
  care	
  and	
  thus	
  compassionate	
  and	
  geriatric	
  release	
  laws	
  should	
  clearly	
  provide	
  language	
  
that	
  speaks	
  to	
  these	
  fundamental	
  human	
  rights.	
  	
  
A	
   human	
   rights	
   framework	
   and	
   implementing	
   principles	
   are	
   critical	
   to	
   developing	
   or	
  
evaluating	
   the	
   extent	
   to	
   which	
   laws	
   meets	
   basic	
   standards.	
   Fundamental	
   to	
   human	
   rights	
  
	
  18	
  

values	
   and	
   principles	
   are	
   dignity	
   and	
   respect	
   for	
   all	
   persons	
   and	
   the	
   indivisible	
   and	
   interlocking	
  
holistic	
   relationship	
   of	
   all	
   human	
   rights	
   in	
   civil,	
   political,	
   economic,	
   social,	
   and	
   cultural	
   domains	
  
(UN,	
   1948).	
   Additional	
   principles	
   include	
   participation	
   (especially	
   with	
   key	
   stakeholder	
   input	
   on	
  
legal	
  decision-­‐making),	
  nondiscrimination	
  (i.e.,	
  laws	
  and	
  practices	
  in	
  which	
  individuals	
  are	
  not	
  
discriminated	
   against	
   based	
   on	
   differences,	
   such	
   as	
   age,	
   race,	
   gender,	
   and	
   legal	
   history),	
   and	
  
transparency	
   and	
   accountability	
   (especially	
   for	
   government	
   transparency	
   and	
   accountability	
  
with	
  their	
  citizens;	
  Maschi	
  et	
  al.,	
  2012).	
  	
  As	
  shown	
  in	
  our	
  results,	
  Oregon	
  was	
  the	
  only	
  state	
  that	
  
included	
  language	
  suggestive	
  of	
  human	
  rights	
  in	
  regards	
  to	
  the	
  humane	
  treatment	
  of	
  an	
  aging	
  
population.	
   Their	
   law	
   states	
   that	
   without	
   the	
   release	
   of	
   the	
   prisoner	
   at	
   the	
   advanced	
  
age/infirmity,	
  their	
  incarceration	
  may	
  be	
  considered	
  “cruel	
  or	
  inhumane.”	
  	
  Additionally,	
  despite	
  
laws	
   and	
   policies	
   that	
   guarantee	
   prisoner	
   rights	
   to	
   healthcare	
   and	
   compassionate	
   release	
   for	
  
the	
   serious	
   and	
   terminally	
   ill	
   in	
   prison,	
   there	
   remains	
   attitudinal	
   and	
   systemic	
   barriers	
   in	
   which	
  
many	
   seriously	
   ill	
   people	
   in	
   US	
   prisons	
   are	
   denied	
   community	
   treatment	
   from	
   community	
  
service	
  providers.	
  
Many	
  of	
  the	
  laws	
  often	
  fall	
  short	
  of	
  nondiscrimination	
  standards	
  given	
  that	
  those	
  with	
  
violent	
   offense	
   histories	
   (despite	
   their	
   failing	
   health	
   status)	
   or	
   elderly	
   in	
   general	
   are	
   often	
  
excluded	
  from	
  conditional	
  release	
  provisions.	
  Also	
  rarely	
  cited	
  are	
  undergirding	
  principles	
  that	
  
speak	
   to	
   the	
   dignity	
   and	
   worth	
   of	
   the	
   person,	
   family	
   and	
   victim	
   rights	
   and	
   supports,	
   and	
  
accountability	
   and	
   transparency	
   on	
   the	
   part	
   of	
   corrections	
   to	
   grant	
   release	
   or	
   respecting	
  
agencies	
   that	
   deny	
   access	
   to	
   the	
   formerly	
   incarcerated.	
   A	
   recent	
   “Report	
   of	
   the	
   United	
   Nations	
  
High	
  Commissioner	
  for	
  Human	
  Rights”	
  (UN,	
  2012)	
  urges	
  that	
  special	
  consideration	
  be	
  given	
  to	
  
older	
   adults	
   and	
   seriously	
   ill	
   people	
   in	
   prison	
   and	
   post	
   release	
   due	
   to	
   the	
   accumulated	
  
disadvantages	
   inherent	
   in	
   their	
   status	
   and	
   grave	
   human	
   rights	
   conditions.	
   Following	
   suit,	
  
correctional	
   systems	
   and	
   laws	
   and	
   policies	
   can	
   recognize	
   this	
   standard	
   classification	
   in	
  
institutional	
  and	
  community	
  practices	
  and	
  legal	
  remedies.	
  	
  
The	
   United	
   Nations	
   also	
   provides	
   some	
   helpful	
   guidelines	
   for	
   special	
   needs	
   populations,	
  
which	
   includes	
   “older	
   prisoners”	
   as	
   a	
   special	
   needs	
   population	
   along	
   with	
   racial/ethnic	
  
minorities,	
   persons	
   with	
   disabilities	
   or	
   terminal	
   illnesses,	
   homosexuals	
   (LGBT),	
   and	
   death	
   row	
  
incarcerated	
   persons.	
   These	
   are	
   non-­‐binding	
   guidelines	
   for	
   treatment	
   that	
   includes	
   transitional	
  
	
  19	
  

care	
   planning	
   and	
   are	
   outlined	
   below	
   (Maschi	
   et	
   al.,	
   2012b;	
   UNODC,	
   2009).	
   These	
  
recommendations	
   can	
   be	
   incorporated	
   into	
   the	
   development	
   or	
   amendment	
   of	
   existing	
   laws	
  
and	
  policies4	
  from	
  sentencing	
  to	
  compassionate	
  and	
  geriatric	
  release.	
  	
  
1. Courts	
   should	
   review	
   and	
   revise,	
   if	
   needed,	
   long-­‐term	
   prison	
   sentencing	
   policies.	
   This	
  
would	
  include	
  minimal	
  use	
  of	
  long-­‐term	
  sentences	
  (unless	
  there	
  is	
  significant	
  evidence	
  
community	
  safety	
  is	
  a	
  concern).	
  
2. The	
   development	
   or	
   refinement	
   of	
   alternatives	
   to	
   incarceration	
   and	
   diversion	
   programs	
  
for	
  older,	
  seriously	
  or	
  terminally	
  ill	
  involved	
  in	
  the	
  criminal	
  justice	
  system.	
  	
  
3. In	
  prison,	
  developing	
  special	
  strategies	
  for	
  older	
  prisoners.	
  
4. Obtaining	
   the	
   input	
   of	
   a	
   multidisciplinary	
   team	
   of	
   prison	
   specialists	
   who	
   work	
   in	
  
conjunction	
  with	
  community	
  service	
  providers.	
  
5. 	
  Providing	
   geriatric-­‐specific	
   staff	
   training	
   and	
   encouraging	
   staff	
   to	
   participate	
   in	
  
community	
  organizations	
  to	
  best	
  ensure	
  a	
  continuum	
  of	
  care.	
  
6. Assisting	
  older	
  prisoners	
  in	
  accessing	
  legal	
  counsel	
  and	
  services	
  to	
  reduce	
  discrimination	
  
based	
  on	
  age	
  or	
  disability	
  status.	
  
7. Conducting	
   initial	
   and	
   ongoing	
   comprehensive	
   assessments	
   to	
   identify	
   the	
   varied	
   and	
  
changing	
  needs	
  of	
  incarcerated	
  elders.	
  
8. Providing	
  appropriate	
  accommodations,	
  including	
  special	
  units	
  within	
  prisons.	
  
9. Ensuring	
   health	
   care	
   needs	
   such	
   as	
   medical,	
   nutritional,	
   and	
   psychological	
   health,	
   social	
  
engagement	
  with	
  interdisciplinary	
  staff,	
  and	
  special	
  programs	
  to	
  address	
  mental	
  health	
  
and	
  psychosocial	
  concerns.	
  
10. Placing	
   incarcerated	
   elders	
   close	
   to	
   their	
   home	
   to	
   maintain	
   family	
   and	
   community	
  
contacts,	
  including	
  the	
  use	
  of	
  family	
  visitation	
  programs	
  (UNODC,	
  2009).	
  
Other	
   recommendations	
   relevant	
   to	
   serious/terminally	
   ill	
   incarcerated	
   people	
   include	
   the	
  
establishment	
  of	
  palliative	
  and	
  end-­‐of-­‐life	
  care	
  practices	
  and	
  policies	
  with	
  ongoing:	
  	
  
1. Services	
  of	
  qualified	
  interdisciplinary	
  professionals;	
  
2. Medical	
  and	
  psychosocial/spiritual	
  assessment	
  and	
  care	
  plans;	
  
3. 24/7	
  staff	
  availability;	
  
4. Counseling	
  services	
  offered	
  by	
  qualified	
  counselors	
  or	
  social	
  workers;	
  and	
  
	
  20	
  

5. 	
  Spiritual	
   care	
   provided	
   by	
   a	
   qualified	
   chaplain	
   of	
   the	
   interdisciplinary	
   team	
   (UNODC,	
  
2009).	
  	
  
Correctional	
   systems,	
   state	
   and	
   federal	
   governments,	
   and	
   advocates	
   can	
   compare	
   these	
  
guidelines	
   with	
   existing	
   organizational	
   level	
   policies	
   and	
   laws	
   to	
   adopt	
   or	
   modify	
   existing	
  
provisions.	
  	
  	
  
	
  

Using	
   a	
   rights-­‐based	
   approach,	
   multi-­‐stakeholder	
   evidence-­‐informed	
   and	
   evidence-­‐

based	
   policies	
   should	
   incorporate	
   the	
   voices	
   of	
   the	
   incarcerated	
   and	
   their	
   families	
   in	
   the	
  
decision-­‐making	
   process	
   along	
   with	
   other	
   key	
   stakeholders.	
   At	
   the	
   grassroots	
   and	
   national	
  
levels,	
   advocates	
   and	
   governments	
   should	
   assess	
   the	
   extent	
   to	
   which	
   human	
   rights	
  
declarations,	
  covenants,	
  and	
  conventions	
  are	
  being	
  realized	
  in	
  response	
  to	
  aging	
  and	
  seriously	
  
ill	
  people	
  in	
  prison.	
  Appendix	
  A	
  of	
  this	
  document,	
  provides	
  an	
  advocacy	
  toolkit	
  worksheet	
  that	
  
can	
   be	
   used	
   by	
   key	
   correctional	
   stakeholders	
   to	
   evaluate	
   and	
   monitor	
   the	
   extent	
   to	
   which	
   a	
  
recommended	
  minimum	
  legal	
  standard	
  concerning	
  the	
  treatment	
  of	
  the	
  aging	
  and	
  seriously	
  ill	
  
is	
  being	
  achieved.	
  	
  Appendices	
  B	
  and	
  C	
  provide	
  sensitizing	
  experiential	
  exercises	
  using	
  the	
  first	
  
hand	
   experiences	
   of	
   aging	
   and	
   seriously	
   ill	
   people	
   in	
   prison	
   about	
   their	
   own	
   health	
   and	
   their	
  
response	
  to	
  witnessing	
  others	
  dying	
  in	
  prison.	
  These	
  resources	
  are	
  awareness	
  building	
  advocacy	
  
tools	
   or	
   can	
   be	
   used	
   as	
   sensitivity	
   trainings	
   with	
   key	
   stakeholders,	
   especially	
   policy	
   makers	
   and	
  
community	
  members,	
  to	
  facilitate	
  dialogue	
  and	
  to	
  devise	
  an	
  action	
  plan.	
  	
  
When	
   investigating	
   inconsistencies	
   amongst	
   states	
   and	
   systems	
   that	
   include	
   advanced	
  
age	
   and/or	
   deteriorating	
   health	
   as	
   considerations	
   for	
   potential	
   early	
   release,	
   results	
   suggest	
  
that	
  further	
  research	
  and	
  evaluation	
  is	
  necessary	
  to	
  understand	
  the	
  impact	
  of	
  each	
  law	
  on	
  the	
  
incarcerated	
   person,	
   their	
   family	
   members,	
   their	
   local	
   communities,	
   the	
   corrections	
   systems,	
  
and	
   society.	
   Cost	
   benefit	
   analyses	
   also	
   are	
   needed	
   to	
   evaluate	
   the	
   financial	
   cost	
   to	
   housing	
  
aging	
  and	
  seriously	
  ill	
  people	
  in	
  prison	
  as	
  opposed	
  to	
  the	
  community.	
  	
  
It	
   will	
   be	
   key	
   to	
   begin	
   by	
   understanding	
   how	
   the	
   process	
   of	
   applying	
   and	
   receiving	
   early	
  
release	
  is	
  perceived	
  and	
  carried	
  out	
  by	
  various	
  stakeholders.	
  	
  More	
  specifically,	
  in	
  order	
  to	
  learn	
  
whether	
  the	
  people	
  who	
  qualify	
  for	
  early	
  release	
  are	
  actually	
  able	
  to	
  acquire	
  that	
  status,	
  and	
  to	
  
evaluate	
  the	
  early	
  release	
  process	
  to	
  determine	
  whether	
  	
  the	
  law	
  is	
  implemented	
  	
  as	
  	
  intended.	
  
Further,	
   additional	
   information	
   is	
   needed	
   on	
   which	
   systems	
   are	
   most	
   successful	
   at	
   achieving	
  
	
  21	
  

their	
   ends.	
   	
   For	
   example,	
   evaluating	
   whether	
   more	
   quantitative	
   measures	
   versus	
   qualitative	
  
decisions	
   result	
   in	
   more	
   successful	
   early	
   releases	
   for	
   qualified	
   incarcerated	
   people	
   and	
   their	
  
families.	
  	
  In	
  addition,	
  to	
  better	
  understand	
  the	
  context	
  for	
  the	
  regulations	
  adopted	
  in	
  each	
  state	
  
or	
  system,	
  it	
  would	
  be	
  useful	
  to	
  investigate	
  the	
  attitudes	
  and	
  influential	
  factors	
  that	
  influence	
  
each	
  community	
  in	
  how	
  it	
  regards	
  aging	
  or	
  ailing	
  people	
  in	
  prison	
  and	
  their	
  families	
  from	
  both	
  
qualitative	
  and	
  quantitative	
  viewpoints.	
  	
  
Limitations	
  of	
  the	
  Current	
  Review	
  
	
  	
  

These	
  findings	
  have	
  methodological	
  limitations	
  that	
  warrant	
  discussion.	
  First,	
  although	
  a	
  

comprehensive	
  search	
  of	
  the	
  Lexis	
  Nexus	
  database	
  was	
  conducted,	
  the	
  extent	
  to	
  which	
  all	
  of	
  
the	
   subject	
   laws	
   and	
   possible	
   amendments	
   were	
   available	
   is	
   unknown.	
   Second,	
   although	
  
multiple	
  coders	
  were	
  used	
  to	
  select	
  a	
  sample	
  of	
  laws,	
  classify	
  them,	
  and	
  analyze	
  their	
  findings,	
  
it	
   is	
   entirely	
   possible	
   that	
   other	
   research	
   teams	
   may	
   obtain	
   different	
   results.	
   Third,	
   the	
   content	
  
analyses	
   of	
   categories	
   and	
   themes	
   were	
   developed	
   deductively	
   and	
   inductively	
   by	
   the	
   research	
  
team	
  and	
  it	
  goes	
  without	
  saying	
  that	
  a	
  content	
  analysis	
  with	
  a	
  different	
  set	
  of	
  categories	
  and	
  
frequency	
   counts	
   would	
   yield	
   a	
   different	
   outcome.	
   .	
   Yet,	
   despite	
   these	
   limitations,	
   this	
  
comprehensive	
   analysis	
   of	
   the	
   compassionate	
   and	
   geriatric	
   release	
   laws	
   in	
   the	
   United	
   States	
  
offers	
   insight	
   into	
   the	
   next	
   steps	
   for	
   research	
   and	
   evaluation	
   to	
   improve	
   conditions	
   for	
   the	
  
elderly	
  and	
  seriously	
  and	
  terminally	
  ill	
  persons	
  in	
  prison	
  and	
  for	
  their	
  families	
  and	
  communities.	
  	
  
Conclusion	
  
If	
   there	
   is	
   enough	
   awareness	
   for	
   47	
   prison	
   systems	
   to	
   include	
   ailing	
   and	
   aging	
   as	
  
potential	
   characteristics	
   for	
   early	
   release,	
   it	
   is	
   important	
   to	
   determine	
   whether	
   those	
  
allowances	
   are	
   being	
   accessed	
   and	
   utilized.	
   If	
   the	
   legal	
   and	
   correctional	
   systems	
   prevent	
  
persons	
  from	
  acquiring	
  the	
  protections	
  afforded	
  by	
  enacted	
  law,	
  then	
  the	
  applicable	
  systems,	
  
as	
  operated	
  and	
  as	
  a	
  structure,	
  must	
  be	
  investigated	
  in	
  order	
  to	
  remove	
  such	
  barriers.	
  From	
  a	
  
human	
   rights	
   perspective,	
   human	
   beings	
   –	
   even	
   considering	
   the	
   crimes	
   committed	
   –	
   should	
  
receive	
   adequate	
   physical	
   and	
   psychological	
   care	
   in	
   the	
   prison	
   system,	
   and	
   to	
   ensure	
   that	
   their	
  
care	
   and	
   well-­‐being	
   will	
   not	
   be	
   limited	
   significantly	
   by	
   age	
   or	
   illness	
   or	
   by	
   remaining	
  
incarcerated.	
  If	
  	
  incarcerated	
  individuals	
  are	
  unable	
  to	
  receive	
  adequate	
  care	
  inside	
  prisons,	
  it	
  is	
  
incumbent	
   upon	
   advocates	
   and	
   researchers	
   to	
   press	
   for	
   	
   further	
   investigation	
   into	
   	
   the	
   barriers	
  
	
  22	
  

to	
  care,	
  including	
  but	
  not	
  limited	
  to	
  potential	
  cost	
  of	
  care	
  for	
  aging	
  and	
  terminally-­‐ill	
  patients,	
  
public	
  perception	
  of	
  release,	
  expediency	
  of	
  the	
  process	
  of	
  consideration	
  as	
  mentioned	
  above,	
  
and	
   access	
   of	
   timely	
   evidence-­‐based	
   treatment.	
   Supports	
   for	
   family	
   members,	
   surrogates	
  
and/or	
  guardians,	
  and	
  survivors	
  of	
  crimes	
  should	
  be	
  part	
  of	
  compassionate	
  or	
  geriatric	
  release	
  
legislation.	
  	
  
We,	
   as	
   a	
   society,	
   must	
   be	
   able	
   to	
   provide	
   evidence	
   that	
   we	
   are	
   able	
   to	
   provide	
   a	
  
humane	
  standard	
  of	
  care	
  to	
  those	
  within	
  the	
  prison	
  systems,	
  and	
  if	
  not,	
  national	
  and	
  state-­‐level	
  
legislation	
  must	
  be	
  evaluated	
  to	
  determine	
  if	
  care	
  outside	
  the	
  system	
  –	
  while	
  adhering	
  to	
  state-­‐
determined	
   factors	
   for	
   early	
   release	
   –	
   is	
   more	
   effective	
   than	
   care	
   offered	
   to	
   incarcerated	
  
persons	
   inside.	
   If	
   the	
   standard	
   of	
   care	
   available	
   in-­‐prison	
   remains	
   suboptimal	
   to	
   a	
   basic	
  
standard	
   of	
   care	
   outside	
   the	
   prison	
   system,	
   society	
   has	
   an	
   obligation	
   to	
   evaluate	
   release	
  
policies	
   -­‐-­‐with	
   or	
   without	
   parole	
   policies.	
   	
   An	
   interdisciplinary	
   	
   	
   team-­‐approach	
   to	
   determine	
  
those	
  standards	
  of	
  care	
  should	
  include	
  physicians,	
  psychologists,	
  social	
  workers,	
  and	
  legal	
  and	
  
community	
  health	
  experts.	
  Evidence-­‐based	
  practices	
  should	
  be	
  identified	
  in	
  consultation	
  with	
  
national	
   health	
   organizations	
   such	
   as	
   the	
   National	
   Institute	
   of	
   Health	
   (NIH)	
   or	
   the	
   National	
  
Comprehensive	
   Cancer	
   Network	
   (NCCN).	
   Issues	
   for	
   consideration	
   might	
   include:	
   time	
   to	
  
diagnosis	
   of	
   disease,	
   access	
   to	
   adequate	
   medical	
   care,	
   access	
   to	
   palliative	
   care,	
   family	
   inclusion	
  
for	
  support,	
  psychological	
  care,	
  safety,	
  cost	
  assessments,	
  and	
  the	
  impact	
  upon	
  others	
  of	
  caring	
  
for	
  aging	
  or	
  ailing	
  incarcerated	
  persons.	
  	
  
	
  

	
  

	
  23	
  

Suggested	
  Action	
  Steps	
  
Here	
  are	
  some	
  suggested	
  action	
  steps	
  to	
  build	
  upon	
  these	
  report	
  findings:	
  	
  
•

Using	
  Evidence-­‐based	
  Policy	
  Making	
  to	
  Think	
  Before	
  You	
  Act.	
  Use	
  these	
  findings	
  and	
  other	
  
evidence	
  to	
  develop,	
  amend,	
  or	
  monitor	
  implementation	
  of	
  existing	
  policies	
  and	
  practices	
  
that	
  address	
  the	
  aging,	
  seriously	
  ill,	
  and	
  dying	
  in	
  prison	
  (See	
  Appendix	
  A-­‐Worksheet).	
  	
  

•

Speak	
  Up:	
  If	
  you	
  have	
  a	
  personal,	
  practice,	
  or	
  advocacy	
  story	
  you	
  would	
  like	
  to	
  share	
  for	
  
inclusion	
  in	
  future	
  editions	
  of	
  this	
  report,	
  please	
  email	
  us	
  at	
  btep@fordham.edu	
  

•

Sign	
  this	
  Petition.	
  Please	
  sign	
  our	
  petition	
  to	
  improve	
  policies	
  and	
  practices	
  for	
  elder,	
  
seriously	
  ill,	
  and	
  dying	
  in	
  prison:	
  http://petitions.moveon.org/sign/compassionate-­‐and-­‐
restorativ-­‐1?source=c.em&r_by=12132691	
  

•

Write	
  a	
  Letter.	
  Write	
  a	
  letter	
  to	
  your	
  county,	
  state,	
  or	
  federal	
  legislators	
  or	
  a	
  newspaper	
  op-­‐
ed	
  or	
  letter	
  to	
  the	
  editor.	
  	
  

•

Build	
  Awareness.	
  Use	
  this	
  report	
  or	
  other	
  writings	
  to	
  generate	
  awareness	
  of	
  about	
  the	
  aging	
  
in	
  prison	
  crisis	
  and	
  innovative	
  solutions	
  that	
  attempt	
  to	
  remedy	
  it.	
  

•

Reach	
  Out.	
  Volunteer	
  to	
  be	
  a	
  friendly	
  visitor	
  or	
  pen	
  pal	
  with	
  elders	
  or	
  seriously	
  ill	
  people	
  in	
  
prison.	
  

•

Form	
  Partnerships	
  and	
  Coalitions.	
  Form	
  partnerships	
  and	
  coalitions	
  among	
  key	
  
stakeholders,	
  such	
  as	
  incarcerated	
  and	
  formerly	
  incarcerated	
  elders,	
  family	
  members,	
  and	
  
community	
  service	
  providers	
  to	
  address	
  the	
  rights	
  and	
  needs	
  of	
  the	
  aging,	
  seriously	
  ill,	
  and	
  
dying	
  in	
  prison.	
  	
  

•

Innovate-­‐Think	
  and	
  Act	
  Outside	
  the	
  Box.	
  Be	
  creative	
  and	
  think	
  of	
  a	
  unique	
  solutions	
  that	
  
can	
  influence	
  improved	
  policies	
  and	
  practices	
  for	
  the	
  aging,	
  seriously	
  ill	
  and	
  dying,	
  especially	
  
In	
  prison.	
  	
  

	
  

	
  

	
  24	
  

Legal	
  References	
  
Advancing	
  release	
  date	
  of	
  prisoner	
  with	
  severe	
  medical	
  condition	
  or	
  who	
  is	
  elderly	
  	
  
and	
  permanently	
  incapacitated	
  ,	
  ORS	
  §	
  144.126	
  (1976).	
  
Alabama	
  Medical	
  Furlough	
  Act,	
  Code	
  of	
  Alabama	
  §	
  14-­‐14-­‐1	
  (2013).	
  
An	
  Act	
  Regarding	
  the	
  Operation	
  of	
  County	
  Jails	
  and	
  the	
  State	
  Board	
  of	
  Corrections,	
  	
  
Sec.	
  1.17-­‐A	
  MRSA	
  §	
  1175	
  (2009).	
  	
  
An	
  Act	
  Relating	
  to	
  and	
  making	
  appropriations	
  to	
  the	
  justice	
  system,	
  Iowa	
  Law	
  S	
  	
  
F510(2011).	
  	
  
Commissioner's	
  duties,	
  Tenn.	
  Code	
  Ann.	
  §	
  4-­‐3-­‐603	
  (2010).	
  	
  
Compassionate	
  Release	
  for	
  the	
  Terminally	
  Ill,	
  HI.	
  Rev.	
  Stat.	
  §	
  COR.10.1G.11	
  (2011).	
  	
  
Conditional	
  medical	
  release,	
  Fla.	
  Stat.	
  §	
  947.149	
  (2014).	
  	
  
Conditional	
  medical	
  release,	
  Minn.	
  Stat.Ann.	
  s	
  244.05	
  Subd.	
  8	
  (2014).	
  	
  
Conditional	
  medical	
  release;	
  nonviolent	
  terminally	
  ill	
  offenders	
  ,	
  Miss.	
  Code	
  Ann.	
  §	
  	
  
47-­‐7-­‐4	
  (2015).	
  	
  
Conditional	
  release	
  of	
  geriatric	
  prisoners	
  ,	
  VA	
  Code	
  Ann.	
  §	
  53.1-­‐40.01	
  (1994).	
  	
  
County	
  jail	
  sentencing	
  alternatives	
  -­‐	
  work,	
  educational,	
  and	
  medical	
  release	
  -­‐	
  home	
  	
  
detention	
  –	
  day	
  reporting,	
  Col	
  Rev	
  Stat	
  §	
  	
  18-­‐1.3-­‐106	
  (2014).	
  	
  
Directives,	
  Burns	
  Ind.	
  Code	
  Ann.	
  §	
  11-­‐10-­‐8-­‐5	
  (1979).	
  	
  
Functional	
  incapacitation	
  release	
  ,	
  K.S.A.	
  §	
  22-­‐3728	
  (2014).	
  	
  
Furlough	
  ,	
  Tenn.	
  Code	
  Ann.	
  §	
  41-­‐21-­‐227	
  (2010).	
  	
  
Home	
  Detention	
  and	
  Monitoring	
  for	
  Certain	
  Offenders,	
  	
  N.D.	
  Cent.	
  Code,	
  §	
  12-­‐67-­‐01	
  	
  
(2012).	
  	
  
Imposition	
  of	
  a	
  sentence	
  of	
  imprisonment	
  ,	
  18	
  USCS	
  §	
  3582	
  (1987).	
  	
  
Jurisdiction	
  over	
  sentence	
  retained	
  ,	
  11	
  Del.	
  C.	
  §	
  4217(2001).	
  	
  
Medical	
  and	
  Geriatric	
  Parole,	
  D.C.	
  Code	
  §	
  24-­‐461(2014).	
  
Medical	
  parole,	
  Cal	
  Pen	
  Code	
  §	
  3550	
  (2010).	
  	
  
Medical	
  parole;	
  eligibility;	
  conditions;	
  term,	
  Neb.Rev.St.	
  §	
  83-­‐1,110.02	
  (2006).	
  	
  
Medical	
  parole	
  for	
  a	
  terminal	
  illness	
  or	
  permanent	
  incapacitation,	
  Arkansas	
  Code	
  	
  
Annotated	
  §	
  12-­‐29-­‐404	
  (2013).	
  
Medical	
  Parole,	
  Mont.	
  Code	
  Anno.,	
  §	
  46-­‐23-­‐210	
  (2014).	
  	
  
Medical	
  parole	
  program;	
  eligibility;	
  revocation,	
  LA	
  Rev	
  Stat	
  §	
  15:574.20	
  (2011).	
  
Medical	
  parole;	
  requests,	
  criteria,	
  MD	
  Code,	
  Correctional	
  Services,	
  §	
  7-­‐309	
  (2010).	
  	
  
Medical	
  Parole,	
  Rev.	
  Stat.	
  Ann.	
  651-­‐A:10-­‐a	
  (2004).	
  	
  
Medical	
  Parole,	
  RI	
  Gen.Laws	
  1956,	
  §	
  13-­‐8.1-­‐2	
  (1956).	
  	
  
Medical	
  Parole,	
  Wyo.	
  Stat.	
  §	
  7-­‐13-­‐424	
  (2012).	
  	
  
Medically	
  Recommended	
  Intensive	
  Supervision,	
  Tex	
  Gv	
  Code	
  Ann	
  §	
  508.146	
  (2015).	
  	
  
Medical	
  Release	
  of	
  Inmates,	
  N.C.G.S.A.	
  §	
  15A-­‐1369.1	
  et	
  seq.	
  (2008).	
  	
  
Offender	
  with	
  terminal	
  disease	
  or	
  advanced	
  age	
  where	
  confinement	
  will	
  endanger	
  	
  
or	
  shorten	
  life	
  §	
  217.250	
  R.S.Mo.	
  (2013).	
  	
  
Order	
  for	
  Removal,	
  AZ	
  Rev	
  Stat	
  §	
  31-­‐233	
  (2014).	
  	
  
Parole	
  and	
  rules	
  governing,	
  Idaho	
  Code	
  §	
  20-­‐223	
  (1980).	
  	
  
Parole	
  board;	
  additional	
  powers	
  and	
  duties;	
  medical	
  and	
  geriatric	
  parole	
  program,	
  	
  
	
  25	
  

New.	
  Mex.	
  Stat.	
  Ann.	
  1978,	
  §	
  31-­‐21-­‐17.1	
  (1978).	
  	
  
Parole	
  of	
  prisoners	
  with	
  documented	
  terminal	
  medical	
  conditions,	
  KRS	
  §	
  439.3405	
  	
  
(2011).	
  	
  
Parole	
  Release,	
  Conn.	
  Gen.	
  Stat.	
  §	
  54-­‐131k	
  (2012).	
  	
  
Pardon,	
  commutation,	
  medical	
  release,	
  or	
  reprieve	
  ,	
  ORC	
  Ann.	
  2967.03	
  (2013).	
  	
  
Placement	
  on	
  Board	
  docket	
  for	
  medical	
  reason,	
  57	
  Okl.St.Ann.	
  §	
  332.18(2006).	
  
Powers	
  and	
  authority	
  ,	
  Ga.	
  Const.	
  Art.	
  IV,	
  §	
  II,	
  Para.	
  II	
  (1982).	
  	
  	
  
Release	
  of	
  inmate	
  on	
  medical	
  parole,	
  Conn.	
  Gen.	
  Stat.	
  §	
  54-­‐131a	
  (2012).	
  	
  
Release	
  of	
  prisoner	
  on	
  parole;	
  procedure,	
  M.C.L.A.	
  791.235	
  (1953).	
  	
  
Release	
  on	
  medical	
  parole	
  for	
  inmates	
  suffering	
  significant	
  debilitating	
  illnesses	
  ,	
  	
  
N.Y.	
  Exc.	
  Law	
  §	
  259-­‐r	
  (2006).	
  
Release	
  on	
  parole,	
  28	
  VT	
  Stat.Ann.	
  §	
  502a	
  (2012).	
  	
  
Release	
  prior	
  to	
  expiration	
  of	
  sentence	
  ,	
  Rev.	
  Code	
  Wash.	
  (ARCW)	
  §	
  9.94A.728	
  	
  
(2010).	
  	
  
Release	
  to	
  extended	
  supervision	
  for	
  felony	
  offenders	
  not	
  serving	
  life	
  sentences,	
  Wis.	
  	
  
Stat.	
  §	
  302.113(2011).	
  	
  
Residential	
  confinement	
  or	
  other	
  appropriate	
  supervision	
  of	
  offenders	
  who	
  are	
  	
  
physically	
  incapacitated	
  or	
  in	
  ill	
  health,	
  Nev.	
  Rev.	
  Stat.	
  Ann.	
  §	
  209.3925	
  (2013).	
  	
  
Special	
  Medical	
  Parole,	
  Alaska	
  Statue	
  §	
  33.16.085	
  (2008).	
  
“Terminal	
  condition,	
  disease	
  or	
  syndrome,”	
  defined;	
  medical	
  parole	
  conditions,	
  NJ	
  	
  
Rev	
  Stat	
  §	
  30:4-­‐123.51c	
  (2013).	
  
Terminal	
  Medical	
  Release	
  ,	
  K.S.A.	
  §	
  22-­‐3729	
  (2012).	
  	
  
Transfer	
  of	
  inmates	
  in	
  need	
  of	
  medical	
  treatments	
  ,	
  42	
  Pa.C.S.	
  §	
  9777	
  (2009).	
  	
  
Transfer	
  of	
  inmates	
  of	
  state	
  institutions	
  or	
  facilities	
  ,	
  W.	
  Va.	
  Code	
  §	
  25-­‐1-­‐16	
  (2010).	
  	
  
	
  
Additional	
  References	
  and	
  Bibliography	
  
	
  
Aday,	
  R.	
  H.	
  (2005).	
  Aging	
  prisoners'	
  concerns	
  toward	
  dying	
  in	
  prison.	
  OMEGA-­‐Journal	
  of	
  Death	
  
and	
  Dying,	
  52(3),	
  199-­‐216.	
  
American	
  Civil	
  Liberties	
  Union	
  [ACLU].	
  (2012).	
  At	
  America’s	
  expense:	
  The	
  mass	
  incarceration	
  of	
  
the	
  elderly.	
  Washington,	
  DC:	
  Author.	
  
American	
  Geriatrics	
  Society	
  (2003).	
  Transitional	
  Care.	
  Retrieved	
  May	
  9,	
  2012	
  from	
  
http://www.nicheprogram.org/niche_encyclopedia-­‐geriatric_models_of_care-­‐
transitional_models	
  	
  
Anno,	
  B.,	
  Graham,	
  C.,	
  Lawrence,	
  J.E.,	
  Shansky,	
  R.,	
  Bisbee,	
  J.,	
  &	
  Blackmore,	
  J.	
  (2004).	
  Correctional	
  
health	
  care:	
  Addressing	
  the	
  Needs	
  of	
  Elderly,	
  Chronically	
  Ill,	
  and	
  Terminally	
  Ill	
  Inmates.	
  
Retrieved	
  April	
  1,	
  2010	
  from	
  http://nicic.gov/library/018735	
  	
  
	
  
CA:	
  Sage	
  Publications.	
  	
  
Bureau	
  of	
  Justice	
  Statistics	
  [BJS]	
  (2014).	
  Probation	
  and	
  parole	
  in	
  the	
  United	
  States,	
  2013.	
  
Retrieved	
  February	
  1,	
  2015	
  from	
  http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5135	
  	
  
Byock,	
  I.	
  (2002).	
  Dying	
  well	
  in	
  corrections:	
  Why	
  should	
  we	
  care?	
  Journal	
  of	
  Correct	
  Health	
  Care,	
  
9(2),	
  107-­‐117.	
  
	
  26	
  

Chiu,	
  T.,	
  (2010).	
  It’s	
  about	
  time:	
  Aging	
  prisoners,	
  increasing	
  costs,	
  and	
  geriatric	
  release.	
  New	
  
York:	
  Vera	
  Institute	
  of	
  Justice.	
  
http://beepdf.com/doc/6114/elderly_jail_inmates__problems_prevalence_and_public_
health.html	
  
Coleman,	
  E.A.	
  2003.	
  Falling	
  through	
  the	
  cracks:	
  Challenges	
  and	
  opportunities	
  for	
  improving	
  
transitional	
  care	
  for	
  persons	
  with	
  continuous	
  complex	
  care	
  needs.	
  Journal	
  of	
  the	
  
American	
  Geriatrics	
  Society,	
  2003;	
  51(4):	
  549-­‐555.	
  
Drisko,	
  J.,	
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  T.	
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  press).	
  Content	
  Analysis	
  Methods.	
  New	
  York:	
  Oxford	
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Press.	
  	
  
Fazel,	
  S.,	
  Hope,	
  T.,	
  O’Donnell,	
  I.,	
  &	
  Jacoby,	
  R.	
  (2001).	
  Hidden	
  psychiatric	
  morbidity	
  
Hoffman,	
  H.C.	
  and	
  Dickinson,	
  G.E.	
  (2011),	
  “Characteristics	
  of	
  prison	
  hospice	
  programs	
  in	
  
the	
  United	
  States”American	
  Journal	
  of	
  Hospice	
  Palliative	
  Care,	
  Vol.	
  28	
  No.	
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  pp.	
  245-­‐
252.	
  
Human	
  Rights	
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  [HRW].	
  (2012).	
  Old	
  behind	
  bars.	
  Retrieved	
  from	
  
http://www.hrw.org/reports/2012/01/27/old-­‐behind-­‐bars	
  
James,	
  D.J.,	
  &	
  Glaze,	
  L.E.	
  (2006).	
  Mental	
  health	
  problems	
  of	
  prison	
  and	
  jail	
  inmates.	
  (NCJ	
  
Publication	
  No.	
  213600).	
  Rockville,	
  MD:	
  U.S.	
  Department	
  of	
  Justice.	
  	
  	
  	
  
Jhi,	
  K.Y.,	
  	
  &	
  Joo,	
  H.J.	
  (2009).	
  Predictors	
  of	
  recidivism	
  among	
  major	
  age	
  groups	
  of	
  parolees	
  in	
  
Texas.	
  Justice	
  Policy	
  Journal,	
  6,	
  1-­‐28.	
  
Katz,	
  S.	
  &	
  Akpom,	
  C.A.	
  (1976).	
  A	
  measure	
  of	
  primary	
  sociobiological	
  functions.	
  International	
  
Journal	
  of	
  Health	
  Services.	
  6,	
  493–508.	
  
Kinsella,	
  C.	
  (2004).	
  Correctional	
  Health	
  Care	
  Costs.	
  	
  Retrieved	
  from	
  The	
  Council	
  of	
  State	
  
Governments,	
  Lexington,	
  KY	
  website:	
  
http://www.csg.org/knowledgecenter/docs/TA0401CorrHealth.pdf	
  
Lansing,	
  S.	
  (2012).	
  New	
  York	
  State	
  COMPAS-­‐probation	
  risk	
  and	
  need	
  assessment	
  study:	
  
Examining	
  the	
  recidivism	
  scale’s	
  effectiveness	
  and	
  predictive	
  accuracy.	
  Retrieved	
  March	
  
1,	
  2013	
  from	
  
http://www.criminaljustice.ny.gov/crimnet/ojsa/opca/compas_probation_report_2012.
pdf	
  
Maruschak,	
  L.	
  M.	
  (2008).	
  Medical	
  problems	
  of	
  prisoners	
  (NCJ	
  Publication	
  No.	
  221740).	
  Rockville,	
  
MD:	
  US	
  Department	
  of	
  Justice.	
  London,	
  England:	
  Author.	
  	
  
Maschi,	
  T.	
  &	
  Aday,	
  R.	
  (2014).	
  The	
  social	
  determinants	
  of	
  health	
  and	
  justice	
  and	
  the	
  aging	
  in	
  
prison	
  crisis:	
  A	
  call	
  to	
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  30	
  

	
  
	
  

	
  

Appendices	
  

	
  31	
  

Appendix	
  A.	
  Compassionate	
  and	
  Geriatric	
  Release	
  Worksheet.	
  Human	
  Rights	
  Principles	
  Assessment	
  for	
  Compassionate	
  and	
  Geriatric	
  Release	
  Laws	
  
Regarding	
  Physical	
  and	
  Mental	
  Health,	
  Age,	
  Pathway	
  to	
  Release	
  Decision,	
  Post	
  Release	
  Plan,	
  Personal	
  and	
  Criminal	
  History,	
  Style	
  of	
  Review	
  
Assessor/s’	
  Name:	
  	
  
Date:	
  	
  
Federal/State/Institutional	
  Law/Policy:	
  
Yes	
   No	
   Does	
  the	
  law	
  address	
  any	
  of	
  the	
  following	
  minimum	
  standards	
  of	
  existing	
  laws?	
  (Check	
  yes	
  or	
  no)	
  
	
  
	
  
Dignity	
  and	
  respect	
  of	
  the	
  person	
  
Notes	
  (Developing	
  or	
  improving	
  practice/policy	
  response)	
  
	
  
	
  
Humane	
  treatment	
  of	
  prisoners,	
  esp.	
  advanced	
  aged	
  and	
  infirm	
  
	
  
	
  
	
  
Post	
  release	
  plan	
  vetted	
  for	
  safety	
  and	
  appropriateness	
  
	
  
	
  
	
  
Placement	
  are	
  available	
  in	
  prison	
  special	
  medical	
  units	
  (e.g.,	
  hospice)	
  prior	
  to	
  release	
  
	
  
	
  
	
  
Holistic	
  care	
  models-­‐prison	
  and	
  post	
  release	
  
	
  
	
  
	
  
Interprofessional	
  pre	
  and	
  post	
  release	
  care	
  plans	
  
	
  
	
  
	
  
Interprofessional	
  pre	
  and	
  post	
  release	
  service	
  linkages	
  set	
  in	
  place	
  
	
  
	
  
	
  
Vetting	
  post	
  care	
  placement	
  for	
  safety	
  &	
  appropriate	
  healthcare	
  services	
  
	
  
	
  
	
  
Promote	
  Political,	
  Civil,	
  Economic,	
  Social,	
  and	
  Cultural	
  Rights	
  
	
  
	
  
	
  
Legal	
  language	
  that	
  refers	
  to	
  ‘cruel	
  or	
  inhumane’	
  if	
  release	
  denied	
  
	
  
	
  
	
  
No	
  life	
  limit	
  for	
  release	
  (expected	
  life	
  term)	
  
	
  
	
  
	
  
Benefits	
  (Medicaid/SSI/public	
  assistance)	
  available	
  prior	
  to	
  release	
  
	
  
	
  
	
  
Family	
  and	
  community	
  involvement	
  
	
  
	
  
	
  
Assigned	
  surrogate	
  when	
  no	
  family	
  are	
  identified	
  that	
  can	
  provide	
  care	
  
	
  
	
  
	
  
Request	
  made	
  by	
  incarcerated	
  person	
  or	
  someone	
  on	
  their	
  behalf	
  
	
  
	
  
	
  
Emotional	
  and	
  reintegration	
  support	
  for	
  released	
  person	
  and	
  caregiver/s	
  	
  
	
  
	
  
	
  
If	
  a	
  person	
  recovers,	
  he	
  or	
  she	
  does	
  not	
  need	
  to	
  return	
  to	
  prison	
  
	
  
	
  
	
  
Home	
  care	
  supervision	
  plans	
  
	
  
	
  
	
  
No	
  life	
  limit	
  for	
  release	
  
	
  
	
  
	
  
If	
  released	
  and	
  recover,	
  must	
  be	
  returned	
  to	
  prison	
  	
  
	
  
	
  
	
  
Nondiscrimination	
  
	
  
	
  
	
  
No	
  constraint	
  on	
  sentence	
  length	
  to	
  request	
  release	
  
	
  
	
  
	
  
Released	
  if	
  determined	
  there	
  is	
  no	
  public	
  safety	
  threat	
  to	
  society	
  
	
  
	
  
	
  
Age	
  classified	
  as	
  aged	
  50	
  or	
  above	
  
	
  
	
  
	
  
Does	
  not	
  discriminate	
  based	
  on	
  chronological	
  age	
  (without	
  infirmity)	
  
	
  
	
  
	
  
Does	
  not	
  discriminate	
  based	
  on	
  sex	
  offense	
  history	
  
	
  
	
  
	
  
Does	
  not	
  discriminate	
  based	
  on	
  murder	
  1st	
  or2nd	
  degree	
  history	
  
	
  
	
  
	
  
Does	
  not	
  discriminate	
  based	
  on	
  Felony	
  (class	
  A,	
  B,	
  C)	
  history	
  
	
  
	
  
	
  
Does	
  not	
  discriminate	
  	
  based	
  on	
  length	
  of	
  time	
  served	
  
	
  
	
  
	
  
Participation	
  
	
  
	
  
	
  
Age	
  (older	
  people)	
  
	
  
	
  
	
  
Persons	
  with	
  disabilities	
  (physical	
  or	
  mental)	
  
	
  
	
  
	
  
Persons	
  with	
  terminal	
  illness	
  
	
  
	
  
	
  
Correctional	
  leaders	
  (e.g.,	
  warden,	
  commissioner,	
  or	
  medical	
  director)	
  	
  
	
  
	
  
	
  
Parole	
  board	
  
	
  
	
  
	
  
Family	
  members	
  or	
  surrogates	
  
	
  
	
  
	
  
Legal	
  Advocates/Petitioners	
  (including	
  family)	
  
	
  
	
  
	
  
Crime	
  survivors	
  (victim	
  involvement)	
  
	
  
	
  
	
  
Physician	
  Involvement	
  
	
  
	
  
	
  
Other	
  professionals:	
  psychiatrist,	
  psychologist,	
  social	
  worker,	
  lawyer	
  
	
  
	
  
	
  
Transparency	
  
	
  
	
  
	
  
Laws	
  with	
  clear	
  definition	
  of	
  key	
  terms	
  
	
  
	
  
	
  
Clear	
  pathways	
  for	
  release	
  determination	
  
	
  
	
  
	
  
Laws	
  with	
  specific,	
  measurable,	
  specific,	
  and	
  time	
  limited	
  procedures	
  
	
  
	
  
	
  
%	
  of	
  parole	
  petitions	
  responded	
  to	
  in	
  a	
  timely	
  fashion	
  
	
  
	
  
	
  
%	
  of	
  parole	
  requests	
  honored	
  	
  
	
  
	
  
	
  
Accountability	
  
	
  
	
  
	
  
Time	
  limits	
  for	
  each	
  stage	
  of	
  review	
  process	
  
	
  
	
  
	
  
Discharge	
  planning	
  evaluation	
  	
  
	
  
	
  
	
  
Staff	
  filing	
  of	
  release	
  paperwork	
  and	
  follow-­‐up	
  
	
  
	
  
	
  
Special	
  Populations	
  Addressed	
  
	
  
	
  
	
  
Older	
  Persons	
  (Elderly)	
  
	
  
	
  
	
  
Persons	
  with	
  Disabilities	
  (Physical	
  and/or	
  Mental,	
  Mental	
  Retardation)	
  
	
  
	
  
	
  
Persons	
  with	
  Terminal	
  Illness	
  
	
  
	
  
	
  
Other:	
  	
  
	
  

	
  
	
  32	
  

Appendix	
  B	
  
	
  
Releasing	
  Their	
  Stories:	
  Awareness-­‐Building	
  Activities	
  
Qualitative	
  Select	
  Excerpts	
  from	
  Incarcerated	
  Elders	
  (Maschi,	
  2010)	
  

	
  

These	
  excerpts	
  are	
  verbatim	
  quotes	
  from	
  older	
  people	
  in	
  prison.	
  This	
  exercise	
  can	
  be	
  completed	
  individually	
  
or	
  in	
  groups.	
  Please	
  read	
  each	
  response	
  and	
  write	
  or	
  discuss	
  your	
  reaction	
  to	
  each	
  quote.	
  What	
  do	
  you	
  
and/or	
  your	
  group	
  think	
  should	
  be	
  done	
  about	
  it	
  (if	
  anything	
  at	
  all)?	
  Please	
  provide	
  a	
  rationale	
  for	
  your	
  
choice.	
  	
  
	
  
1. “Prison	
  is	
  a	
  hard	
  place.	
  Pure	
  Hell!	
  As	
  long	
  as	
  you	
  are	
  in	
  khaki,	
  you	
  are	
  considered	
  non-­‐human.	
  The	
  
elder	
  suffer	
  the	
  most	
  because	
  there	
  isn't	
  much	
  for	
  them,	
  us.	
  I	
  have	
  the	
  starts	
  of	
  osteoporosis	
  and	
  
seeing	
  how	
  some	
  people	
  young	
  and	
  old	
  are	
  treated	
  makes	
  me	
  suffer	
  and	
  deal	
  with	
  it.	
  Overall	
  it's	
  
horrible	
  and	
  wouldn't	
  wish	
  this	
  on	
  my	
  worst	
  enemy”.	
  –Quote	
  for	
  a	
  56	
  year	
  old	
  incarcerated	
  woman	
  
2. “I	
  am	
  72	
  and	
  I	
  am	
  afraid	
  of	
  being	
  assaulted	
  again.	
  I	
  get	
  stressed	
  out	
  because	
  we	
  are	
  treated	
  like	
  
pieces	
  of	
  garbage	
  and	
  always	
  threatened	
  with	
  harm	
  from	
  officers.	
  I	
  have	
  a	
  sister	
  in	
  the	
  rest	
  home	
  
and	
  have	
  no	
  contact	
  with	
  her.	
  My	
  son	
  is	
  in	
  prison.”	
  –Quote	
  from	
  a	
  72	
  year	
  old	
  incarcerated	
  man	
  
3. “I	
  was	
  assigned	
  to	
  a	
  job	
  in	
  the	
  Prison	
  Infirmary	
  (E.C.U.)	
  as	
  a	
  porter.	
  The	
  infirmary	
  job	
  was	
  often	
  very	
  
depressing.	
  They	
  have	
  a	
  couple	
  of	
  padded	
  cells	
  there	
  and	
  the	
  screams	
  of	
  tormented	
  souls	
  could	
  be	
  
heard	
  throughout	
  many	
  shifts.	
  There	
  were	
  also	
  what	
  we	
  called	
  the	
  "death	
  rooms".	
  These	
  were	
  a	
  
row	
  of	
  5-­‐6	
  cells,	
  which	
  housed	
  terminally	
  ill	
  inmates.	
  They	
  had	
  been	
  brought	
  in	
  from	
  prisons	
  
throughout	
  the	
  state.	
  Many	
  were	
  fairly	
  young.	
  The	
  medical	
  "professionals"	
  working	
  here	
  had	
  
minimal	
  interaction	
  with	
  them;	
  they	
  were	
  largely	
  cared	
  for	
  by-­‐care	
  inmate	
  volunteers.	
  When	
  one	
  of	
  
the	
  terminal	
  cases	
  passed	
  away,	
  and	
  ambulance	
  would	
  eventually	
  arrive	
  to	
  take	
  the	
  body	
  out	
  of	
  the	
  
prison.	
  The	
  guards	
  and	
  medical	
  staff	
  would	
  not	
  help	
  "bag	
  and	
  tag"	
  the	
  body,	
  so	
  it	
  was	
  left	
  to	
  us	
  
porters	
  to	
  assist	
  in	
  it”	
  56	
  year	
  old	
  incarcerated	
  man	
  
4. “The	
  apathy	
  of	
  the	
  guards	
  toward	
  dying	
  inmates	
  was	
  unconscionable.	
  We	
  had	
  one	
  inmate	
  about	
  30	
  
years	
  old	
  whose	
  wife	
  and	
  2	
  small	
  children	
  were	
  given	
  permission	
  for	
  a	
  special	
  visit	
  because	
  he	
  was	
  
near	
  death.	
  As	
  shift	
  change	
  approached,	
  a	
  nurse	
  entered	
  the	
  room	
  and	
  the	
  family	
  had	
  to	
  stand	
  
outside	
  of	
  the	
  door.	
  A	
  female	
  guard	
  yelled	
  to	
  the	
  nurse,	
  "Isn't	
  he	
  dead	
  yet?	
  I	
  don't	
  want	
  to	
  have	
  to	
  
stay	
  late	
  to	
  do	
  the	
  paperwork."	
  The	
  two	
  little	
  girls	
  were	
  sobbing	
  in	
  no	
  time.	
  We	
  also	
  had	
  an	
  inmate	
  
turn	
  100	
  years	
  old	
  there.	
  He	
  was	
  completely	
  bed-­‐ridden.	
  He	
  passed	
  away	
  eventually.	
  I	
  was	
  left	
  
wondering	
  how	
  society	
  was	
  being	
  served	
  by	
  that.	
  In	
  the	
  6	
  months	
  that	
  I	
  worked	
  there,	
  6-­‐7	
  inmates	
  
passed	
  away.	
  Hepatitis	
  and	
  diabetes	
  cases	
  abounded,	
  with	
  many	
  amputations.”	
  
5. “When	
  I	
  had	
  my	
  last	
  surgery	
  in	
  prison,	
  um,	
  there	
  was	
  a	
  93-­‐year-­‐old	
  man,	
  white	
  guy,	
  he	
  was	
  a	
  
nice	
  guy.	
  	
  He	
  was	
  in	
  there,	
  I	
  believe,	
  for,	
  um,	
  assault.	
  	
  He’s	
  been	
  in	
  there	
  for	
  like	
  17	
  years	
  or	
  18	
  
years,	
  but	
  this	
  guy	
  is	
  in	
  a	
  hospital.	
  	
  He	
  can’t	
  even	
  hold	
  his	
  bowels,	
  so	
  I’m	
  like	
  what	
  is	
  a	
  guy	
  like	
  
this	
  going	
  to	
  do?	
  	
  What	
  is	
  he	
  going	
  to	
  do?	
  	
  He	
  can’t,	
  he	
  can	
  barely	
  walk.	
  	
  He’s	
  been	
  in	
  a	
  hospital,	
  
in	
  a	
  hospital	
  or	
  infirmary,	
  for	
  a	
  year.	
  	
  What	
  is	
  he	
  going	
  to	
  do?	
  You’ll	
  see	
  guys	
  in	
  there	
  that	
  just	
  sit	
  
there	
  staring	
  into	
  space.”	
  

	
  

	
  

	
  33	
  

	
  
Appendix	
  C	
  
To	
  Release	
  or	
  Not	
  To	
  Release:	
  Critical	
  Dialoguing	
  Activity	
  
Directions:	
  This	
  exercise	
  can	
  be	
  done	
  with	
  individuals	
  or	
  small	
  or	
  large	
  group	
  with	
  a	
  facilitator	
  or	
  co-­‐
facilitator.	
  Please	
  review	
  each	
  of	
  the	
  photos	
  and	
  vignettes	
  below.	
  For	
  each	
  one,	
  answer	
  the	
  following	
  
questions:	
  (1)	
  Would	
  you	
  support	
  the	
  release	
  of	
  this	
  elder	
  from	
  prison?	
  (Yes,	
  No,	
  Maybe).	
  Is	
  there	
  enough	
  
information	
  to	
  confidently	
  make	
  a	
  decision?	
  (Yes,	
  No,	
  Maybe)	
  Please	
  explain	
  your	
  decision-­‐making	
  process.	
  
After	
  hearing	
  others	
  people	
  perspectives	
  did	
  you	
  change	
  your	
  response/s.	
  Process	
  the	
  experience	
  after	
  each	
  
individual	
  or	
  group	
  has	
  had	
  an	
  opportunity	
  to	
  share.	
  	
  
Photos	
  and	
  Quotes	
  Courtesy	
  of	
  Prisoners	
  of	
  Age	
  Photos	
  and	
  Quotes	
  	
  (Ron	
  Levine,	
  2014)	
  

	
  

	
  
	
  
	
  
My	
  God.	
  When	
  I	
  get	
  out	
  I’m	
  gonna	
  sue	
  those	
  three	
  judges	
  and	
  my	
  
attorney	
  also.	
  I’m	
  gonna	
  sue	
  them.	
  	
  I	
  was	
  in	
  because	
  of	
  a	
  little	
  girl	
  
who	
  made	
  remarks	
  about	
  me	
  which	
  did	
  not	
  happen.	
  That	
  was	
  
about	
  13	
  or	
  14	
  years	
  ago.	
  I	
  didn’t	
  do	
  anything.	
  I	
  didn’t	
  do	
  a	
  damned	
  
thing	
  to	
  this	
  girl	
  that	
  was	
  running	
  around	
  the	
  park.	
  I	
  lived	
  in	
  a	
  
mobile	
  home.	
  And	
  she	
  ran	
  around…	
  and	
  it	
  was	
  terrible.	
  
	
  
Joseph	
  Mannina,	
  96	
  
Sex	
  Crime	
  	
  
	
  
	
  

	
  

	
  

	
  
What	
  brought	
  me	
  here?	
  I	
  killed	
  my	
  wife.	
  It	
  was	
  in	
  nineteen	
  eighty-­‐
eight.	
  What	
  brought	
  it	
  on?	
  	
  She	
  got	
  to	
  accusing	
  me	
  that	
  I	
  was	
  going	
  
with	
  some	
  other	
  girls,	
  you	
  know.	
  	
  And	
  cussing	
  at	
  me.	
  Same	
  thing	
  she	
  
always	
  did.	
  	
  We	
  would	
  go	
  to	
  the	
  super-­‐market	
  and	
  girls	
  speak	
  to	
  me	
  
and	
  she	
  would	
  tell	
  me,	
  “Is	
  that	
  your	
  girlfriend?”	
  I	
  tell	
  you,	
  she	
  got	
  
jealous	
  and	
  all	
  and	
  you	
  know	
  how	
  I	
  feel	
  about	
  it.	
  	
  If	
  I	
  had	
  to	
  do	
  it	
  all,	
  
I'd	
  do	
  it	
  over	
  again,	
  I	
  would.	
  
	
  
Leo	
  Eason,	
  73	
  
Murder	
  	
  

	
  34	
  

	
  

	
  

	
  

	
  

	
  

	
  
Well,	
  I	
  got	
  50	
  years.	
  Snatching	
  $24	
  out	
  of	
  a	
  man's	
  hand.	
  It	
  was	
  
1959,	
  in	
  Birmingham	
  (Alabama).	
  	
  I’m	
  in	
  no	
  shape	
  to	
  run	
  now.	
  I’d	
  
like	
  the	
  freedom.	
  But	
  I’d	
  never	
  get	
  over	
  the	
  fence.	
  I’m	
  doing	
  50	
  years	
  
for	
  robbery.	
  But	
  I	
  never	
  robbed	
  anyone.	
  I	
  only	
  took	
  24	
  dollars	
  from	
  
one	
  man.	
  I	
  consider	
  robbery	
  is	
  when	
  you	
  use	
  a	
  weapon.	
  I	
  never	
  used	
  
a	
  weapon.	
  What	
  I	
  would	
  like	
  to	
  do.	
  I	
  would	
  like	
  to	
  write	
  a	
  book	
  for	
  
young	
  black	
  people.	
  Tell	
  them	
  that	
  this	
  ain't	
  the	
  way.	
  This	
  ain't	
  the	
  
way.	
  You	
  don’t	
  do	
  it	
  this	
  way.	
  That’s	
  what	
  I	
  would	
  like	
  to	
  do.	
  Maybe	
  
someday,	
  I	
  will.	
  
	
  
William	
  Howard	
  ‘Tex’	
  Johnson,	
  67	
  
Robbery	
  
	
  
I	
  started	
  stealing	
  when	
  I	
  was	
  15.	
  I	
  robbed	
  banks.	
  	
  
I	
  always	
  worked	
  alone.	
  In	
  1994,	
  I	
  was	
  caught	
  for	
  attempted	
  
murder.	
  I	
  had	
  mixed	
  booze	
  and	
  medications.	
  Eight	
  months	
  ago	
  I	
  got	
  
married	
  to	
  a	
  woman	
  my	
  age	
  and	
  it’s	
  going	
  well.	
  That’s	
  why	
  I	
  want	
  
my	
  release,	
  to	
  live	
  with	
  her.	
  In	
  1996	
  I	
  got	
  lung	
  cancer.	
  Now,	
  I’m	
  
getting	
  treated	
  but	
  they	
  won’t	
  release	
  me.	
  They’re	
  waiting	
  for	
  me	
  to	
  
die.	
  I	
  lost	
  50	
  pounds	
  since	
  October	
  1999.	
  I	
  regret	
  committing	
  the	
  
crime	
  that	
  sent	
  me	
  here,	
  but	
  I	
  think	
  the	
  system	
  isn’t	
  fair	
  for	
  the	
  
situation	
  I’m	
  living	
  in	
  now.	
  There	
  should	
  be	
  improvements.	
  
Especially	
  when	
  someone	
  has	
  cancer.	
  They	
  should	
  let	
  them	
  go	
  live	
  
with	
  their	
  family.	
  I	
  was	
  twice	
  refused	
  conditional	
  release.	
  	
  
	
  
Jules	
  Sauvageau,	
  59	
  
Attempted	
  Murder	
  
	
  

	
  

	
  
	
  
	
  

	
  
I	
  had	
  trouble	
  with	
  a	
  police	
  officer	
  in	
  Utah.	
  	
  
He	
  shot	
  me.	
  	
  I	
  shot	
  him	
  back.	
  	
  That's	
  what	
  put	
  me	
  in	
  trouble.	
  
He	
  didn't	
  hurt	
  me	
  too	
  bad.	
  	
  I	
  didn't	
  hurt	
  him	
  too	
  bad.	
  	
  And	
  then	
  they	
  
gave	
  me	
  ten	
  years	
  for	
  that.	
  	
  I	
  got	
  two	
  more	
  to	
  go.	
  I	
  might	
  make	
  it.	
  
I'm	
  hanging	
  in	
  there.	
  
	
  
John	
  Wilson,	
  72	
  
Attempted	
  Murder	
  
	
  
	
  
	
  
	
  35	
  

	
  
	
  

	
  
I’ve	
  lived	
  81	
  years	
  enjoying	
  life,	
  I	
  was	
  heavy,	
  I	
  was	
  210	
  pounds,	
  I’m	
  
116	
  now.	
  It’s	
  a	
  lot	
  of	
  weight	
  to	
  lose.	
  I’ll	
  show	
  you	
  a	
  picture	
  of	
  me,	
  
you’d	
  say,	
  “God	
  were	
  you	
  ever	
  beautiful”.	
  	
  You’d	
  take	
  me	
  out.	
  I	
  don’t	
  
bother	
  with	
  men	
  now.	
  
	
  	
  
[They	
  say]	
  that	
  I	
  beat	
  the	
  children	
  and	
  that	
  I	
  burnt	
  the	
  children	
  ...	
  	
  	
  I	
  
just	
  love	
  kiddies,	
  I	
  see	
  them	
  there	
  crying,	
  you	
  know,..	
  they	
  want	
  to	
  
get	
  picked-­‐up,..	
  I	
  always	
  pick	
  them	
  up	
  and	
  say,	
  “Come	
  on	
  to	
  
mommy”.	
  
	
  

	
  

Edith	
  May	
  Sanders,	
  81	
  
Child	
  Abuse	
  
	
  
From	
  young	
  on,	
  most	
  time,	
  I	
  was	
  locked	
  up	
  bad.	
  	
  I	
  was	
  in	
  
reformatory	
  school	
  back	
  in	
  the	
  '40's.	
  	
  All	
  black	
  school.	
  	
  It	
  was	
  a	
  
mean	
  place.	
  	
  I	
  was	
  in	
  for	
  shooting	
  a	
  boy	
  with	
  a	
  shot	
  gun.	
  	
  He	
  owed	
  
another	
  boy	
  $3.00	
  and	
  threw	
  it	
  on	
  the	
  ground	
  and	
  told	
  the	
  boy	
  to	
  
pick	
  it	
  up.	
  	
  The	
  boy	
  told	
  him	
  to	
  pick	
  it	
  up	
  himself	
  and	
  I	
  said	
  "give	
  me	
  
the	
  three	
  dollars".	
  	
  I	
  told	
  the	
  boy	
  to	
  pick	
  it	
  up	
  off	
  the	
  ground	
  and	
  he	
  
didn't	
  so	
  I	
  shot	
  him	
  with	
  a	
  shot	
  gun.	
  	
  I	
  did	
  one	
  year	
  for	
  that	
  and	
  he	
  
lived,	
  but	
  his	
  right	
  arm	
  was	
  crooked.	
  	
  After	
  reformatory	
  school	
  I	
  
robbed	
  a	
  man	
  and	
  went	
  to	
  penitentiary.	
  	
  I	
  was	
  about	
  17	
  then.	
  	
  I	
  did	
  
12	
  year	
  for	
  that	
  in	
  Kilby	
  prison.	
  	
  It	
  was	
  a	
  rough	
  place,	
  but	
  I	
  was	
  
rough	
  with	
  it	
  though.	
  	
  It	
  was	
  a	
  segregated	
  prison.	
  Then	
  you	
  did	
  six	
  
months	
  for	
  a	
  year	
  in	
  the	
  '50's.	
  	
  I	
  did	
  12	
  full	
  years	
  for	
  that.	
  
	
  

Leon	
  Davis,	
  73	
  
Attempted	
  Murder	
  
	
  

I’m	
  in	
  here	
  for	
  ‘helping	
  my	
  family’.	
  I	
  learnt	
  my	
  lesson.	
  That	
  won’t	
  
happen	
  again.	
  But	
  y’see	
  they	
  don’t	
  help	
  me.	
  I	
  have	
  children,	
  but	
  the	
  
last	
  I’ve	
  heard	
  from	
  them	
  was	
  in	
  2005.	
  
I	
  just	
  take	
  care	
  of	
  myself	
  the	
  best	
  that	
  I	
  can.	
  
	
  

Theda	
  Rice,	
  77	
  
Murder	
  

	
  

	
  36	
  

	
  
	
  
	
  
	
  
	
  
	
  
	
  

It’s	
  something	
  in	
  my	
  life	
  that	
  happened	
  and	
  I	
  took	
  the	
  law	
  into	
  my	
  
own	
  hands.	
  	
  
	
  
Lucille	
  Carter,	
  87	
  
Murder	
  
	
  
	
  
	
  
	
  

	
  

	
  
Back	
  in	
  the	
  early	
  80’s	
  I	
  met	
  this	
  old	
  boy	
  and	
  we	
  become	
  closer	
  and	
  
closer	
  as	
  time	
  went	
  on.	
  At	
  the	
  time	
  my	
  wife	
  died	
  and	
  left	
  me	
  alone.	
  
His	
  wife	
  left	
  him.	
  He	
  was	
  the	
  kind	
  of	
  guy	
  that	
  you	
  give	
  him	
  two	
  
drinks	
  around	
  a	
  girlfriend,	
  he	
  was	
  20	
  feet	
  tall	
  and	
  gonna	
  prove	
  it.	
  
He	
  and	
  his	
  girlfriend	
  was	
  broke.	
  I	
  had	
  given	
  him	
  a	
  job.	
  I	
  was	
  in	
  the	
  
roofing	
  business.	
  And	
  he	
  wanted	
  some	
  money	
  to	
  go	
  and	
  play	
  darts	
  
and	
  drink	
  some	
  more.	
  And	
  I	
  said	
  ‘no’.	
  So	
  he	
  went	
  out	
  in	
  the	
  woods.	
  
He	
  got	
  some	
  boards	
  from	
  a	
  house	
  and	
  came	
  back	
  in	
  and	
  started	
  
running	
  me	
  across	
  the	
  head...	
  started	
  beating	
  me.	
  He	
  was	
  trying	
  to	
  
beat	
  me	
  half	
  to	
  death.	
  He	
  had	
  a	
  pistol	
  in	
  his	
  pocket.	
  Well,	
  when	
  he	
  
come	
  around	
  in	
  front	
  of	
  my	
  truck,	
  I	
  raised	
  the	
  gun	
  up	
  and	
  shot	
  him	
  
in	
  the	
  neck.	
  It	
  should’a	
  been	
  self-­‐defence.	
  
	
  
Boyd	
  Edward	
  Whitely,	
  80	
  
Murder	
  
	
  
I	
  know	
  I’m	
  blessed.	
  All	
  my	
  troubles,	
  I	
  put	
  them	
  in	
  the	
  Lord’s	
  hands.	
  I	
  
don’t	
  get	
  mad.	
  I	
  take	
  it	
  a	
  day	
  at	
  a	
  time.	
  While	
  you’re	
  in	
  here,	
  life	
  is	
  
still	
  going	
  on.	
  You’ve	
  got	
  to	
  make	
  the	
  best	
  of	
  it	
  where	
  you’re	
  at.	
  	
  I	
  
take	
  pride	
  in	
  what	
  I	
  do.	
  When	
  I	
  go	
  to	
  driving	
  [the	
  hearse],	
  I’m	
  
working	
  for	
  the	
  Lord.	
  I’m	
  bringing	
  his	
  children	
  home.	
  Everyone	
  
here’s	
  inmates	
  just	
  like	
  me.	
  All	
  us	
  got	
  to	
  die	
  and	
  that’s	
  something	
  I	
  
don’t	
  worry	
  about.	
  One	
  day,	
  someone’s	
  gonna	
  have	
  to	
  drive	
  me.	
  
	
  
Lord	
  Bones,	
  72	
  	
  
Undisclosed	
  Crime	
  [in	
  prison	
  since	
  1971]	
  

	
  

	
  
	
  

	
  

	
  37	
  

.	
  

APPENDIX	
  D:	
  ABOUT	
  US	
  
	
  

Be	
   the	
   Evidence	
   International	
   (BTEI)	
   is	
   a	
   nonprofit	
   (501c3)	
   grassroots	
   organization	
   that	
   promotes	
   human	
   rights	
   and	
  
social	
   justice	
   issues	
   through	
   research,	
   education,	
   and	
   advocacy	
   activities.	
   These	
   are	
   designed	
   to	
   raise	
   critical	
  
consciousness	
   and	
   the	
   recognition	
   of	
   psychological	
   sociopolitical	
   contexts	
   in	
   which	
   injustices	
   can	
   occur,	
   such	
   as	
   aging	
  
and	
   the	
   criminal	
   justice	
   system.	
   Through	
   this	
   critical	
   lens,	
   individuals	
   and	
   communities	
   can	
   make	
   informed	
   decisions	
  
about	
   how	
   we	
   want	
   to	
   'co-­‐construct'	
   healthy	
   and	
   just	
   communities.	
   Transforming	
   society	
   first	
   entails	
   transforming	
  
ourselves	
  to	
  "be	
  the	
  evidence	
  we	
  want	
  to	
  see	
  in	
  the	
  world".	
  Through	
  participation	
  in	
  self	
  or	
  project-­‐sponsored	
  activities,	
  
each	
   of	
   us	
   can	
   help	
   promote	
   the	
   achievement	
   of	
   a	
   socially	
   just	
   world	
   in	
   which	
   human	
   rights,	
   social	
   justice,	
   and	
   well-­‐
being	
  are	
  realized	
  for	
  all	
  individuals,	
  families,	
  and	
  communities	
  across	
  the	
  developmental	
  lifespan.	
  On	
  a	
  daily	
  basis,	
  the	
  
lived	
   reality	
   of	
   "being	
   the	
   evidence"	
   challenges	
   individuals	
   everywhere	
   to	
   look	
   inside	
   themselves	
   first	
   to	
   identify	
   and	
  
eradicate	
  stigmatizing	
  and	
  oppressive	
  attitudes,	
  thoughts,	
  and	
  practices	
  towards	
  one	
  self	
  and	
  others	
  so	
  we	
  can	
  see	
  each	
  
other's	
   common	
   humanity.	
   BTEI	
   provides	
   the	
   following	
   services	
   to	
   the	
   community:	
   Research	
  and	
   Evaluation,	
   Program	
  
Design,	
   Policy,	
   Advocacy,	
   Public	
   Education	
   &	
   Awareness	
   Campaigns,	
   and	
   Forensic	
   Social	
   Work	
   &	
   Inter-­‐Professional	
  
Education	
   &	
   Training.	
   Be	
   the	
   Evidence	
   Press	
   publishes	
   cutting	
   research	
   and	
   practice	
   report	
   and	
   briefs.	
   For	
   more	
  
information	
   or	
   to	
   request	
   project	
   related	
   publications,	
   please	
   visit	
   our	
   website	
   at	
   www.betheevidence.org	
   or	
   contact	
  
BTEI	
  at	
  btep@fordham.edu	
  or	
  tmaschi@fordham.edu	
  	
  
	
  
International	
  Citizens	
  United	
  for	
  Rehabilitation	
  of	
  Errants	
  (CURE)	
  is	
  a	
  grassroots	
  organization	
  
dedicated	
  to	
  the	
  reduction	
  of	
  crime	
  through	
  the	
  reform	
  of	
  the	
  criminal	
  justice	
  system	
  (especially	
  
prison	
  reform.).	
  Prisons	
  should	
  be	
  used	
  only	
  for	
  people	
  who	
  absolutely	
  must	
  be	
  incarcerated.	
  And	
  
that	
  those	
  who	
  are	
  incarcerated	
  should	
  have	
  all	
  of	
  the	
  resources	
  they	
  need	
  to	
  turn	
  their	
  lives	
  
around.	
  	
  A	
  person	
  is	
  sent	
  to	
  prison	
  AS	
  PUNISHMENT	
  AND	
  NOT	
  FOR	
  PUNISHMENT.	
  We	
  also	
  believe	
  that	
  human	
  rights	
  
documents	
  provide	
  a	
  sound	
  basis	
  for	
  ensuring	
  that	
  these	
  goals	
  are	
  met.	
  	
  We	
  encourage	
  members	
  to	
  become	
  VOCAL	
  
especially	
  when	
  you	
  are	
  struggling	
  with	
  a	
  criminal	
  justice	
  system.	
  Finally,	
  CURE	
  is	
  a	
  membership	
  organization.	
  We	
  work	
  
hard	
  to	
  provide	
  our	
  members	
  with	
  the	
  information	
  and	
  tools	
  necessary	
  to	
  help	
  them	
  understand	
  the	
  criminal	
  justice	
  
system	
  and	
  to	
  advocate	
  for	
  changes.	
  	
  

	
  

Take	
  Action:	
  Compassionate	
  Laws,	
  Policies,	
  and	
  Practices	
  for	
  the	
  	
  
Aging,	
  Seriously	
  Ill,	
  and	
  Dying	
  in	
  Prison	
  and	
  Their	
  Families	
  and	
  Communities	
  
	
  
After	
  reading	
  this	
  report,	
  if	
  you	
  want	
  to	
  get	
  involved	
  in	
  promoting	
  compassionate	
  approaches	
  for	
  the	
  aging,	
  seriously	
  ill,	
  
and	
  dying	
  in	
  prison,	
  below	
  are	
  some	
  suggested	
  action	
  steps:	
  	
  
	
  

(1)	
  Give	
  Feedback:	
  We	
  welcome	
  your	
  input	
  and	
  feedback	
  about	
  this	
  report	
  to	
  include	
  in	
  future	
  updates	
  and	
  editions.	
  
Please	
  send	
  to	
  btep@fordham.edu	
  	
  	
  
(2)	
  Speak	
  Up:	
  If	
  you	
  have	
  a	
  personal,	
  practice,	
  or	
  advocacy	
  story	
  you	
  would	
  like	
  to	
  share	
  for	
  inclusion	
  in	
  future	
  editions	
  
of	
  this	
  report,	
  please	
  email	
  us	
  at	
  btep@fordham.edu	
  
(3)	
  Sign	
  a	
  Petition.	
  Please	
  sign	
  our	
  petition	
  to	
  improve	
  policies	
  and	
  practices	
  for	
  elder,	
  seriously	
  ill,	
  and	
  dying	
  in	
  prison:	
  
http://petitions.moveon.org/sign/compassionate-­‐and-­‐restorativ-­‐1?source=c.em&r_by=12132691	
  
(4)	
  Write	
  a	
  letter.	
  Write	
  a	
  letter	
  to	
  your	
  county,	
  state,	
  or	
  federal	
  legislators	
  or	
  a	
  newspaper	
  op-­‐ed	
  or	
  letter	
  to	
  the	
  editor.	
  	
  
(5)	
  Join	
  the	
  Movement.	
  Contact	
  us	
  at	
  btep@fordham.edu	
  or	
  212-­‐636-­‐6640	
  to	
  get	
  involved	
  in	
  one	
  of	
  aging	
  and	
  CJ	
  or	
  
other	
  research	
  projects,	
  grassroots	
  social	
  innovation	
  development	
  and	
  implementation,	
  trainings,	
  advocacy	
  efforts	
  or	
  
fellowship	
  and	
  volunteer	
  opportunities.	
  

	
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