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Medical Parole for Texas Prisoners on the Decline

by Matt Clarke

The number of prisoners granted medical parole in Texas decreased in fiscal year 2012 compared with those paroled due to medical reasons in the previous two years. The Texas Board of Pardons and Paroles approved just 72 prisoners for medical parole in FY 2012, down from 100 in FY 2011 and 102 in FY 2010.

Although medical parole – officially called Medically Recommended Intensive Supervision – may be insignificant in terms of reducing Texas’ prison population, it can have a much greater effect on the amount of money spent on prisoners’ health care. Medical parole can also relieve the strain on the limited number of prison hospital beds available – about 300 statewide for a prison population of 150,000 that is growing older each year, and thus in need of more medical treatment.

“It’s becoming an issue for the state and the [criminal justice] department,” said Dr. Owen Murray, vice president for prisoner health care at the University of Texas Medical Branch, which provides medical services for over two-thirds of Texas prisoners. “We have been very vigilant about doing everything we can to look after these patients. The parole board is in a difficult spot. [Besides costs] they really have to look out for public safety. I don’t envy their job, trying to balance those two things.”

Parole officials, however, have denied they take costs into account when deciding whether to grant parole based on medical reasons.

“The medical care cost is not included in the information sent to the board,” said Rissie L. Owens, chairwoman of the Board of Pardons and Paroles (BPP). “The [BPP] makes a determination based on the inmate’s medical condition and medical evaluation and if he will be a threat to public safety,” she stated. “Along with the nature of the inmate’s crimes and ability to carry out future criminal activity, the board looks at things like the prisoner’s degree of mobility, assistance needed for daily living, cognitive condition and expected life expectancy.”

According to state records, the ten Texas prisoners with the most expensive medical conditions cost the state almost $2 million in 2011 alone. While prisoners over the age of 55 make up just 8% of Texas’ prison population, they account for 30% of the prison system’s medical expenses.

The vast majority of medical parole applications are denied. In FY 2012, for example, the BPP screened 1,857 applications, of which 491 were presented to parole officials and 72 were granted – an approval rate of 3.8%. Some prisoners have died while their applications were pending.

Most medical parolees are simply sent home to die; 68.1% of prisoners paroled due to medical reasons in FY 2012 were terminally ill, while 29.2% needed long-term care. From December 1, 1991 through the end of FY 2012, around 1,480 prisoners were released on medical parole. Of those, 986 (66%) have died, 268 finished their sentences, 121 remain on parole supervision and 67 (4.5%) returned to prison.

The nature of a prisoner’s offense is not considered by the doctors who recommend medical parole. “We don’t know what their crimes are; we just submit them based on their medical criteria,” Murray said.

Rather, the nature of a prisoner’s offense is taken into account when the BPP reviews the application for medical parole. At that point the district attorney (DA) for the sentencing jurisdiction is notified and allowed to provide input. Due to federal medical privacy laws, however, the DA is not informed of the nature of the prisoner’s health condition. This has led some prosecutors, such as Tarrant County DA Joe Shannon, Jr., to oppose all medical parole requests.

“Do they have a sore throat or a hangnail, or are they dying of cancer?” asked Shannon. “I’m not going to release someone for intensive medical treatment if I don’t know why they are being treated. I’m not going to overturn a jury verdict or plea of guilty without any information at all.... I don’t know what they need that cannot be provided inside the prison.”

Of course, a serious, debilitating and usually life-threatening condition is a prerequisite to even apply for medical parole, and prisoners aren’t paroled to get better treatment but rather because their medical condition makes it unlikely they will pose a threat to public safety. Once released, they may qualify for health care services through Medicaid or Medicare.

Regardless, some are still critical of the medical parole process.

“The state government through the Board of Pardons and Paroles appears to be playing a shell game or hot potato by shifting the cost of inmate care to the county and the federal government,” said former Harris County assistant DA Kim Ogg. “It sounds like an austerity measure taken by the state at the expense of crime victims.”

In January 2013, state Rep. Senfronia Thompson introduced HB 512, which would remove certain eligibility restrictions for prisoners who apply for medical parole – including restrictions on prisoners convicted of violent crimes and sex offenses – but would also limit the types of conditions for which medical parole is available. The bill died in the House Committee on Corrections. Legislation containing similar provisions, SB 991, was passed by the Senate but died in committee in May 2013.

Sources: Texas Tribune, Fort Worth Star-Telegram,,

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