BILL ANALYSIS SB 1399 Page 1 SENATE THIRD READING SB 1399 (Leno) As Amended August 20, 2010 Majority vote SENATE VOTE :21-13 PUBLIC SAFETY 4-2 APPROPRIATIONS 10-4 ----------------------------------------------------------------- |Ayes:|Ammiano, Beall, Hill, |Ayes:|Fuentes, Bradford, | | |Skinner | |Charles Calderon, Coto, | | | | |Davis, De Leon, Hall, | | | | |Skinner, Torlakson, | | | | |Torrico | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Gilmore, Portantino |Nays:|Conway, Harkey, Miller, | | | | |Nielsen | ----------------------------------------------------------------- SUMMARY : Establishes a medical parole program, as specified. Specifically, this bill : 1)Provides that, except as to those prisoners specified, any prisoner sentenced to state prison with a determinate term who the head physician at the institution where the prisoner is located determines is permanently medically incapacitated with a medial condition that renders the prisoner permanently unable to perform activities of daily living, results in 24-hour care, and that incapacitation did not exist at the time of sentencing shall be granted medical parole if the Board of Parole Hearings (BPH) determines that the conditions under which the prisoner would be released would not reasonably pose a threat to public safety. 2)Specifies that medical parole shall not apply to any prisoner sentenced to death or life in prison without possibility of parole or to any inmate who is serving a sentence for which parole is prohibited by any initiative statute. Provides that the parole placements and related provisions shall not be construed to alter or diminish the rights conferred under the Victim's Bill of Rights Act of 2008: Marcy's Law. 3)States that when a physician employed by the California Department of Corrections and Rehabilitation (CDCR) who is the SB 1399 Page 2 primary care provider for an inmate identifies an inmate that he or she believes meets the medical criteria for medical parole, the primary care physician shall recommend to the head physician of the institution where the prisoner is located that the prisoner be referred to the BPH for consideration for medical parole. Within 30 days of receiving that recommendation, if the head physician concurs in the recommendation of the primary care physician, he or she shall refer the matter to the BPH, and if the head physician does not concur in the recommendation, he or she shall provide the primary care physician with a written explanation of the reasons for denying the referral. 4)States that the prisoner or his or her family member or designee may independently request consideration for medical parole by contacting the head physician at the prison or the CDCR Secretary. Within 30 days of receiving the request, the head physician shall, in consultation with the prisoner's primary care physician, make a determination whether the prisoner meets the criteria for medical parole and, if the head physician determines that the prisoner satisfies the criteria set forth, he or she shall refer the matter to the BPH. If the head physician does not concur in the recommendation, he or she shall provide the prisoner or his or her family member or designee with a written explanation of the reasons for denying the application. 5)Mandates that CDCR complete parole plans for inmates referred to the BPH for medical parole consideration. The parole plans shall include, but not be limited to, the inmate's plan for residency and medical care. 6)Provides that medical parole hearings shall be conducted by two-person panels consisting of at least one commissioner. In the event of a tie vote, the matter shall be referred to the full BPH for a decision. 7)States that upon receiving a recommendation from a head physician of the institution for a prisoner to be granted medical parole, the BPH shall make an independent judgment regarding whether the conditions under which the inmate would be released pose a reasonable threat to public safety, and make written findings related thereto. 8)States that the BPH or the Division of Adult Parole Operations SB 1399 Page 3 shall have the authority to impose any reasonable conditions on prisoners subject to medical parole supervision, including, but not limited to, the requirement that the parolee submit to electronic monitoring. As a further condition of medical parole, the parolee may be required to submit to an examination by a physician for the purpose of diagnosing their current medical condition. In the event such an examination takes place, a report of the examination and diagnosis shall be submitted to the board by the examining physician. If the BPH , based on a medical examination, determines that the person's medical condition has improved to the extent that the person no longer qualifies for medical parole, the BPH shall return the person to the custody of CDCR. 9)Provides that prisoners sentenced to determinate terms who are placed on medical parole supervision prior to the earliest possible release date and who remain eligible for medical parole shall remain on medical parole until the earliest possible release date; at which time, that parolee shall commence serving a standard parole term as specified. 10)Provides that prisoners sentenced to indeterminate terms who are placed on medical parole prior to the minimum eligible parole date and who remain on medical parole shall remain on medical parole until the minimum eligible parole date; at which time, the parolee shall be eligible for standard parole as specified. 11)Provides that CDCR shall, at the time a prisoner is placed on medical parole supervision ensure that the prisoner has applied for any federal entitlement programs for which the prisoner is eligible, and has in his or her possession a discharge medical summary, full medical records, parole medications, and all property belonging to the prisoner that was under the control of the CDCR. Any additional records shall be sent to the prisoner's forwarding address after release to health care-related parole supervision. 12)Specifies that CDCR shall complete all of the following tasks associated with inmates granted medical parole: a) CDCR shall enter into memoranda of understanding with the Social Security Administration and the State Department of Health Care Services in addition to other entities to facilitate prerelease agreements to help inmates initiate SB 1399 Page 4 benefits claims; b) Requires CDCR to establish contracts with appropriate medical providers in cases where medical parolees are ineligible for Medi-Cal; and, c) CDCR shall reimburse counties for the costs associated with providing an inmate granted medical parole with a public guardian. FISCAL EFFECT : According to the Assembly Appropriations Committee: 1)Significant net annual General Fund (GF) savings, potentially in the low tens of millions of dollars, as a result of eliminating costly security for incapacitated inmates and making these inmates eligible for Medi-Cal, for with the federal government pays 50%. Based on 32 inmates the federal prison health care receiver contends are the most likely and immediate candidates for medical parole, the receiver estimates a net first year savings of about $30 million. These include 21 incapacitated inmates housed in nursing facilities or hospitals outside the prison at a cost of about $5,800 per day ($2.1 million per year) and 11 incapacitated inmates in a correctional treatment center (CTC) bed at a cost of about $433 per day ($158,000 per year). According to the receiver's figures, the annual cost for these 32 inmates alone is $46 million. If, for example, the 21 inmates costing the state $44 million were released to medical parole, with no guarding or transportation costs ($758.000 per inmate, per year), and annual medical costs were reduced from $1.35 million per inmate per year to $100,000, one-half of which would be covered by the federal government via Medi-Cal, the annual GF savings would be about $42 million for these 21 inmates alone. The potential savings for the 11 inmates referenced by the receiver who are incapacitated in CTCs would be about $108,000 per inmate per year ($1.2 million total), assuming no guarding or transportation costs (currently about $104,000 per inmate, per year) and assuming medical/housing costs changed from about $54,000 per inmates, per year, to $100,000 per year, one-half of which would be paid by the federal government via SB 1399 Page 5 Medi-Cal. These savings could be higher or lower depending on existing contract medical costs and specific circumstances. 2)Minor annual GF costs to CDCR, likely averaging in the range of several thousand of dollars per guardian, to cover the cost of medical guardians for inmates with no next of kin or legal guardian to make legal and medical decisions. 3)Minor annual GF costs, likely in the range of $200,000, assuming the number of medial parolees is in the range of 35: a) ensure a medial parolee has applied for any federal entitlement programs and possesses a discharge medical summary, full medical records, and medication; b) enter into a memoranda of understanding with the Social Security Administration and the State Department of Health Care Services to facilitate prerelease agreements to help inmates initiate benefits claims; c) complete parole plans for inmates referred to the Board of Parole Hearings for medial parole; and, d) hold additional parole hearings and require electronic monitoring in certain cases. COMMENTS : According to the author, "Does it make sense for the state to pay for two correctional officers to guard an inmate 24-hours-a-day as the inmate lies comatose or in a permanent vegetative state in a hospital bed? Does it make sense for CDCR to become a long-term care facility for inmates with, for example, end-stage Alzheimer's disease, whose dementia is so severe they no longer understand that they are in prison? California is paying tens of millions of dollars every year to incarcerate these very high-cost inmates. These offenders were sent to prison to protect society and to punish them for their crimes. Because of their medical condition, however, they are no longer a threat and the ones being punished are the taxpayers. "California is not alone in facing this problem. Across the country 36 states have implemented some form of medical release to relieve them of the crushing financial burden of keeping inmates in prison whose medical condition has rendered their incarceration no longer necessary. In 1997, California first authorized the Secretary of CDCR or the BPH to recommend to the sentencing judge that an inmate's sentence be recalled due to terminal illness. Ten years later that authority was extended SB 1399 Page 6 to cover cases of medical incapacitation. However, last year only two such releases were approved and we continue to incarcerate inmates who could, by any rational standard, be released without posing a threat to the public. "SB 1399 addresses some of the issues that have been identified as problematic in the current law. Rather than requiring a sentence recall it creates an alternative procedure that permits these inmates to be placed on parole supervision under conditions determined by the parole board, and allows the parole to be revoked if for any reason the parolee's condition changes and creates a danger to the public. "This medical parole, will place public safety paramount and stop needlessly punishing the taxpayers. Please see the policy committee for a full discussion of this bill. Analysis Prepared by : Gabriel Caswell / PUB. S. / (916) 319-3744 FN: 0006468