BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
SB 1462 (Leno) - County sheriffs: medical release of prisoners.
Amended: April 9, 2012 Policy Vote: Public Safety 5-2
Urgency: No Mandate: No
Hearing Date: May 24, 2012 Consultant: Jolie Onodera
SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
Bill Summary: SB 1462 would authorize a sheriff to release a
prisoner from a county jail after conferring with a jail
physician if the sheriff determines the prisoner would not
reasonably pose a threat to public safety and the prisoner is
deemed to have a life expectancy of six months or less. This
bill would also authorize the court, at the request of a
sheriff, to grant medical probation to any prisoner sentenced to
a county jail who is physically incapacitated, as specified, if
that incapacitation did not exist at the time of sentencing, or
to a prisoner who would require acute long-term inpatient
rehabilitation services. Before a prisoner's compassionate
release or release to medical probation, the sheriff would be
required to secure a placement option for the prisoner, as
specified.
Fiscal Impact:
No state costs. Increased annual costs to provide long-term
care services of $1.5 million federal statewide, to the
extent 30 prisoners are granted medical probation and
determined eligible for Medi-Cal. Estimated costs are based
on an average annual cost of $100,000 per individual.
Statewide costs could be higher or lower commensurate with
the actual number of prisoners granted medical probation and
the medical costs specific to each individual.
Major annual savings in the millions of dollars to local
jails as a result of eliminating costly security and medical
costs for these prisoners. In Los Angeles (LA) County alone,
annual savings of $7.3 million is estimated for ten
individuals identified as potentially eligible for medical
probation (based on an average daily security/base medical
rate of $2,000 per prisoner).
Background: Existing law authorizes a sheriff to release a
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prisoner for transfer to a medical facility or residential care
facility if the prisoner's physical condition, as determined by
a private physician (not under contract with the county or a
county employee), renders the prisoner incapable of causing harm
to others upon release, the prisoner's condition is not expected
to improve to the extent he/she would pose a threat to public
safety, and the sheriff determines the prisoner's medical needs
would be better served in a medical facility or residence other
than a county correctional facility.
Existing law includes a form of "compassionate release" for
prisoners determined by the Secretary of the CDCR or the Board
of Parole Hearings to be either, 1) terminally ill with an
incurable condition caused by an illness or disease that would
produce death within six months, as determined by a CDCR
physician, or, 2) permanently medically incapacitated with a
medical condition that renders him or her permanently unable to
perform activities of daily living, resulting in 24-hour care,
and the incapacitation did not exist at the time of original
sentencing.
Current law also includes medical parole, if determined by the
BPH would not pose a threat to public safety, for any state
prisoner other than those sentenced to death, life without
parole, or who is otherwise barred by an initiative statute, who
the head physician of the institution where the prisoner is
located determines is permanently medically incapacitated with a
medical condition that renders him or her permanently unable to
perform activities of basic daily living resulting in the
prisoner requiring 24-hour care, and that incapacitation did not
exist at the time of sentencing. Data as of April 2012 from the
California Correctional Health Care Services indicates that of
39 cases set for hearing, 35 cases (nearly 90 percent) were
approved by the BPH for medical parole. An additional six people
received compassionate release prior to their medical parole
hearing.
Proposed Law: This bill would authorize a sheriff, after
conferring with a jail physician, to release from a county
correctional facility, a prisoner sentenced to the county jail
if the sheriff determines that the prisoner would not reasonably
pose a threat to public safety, and the prisoner, upon diagnosis
by the examining physician, is deemed to have a life expectancy
of six months or less. Prior to a prisoner's compassionate
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release, the sheriff would be required to notify the court of
his/her intention to release the prisoner, as specified.
This bill would further provide that the sheriff, after
conferring with the jail physician, may request the court to
grant medical probation or to resentence a prisoner to medical
probation in lieu of jail time for any prisoner sentenced to the
county jail under either of the following circumstances:
The prisoner is physically incapacitated with a medical
condition that renders the prisoner permanently unable to
perform activities of basic daily living, which has resulted
in the prisoner requiring 24-hourcare, if that
incapacitation did not exist at the time of sentencing.
The prisoner would require acute long-term inpatient
rehabilitation services.
During the time on medical probation, the probation officer or
court may, at any time, request a medical examination of the
person by a jail physician. If the court determines based on the
medical examination that the person's medical condition has
improved to the extent that the person no longer qualifies for
medical probation, the court may return the person to the
custody of the sheriff.
Before a prisoner's compassionate release or release on medical
probation, the sheriff shall secure a placement option for the
prisoner in the community, and in consultation with the county
welfare department or another applicable county agency, examine
the prisoner's eligibility for Medicaid benefits or other
medical coverage that might assist in funding the prisoner's
medical treatment while in the community.
The bill further states that it may not be construed as
authorizing the sheriff to refuse to receive and incarcerate a
defendant or sentenced individual who is not in need of
immediate medical care or who has a terminal medical condition.
Related Legislation: SB 1399 (Leno) Chapter 405/2010 provides
that any prisoner determined to be medically incapacitated with
a medical condition that renders the prisoner permanently unable
to perform activities of basic daily living, and results in the
prisoner requiring 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 determines that the
conditions under which the prisoner would be released would not
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reasonably pose a threat to public safety.
Staff Comments: The fiscal impact of this bill is dependent on
several factors that are indeterminable at this time. Because
the statute defining eligibility for medical parole is very
restrictive and requires both medical documentation and a parole
board hearing, there are a relatively small number of eligible
prisoners. As the provisions of this bill would authorize the
courts to grant medical probation based on a sheriff's
determination after discussion with the jail physician, and
would not require additional review or a board hearing, the
number of medical probationers could potentially be greater.
Although an earlier version of the bill would have applied its
provisions only to felons sentenced to jail pursuant to 2011
Public Safety Realignment who would have otherwise been
sentenced to state prison, the bill as currently proposed would
extend the authority for compassionate release and medical
probation to any inmate sentenced to county jail, including all
felons and misdemeanants.
The number of eligible prisoners statewide is unknown at this
time. LA County has identified 10 prisoners currently eligible
for medical probation under the provisions of this bill. County
jails will see substantial savings in the millions of dollars
annually due to the elimination of costly security and medical
costs associated with these high-cost prisoners. As of April
2012, LA County indicated expenditures of over $900,000 for ten
prisoners over a period of less than three months. At an average
daily rate of approximately $2,000 for security and basic
medical costs, the county would save $7.3 million annually.
The bill requires the sheriff to secure a placement option for
the prisoners before the prisoner's release on medical
probation. To the extent the prisoner is determined eligible for
Medi-Cal, increased costs of approximately $100,000 per year per
medical probationer would be funded federally 50 percent and 50
percent General Fund. Assuming LA County represents
approximately one third of the statewide eligible caseload, 30
prisoners granted medical probation would result in annual
costs of $3 million ($1.5 million federal/$1.5 million General
Fund). Statewide costs could be higher or lower dependent on the
number of prisoners granted medical probation and the medical
costs specific to each case.
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Recommended Amendments: To address the potential General Fund
impact associated with this bill, staff recommends an amendment
to specify the local entity currently responsible for payment of
the prisoner's medical costs would continue to pay the
nonfederal share of Medi-Cal costs associated with each
individual's medical treatment.
Author's amendments would specify that for any prisoner released
pursuant to compassionate release or medical probation that is
eligible for Medi-Cal, the county shall continue to pay the
non-federal share of the prisoner's Medi-Cal costs.