Dear Neighbor,
It's frustrating when you work for years to pass a bill, and then it's not carried out as intended. That's happened with medical parole. A little history, then individuals' stories by MassLive on "Death Under Watch."
WHY MEDICAL PAROLE?
In 2011, I filed a bill to allow dying and incapacitated people to be released from prison into care by their family, a nursing home, or other facility.
I visited the Health Services and the Activities of Daily Living Units at MCI Shirley with other legislators. We saw a quadriplegic who could not sit up in bed, being cared for by a prisoner from another unit. Others required dialysis to survive. There were many men with dementia, some of whom had no idea where they were. The unit was like a nursing home, but much more expensive, with no benefit to public safety. None of the men was a danger to others.
Gov. Patrick's budget that year proposed a medical release program. His Department of Corrections Commissioner Harold Clarke estimated 22 prisoners a year would be paroled, saving the state $2 million.
Neither my bill nor Patrick's proposal passed that year, but I kept working with Prisoners Legal Services (PLS) to pass a law.
A member of the Criminal Justice Policy Coalition wrote to me about his visit to a man the day before he died of liver cancer at Shattuck Hospital. "A botched procedure to drain his lungs of fluid had given him pneumonia, and he was short of breath, coughing up dark brown mucus that nurses failed to clean from his bedclothes. His arms bore a dozen or more bruises from apparently failed IV needle insertions. He said despite his weak condition, guards still shackled him just to use the toilet, and there were marks on his wrists and ankles."
MEDICAL PAROLE BILL PASSED
In 2018, Massachusetts was the 41st state to enact medical parole. My bill was included in the criminal justice bill, along with improvements to compensation for the wrongfully convicted.
That fall, the first prisoner to receive medical parole, Alexander Phillips, was released to his home and the care of his mother, an oncology and hospice nurse. He died 24 days later of metastatic liver cancer.
From 2018 until March 2020, only 13 men were released. During the first nine months of COVID, 42 were released, because of the need to reduce crowding in prisons. Three of them were "released" hours before they died of COVID, possibly to improve statistics.
From 2018 through 2024, 534 people applied for medical parole. 101 were granted. This graph from MassLive demonstrates how few petitions were granted.
In 2025, 36 people applied for medical parole. 10 were granted parole. Six died while a request or appeal was pending. For those granted parole, it took up to 6 months to be released, so three died after approval but before release. So only 7 were actually paroled.
MORE LEGISLATION NEEDED
Successful applicants for medical parole are far fewer than Commissioner Clarke predicted. Applicants are less than half as likely to be successful as for regular parole, even for lifers. Barriers are almost all within the Department of Corrections (DOC), where the commissioner must approve each one.
Why are so many applications delayed and rejected? DOC hasn't responded to questions about how many are rejected for medical vs safety reasons, but it appears that they often consider the person's original crime, rather considering the current risk of violence given the person's incapacitation. Prosecutors and the members of victims' families sometimes object, although their reasons are not included in the law.
Stories from the MassLive series demonstrate the failure of DOC to effectively carry out the intent of the law. Meetings with DOC and Parole have so far failed to ensure that the process is more timely, so that people don't predictably die while waiting.
Our bill would clarify the criteria and expedite the process. It would require cognitive screening of older people who may have dementia and not be able to advocate for themselves. And it would create a presumption in favor of home confinement rather than requiring nursing home placement, which would be more compassionate for parolees and their families as well as saving money. The bill received a favorable committee report, and it is among my top priorities this year.
Here's a 2023 Globe editorial in favor of our bill, with more examples of delay and denial.
THE COST OF CARE
Keeping a terminally ill or incapacitated person in prison doesn't protect public safety, deter crime or prevent re-offending. No one released on medical parole has been arrested for a new crime. Keeping very sick people incarcerated costs enormous amounts of money.
Many if not most of the oldest and sickest people in prison were convicted of murder, mostly decades ago. Some people object to their "release," even though they remain on parole, and even in nursing homes they may remain on GPS, even if they can't move independently.
But medical parole not only allows incarcerated people to die with some dignity. It saves a lot of money. It costs about $600,000 per year to house one incarcerated person at Shattuck Hospital, compared to between $85,000 and $215,000 to house a prisoner in typical prison settings. (Info from MassLive) In a private hospital, there's also the cost of 2 guards, 24 hours a day, often on overtime. If they were paroled to a nursing home, the cost is less than $200,000 a year, of which about half would be paid by Medicaid. So the savings are at least $500,000 a year when someone is granted medical parole.
Massachusetts is practically tied with New Hampshire for having the highest percentage (21.9%) of incarcerated people over 55, though our rate of incarceratioin is relatively low. An ACLU report says that "Older incarcerated individuals have more chronic diseases, mental health conditions, and mobility issues compared to their younger counterparts, and caring for this population inevitably involves higher healthcare costs."
INDIVIDUAL STORIES
MassLive is publishing a series of articles on deaths in prison, from suicide to sickness, including medical parole stories. They report that people often wait months for parole approval - and then more months waiting to have a placement approved.
Howard Payne died last June at Boston Medical Center, despite a DOC doctor's application for his release due to terminal cancer. Like all incarcerated people in hospitals, he was shackled and guarded 24 hours a day by correctional officers, often with overtime pay.
James Ware was granted medical parole in January after multiple denials. Lung cancer had spread to his brain; he was "somewhat oriented" and had no arm movement. But he died in early April, still at Shattuck Hospital. Visits from family and friends were denied until the day he died.
WBUR reports that "patients have to be in the hospital for 21 days before anyone, including family, is allowed to visit — unless death is 'imminent.' ” And "according to Shattuck Hospital rules only one visit per week is allowed for long-time patients."
MassLive wrote that James Keown "can’t walk and uses a wheelchair. He uses oxygen to supplement his breathing and has braces on his wrists because he can’t control them. He also uses a voice amplifier because he is weak." He's been denied parole many times. The article quotes a formerly incarcerated person who worked as a medical companion for Keown: "Prison is like the worst nursing home ever, as far as the hospital units go.”
Jose Hernandez had such advanced dementia that he couldn't count to 20 or draw a basic clock. Prisoners Legal Services filed several applications for medical parole which were denied. Parole was finally granted, but he was not allowed to go to a home placement with his wife, who is a certified nursing assistant and has experience caring for people with dementia. Hernandez remained in prison 137
days after he was granted medical parole. He was finally placed in a nursing home, but moved to Bay State Medical Center where he died 27 days after "release." His wife was allowed to sleep there to accompany him.
Brenda Brousseau testified by video at a hearing in favor of our bill to make medical parole effective. "She was unable to shower or use the bathroom by herself, largely depending on a wheelchair, and had kidney disease and heart failure." After being denied multiple times, she'd been granted parole to a nursing home, where she was so happy to be able to have knitting needles and caring staff. She died a few months later.
Women are even less likely to be medically paroled than men. MassLive reported that "From 2018 to mid-2025, four women were approved while 38 women were denied, and one died before the DOC made a decision."
MOVIE OF THE MONTH
Fred Wiseman, renowned documentary maker, died this year. His film, Near Death, is available on Kanopy online from your library. Filmed at Beth Israel Hospital Intensive Care in 1983, it shows what end-of-life looks like.
TRIVIA WINNER!
Congratulations to Sebastian Derian, who was first to answer all questions correctly last newsletter's trivia contest.
1. David Bernstein predicted that Charlie Baker, Marty Walsh, and Robert Kraft would leave Massachusetts because their multi-million dollar pay would make them pay higher taxes under the Fair Share Amendment. Sebastian correctly noted that they all still live here officially, though Kraft has residences in multiple states.
2. I asked for two elected officials who left before Fair Share. Sebastian identified Bill Weld, who ran for governor of New York, and Scott Brown, who became ambassador to New Zealand and is running again for Senate in NH. There's also Mitt Romney, who ran for president twice, then moved to Utah and was elected senator for one term.
I know this isn't a newsletter. Instead I focus usually on particular issues. We are very busy in the Senate. This coming week, we'll finally take up our version of the PROTECT Act, and then the budget.
Stay in touch,
Pat Jehlen