How does an inmate's medical condition affect his parole review in Texas?

 Posted on January 27, 2023 in Uncategorized

Sometimes my clients get sick while serving their Texas felony prison sentences. Sometimes they are already sick and their condition worsens. Obviously, if we are fighting to get a client released to parole, his health can be an important factor for the Board to consider. Below I try to set out common issues that arise when advocating for a sick or physically compromised client.

TDCJ Medically Recommended Intensive Supervision

If a client is terminally ill, he may be eligible for special review and release to parole under TDCJ’s “MRIS” program (Medically Recommended Intensive Supervision). The requirements are strict. As a threshold issue, you have to be terminally ill, over the age of 65, mentally ill, developmentally disabled, require long term intensive medical care, have an organic brain syndrome, or be in a persistent vegetative state. Additionally, only inmates convicted of non-violent and non-sexually assaultive offenses can normally qualify (except that if an inmate is in a vegetative state he may be released under MRIS even if he was convicted of a sexual assault offense).

The procedure requires a medical professional, such as a doctor, physician’s assistant, or nurse to fill out portions of the application paperwork. This medical provider CANNOT be someone in the TDCJ system. You can see how much of a challenge this can be — a client needs to be in a physician’s care before even applying for parole release under MRIS.

Another issue that families do not anticipate is insurance and Medicaid. Typically, TDCJ will want to parole someone through the MRIS program directly into a hospice or other intensive health care facility. If you don’t have insurance and if the inmate is not eligible for Medicaid, then it may be impossible to have a care facility lined up to accept the inmate upon release. Additionally, please keep in mind that many hospice care facilities have strict rules on who can be admitted. Persons with certain types of felony offenses may be categorically excluded from admission. This seems unfair, but unless your loved one has on-going medical care and the financial means to pay for intensive medical care, either by means of Medicaid or private insurance, then he will probably not be considered for release to MRIS.

Only seriously ill inmates with a current doctor who is eligible under Medicaid or private insurance for intensive care should attempt to apply for MRIS.

Worsening but non-fatal conditions

If an inmate is getting sicker while serving time in a TDCJ facility, this fact should be highlighted to the parole board. But it does not guarantee release and should not be “overplayed.”

Physical conditions inside TDCJ are not ideal (to put it mildly) and many inmates have non-fatal medical conditions that get worse as they serve their time. Hypothetical examples would be benign tumors, infections, certain carcinomas, allergies, and any cancer that does not limit life expectancy to six months or less.

Generally speaking, a medical condition such as those described above will not be determinative of a client’s release. Parole Boards have discretion to take an inmate’s health into account, but their primary goal, as set forth in the Texas Administrative Code, is to ensure that their vote is in the best interests of the State of Texas. Just because an inmate would be better off handling his medical care outside the prison system is usually not persuasive to the Board. Criminal history and the nature of the offense that the inmate is serving time for will always be more important to the Board’s consideration.

But a client’s health is still an important factor. The goal is provide a narrative to the Board that shows both the inmate and the State of Texas will benefit from the inmate’s release to parole. For example, if the physical condition means the client has limited mobility, I would need to explain to the Board how the client would have sufficient support to meet the requirements for parole, still be able to work, and have family support. I’d also argue that such conditions make it highly unlikely that the inmate will reoffend.

Often a physically-compromised inmate will take on a dual role upon release, being both a patient and a caretaker of other family members. I would try to highlight to the Board that the inmate would be shouldering caretaking duties of older family members while also receiving treatment. Again, this duel-dependency dynamic usually means the inmate is less likely to reoffend.

Elderly inmates

With elderly inmates, the argument that they should be released due to health concerns can be much more persuasive to the Parole Boards. One reason is that age is always a factor in the Board’s Risk Assessment, so it’s already “baked into” the decision-making process. Older inmates are just less likely to reoffend, full stop. Second, if an elderly inmate is dealing with an on-going illness, it can be expensive and logistically-challenging for TDCJ to provide treatment. Speaking cynically, Boards might be motivated to off-load the expenses of such care to the Federal Government through Medicaid.

Convictions for Substance Abuse and Preexisting Medical Conditions

Inmates serving time for controlled substance cases or felony DWI have, in my experience, a higher probability of release if they are already dealing with an on-going medical condition. I’m not making a statistical claim here, but going off anecdote and professional experience. Of course, inmates with non-violent substance abuse case are already more likely to be released to parole since the nature of the offense is part of the TDCJ Risk Assessment Matrix. But, having a preexisting condition can allow an advocate to make a more compelling argument that the client is less likely to reoffend. The advocate can also argue that disease management and management of chemical dependencies goes hand-in-hand.

Conclusion

Don’t bet on a medical condition being your pathway to release to parole. The better approach is to fold the client’s on-going medical issues into a broader plan of release that includes considerations of work, shelter, and family support. Taking a holistic approach that emphasizes your medical condition can be an effective strategy for a release vote.