Early Medical Release

North Carolina has a law allowing certain prison inmates to be released early for medical reasons. It was passed in 2008, largely in response to concerns that a small number of aging inmates accounted for a sizeable percentage of the system’s medical budget.

The law is similar in concept to compassionate release in the federal system under 18 U.S.C. § 3582(c)(1)(A) (and former § 4205(g)) . The federal law has been criticized for its rarity of use; the average number of prisoners receiving compassionate release annually is less than two dozen. A 2013 U.S. Department of Justice internal review described the program as “poorly managed and implemented inconsistently,” prompting policy changes intended to improve access.

North Carolina’s early release law is similarly rarely used. Each year the legislature directs the Department of Public Safety and the Post-Release Supervision and Parole Commission to prepare a report on the number of inmates proposed for and granted release. That directive was written into G.S. 143B-707.2(b) last year. S.L. 2013-360, sec. 16C.11.(d). The 2012 report showed that 16 inmates were considered for the program in 2011, resulting in 10 releases, 3 denials, 1 release plan that “did not work out,” and 2 inmates who died prior to release. The 2013 report showed 6 proposals resulting in 6 releases in 2012. Media reports have collected anecdotes about some of the participants in the program.

How exactly does North Carolina’s medical release program work? Here is a short summary.

Eligibility. Inmates are eligible to be considered for medical release if the prison system determines that they fall into one of the following categories, each of which is defined in G.S. 15A-1369:

• Permanently and totally disabled, defined as a “permanent and irreversible physical incapacitation” determined by a licensed physician that “render[s] the inmate permanently and totally disabled, such that the inmate does not pose a public safety risk.”
• Terminally ill, defined as “an incurable condition . . . that will likely produce death within six months,” as determined by a licensed physician, that is “so debilitating such that the inmate does not pose a public safety risk.”
• Geriatric, defined as 65 or older and suffering from a “chronic infirmity, illness, or disease related to aging that has progressed such that the inmate is incapacitated to the extent that he or she does not pose a public safety risk.”

Class A, B1, and B2 felons and inmates convicted of reportable sex crimes are not eligible for release. G.S. 15A-1369.2.

Procedure. The process for early release begins with a request or petition from the inmate, the inmate’s attorney, the inmate’s next of kin, or upon a recommendation from medical staff within the prison system. A licensed physician assesses the inmate’s medical condition and prison staff assesses the inmate’s risk for violence and recidivism. These assessments must be completed within 45 days. If they indicate that the inmate meets the criteria for release, the request is referred to the Parole Commission for review. The Parole Commission has has 15 days to make a release determination for terminally ill inmates and 20 days to review referrals of disabled or geriatric inmates. The Commission must provide the inmate’s victims with an opportunity to be heard.

Conditions of medical release. An inmate granted release is subject to conditions of release set by the Parole Commission, including supervision by a Community Corrections officer. The released inmate must comply with a prescribed medical release plan and the requirements of medical providers. A failure to comply can lead to a return to imprisonment. G.S. 15A-1369.4. An inmate must also be reimprisoned if his or her medical status improves to the point that he or she no longer meets one of the eligibility criteria. G.S. 15A-1369.5.

The prison system’s rules and regulations on medical release are available here.

Another possible avenue of release for a sick or dying inmate is the Secretary of Public Safety’s authority to extend an inmate’s limits of confinement under G.S. 148-4. Under that law the Secretary can allow a person to “obtain medical services not otherwise available” or, in listed circumstances, to “receive palliative care.” Prison rules for that type of release are available here.