Understanding the Impact of California’s Decision to End Medical Parole for Critically Ill Prisoners
Imagine the sensation of feeling your body weaken, your mind slipping into foggy memories, or your mobility fading as age or illness take hold. For some of California’s most vulnerable prisoners—those battling severe health conditions—being confined behind bars can feel like an additional layer of harm, stripping away dignity and the chance for compassionate care. Now, imagine that this fragile population faces an even greater threat: the state’s recent decision to halt its medical parole program, sending many of these severely ill individuals back to prison or into early release, often without adequate support.
This shift raises profound questions about the human toll of policy decisions made in the name of fiscal savings or administrative convenience. For years, California’s medical parole program has served as a lifeline for prisoners with debilitating conditions—those who are no longer a danger to society but who require specialized, compassionate care beyond what the prison system can provide. The recent move to pause or end this program leaves many in a state of uncertainty and vulnerability.
If you or someone you care about has experienced the challenges of aging or illness while incarcerated, you might understand the importance of humane treatment and proper care for those with cognitive impairments, such as dementia or traumatic brain injury. These conditions often leave individuals helpless, unable to care for themselves, and in need of attentive, specialized support. The state’s decision to send these individuals back to prisons, where resources are limited and care is often insufficient, feels like a step backward in the pursuit of dignity and compassion.
The core challenge lies in the growing aging prison population. Across the United States, caring for older prisoners has become a significant, costly issue. It costs twice as much to care for an older inmate, and those over 55 are at higher risk for cognitive difficulties—conditions that require more than just medical attention; they demand compassionate, person-centered care. California’s medical parole law was designed precisely for this population—those whose health has deteriorated to the point where they can no longer function independently.
However, critics argue that the recent policy change disregards the complex needs of these individuals. Many of the roughly twenty parolees being returned to prison are severely disabled—some in wheelchairs or suffering from mental or physical disabilities that demand specialized care. Outside facilities, such as memory care units and skilled nursing homes, are better equipped to provide humane treatment and engagement. These settings offer more than just medical management—they offer dignity, engagement, and a sense of community that prisons cannot replicate.
The debate around the program’s suspension also highlights the financial and logistical realities of caring for aging prisoners. While the program was costly—averaging between $250,000 and $300,000 annually per parolee—advocates argue that the human costs outweigh the savings. Compassionate release, which reduces a prisoner’s sentence due to health reasons, can be a more humane and cost-effective solution, allowing critically ill individuals to spend their final days in familiar, supportive environments.
This policy shift prompts reflection on the balance between fiscal responsibility and human kindness. Is it truly just to return severely ill prisoners to environments ill-suited for their needs? Or does this decision risk turning prisons into de facto hospices, where the focus shifts from compassionate care to cost-cutting?
For advocates, the emphasis remains on dignity—ensuring that those most in need receive care that respects their humanity. The call for reform is about recognizing the limits of incarceration and expanding humane alternatives like compassionate release. These options not only honor the dignity of individuals at the end of life or facing severe health challenges but also align with a broader understanding of justice and compassion.
As California navigates these difficult decisions, the core message is clear: the way society cares for its most vulnerable reflects its values. Moving forward, it’s crucial to find balanced, humane solutions that address both fiscal realities and the fundamental need for compassion in caring for the aging and critically ill.
Learn More: California Halts Medical Parole, Sends Several Critically Ill Patients Back to Prison
Abstract: SACRAMENTO, Calif. — California has halted a court-ordered medical parole program, opting instead to send its most incapacitated prisoners back to state lockups or release them early. The unilateral termination is drawing protests from attorneys representing prisoners and the author of the state’s medical parole legislation, who say it unnecessarily puts this vulnerable population at risk. The move is the latest wrinkle in a long-running drive to free those deemed so ill that they are no longer a danger to society. “We have concerns that they cannot meet the needs of the population for things like memory care, dementia, traumatic brain injury,” said Sara Norman, an attorney who represents the prisoners as part of a nearly three-decade-old federal class-action lawsuit. “These are not people who are in full command and control of their own surroundings, their memories — they’re helpless.” Caring for a rapidly aging prison population is a growing problem across the United States. It is twice as expensive to imprison older people than those younger, according to Johns Hopkins University researchers, and prisoners 55 and older are more than twice as likely to have cognitive difficulties as non-incarcerated older adults. Medical parole is reserved for the sliver of California’s 90,000 prisoners who have a “significant and permanent condition” that leaves them “physically or cognitively debilitated or incapacitated” to the point they can’t care for themselves, according to the state parole board. Prisoners who qualify — excluded are those sentenced to death or life without parole — can be placed in a community health care facility instead of state prison. Attorneys said the roughly 20 parolees the state has returned to lockup need significant help performing basic functions of daily life, with some in wheelchairs or suffering from debilitating mental or physical disabilities. They say outside facilities have the capacity to provide more compassionate and humane care to very ill prisoners. Kyle Buis, a California Correctional Health Care Services spokesperson, characterized the program as “on pause” as patients return to in-prison facilities and as officials anticipate increasing their use of the compassionate release program. Prisoners granted compassionate release have their sentences reduced and are released into society, while those on medical parole remain technically in custody. “There were multiple considerations that went into this decision,” Buis said. “Our growing ability to support those with cognitive impairment inside of our facilities was one factor.” Democratic Gov. Gavin Newsom also cited “eliminating non-essential activities and contracts” to save money. While nearly every state now has a medical parole law, they are rarely used, according to the National Conference of State Legislatures. One common reason is eligibility. Texas, for instance, screened more than 2,600 prisoners in 2022 but approved just 58 people. Officials also often face procedural hurdles, according to the Vera Institute of Justice, a national nonprofit research and advocacy group. Some states, however, have tried to expand medical parole programs. Michigan did so because an earlier version of the law proved too difficult to use, resulting in the release of just one person. New York has some of the nation’s broadest criteria for release but is among states struggling to find nursing home placements for parolees. California’s first effort to free prisoners deemed so incapacitated that they are no longer dangerous began in 1997 with a little-used process that allowed corrections officials to seek the release of dying prisoners. But that program resulted in the release of just two prisoners in 2009. The medical parole program was officially created by a state law that took effect in 2011 and was expanded in 2014 to help reduce prison crowding so severe that federal judges ruled it was harming prisoners’ physical and mental health. Nearly 300 prisoners had been granted medical parole since July 2014, state officials reported. The average annual cost per medical parolee was between about $250,000 and $300,000 in 2023, Buis said. And despite lawmakers’ expectations when they started the program, he said, Medi-Cal — California’s Medicaid program, which is partly funded by the federal government — did not reimburse the state for their care because they were still considered incarcerated. California has had a rollercoaster relationship with its sole nursing home contractor for medical parolees. The state ended its contract with Golden Legacy Care Center in Sylmar at the end of 2024, Newsom reported in January in his summary of the state’s 2025-26 budget. In 2021, prison officials said they were sending dozens of paralyzed and otherwise disabled prisoners back to state prisons and limiting medical parole, blaming a federal rule change that barred any restrictions on prisoners in such facilities. The move came after state public health inspectors fined Golden Legacy for handcuffing an incapacitated patient’s ankle to the bed in violation of state and federal laws. Golden Legacy did not return repeated telephone and email requests for comment. Buis said state officials “continuously monitored care at Golden Legacy, and we never had concern for the quality of care provided.” Attorney Rana Anabtawi, who also represents prisoners in the class-action suit, toured Golden Legacy’s medical parole building with Norman in November and saw caregivers offering memory care patients special art classes and a “happy feet” dance party. She felt it “was a much better place for our patients than being in prison — there appeared to be regular programming aimed at engaging them, there were no officers walking around, the patient doors were open and unlocked, patients had general freedom of movement within their building.” Over the past several years, the California Department of Corrections and Rehabilitation has built up its capacity to service those with severely compromised health. The state created two of its own memory care units in men’s prisons, a 30-bed unit in the California Health Care Facility in Stockton in 2019 and a 35-bed unit in the California Medical Facility in Vacaville in 2023. The Central California Women’s Facility in Chowchilla provides up to 24-hour skilled nursing care for women with life-limiting illnesses including dementia. Yet Norman fears the in-prison facilities are a poor substitute. “They’re nowhere near enough and they are inside prisons, so there’s a limit to how compassionate and humane they can be.”
Dr. David Lowemann, M.Sc, Ph.D., is a co-founder of the Institute for the Future of Human Potential, where he leads the charge in pioneering Self-Enhancement Science for the Success of Society. With a keen interest in exploring the untapped potential of the human mind, Dr. Lowemann has dedicated his career to pushing the boundaries of human capabilities and understanding.
Armed with a Master of Science degree and a Ph.D. in his field, Dr. Lowemann has consistently been at the forefront of research and innovation, delving into ways to optimize human performance, cognition, and overall well-being. His work at the Institute revolves around a profound commitment to harnessing cutting-edge science and technology to help individuals lead more fulfilling and intelligent lives.
Dr. Lowemann’s influence extends to the educational platform BetterSmarter.me, where he shares his insights, findings, and personal development strategies with a broader audience. His ongoing mission is shaping the way we perceive and leverage the vast capacities of the human mind, offering invaluable contributions to society’s overall success and collective well-being.
