H.B. NO.



H.D. 1
















     SECTION 1.  An ever increasing number of men and women are entering prison with serious medical illnesses, and many face the risk of developing a serious illness or disability, particularly prisoners with long mandatory sentences.  Long sentences and an aging population mean that correctional facilities in this State and across the United States are housing a growing number of elderly inmates who often have extensive medical needs.  Concern over how society should deal with the aging and seriously ill prison population has led policy makers in many states to endorse early release for older and seriously ill prisoners who pose a low risk to public safety.  Presently, the United States federal prison system and many states grant some kind of medical or compassionate release.

     Compassionate release provides physicians and other medical professionals an opportunity to use their unique expertise and knowledge of prognosis, geriatrics, cognitive and functional decline, and palliative medicine to ensure that medical criteria for compassionate release are appropriately evidence-based.  With this information, criminal justice professionals are able to better determine whether or not an inmate should be granted medical release.

     Compassion is an integral part of the aloha spirit.  The purpose of this Act is to create a three-year medical or compassionate release pilot project for certain ill, disabled, or geriatric inmates who pose a low risk to public safety.

     SECTION 2.  (a)  The department of public safety shall implement a three-year medical release pilot project for certain ill, disabled, or geriatric inmates who pose a low risk to public safety.

     (b)  The department of public safety shall assess and refer inmates to the Hawaii paroling authority for possible medical release as provided in this Act.

     (c)  An inmate may be considered for medical release if the inmate:

     (1)  Has an illness, disease, or medical condition with a prognosis to a reasonable medical probability that death will occur within one year;

     (2)  Has a seriously debilitating and irreversible mental or physical condition that impairs the inmate's functional ability and that can be managed more appropriately in a community setting; or

     (3)  Suffers from a serious, debilitating, and irreversible physical or mental condition related to aging that impairs the inmate's functional ability and is expected to require complex care, treatment, or management.

     (d)  All requests for medical release shall be in writing and shall be made to the paroling authority.  Requests may be made by the director, an inmate, or an inmate's representative.

     (e)  If a request for medical release is made by the director, the request shall contain the following information:

     (1)  A report from a department physician stating that the inmate meets the criteria for medical release and the basis for the physician's opinion; provided that the report shall state each diagnosis that applies to the inmate and the prognosis for each condition to a reasonable medical probability; and provided further that where practicable, the physician shall discuss the results of any tests, studies, or physical findings that support the diagnosis and prognosis, and the nature and extent of the medical treatment that will most likely be required to manage the inmate's condition while incarcerated within the standard of care.  Where appropriate, the physician shall provide citations to relevant medical literature;

     (2)  A written evaluation prepared by the director on the risk for violence and recidivism, if any, that the inmate poses to society in light of factors such as the inmate's medical condition, the severity of the offense for which the inmate is incarcerated, the inmate's prison record, and the medical release plan; and

     (3)  A medical release plan that provides for continuity of care.

The department shall provide the inmate with a copy of the director's medical release request.

     (f)  If a request for medical release is made by an inmate or an inmate's representative, the request shall state the grounds for the requested release and shall contain a statement as to where the inmate will reside if released, who will care for the inmate, and how the inmate plans to obtain medical care.

     All requests initiated by an inmate shall be referred to the director immediately.  Within twenty days of receiving the request, the department shall submit a medical release report to the paroling authority containing the information required in subsection (e).  The department shall provide the inmate with a copy of the medical release report.

     (g)  The paroling authority shall conduct a hearing on all requests for medical release.  The hearing shall be held within ten days of receiving a medical release report from the department.  The inmate and the inmate's representative shall be permitted to participate in the hearing and may submit medical and other evidence in support of the request.  The paroling authority shall independently determine whether the inmate meets the criteria for medical release and shall independently assess the risk for violence and recidivism, if any, that the inmate poses to society.  The paroling authority shall also provide the victim of the criminal act for which the inmate was sentenced, or the victim's family, with the opportunity to be heard.  The paroling authority shall grant or deny the request within two days following the hearing.

     (h)  The paroling authority shall not grant medical release to an inmate who poses a danger to society.

     (i)  A denial of medical release by the paroling authority shall not affect an inmate's eligibility for any other form of parole or release under applicable law; provided that the inmate may not reapply or be reconsidered for medical release unless there is a demonstrated change in the inmate's medical condition.

     (j)  The director shall appoint an advocate for any inmate who requests medical release and is unable because of incapacitation or debilitation to advocate on the inmate's own behalf.

     (k)  The department shall adopt a fast track procedure for the evaluation and release of rapidly dying prisoners; provided that the procedure shall be posted on the website of the department and the paroling authority.

     (l)  Medical release shall not be considered a reduction of a minimum sentence and the sixty-day notice requirement of section 706-669(5), Hawaii Revised Statutes, shall not apply to any medical release; provided, however, that the department shall give the prosecuting attorney of the appropriate county notice of all requests for medical release as soon as practicable after a request is initiated, and the prosecuting attorney shall be permitted to participate in any medical release hearing conducted by the paroling authority.

     (m)  The paroling authority shall set reasonable conditions on an inmate's medical release that shall apply through the date upon which the inmate's sentence would have expired.  The conditions shall include the following:

     (1)  The released inmate shall be subject to supervision by the paroling authority;

     (2)  Personnel of the department shall be allowed to visit the inmate at reasonable times at the inmate's home or elsewhere; and

     (3)  The released inmate shall comply with all conditions of release set by the paroling authority.

     (n)  The paroling authority shall promptly order an inmate to be returned to the custody of the director to await a revocation hearing if the paroling authority receives credible information that an inmate has failed to comply with any reasonable condition set upon the inmate's medical release.

     (o)  If the paroling authority revokes an inmate's medical release for failure to comply with a condition of release, the inmate shall resume serving the remaining balance of the inmate's sentence, with credit given only for the duration of the inmate's medical release served in compliance with all reasonable conditions.  Revocation of an inmate's medical release for violating a condition of release shall not affect an inmate's eligibility for any other form of parole or release provided by law; provided that revocation of an inmate's medical release may be used as a factor in determining eligibility for future parole or release.

     (p)  The department shall adopt rules pursuant to chapter 91, Hawaii Revised Statutes, to implement the medical release pilot program.

     (q)  For the purpose of this Act:

     "Continuity of care" means an integrated system that ensures that a patient's medical needs are met as the patient transitions from one health care provider to another, from one setting to another, and from one level of care to another.

     "Department" means the department of public safety.

     "Director" means the director of public safety.

     "Inmate" means any person committed to the custody of the director.

     "Medical release" means the release of an inmate before the expiration of the inmate's sentence due to the inmate's medical condition.

     "Medical release plan" means a comprehensive, written medical and psychosocial care plan that is specific to the inmate and that shall include, at a minimum:

     (1)  A recommended course of treatment for the inmate; and

     (2)  A plan to provide continuity of care as the inmate transitions from prison to the community.

     "Paroling authority" means the Hawaii paroling authority.

     "Reasonable medical probability" means that a medical outcome is more likely to occur than not to occur.

     SECTION 3.  This Act shall take effect on July 1, 2050.


Report Title:

Corrections; Medical Release Pilot Project; Compassionate Release




Requires the department of public safety to establish a three-year medical release pilot project.  Effective July 1, 2050.  (HB255 HD1)




The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.