California Ends Medical Parole, Returning Critically Ill Inmates to Prison

Tags: California prisons, medical parole, compassionate release, aging inmates, prison healthcare, criminal justice reform

Vulnerable Inmates Sent Back Behind Bars

California has quietly ended its medical parole program, a move that has raised serious concerns among advocates and lawmakers. The program, designed to allow severely ill inmates to live in community healthcare facilities instead of prisons, is now “on pause,” according to officials. Instead, the state has returned about 20 medically paroled prisoners to correctional facilities or released them under a different program.

Attorneys say these individuals, many of whom suffer from dementia, traumatic brain injuries, or other debilitating conditions, require round-the-clock care and assistance with daily tasks—services more appropriately provided in a specialized facility, not behind prison walls.

“These are not people in command of their surroundings or memories — they’re helpless,” said Sara Norman, an attorney representing inmates in a longstanding federal class-action lawsuit.

Higher Costs, Limited Compassion

Caring for aging inmates is both a logistical and financial challenge. Researchers at Johns Hopkins University estimate it costs twice as much to imprison older individuals, who are also more likely to experience cognitive impairments. Medical parole was meant to address this issue by moving the most debilitated prisoners—those with permanent physical or mental incapacitation—into outside facilities.

However, the program has been underutilized. Only around 300 inmates have been granted medical parole since 2014, despite California’s prison population nearing 90,000. The average annual cost per parolee ranged from $250,000 to $300,000, without reimbursement from Medi-Cal, since these individuals were still considered incarcerated.

End of the Golden Legacy Contract

California’s only nursing home contractor for medical parole, Golden Legacy Care Center, saw its contract terminated at the end of 2024. Although corrections officials claimed there were no quality concerns, previous incidents, including illegal restraints and regulatory fines, raised red flags.

Advocates like attorney Rana Anabtawi, who visited the facility, described it as far more humane than prisons—offering dementia patients therapeutic art programs and freedom of movement without the presence of guards.

“It was a much better place for our patients than being in prison,” she said.

Shift Toward Compassionate Release

Officials now plan to expand the use of the compassionate release program, which fully releases inmates from custody. Unlike medical parole, these individuals are no longer technically incarcerated. A 2022 law has broadened eligibility to include dementia patients, significantly increasing the number of compassionate releases—from just 53 in six years to 87 last year.

Still, critics argue that the state’s current facilities, even with recent upgrades like memory care units in Stockton and Vacaville, fall short of providing dignified care.

“They’re nowhere near enough,” Norman said. “And they are inside prisons, so there’s a limit to how compassionate and humane they can be.”

Critics Condemn the Move

Former state senator Mark Leno, who authored the medical parole law, blasted the state’s decision to end the program without legislative approval. He called the return of incapacitated individuals to prison “perfectly inhumane.”

“Is it just cruel punishment and retribution,” Leno asked, “or is this thoughtful execution of the law put in place by the legislature?”

Criminal justice advocates hope the expanded use of compassionate release will prevent prisons from becoming de facto nursing homes. But for many of California’s most vulnerable prisoners, the recent shift may mean facing their final days in confinement.