When the letter arrived in Westil Gonzalez's cell saying he had been granted parole, he was unable to read it. He was imprisoned for 33 years for murder, and multiple sclerosis robbed him of most of his sight, leaving him reliant on a wheelchair.
He had a clear sense of what he would do upon release. “I want to testify against some of the young men who are out there picking up guns,” Gonzalez, 57, said in a recent interview. “I want to save one person from the hardships I went through.”
But six months later, Gonzalez remains incarcerated outside Buffalo. The Department of Corrections has not been able to find a nursing home that will accept Gonzalez. Another New York inmate has been in a similar limbo for 20 months. Some were only released after suing the state.
In the United States, the elderly prison population is growing, in part because more people are serving long sentences for violent crimes. In 2022, nearly 16 percent of inmates will be 55 or older, up from 5 percent in 2007. The percentage of prisoners 65 and older quadrupled over the same period to about 4 percent.
Complex and costly medical conditions require more nursing care, both in prison and after an inmate's release. Across the country, prisons seeking to release inmates convicted of serious crimes often have few options. Even for people without a criminal record, finding a nursing home bed can be difficult.
Medical costs for inmates are increasing, increasing from about $6,000 per inmate in 2012 to just over $7,500 in 2021 in New York state. Still, those who work with inmates say the money is often not enough to keep up. The proportion of older prisoners with chronic health problems is increasing.
“There is an unfortunate gap in care,” said Dr. William Weber, a Chicago emergency physician and medical director of the Medical Justice Alliance, a nonprofit organization that trains doctors to serve as expert witnesses in cases involving prison inmates. There are a lot of them,” he said. Inmates often struggle to access professional treatment or even get copies of their medical records, he said, and “the situation is bleak.”
Dr. Weber said he has recently been involved in two cases in Pennsylvania and Illinois of critically ill prisoners who could not be released without admission to a nursing home. He said a Pennsylvania inmate died in prison and an Illinois man remains behind bars.
Almost every state has programs for early release of prisoners with serious or life-threatening medical conditions. New York State's program is one of the broader programs. While other states often limit this policy to people who have less than six months to live, New York State accepts anyone with a terminal or debilitating illness. Nearly 90 people were granted medical parole in New York from 2020 to 2023.
But the state's nursing home occupancy rate hovers around 90%, one of the highest in the nation, making it especially difficult to find places for inmates.
Thomas Maley, a spokesman for the New York State Department of Corrections and Community Supervision, said the prison system is “competing for a limited number of beds with hospitalized patients who require skilled nursing care, rehabilitation patients, and the general population.” said. He declined to comment on Gonzalez's case or the medical conditions of other inmates.
Parolees remain in state custody until their original prison term expires. Courts have previously upheld states' right to impose conditions on prisoners' release to protect the public, such as barring paroled sex offenders from living near schools.
But lawyers and medical ethicists say paroled patients should be able to choose how they receive treatment. Others noted that the medical needs of these prisoners were not always met in prison. For example, Gonzalez said she has not received her glasses despite repeated requests. His illness has caused one of his hands to curl inward, leaving his uncut nails dug into his palm.
“While we sympathize with the difficulty of finding employment, we cannot continue to incarcerate as the default solution,” said Stephen Zeidman, director of the New York State School of Law's Criminal Defense Clinic. In 2019, one of his clients died in prison weeks after being granted medical parole.
New York state does not release data on the number of inmates waiting to be admitted to nursing homes. A 2018 study found that six of the 36 prisoners granted medical parole between 2013 and 2015 died before they could find housing. Research shows that the medical parole process moves slowly, sometimes taking years before an inmate is interviewed for possible release.
Even for patients without a criminal history, finding a nursing home can be difficult. Facilities have struggled to hire staff, especially since the coronavirus pandemic. Nursing homes may also worry about the safety risks of people with criminal records and the financial risks of losing residents who don't want to live in facilities that host ex-convicts.
“Nursing homes have concerns, and whether it's reasonable or not, it's easy for them not to answer or return those calls,” said a senior policy expert who reviewed the legal filings for The News. said Ruth Finkelstein, a professor at Hunter College. The Times please.
Some officials involved in such cases said New York prisons often conduct only cursory searches for care.
Jose Saldana, director of a nonprofit called the Campaign for the Release of Older People in Prison, said that when he was incarcerated at Sullivan Correctional Facility from 2010 to 2016, he worked in the unit that coordinates the release of parolees. spoke. He said he reminded his boss to call the nursing home that didn't answer the phone the first time.
“They'll say they have too many other responsibilities to stay on the phone,” Saldana said.
Maley, a New York Department of Corrections spokeswoman, said the agency has multiple discharge teams seeking placement options.
In 2023, Arthur Green, a 73-year-old patient undergoing kidney dialysis, sued the state to be released four months after being granted medical parole. In the lawsuit, Green's attorneys said they secured a nursing home placement for him, but it lapsed because the Department of Corrections submitted an incomplete application to a nearby dialysis center.
Martha Rayner, a lawyer who specializes in prisoner release cases, said the state found a placement for Greene a year after his parole date.
John Teixeira was granted medical parole in 2020 at age 56, but remained incarcerated for two and a half years as the state searched for a nursing home. He had a history of heart attacks and was taking daily medications, including those administered through an intravenous port. However, an evaluation by an independent cardiologist concluded that Teixeira did not require nursing care.
Lawyers for the New York State Legal Aid Society sued the state for his release, noting that Port was repeatedly infected during his stay and his diagnosis progressed from “progressive” to “end-stage” heart failure. .
The Department of Corrections responded that 16 nursing homes had refused Teixeira because they were unable to meet his medical needs. Stephen Short, one of Teixeira's lawyers, said the case was resolved three months after it was filed, when “the judge put significant pressure on the state” to find a suitable placement.
Some sick prisoners awaiting release find it difficult to access medical care inside.
Steve Coleman, 67, has difficulty walking and spends most of the day sitting. After serving 43 years in prison for murder, he was granted parole in April 2023 and remains behind bars as the state searches for a nursing home that can work with a kidney dialysis center three times a week.
But Coleman hasn't received dialysis treatment since March, when the state ended its contract with the health care provider. The prison offered to take Coleman to a nearby clinic for treatment, but Coleman declined, citing the painful and invasive process of undressing, shackling and testing.
“I'm being told I have to undergo a strip search,” he said in a recent interview. “If I get paroled and can't walk and end up in the hospital, who will I hurt?”
In June, volunteers from the nonprofit Parole Preparation Project, which supported Coleman's parole application, received a letter from Mount Sinai Hospital in New York City stating that they would provide Coleman with medical care and support his reintegration into society. I got it.
Two months later, still incarcerated, Coleman filed a lawsuit seeking his release.
The state argued in court filings that it would be “dangerous and irresponsible” to release Coleman without a plan to meet his medical needs. The state also said it contacted Mount Sinai and hundreds of nursing homes about Coleman's placement but received no response.
In October, a court ruled in favor of the prison system. New York State Supreme Court Justice Debra Givens called Coleman's situation “extremely sad and frustrating” and concluded that the state had reasonable grounds to keep Coleman in custody beyond his parole date. Rayner, Coleman's attorney, and the New York Civil Liberties Union appealed the ruling Wednesday.
Fourteen medical ethicists sent a letter to the prison supporting Coleman's release. “Forcing continued incarceration under the guise of 'best interests,' even if well-intentioned, disregards his autonomy,” they wrote.
Several other states have come up with other solutions for people on medical parole. The idea is to solicit business for a nursing home that specializes in accommodating patients who have been rejected elsewhere.
A private company called iCare opened its first similar facility in Connecticut in 2013, and it currently houses 95 residents. The company operates similar nursing homes in Vermont and Massachusetts.
David Skoczulek, iCare's vice president of business development, said these facilities tend to save states money because the federal government covers some of the costs through Medicaid.
“It's more humane, less restrictive and more cost-effective,” he said. “There is no reason for these people to remain in a correctional setting.”
