Statistics show that 50% of the almost two million prison population in the United States lacked health insurance at the time of their arrest.
In addition, a portion of the inmate population disproportionately receives the government-funded health care program, Medicaid, making it hard to cover health needs during medical emergencies.
However, if this staggering number of people have medical problems, why are they still in jail? Are there illnesses or diseases that can get you out of imprisonment?
This article explores the different medical conditions or illnesses that may prevent someone from spending time in jail. Also, it tackles the alternative terms given to convicted people who are physically unfit to go to jail.
Read on to get an overview of the Compassionate Release Program, including how it works and how it can be used to free inmates with serious medical illnesses.
If you need an inmate or facility locator to get your loved one’s records which you may need when raising concerns about their medical condition to prison authorities, visit LookUpInmate.org.
LookUpInmate.org gives you access to an extensive database of more than 7,000 correction facilities in the United States. You also get links to a specific prison’s websites to obtain the necessary documents.
Can Illness Get You Out of Jail?
There are instances where prisoners may contract illnesses that are severe enough that it can question whether their continuing incarceration is still humane. However, one way to resolve this is an underutilized avenue of clemency called “compassionate release.”
Do People With Mental Illnesses Go to Jail?
You often hear that you can’t incarcerate someone with mental disorders. Also, some movies show culprits of criminal activity feigning mental issues to avoid going to trial or being sentenced to prison. But is this true? Do people with mental illness go to jail?
When a person on trial for a serious crime happens to be mentally disabled or have mental health disorders, they’re typically deemed unfit for trial and admitted to a hospital for observation.
Some states may impose up to 120 days of medical observation to determine if the defendant is indeed unfit for trial due to mental problems.
When Facing Life in Prison in a Federal Facility, Individuals Face Many Challenges
Incarceration should not endanger an inmate’s life. The criminal justice system aims to ensure public safety from dangerous people but also provides ways for the incarcerated to rehabilitate and hopefully reintegrate into society.
The Bureau of Prison’s (BOP) system is required to provide health care services to prisoners inside correctional facilities, even at the very minimum. Services should include dental, medical, eye care, hearing, and pharmacy services.
However, many reports reveal that federal prisons face challenges in providing medical treatment and other medical services.
Admission and Orientation Issues
Included in the orientation of prisoners in federal prisons are the different services that the BOP provides to ensure the emotional, mental, and physical health of the prison population.
However, reports have shown lapses in providing medical services to inmates. In some cases, even physicians are not present to provide health care to inmates.
Though the BOP works hard to resolve these issues, problems can still happen, especially when handling thousands of inmates in one facility alone.
Medical Designation Levels
To provide efficient service to prisoners, the BOP provides medical designation levels to help direct inmates to the needed facilities.
There are four designation levels for inmates concerning medical health.
- Level one inmates are relatively healthy and require little medical assistance.
- Level two inmates have relatively chronic condition but are still regarded as having good health.
- Level three inmates have regular medical needs. Some require weekly evaluations because of diseases like asthma, diabetes, heart problems, and mental health issues.
- Level four inmates need daily medical care because of health issues that are usually terminal.
Medical Care of Inmates
The Bureau of Prisons designates five levels of medical care for its inmate population.
- Inmates with immediate acute conditions
- Inmates without a life-threatening medical condition but need treatment to avoid premature death
- Inmates who don’t always need medical care to improve their quality of life
- Inmates with conditions where treatment is limited or has no medical value
- Inmates in need of medical interventions that can affect another life, like an organ transplant
Inmate Dental Care
Oral health is a vital part of medical care for inmates. Research shows that inadequate dental care may cause reentry problems for incarcerated individuals. Living in pain can stunt the self-confidence of inmates scheduled for release and reentry.
Some inmates don’t want their loved ones to see them with missing dentures, which impacts their self-esteem.
The American College of Prosthodontists published a study that showed a clear correlation between psychological distress and tooth loss. However, treatment for these conditions inside prisons is not always available.
Prisoners must be proactive before entering prison and take the following steps to maintain one’s health.
- Have a medical check-up with a local hospital or a family physician.
- Have all minor surgeries.
- Have a complete dental check-up and dental service.
- Have a complete ear and eye examination and services.
- Have a prescription letter complete with the medication needed and dosages.
Inmate Eye Care
The BOP is required to provide eye examinations to inmates and to furnish prescription glasses when needed. However, not all prisons provide this service adequately. Some inmates may take a long time before getting their prescribed eyeglasses.
Inmate Hearing Care
Like eye care, hearing care is an essential medical service the BOP should provide. However, there are instances where it’s not readily available.
The BOP strives to provide the daily prescription medicines inmates need in correctional facilities. However, there are instances where these medicine are not available. The resulting wait time may be considerable and is a problem in other correctional institutions.
Primary Care Provider Teams
Each prison facility must have adequate medical staff to accommodate the growing inmate population in the United States. However, many prisons have understaffed personnel expected to handle thousands of inmates.
Lack of Standardized Chronic Condition Screening for Individuals in Jail
Healthcare service amid mass incarceration is an issue that needs quick solutions. When inmates are released from prisons and then get rearrested, the medical service strains. This strain is because most inmates already have diabetes, asthma, and hypertension.
Lack of Health Screening Upon Jail Entry
You can pin the increased health issues inside prisons on the lack of health screening. Inmates must be screened before incarceration to check their medical history and if they need additional medical care inside prison.
Prevalence of Chronic Medical Conditions of the Jail Population and the General Population
One primary reason for the prevalence of chronic medical conditions within incarcerated populations is the lack of medical screening before booking.
Many inmates don’t go through medical check-ups before going to prison. This problem resulted in an increased number of inmates with diseases requiring constant attention inside prisons.
Exacerbation of Disease in Jails and Upon Reentry
There are instances where the existing medical conditions of inmates get exacerbated due to the conditions inside the prison. For example, a prisoner might develop uncontrollable hypertension due to the drastic difference in lifestyle inside prison.
Also, inmates with a criminal history of drug or alcohol abuse may experience withdrawal while in prison.
Legal Rights and Protection
The legal basis for implementing health care services to inmates is the Eight Amendment, which protects citizens from cruel and unusual punishments, and the Fourteenth Amendment or the “due process clause” of the U.S. Constitution.
Aside from the provisions cited in the U.S. Constitution, various cases involving inmate welfare and health care further established inmates’ legal rights and protection inside prison.
National Commission on Correctional Health Care Guidelines for Jail Health Screening and Documentation
The National Commission on Correctional Health Care (NCCHC) is a national organization focused on improving the health care and medical services inside prisons in the United States.
This organization has created a set of guidelines that jails and prisons must adopt if they want to improve their city’s performance.
The screening and documentation phase of inmates is essential when treating people with medical issues behind bars. The NCCHC suggests that all inmates have access to a video that shows how an inmate can acquire medical services.
The NCCHC has set guidelines on combating healthcare risk inside prisons by issuing mandatory protocols. These protocols include the following:
- Perform medical clearance of an inmate before booking by screening and health assessment
- Provide medical needs and services to inmates while inside a prison facility
Obstacles to Implementation
An obstacle to implementing the guidelines put forward by the NCCHC is the lack of staff. Prison facilities usually have less number of staff for the health care service to function correctly.
Unless the staffing issues are resolved, the medical care system of prisons will not be able to cater to prisoners’ needs thoroughly.
Debilitated Medical Condition Compassionate Release Criteria
Congress has authorized the BOP to seek compassionate release for cases that require such action. A compassionate release is justified if the inmate has an extraordinary and compelling reason. The BOP uses the term reduction in sentence (RIS) to describe compassionate release.
Eligibility for Compassionate Release
The main criterion for a person receiving compassionate release is having extraordinary and compelling reasons. However, Congress ratified the First Step Act of 2018 to include sentencing judges to determine whether an inmate is eligible for compassionate release.
It should be noted that before compassionate release is considered, the inmate must have exhausted all the services and assistance the BOP can provide.
What Are the Conditions of Compassionate Release?
Compassionate release is a broad concept that covers policies offering “compassion” to inmates. The policy hinges on the government’s empathy towards inmates with debilitating diseases.
Compassionate release acknowledges that there are instances where medical treatment isn’t available inside prison.
Compassionate release is a complicated policy that should be dissected to make it easy to understand. The topics below cover the conditions needed for a compassionate release grant.
How Does Compassionate Release Work?
When inmates have extraordinary and compelling reasons, they can request the BOP and the sentencing court for compassionate release.
There is no comprehensive list of “extraordinary and compelling” reasons, but the U.S. Sentencing Commission provides three distinct categories.
- Medical reasons
- Non-medical reasons
- Age-related reasons
Each of these categories has specific requirements that need to be met before a reduction in sentence is approved.
Medical Reasons for Compassionate Release
Here are the conditions for an inmate to receive a compassionate release for medical reasons:
- The inmate has terminal illnesses like cancer, end-stage organ disease, or advanced dementia.
Terminal illnesses are incurable, resulting in an 18-month life expectancy or less. Inmates with terminal diseases must inform the BOP within 72 hours of diagnosis.
- The inmate has a debilitating medical condition. Debilitating diseases progress over time and can render an inmate unlikely to recover and unable to care for themselves, resulting in disabilities.
Official medical records must substantially back up these requests for compassionate release.
Other criteria include the following:
- Confinement to a bed or chair
- Partial confinement (resulting in 50% of an individual’s waking hours in confinement)
- Debilitating cognitive defects or diseases
The BOP will help draft, submit, and process compassionate release requests.
Non-medical Reasons for Compassionate Release
For non-medical reasons, the inmate must be in either of the following situations:
- Death or incapacitation of a family member
- Death or incapacitation of a spouse or a registered partner
However, the family member, spouse, or registered partner must fully fit the following criteria to justify an inmate’s request for compassionate release.
- The guardian or caregiver of the inmate’s biological or legally adopted child was severely injured or killed.
- The guardian or caregiver is the only family member capable of caring for the inmate’s child.
- There is official medical documentation of the injuries and a copy of the death certificate, if applicable.
- There is a concrete release plan outlining housing and financial plans.
These added requirements may prove that the family member, spouse, or registered partner supports the inmate’s release and would want to be their child’s primary caregiver in the event of incapacitation.
In the case of the death of a family member, spouse, or registered partner, the inmate musts provide proof that their loved one had a serious injury, severe cognitive damage, or death through an official medical report and death certificate.
Age-Related Reasons for Compassionate Release
Depending on the circumstance of their sentences, many elderly or senior inmates are eligible for compassionate release.
Inmates sentenced for a crime that happened on or after November 1, 1987, and who served 30 years or more of their imprisonment term become eligible for compassionate release once they reach 70 years of age.
Aside from this, the new law for elderly inmates also includes other criteria that make an inmate eligible for compassionate release.
- The inmate is 65 or older.
- The inmate is living with a chronic medical or health condition.
- The inmate experiences mental health problems and deterioration of physical health.
- The inmate’s condition is not likely to improve through conventional treatment.
- The inmate has served at least half of their prison sentence.
COVID-19 Reasons for Compassionate Release
During the onset of the COVID-19 pandemic, many inmates could secure release. The main reason for their release is the underlying health conditions that made inmates more susceptible to infection or death once they contracted the pandemic virus.
However, after the widespread availability of vaccines, COVID-19 is no longer considered an extraordinary or compelling reason for compassionate release.
Changes in the Law as Reasons for Compassionate Release
Some inmates have received compassionate release by citing non-retroactive changes in the law. An example is the First Step Act, which removed the “stacking” provision stated in 18 U.S.C. § 924(c).
However, the problem is that the law changes are non-retroactive, which means that the new changes don’t apply to previous cases before the changes.
Despite this apparent setback, inmates continue to request compassionate release, citing that their sentences would be shorter because of the changes. Some district courts agreed to the petition, while others did not.
Warden’s Review of Petition
The BOP will also consider other factors, alongside the documents provided by the inmate, for granting compassionate release. The warden will aid in the review by considering the following inmate information:
- Current offense
- Criminal history
- Supervised release violations
- Length of sentence and time served
- Current age and at the time of the offense
- Unresolved detainers
- Personal history
- Institutional adjustment, including disciplinary records
The Compassionate Release Process
Some may think that the compassionate release process is complicated. However, the process is relatively straightforward if all documents are in order. Here is the standard compassionate release request process.
- The inmate submits the request to the warden.
- The warden determines if a sentence reduction applies to the inmate’s medical condition.
- If approved, the warden will forward the approval and the documents to the BOP’s General Counsel.
- The General Counsel will get the medical director’s opinion regarding the inmate’s request.
- If the General Counsel approves the inmate’s request, it gets forwarded to the BOP director, which will be the final agency decision.
- If the BOP director approves the request, the director will request the U.S. attorney for the sentencing district to approve the prisoner’s early release.
- The court will then hear the request, consider the arguments and evidence, and provide a decision.
- If the court approves the request, the BOP will release the prisoner as soon as the plans are finalized.
Sheriffs Release Sick Inmates to Avoid Paying Their Hospital Bills
There was a case where an inmate’s health condition became a factor for an early release. However, upon investigation, records showed that sheriffs release sick inmates to avoid paying hospital bills of inmates in need of medical attention.
The following is the story of Michael Tidwell and his experience after becoming seriously ill while in jail when his sugar levels reached 15 times the normal level.
The sheriffs of the Washington County Jail brought him to the hospital. However, before he was placed at the back of the vehicle, he was given a pen and unknowingly signed a document that freed him on bond.
As a result, the Washington County Jail was no longer responsible for his medical costs once they took him to the hospital. This kind of last-minute inmate release by a county jail during medical emergencies is called a “medical bond.”
“They Have to Do Something”
When a person is incarcerated, the prison authorities must do something to alleviate the medical problems they may experience. Unfortunately, Tidwell’s experience revealed how the county jail officers opted to pass the responsibility to the hospital.
“They’ll Lower the Bond”
Some county jails have a limited budget for inmate use. An example is the experience of Sheriff Jim Underwood of Walker County jail in Alabama. He said that the budget for medical care for inmates is $350,000. However, one inmate in their custody had medical bills already costing $300,000.
Money was insufficient to handle all medical care cases in jail. So, he posted “medical bonds,” a practice he believed is done in many places in Alabama. He asked the inmate to pay bonds before bringing them to the hospital or have the judge lower the bond.
“They Are Responsible”
Another case where county jails rely on sudden release policies when inmates need medical care happened to Marcus Echols, who was jailed in Morgan County Jail in Decatur, North Alabama.
On January 16, 2016, Echols suffered a heart attack. However, the jail officers weren’t sure if they would bring Echols to the hospital, but eventually, they did.
Echols eventually recovered from his heart attack, although he needed three stents to patch up his heart. However, he was surprised when the doctor told him that the county jail had formally released him.
Echols was initially happy about the news, but when the bill arrived weeks later, he saw that the entire medical process that kept him alive cost around $80,000.
He realized that the county jail managed to avoid the responsibility for paying the medical bill by somehow releasing him despite being unaware of what legal procedure the jail did to formalize his release.
“They Said They Would Release Me”
The “quick release” of inmates during medical emergencies is not relatively new. In 1996, Leroy Owens, an inmate in Butler County jail in Alabama, was attacked by fellow inmates, stabbed with a screwdriver, and beaten.
The jail officials managed to bring Owens to the hospital, where he got “signed out” of prison. According to Owen, he signed a document promising that they would release him. He signed, and he was released.
“They’re Technically Still in Custody”
The stories of people stated previously show that they have all been released from jail due to what they know as “medical bonds.” However, are they legally free from jail?
Chris Connolly, district attorney of Lauderdale County, explained that placing monitors and signing them off to weeklong furloughs for medical reasons is not releasing them. They’re technically still under their custody, and their release can be considered house arrest.
What Are the Two Most Prevalent Medical Conditions That Inmates Have?
Two prevalent types of medical conditions are affecting inmates in prison. These are infectious diseases and mental health problems.
According to the Bureau of Justice Statistics, the list of prevalent infectious diseases in America’s prisons includes the following:
- HIV (human immunodeficiency virus): Data shows 1.1% of state and federal prison inmates tested positive for HIV. The rate is higher than HIV cases in the rest of the United States.
- Viral hepatitis: Approximately 30% of all people infected by viral hepatitis C in the U.S. have spent at least a part of a year in correctional facilities.
- Sexually-transmitted diseases: There’s a growing rate of inmates developing chlamydia and gonorrhea inside prisons. Inmates aged 35 years (male and female) have higher rates of developing STDs inside prisons.
The second most prevalent medical condition in prison is mental health issues.
There are also cases of depression and anxiety inside prisons that are linked to an inmate’s previous dependence on alcohol and illegal substances. More than 65% of prisoners are classified as drug or alcohol-dependent.
Prisons provide mental health services to these people, but the number of incarcerated individuals is growing annually. If conditions don’t improve rapidly, overcrowding can dramatically reduce the quality of life of prisoners in this country.
LookUpInmate.org provides access to inmate records from over 7,000 U.S. correctional facilities, including federal and state prisons, local jails, military prisons, and immigrant detention facilities.
You can find information on facility regulations, visiting hours, policies for sending money to inmates, and contact details like phone numbers and mailing addresses. You can also get updated on an inmate’s release date to determine when they will rejoin society.
1. Mass Incarceration: The Whole Pie 2023
2. New report, Chronic Punishment, reveals the unmet health needs of people in state prisons
3. Excessive Fines, Cruel and Unusual Punishment
4. The Fourteenth Amendment Due Process Clause
5. Incarceration and Health: A Family Medicine Perspective (Position Paper)
6. Compassionate Release: Debilitated Medical Condition
7. Correctional Health
8. The Health and Health Care of US Prisoners: Results of a Nationwide Survey