H.B. NO.




















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 prison 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 under certain circumstances.

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. Accordingly, the purpose of this Act is to create a medical or compassionate release program for certain ill, disabled, or impaired inmates who pose a low risk to public safety.

SECTION 2. Chapter 353, Hawaii Revised Statutes, is amended by adding a new subpart to part II to be appropriately designated and to read as follows:

" . Medical Release Program

353-    Definitions. As used in this subpart:

"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, or from one level of care to another.

"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.

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

"Terminal illness" means a progressive and incurable medical condition that is expected to result in death.

353-    Medical release program; authority to release; rules. (a) An inmate may be considered for medical release if the inmate:

(1) Has a terminal illness with a predictably poor prognosis;

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

(3) Is too ill or cognitively impaired to participate in rehabilitation or be aware of punishment; or

(4) Has a disease or condition that requires a complexity of treatment or level of care that the department is unable to provide on a long-term basis.

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

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

(1) A report from a department physician stating whether 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; 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; and provided further that, if 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 the inmate's medical condition, the severity of the offense for which the inmate is incarcerated, and the inmate's prison record; and

(3) A medical release plan that provides for continuity of care; provided that the medical release plan shall include a recommended course of treatment for the inmate and plan to provide continuity of care as the inmate transitions from prison to the community.

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

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

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

(e) The Hawaii 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:

(1) Independently determine whether the inmate meets the criteria for medical release and assess the risk for violence and recidivism, if any, that the inmate poses to society;

(2) Provide the victim of the criminal act for which the inmate was sentenced, or the victim's family, with the opportunity to be heard; and

(3) Grant or deny the request within two days following the hearing.

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

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

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

(i) 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 websites of the department and the Hawaii paroling authority.

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

(k) The department shall adopt rules pursuant to chapter 91 to implement the medical release program.

353-    Conditions of a medical release. The Hawaii 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 Hawaii 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 Hawaii paroling authority.

353-    Revocation of medical release; return of inmate to custody. (a) The Hawaii 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 the inmate has failed to comply with any reasonable condition set upon the inmate's medical release.

(b) If the Hawaii paroling authority revokes an inmate's medical release for failure to comply with a reasonable 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 reasonable 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."


SECTION 3. Chapter 353, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

"353-    Medical release program. The department shall assess and refer inmates to the Hawaii paroling authority for possible medical release as provided in subpart B of part II."

SECTION 4. Chapter 353, part II, Hawaii Revised Statutes, is amended by designating sections 353-61 to 353-72 as subpart A, entitled "Hawaii Paroling Authority; General Provisions".


SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.








Report Title:

PDS; Hawaii Paroling Authority; Corrections; Medical Release Program; Compassionate Release; Medical Assistance



Creates a medical release program within the Department of Public Safety for certain ill, disabled, or impaired inmates who pose a low risk to public safety.




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