\n<\/p>\n
When the letter arrived at Westil Gonzalez\u2019s prison cell saying that he had been granted parole, he couldn\u2019t read it. Over the 33 years he had been locked up for murder, multiple sclerosis had taken much of his vision and left him reliant on a wheelchair.<\/p>\n
He had a clear sense of what he would do once freed. \u201cI want to give my testimony to a couple of young people who are out there, picking up guns,\u201d Mr. Gonzalez, 57, said in a recent interview. \u201cI want to save one person from what I\u2019ve been through.\u201d<\/p>\n
But six months have passed, and Mr. Gonzalez is still incarcerated outside Buffalo, because the Department of Corrections has not found a nursing home that will accept him. Another New York inmate has been in the same limbo for 20 months. Others were released only after suing the state.<\/p>\n
America\u2019s elderly prison population is rising, partly because of more people serving long sentences for violent crimes. Nearly 16 percent of prisoners were over 55 in 2022<\/a>, up from 5 percent in 2007<\/a>. The share of prisoners over 65 quadrupled over the same time period, to about 4 percent.<\/p>\n<\/div>\n<\/div>\n Complex and costly medical conditions require more nursing care, both in prison and after an inmate\u2019s release. Across the country, prison systems attempting to discharge inmates convicted of serious crimes often find themselves with few options. Nursing home beds can be hard to find even for those without criminal records.<\/p>\n Spending on inmates\u2019 medical care is increasing \u2014 in New York, it has grown to just over $7,500<\/a> in 2021 from about $6,000 per person in 2012. Even so, those who work with the incarcerated say the money is often not enough to keep up with the growing share of older inmates who have chronic health problems.<\/p>\n \u201cWe see a lot of unfortunate gaps in care,\u201d said Dr. William Weber, an emergency physician in Chicago and medical director of the Medical Justice Alliance, a nonprofit that trains doctors to work as expert witnesses in cases involving prison inmates. With inmates often struggling to get specialty care or even copies of their own medical records, \u201cthings fall through the cracks,\u201d he said.<\/p>\n Dr. Weber said he was recently involved in two cases of seriously ill prisoners, one in Pennsylvania and the other in Illinois, who could not be released without a nursing home placement. The Pennsylvania inmate died in prison and the Illinois man remains incarcerated, he said.<\/p>\n Almost all states have programs that allow early release<\/a> for inmates with serious or life-threatening medical conditions. New York\u2019s program is one of the more expansive: While other states often limit the policy to those with less than six months to live, New York\u2019s is open to anyone with a terminal or debilitating illness. Nearly 90 people were granted medical parole in New York between 2020 and 2023.<\/p>\n<\/div>\n<\/div>\n But the state\u2019s nursing home occupancy rate hovers around 90 percent<\/a>, one of the highest in the nation, making it especially hard to find spots for prisoners.<\/p>\n The prison system is \u201ccompeting with hospital patients, rehabilitation patients and the general public that require skilled nursing for the limited number of beds available,\u201d said Thomas Mailey, a spokesman for the New York Department of Corrections and Community Supervision. He declined to comment on Mr. Gonzalez\u2019s case or on any other inmate\u2019s medical conditions.<\/p>\n Parolees remain in the state\u2019s custody until their original imprisonment term has expired. Courts have previously upheld the state\u2019s right to place conditions on prisoner releases to safeguard the public, such as barring paroled sex offenders from living near schools.<\/p>\n<\/div>\n<\/div>\n But lawyers and medical ethicists contend that paroled patients should be allowed to choose how to get their care. And some noted that these prisoners\u2019 medical needs are not necessarily met in prison. Mr. Gonzalez, for example, said he had not received glasses, despite repeated requests. His disease has made one of his hands curl inward, leaving his unclipped nails to dig into his palm.<\/p>\n<\/div>\n<\/div>\n \u201cAlthough I\u2019m sympathetic to the difficulty of finding placements, the default solution cannot be continued incarceration,\u201d said Steven Zeidman, director of the criminal defense clinic at CUNY School of Law. In 2019, one of his clients died in prison<\/a> weeks after being granted medical parole.<\/p>\n New York does not publish data on how many inmates are waiting for nursing home placements. One 2018 study<\/a> found that, between 2013 and 2015, six of the 36 inmates granted medical parole died before a placement could be found. The medical parole process moves slowly, the study showed, sometimes taking years for a prisoner to even get an interview about their possible release.<\/p>\n Finding a nursing home can prove difficult even for a patient with no criminal record. Facilities have struggled to recruit staff, especially since the coronavirus pandemic. Nursing homes may also worry about the safety risk of someone with a prior conviction, or about the financial risk of losing residents who do not want to live in a facility that accepts former inmates.<\/p>\n \u201cNursing homes have concerns and, whether they are rational or not, it\u2019s pretty easy not to pick up or return that phone call,\u201d said Ruth Finkelstein, a professor at Hunter College who specializes in policies for older adults and reviewed legal filings at The Times\u2019s request.<\/p>\n Some people involved in such cases said that New York prisons often perform little more than a cursory search for nursing care.<\/p>\n<\/div>\n<\/div>\n Jose Saldana, the director of a nonprofit called the Release Aging People in Prison Campaign, said that when he was incarcerated at Sullivan Correctional Facility from 2010 through 2016, he worked in a department that helped coordinate parolees\u2019 releases. He said he often reminded his supervisor to call nursing homes that hadn\u2019t picked up the first time.<\/p>\n \u201cThey would say they had too many other responsibilities to stay on the phone calling,\u201d Mr. Saldana said.<\/p>\n Mr. Mailey, the spokesman for the New York corrections department, said that the agency had multiple discharge teams seeking placement options.<\/p>\n In 2023, Arthur Green, a 73-year-old patient on kidney dialysis, sued the state for release four months after being granted medical parole. In his lawsuit, Mr. Green\u2019s attorneys said that they had secured a nursing home placement for him, but that it lapsed because the Department of Corrections submitted an incomplete application to a nearby dialysis center.<\/p>\n The state found a placement for Mr. Green a year after his parole date, according to Martha Rayner, an attorney who specializes<\/a> in prisoner release cases.<\/p>\n<\/div>\n<\/div>\n 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 took daily medications, including one delivered through an intravenous port. But an assessment from an independent cardiologist concluded that Mr. Teixeira did not need nursing care<\/a>.<\/p>\n Lawyers with the Legal Aid Society in New York sued the state<\/a> for his release, noting that during his wait, his port repeatedly became infected and his diagnosis progressed from \u201cadvanced\u201d to \u201cend-stage\u201d heart failure.<\/p>\n The Department of Corrections responded<\/a> that 16 nursing homes had declined to accept Mr. Teixeira because they could not manage his medical needs. The case resolved three months after the suit was filed, when \u201cthe judge put significant pressure\u201d on the state to find an appropriate placement, according to Stefen Short, one of Mr. Teixeira\u2019s lawyers.<\/p>\n Some sick prisoners awaiting release have found it difficult to get medical care on the inside.<\/p>\n Steve Coleman, 67, has trouble walking and spends most of the day sitting down. After 43 years locked up for murder, he was granted parole in April 2023 and has remained incarcerated, as the state looks for a nursing home that could coordinate with a kidney dialysis center three times each week.<\/p>\n But Mr. Coleman has not had dialysis treatment since March, when the state ended a contract with its provider. The prison has offered to take Mr. Coleman to a nearby clinic for treatment, but he has declined because he finds the transportation protocol \u2014 which involves a strip search and shackles \u2014 painful and invasive.<\/p>\n<\/div>\n<\/div>\n \u201cThey say you\u2019ve got to go through a strip search,\u201d he said in a recent interview. \u201cIf I\u2019m being paroled, I can\u2019t walk and I\u2019m going to a hospital, who could I be hurting?\u201d<\/p>\n Volunteers at the nonprofit Parole Prep Project, which assisted Mr. Coleman with his parole application, obtained a letter from Mount Sinai Hospital in New York City in June offering to give him medical care and help him transition back into the community.<\/p>\n Still incarcerated two months later, Mr. Coleman sued<\/a> for his release.<\/p>\n In court filings<\/a>, the state argued that it would be \u201cunsafe and irresponsible\u201d to release Mr. Coleman without plans to meet his medical needs. The state also said that it had contacted Mount Sinai<\/a>, as well as hundreds of nursing homes, about Mr. Coleman\u2019s placement and had never heard back.<\/p>\n In October, a court ruled in the prison system\u2019s favor. Describing Mr. Coleman\u2019s situation as \u201cvery sad and frustrating,\u201d Justice Debra Givens of New York State Supreme Court concluded<\/a> that the state had a rational reason to hold Mr. Coleman past his parole date. Ms. Rayner, Mr. Coleman\u2019s lawyer, and the New York Civil Liberties Union appealed the ruling on Wednesday.<\/p>\n Fourteen medical ethicists have sent a letter to the prison supporting Mr. Coleman\u2019s release. \u201cForcing continued incarceration under the guise of \u2018best interests,\u2019 even if doing so is well-intentioned, disregards his autonomy,\u201d they wrote.<\/p>\n<\/div>\n<\/div>\n Several other states have come up with a different solution for people on medical parole: soliciting the business<\/a> of nursing homes that specialize in housing patients rejected elsewhere.<\/p>\n