Severely ill prisoners granted early release are left stuck behind bars

Severely ill prisoners granted early release are left trapped inside prisons, unable to access long-term care due to systemic barriers. In Hawaii, Christian Alameda, a 52-year-old man who suffered a debilitating stroke in January, was released from the Halawa Correctional Facility under compassionate release rules. Despite this, he remains confined to the prison’s infirmary, unable to leave because no long-term care facility will accept him. As of June, at least three other prisoners similarly denied placement have remained in the infirmary indefinitely, according to the state parole authority. Alameda, who uses a cane to move around, has been recovering in the infirmary since his stroke left him partially paralyzed. His case highlights a growing national crisis: while all states allow compassionate release for prisoners with severe medical conditions, many long-term care facilities refuse to admit them. This issue is particularly acute in Hawaii, where there is no specific law governing compassionate release, only an internal policy. The state’s parole board grants these releases, but the final step, placement in appropriate care, is blocked by institutional reluctance. The problem extends beyond Hawaii. In Rhode Island, a study revealed that nursing homes increasingly reject patients who come from prison. In Colorado, prisoners with complex medical needs often stay in limbo for over six months after being granted parole, due to rejections from long-term care centers. In New York, some parolees have taken legal action against the state after being denied placement in nursing homes. These cases underscore a broader pattern of systemic exclusion. The situation is compounded by federal legislation. President Donald Trump’s One Big Beautiful Bill Act, signed into law last summer, has made it harder for long-term care providers to accept newly released prisoners. Under the act, facilities must submit Medicaid applications for new residents within 30 days of admission, rather than the previous three-month window. This change increases financial risk for providers, who may lose reimbursement if applications are delayed. The Centers for Medicare & Medicaid Services has encouraged timely submissions to ensure coverage, but the law has created additional hurdles for both prisoners and caregivers. Nursing homes nationwide already face significant challenges in managing capacity. A 2024 report by the American Health Care Association and the National Center for Assisted Living noted that most facilities maintain waiting lists for new residents. This scarcity of available beds makes it even more difficult for prisoners seeking placement. Bob Merce, a former attorney advocating for compassionate release, explained that nursing homes are often hesitant to accept individuals with criminal records, despite assurances that most of them pose no threat. At the Halawa Correctional Facility, the infirmary serves as a temporary holding area for prisoners awaiting long-term care placements. It houses six cells where those granted compassionate release reside until they can secure a spot elsewhere. Some of the men currently in the infirmary require constant assistance, including help with basic tasks like dressing or walking. Others suffer from serious illnesses, such as brain cancer, and struggle to communicate clearly. Their condition underscores the urgency of finding solutions to this growing problem. Ashley Mizuo, a reporter for KFF Health News, documented the plight of these prisoners during her visit to the facility. She spoke with Sean Sanada, the Oʻahu Region CEO of the Hawaiʻi Health Systems Corp., which operates two state-funded long-term care facilities. Sanada confirmed that the health system has reviewed numerous compassionate release referrals but has never accepted any of them. He cited concerns about liability and compliance with state regulations as key factors influencing their decision. While the facilities do not explicitly discriminate based on criminal history, the practical realities of operating a long-term care institution make accepting such patients highly unlikely.