HB 219 - PAROLE OF TERMINALLY ILL PRISONERS CHAIRMAN PORTER introduced Representative Eldon Mulder, sponsor of HB 219, and invited him speak about the bill. Number 140 REPRESENTATIVE ELDON MULDER, Prime Sponsor of HB 219, came before the committee to speak on HB 219. He explained HB 219 allows for the transport for terminally ill. He said the issue was looked at last year at which time the bill was smaller, and a little more concise. REPRESENTATIVE MULDER related that special medical parole is a tool which the Sentencing Commission recommended, and the Department of Administration gave support to as well, in relation to taking advantage of paroling individuals to defer medical costs. He stated it is a tool the Parole Board can use to help control some of the spiraling costs incurring in correctional institutions. Representative Mulder also stated that when an inmate is incarcerated and in a medical facility, the state is responsible for 100 percent of their medical costs. If the inmate is released on medical parole, then the individual is eligible for at least half coverage by Medicaid and the state would be able to save some of the cost. REPRESENTATIVE MULDER gave an example of costs incurred. He said last year, there was a case of an AIDS victim who spent the last two months of his life in a hospital. He was an inmate and his care was part of the supplemental budget request, with those two months costing the state $567,000. Representative Mulder stated that had there been this provision, some of the costs could have been awarded. REPRESENTATIVE MULDER went on to say, he felt the changes that occur relate, in part, to added security and definition of terminally ill. He said it is important to note there is no intention to have this ever be a risk to the community at large, as these individuals pose no risk to society. They are simply ready for their time to die. The inclusions of the changes made were to make the bill more constrictive than in the past and is not as flexible. Representative Mulder said this gives the Board of Parole more direction and definition as to what is meant. He called attention to the proposed draft committee substitute (CS) and a proposed amendment to that CS. He said this was a product of consultation with the Department of Law, the Parole Board, the Department of Corrections and his office. CHAIRMAN PORTER stated there were two people on teleconference wanting to testify as well as people in attendance to answer questions. He then called on Representative Finkelstein. Number 140 REPRESENTATIVE DAVID FINKELSTEIN asked for additional information (indisc.). Number 145 REPRESENTATIVE MULDER described the new sections as adding a small change to inmates for medical care, as a way for Corrections to let inmates know that there is a cost for prescription drugs and medical relief. There is a small incremental amount to see a doctor, if necessary. The whole thing is to make certain there is a need for a doctor so they know it costs to see a doctor. Representative Mulder referred to Section 2, where drug testing is discussed and said it requires the prisoner to reimburse the Department of Corrections. He said it is important to note that it is only to the extent that the person can pay. Representative Mulder stated Section 13 makes other insurance coverage available to prisoners, primarily to the Department of Corrections. In other words, if the inmate has any coverage, his coverage is primary and will be charged before the state will pick up some of the costs. He said Section 14 requires the commissioner of the Department of Public Safety to implement a program requiring other coverage to pay for health care provided in community jails. CHAIRMAN PORTER asked if there were questions of Representative Mulder. REPRESENTATIVE CYNTHIA TOOHEY referred to the wording, "special medical or medical referral," and asked if there would be those who are dying? REPRESENTATIVE MULDER answered that this has been a problem in trying to define "terminally ill," and the answer is basically, yes. The restrictions and constraints are very restrictive. He said the Department of Law could speak to that. REPRESENTATIVE TOOHEY then referred to page 5, line 5, and asked if people wouldn't be released dying but are still able to work. REPRESENTATIVE MULDER said that is current statute. REPRESENTATIVE TOOHEY said to spend $500,000 on a terminally ill patient is horrible. She would like to have backup on that so it can be investigated. REPRESENTATIVE MULDER responded that the patient was in the intensive care unit for most of the time, and she is right. It was outlandish. REPRESENTATIVE FINKELSTEIN complimented Representative Mulder for taking on this subject, which is not very appealing or rewarding. He said the emphasis on public condemnation makes it hard to see how it fits into the criteria listed in the bill. He said the criteria relates to cost savings. REPRESENTATIVE PORTER said his understanding is the emphasis is on protecting the public when making this kind of consideration. REPRESENTATIVE FINKELSTEIN feels it is a philosophical consideration as there is a big prison population with various categories of crimes against society. He asked who do we let out early? He said he is not trying to be inhumane about this, but whatever conditions originally applied to the person, the need to protect society, the need to punish them for their violations, still exist. He said there may be less of a threat if they are going to die, but you can have a terminal disease and still be a threat to society. Representative Finkelstein said he feels it is obvious it is not a clear cut thing in that these requirements are being met. Number 320 DENNIS DEWITT, Legislative Assistant to Representative Eldon Mulder, explained that the bill requires that there be a change in the person's status. This bill is trying to get to where someone has come into the system, their status changed, and they no longer present a danger to society. He said this bill does not give anyone a parole by simply meeting the criteria of being terminally ill. The Parole Board still has the discretion to make a determination whether or not they are a danger to society. The purpose of the bill is to give the Parole Board a little more flexibility in areas where not only is it less costly to provide care, but it would be possible to pick up other third party coverage to help pay for the care. He also stated that most prisons are not the appropriate place to provide for the care, so there is some humane economic to it. Number 350 REPRESENTATIVE FINKELSTEIN referred to page 8, lines 27 through 29, regarding having prisoners pay part of, or all of the costs. He said he feels prisoners and money is a big issue, and what they should be paying for. He suggested that something be added that prisoners shall reimburse the department for drug testing. MR. DEWITT said they had looked at health care costs in general and this was somewhat within that rubric. He gave an example of someone who is in a halfway house and earning wages, then it was felt it was a reasonable expectation they help pay for the requirements of being back in society. Mr. DeWitt said he feels it is a reasonable way to possibly recapture some costs for the department as they are driven by the activity of the individual. REPRESENTATIVE MULDER responded there are numerous instances where friends or cohorts of the inmates smuggle contraband into the institutions such as injecting a tennis ball with whatever, throw it over the fence and it is picked up by the cohort on the inside. He stated this effort is modeled by some other states to try and recoup some of the medical costs being experienced here. Number 400 REPRESENTATIVE CON BUNDE asked what the practical cost was. He stated he wouldn't look at it to really recapture much money, and the net result might be by the time the paperwork is done, there is no money return. He asked what will the net gain be in charging these fees? REPRESENTATIVE MULDER replied that there was no definite price established and he doubts the Department of Corrections could give a range. He said he realizes it will not defray the entire cost of the program, but every little bit helps. This is one of those areas where they are trying to do a little bit of cost prevention. Number 440 REPRESENTATIVE TOOHEY felt drug testing would be a good way to start, to see if it will help. REPRESENTATIVE BETTYE DAVIS wanted to follow up on the subject Representative Bunde was speaking about regarding the amount of money prisoners would pay. How much money do prisoners receive and where does it come from? JERRY SHRINER, Special Assistant, Office of the Commissioner Department of Corrections, answered that while they are institutionalized, the amount of money they would have would be very limited. Those who work can generally expect to make about $1 per hour and there are a number of personal items they are required to buy out of that. He continued that those out on the street, in halfway houses, or on probation, have routine drug testing at specified intervals. Those people generally have some income and probably are capable of paying for their drug testing. Mr. Shriner said on the inside, it would be much more difficult to have them pay. Number 500 CHAIRMAN PORTER said he hoped the routine drug testing is not so routine as to be predictable. REPRESENTATIVE DAVIS indicated she still wants an answer to her question. She said is still not clear about the people who are incarcerated and their money. MR. SHRINER responded that people inside the prison have jobs in the kitchen, maintenance, laundries and various areas. They are paid for that work. Not all of the prisoners have work. There are not enough jobs or money to pay everyone, but some do have jobs and, on rare occasions, some have income that is available from outside sources, i.e., relatives, trust funds, businesses, but there is not a lot of that. He said basically, it is that buck an hour they get for jobs inside the prisons. REPRESENTATIVE DAVIS asked if those who did not have any money would still have their medical needs taken care of. MR. SHRINER affirmed that their medical needs would be taken care of. CHAIRMAN PORTER referred to Section 12 and asked if he was correct in the assumption that to be released with this provision, the inmate must be in a condition wherein he/she is confined to a bed throughout the entire period, or is confined to bed and likely to die from the condition, or is a quadriplegic? He asked if those were the three reasons. MR. DEWITT answered yes, that is the way it was crafted. CHAIRMAN PORTER said he appreciated the victim's rights language in the bill, but wonders if it is necessary. He asked if the victims rights are already in the statute in terms of the victim having the right to be notified of parole hearings that might result in the release of their perpetrator? MR. DEWITT stated they were trying to differentiate between special medical parole and discretionary parole, the concern being to make sure someone later on doesn't suggest the victim's right is not included in special medical parole. CHAIRMAN PORTER interjected that the victim's right is not a constitutional right, and the statute says that any release, determination, or consideration will be determined at the time. MR. DEWITT agreed it may be overkill, but felt that was better than leaving an open question. REPRESENTATIVE MULDER responded he had attempted to be as cautious and conservative as possible when it was approached last time, but he doesn't want to be accused of being soft on crime any more than anyone else does. He said there is still a level of fear raised by certain elements. CHAIRMAN PORTER asked if there were other questions of the sponsor or agency people. There being none, he entertained a motion to adopt the proposed CS. REPRESENTATIVE BUNDE moved to adopt CSHB 219(JUD), Version G, dated 3/23/95. CHAIRMAN PORTER referred to the proposed amendment by the Department of Law. He asked if Mr. DeWitt would like to speak to it. MR. DEWITT referred to the CS and said the drafters suggested it be included as an amendment to the CS rather than rewriting the entire CS for today's meeting. CHAIRMAN PORTER asked Mr. DeWitt to explain the amendment. MR. DEWITT stated it adds the word "quadriplegic" on page 1, line 3, following the word "disabled". The word "quadriplegic" would also be added following the word "disabled" on page 3, lines 8 and 10. CHAIRMAN PORTER called the amendment, "amendment number one." CHAIRMAN PORTER said there was a motion to move amendment number one, Version G.1, dated 3/25/95. He asked if there was an objection. Hearing none, amendment number one was adopted. Number 570 REPRESENTATIVE BUNDE said, "I just want to observe that, you know as I read this, and I want it very clear on the record, that anybody would be eligible for this medical parole because of their physical condition, would no longer be very likely (indisc.), they'd have to think evil thoughts, mostly. And then, while I don't object to the paying, and even if it's only a dollar, and I would guess the average inmate probably makes $120 a month, they have to have a $25 urine test once, twice, three times a month, and they had to pay a full boat, it'd be pretty spendy. Some of them most likely (indisc.) their prorated obligation would be pretty small. And noting, in my mind, that that's simply a token payment so that they're reminded of their cooperation in their rehabilitation or whatever. Also noting that it's not going make any money necessarily for the Department of Corrections. So I don't oppose it, I just want to make sure that we understand we're not making a fiscal impact while we do this." REPRESENTATIVE JOE GREEN asked how many people fall into these three categories. REPRESENTATIVE MULDER responded it was probably between five and ten. REPRESENTATIVE GREEN said at potentially a half million dollars each. REPRESENTATIVE MULDER agreed. REPRESENTATIVE BUNDE made a motion to move CSHB 219(JUD) as amended. CHAIRMAN PORTER said there is a motion to move the bill with individual recommendations and attached fiscal notes. He asked if there was an objection. Hearing none, CSHB 219(JUD) was passed out of the House Judiciary Committee.