Health care bill could quash furlough plan for sick inmates
By R.J. RICO
Jul. 24, 2017
BATON ROUGE, La. (AP) — Among the 1,800 inmates in Louisiana's second-largest prison is a man Corrections Secretary Jimmy LeBlanc describes as "the bubble boy."
Last year, the unidentified prisoner's medical expenses cost about $1.1 million. That and other health issues involving inmates cost Louisiana more than $75 million in fiscal 2016 — a whopping expenditure for a debt-addled state. Officials say they want to drastically reduce that figure under a new medical-furlough law.
The potential flaw in the plan — part of a wider criminal justice package — is that it depends entirely on Medicaid, the state-federal health care assistance program that has been targeted for big cuts in recent health care overhauls proposed by the U.S. Senate Republican leadership. Senators are expected to vote this week whether to consider the latest proposal targeting President Barack Obama's Affordable Care Act.
Louisiana budgeted $77.7 million for inmate health care during fiscal 2017, which ended June 30. Corrections department spokesman Ken Pastorick said precise numbers on what was spent aren't yet available.
Corrections officials don't yet have an estimate for how much Louisiana expects to save under the medical-furlough program. Whatever the savings, they have said 70 percent would be reinvested in anti-recidivism programs, as part of Gov. John Bel Edwards' goal of bringing down the state's highest-in-the-nation incarceration rate, and the other 30 percent would go to the state general fund.
The new state law allows "limited-mobility" inmates to be furloughed temporarily to hospitals or nursing homes, which would make them eligible to receive Medicaid. Under the law, the federal government would pay at least 90 percent of the medical costs for eligible offenders, saving the state a sizable sum.
The legislature's criminal justice package had many controversial components, but the medical-furlough provision was not one of them, said Corrections Medical Director Dr. Raman Singh.
"It was not a hard sell," Singh said of lobbying the Republican-majority state legislature. "They all realized how much the state was paying."
But Singh said the program could be weakened if Medicaid goes through a "drastic change."
Edwards' administration says recent health overhaul proposals unveiled by the U.S. Senate GOP leadership would end Louisiana's Medicaid expansion and cut billions in expected federal financing from the traditional Medicaid program, which the administration says would devastate health care services.
"These are significant degradations in Medicaid," said Andrew Tuozzolo, chief of staff for Louisiana's Department of Health. "Those types of cuts will affect services."
To qualify for medical furlough, inmates must be "limited-mobility" — either bedbound or unable to perform daily activities without assistance. That includes offenders with dementia, those who've suffered a severe stroke, as well as people with advanced heart disease, cancer or AIDS.
Singh emphasized that determining offenders' eligibility would be based not only on medical costs, but also the nature of their crimes and potential risk to public safety.
"Having a medical condition is not a blank check to let people go," he said.
Before releasing inmates on furlough, a parole board must determine they don't present a "substantial flight risk." Offenders on furlough will be supervised by probation and parole officers. If their condition improves, they can be returned to prison.
Singh didn't have a firm date for the furlough program's start but said it would launch in the "near future."
Corrections officials already have two similar programs, reserved for inmates nearing the end of their lives. Compassionate release can be granted to prisoners with fewer than 60 days to live, while medical parole is intended for those believed to be in the final year of their life, Corrections Deputy Assistant Secretary Natalie LaBorde told lawmakers during a committee hearing.
While introducing the concept of the furlough program to state senators, LeBlanc said "the bubble boy" would likely be considered for furlough. If the man — housed at Elayn Hunt Correctional Center in St. Gabriel — had been on furlough last year, the state would have saved more than $950,000. Officials have not released details of his condition or crimes, citing privacy concerns.
Senate Bill 139: http://www.legis.la.gov/