
Sick prisoners in New York have been paroled but remain behind bars

When the letter arrived in Westil Gonzalez’s jail cell saying he had been granted parole, he couldn’t read it. During the 33 years he was incarcerated for murder, multiple sclerosis had impaired much of his vision and left him confined to a wheelchair.
He had a clear idea of what he would do after his release. “I want to give my testimony to some young people who are out there picking up guns,” Mr. Gonzalez, 57, said in a recent interview. “I want to save one person from what I went through.”
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 would accept him. Another New York inmate has been in the same limbo for 20 months. Others were released only after suing the state.
America’s elderly prison population is increasing, in part because more people are serving long sentences for violent crimes. Nearly 16 percent of prisoners were over 55 in 2022, an increase from 5 percent in 2007. The proportion of prisoners over 65 quadrupled to about 4 percent over the same period.
Complex and costly medical conditions require more care, both in prison and after an inmate is released. Across the country, prison systems seeking to release inmates convicted of serious crimes often have few options. Even for people without criminal records, finding nursing home beds can be difficult.
Spending on medical care for inmates is rising – in New York, it has risen from about $6,000 per person in 2012 to just over $7,500 in 2021. Still, those who work with the incarcerated say the money is often not enough to keep up with expenses from the growing proportion of older inmates with chronic health problems.
“We see many unfortunate gaps in care,” 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. Because inmates often have difficulty obtaining specialized care or even copies of their own medical records, “things slip through the cracks,” he said.
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 placement in a nursing home. The Pennsylvania inmate died in prison and the Illinois man remains incarcerated, he said.
Almost all states have programs that allow early release of inmates with serious or life-threatening illnesses. New York’s program is one of the most comprehensive: While other states often limit coverage to people with a life expectancy of less than six months, New York’s program is open to anyone suffering from a terminal or debilitating illness. Nearly 90 people were paroled on medical grounds in New York between 2020 and 2023.
But the state’s nursing home occupancy rate is about 90 percent, one of the highest in the country, making it particularly difficult to find places for prisoners.
The prison system “is competing with hospitalized patients, rehabilitation patients and the general public who need skilled care for the limited number of available beds,” said Thomas Mailey, a spokesman for the New York Department of Corrections and Community Supervision. He declined to comment on Mr. Gonzalez’s case or the health of any other inmate.
Parolees remain in state custody until the end of their original sentence. Courts have previously upheld the state’s right to condition the release of prisoners to protect the public, such as banning paroled sex offenders from being near schools.
But lawyers and medical ethicists say discharged patients should be able to decide how they want to receive their care. And some noted that these prisoners’ medical needs are not necessarily being met in prison. Mr. Gonzalez, for example, said he did not receive glasses despite repeated requests. His illness has caused one of his hands to curve inward and the uncut nails dig into his palm.
“While I agree with the difficulty of finding internships, the default solution cannot be continued incarceration,” said Steven Zeidman, director of the criminal defense clinic at CUNY School of Law. In 2019, one of his clients died in prison just weeks after being granted medical parole.
New York does not release data on how many inmates are awaiting nursing home placement. A 2018 study found that between 2013 and 2015, six of the 36 inmates granted medical parole died before housing could be found. The study showed that the medical parole process moves slowly and sometimes takes years before a prisoner even receives an interview about his possible release.
Even for a patient with no criminal record, finding a nursing home can be difficult. Facilities have had difficulty recruiting staff, particularly since the coronavirus pandemic. Nursing homes may also be concerned about the safety risk of a person with a criminal record or the financial risk of losing residents who do not want to live in a facility that accepts former inmates.
“Nursing homes have concerns, and whether they’re rational or not, it’s pretty easy to not answer that call or not return it,” said Ruth Finkelstein, a Hunter College professor who specializes in policies for older adults and is a legal briefer The request of the Times has been verified.
Some people involved in such cases said New York prisons often conduct little more than a cursory search for care services.
Jose Saldana, the head of a nonprofit called the Release Aging People in Prison Campaign, said that when he was incarcerated at Sullivan Correctional Facility from 2010 to 2016, he worked in a department that coordinated the releases of parolees helped. He said he often reminded his supervisor to call nursing homes that didn’t answer the first time.
“They would say they had too many other responsibilities to stay on the phone,” Mr. Saldana said.
Mr. Mailey, the New York City Department of Corrections spokesman, said the agency had several release teams looking for placement options.
In 2023, Arthur Green, a 73-year-old kidney dialysis patient, sued the state for release four months after he was granted medical probation. In his lawsuit, Mr. Green’s lawyers said they had secured him placement in a nursing home but that it was forfeited because the Department of Corrections submitted an incomplete application to a nearby dialysis center.
According to Martha Rayner, an attorney who specializes in prisoner release cases, the state found a placement for Mr. Green a year after his release date.
John Teixeira was medically paroled 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 administered through an intravenous port. However, an assessment by an independent cardiologist determined Mr Teixeira did not require care.
Lawyers for the Legal Aid Society of New York sued the state for his release, noting that his port repeatedly became infected while he waited and his diagnosis progressed from “advanced” heart failure to “end-stage.”
The Department of Corrections responded that 16 nursing homes had refused to accept Mr. Teixeira because they could not meet his medical needs. According to Stefen Short, one of Mr. Teixeira’s lawyers, the case was resolved three months after the lawsuit was filed when “the judge put significant pressure” on the state to find appropriate housing.
Some sick inmates awaiting release find it difficult to receive medical care inside.
Steve Coleman, 67, has difficulty walking and spends most of the day sitting. After serving 43 years for murder, he was granted parole in April 2023 and remained incarcerated as the state searches for a nursing home that can coordinate with a kidney dialysis center three times a week.
But Mr. Coleman has not received dialysis treatment since March, when the state ended a contract with his provider. The prison has offered to take Mr. Coleman to a nearby clinic for treatment, but he has declined because he finds the transport protocol – which includes a strip search and restraints – painful and invasive.
“They say you have to undergo a strip search,” he said in a recent interview. “If I get paroled and can no longer walk and go to the hospital, who could I harm?”
Volunteers with the nonprofit Parole Prep Project, which assisted Mr. Coleman with his parole application, received a letter from Mount Sinai Hospital in New York City in June offering to provide him with medical care and help him return to the community .
Still imprisoned two months later, Mr. Coleman sued for his release.
In court filings, the state argued that it would be “dangerous and irresponsible” to release Mr. Coleman without plans to address his medical needs. The state also said it contacted Mount Sinai as well as hundreds of nursing homes about housing Mr. Coleman and never received a response.
In October, a court ruled in favor of the prison system. Judge Debra Givens of the New York State Supreme Court described Mr. Coleman’s situation as “very sad and frustrating” and concluded that the state had a rational reason to hold Mr. Coleman beyond his probation term. Ms. Rayner, Mr. Coleman’s lawyer, and the New York Civil Liberties Union appealed the ruling on Wednesday.
Fourteen medical ethicists have sent a letter to the prison supporting Mr. Coleman’s release. “Forcing continued detention under the guise of ‘best interests,’ even when well-intentioned, violates his autonomy,” they wrote.
Several other states have found a different solution for people on medical parole: courting the business of nursing homes that specialize in housing patients turned away elsewhere.
A private company called iCare opened the first such facility in Connecticut in 2013, which now houses 95 residents. The company operates similar nursing homes in Vermont and Massachusetts.
David Skoczulek, vice president of business development for iCare, said these facilities tend to save states money because the federal government covers some of the costs through Medicaid.
“It’s more humane, less restrictive and more cost-effective,” he said. “There is no reason for these people to remain in a corrections environment.”