Challenges in Compassionate Release for Prisoners in Hawai’i

ʻAIEA, Hawai’i — Christian Alameda struggles to get out of bed in his cell at the Halawa Correctional Facility, using a cane. A stroke in January left him mostly paralyzed, and since then, he’s been receiving care in the prison’s medical infirmary.

In February, Hawai’i’s parole board granted him compassionate release, aimed at allowing prisoners early probation for severe medical conditions. Yet Alameda remains in prison because no long-term care facility will accept him.

The problem is widespread. As of June, three other prisoners were also unable to leave the infirmary after being granted compassionate release due to their criminal backgrounds.

“This is a challenge across the country,” said Molly Crane, attorney for FAMM, a group advocating for fairness in prison policies.

Compassionate Release Across States

Every state offers compassionate release, though Hawai‘i relies on internal policy rather than specific laws. Prisoners eligible for this release often can’t care for themselves or face terminal illness. Assisted living centers, nursing homes, or hospice care may be necessary, yet many facilities refuse them.

Rejection from these facilities for parolees is not uncommon. In Rhode Island, nursing homes significantly increased their rejection rates upon learning residents were coming from prison. Colorado prisoners typically waited 200 days on average post-parole approval due to similar denials. New York faced lawsuits from prisoners unable to find placement in nursing homes.

Medicaid Complications

The One Big Beautiful Bill Act signed by former President Donald Trump has exacerbated issues. Prisoners, ineligible for Medicaid, must apply post-release. The Act tightened the timeframe for facilities to receive retroactive reimbursements for new Medicaid patients, reducing it to 30 days, making reimbursement difficult.

“CMS encourages providers and beneficiaries to prioritize timely application submission,” stated CMS spokesperson Timothy Foster.

Challenges Facing Long-Term Care Facilities

A 2024 report pointed to waitlists in nursing homes, adding another barrier to housing these individuals, according to Bob Merce, a former attorney advocating for prisoners. Some inmates at Halawa couldn’t walk or recall their illnesses, showcasing the urgent need for care.

Hawai’i Health Systems Corp. has yet to accept any compassionate release referrals, citing staff safety and insufficient resources. Violent incidents remain documented, with a 2024 study noting that 15% of residents endured peer aggression in one month.

State taxpayers also bear the financial burden. Housing someone with complex needs within prison costs significantly more than the average cost of long-term care, as per FAMM.

Solutions in Other States

Some states, like Connecticut, Georgia, Massachusetts, and Vermont, partner with facilities to accept parolees. iCare Health Network’s MissionCare Health maintains contracts in three states, with higher per-patient costs.

In Hawai’i, the parole board decides release recommendations, relying heavily on family interventions to secure placements.

“Parole has to find a facility willing and able to meet medical needs,” said Corey Reincke of the Hawai’i Paroling Authority.

For one parolee, Reincke contacted over 100 care homes, all declining based on safety concerns.

Family: A Necessary Refuge

Some prisoners depend on family intervention for release. Paul Kupihea’s compassionate release was short-lived, as he passed away five days later, before reaching home.

“She knew he was sick,” said Lahela Kruse, Kupihea’s child’s mother, of her daughter.

Efforts to expand compassionate release laws persist, aiming for broader eligibility and process transparency. Without formal legislation, even family support may not be enough, leading to potentially fatal delays.

Alameda hopes to reunite with his daughter soon. Despite past mistakes, he aims to change for her. Merce remains committed to finding placements, driven by instances where efforts fell short.