Extraordinary Medical Placement. An incarcerated individual may be given an extraordinary medical placement (EMP) when authorized by the secretary of the Department of Corrections (DOC). Such placement will transfer the individual to an alternative care setting outside of the custody of DOC if:
An incarcerated individual sentenced to death, life imprisonment without the possibility of release or parole, or a persistent offender is not eligible for an EMP. An EMP may be revoked at any time.
Electronic Monitoring Requirement. All individuals authorized for an EMP are required to have electronic monitoring unless the monitoring equipment is detrimental to the individual's health, interferes with the function of the individual's medical equipment, or results in the loss of funding for the individual's medical care. For those people that meet the exception, an alternative type of monitoring must be used.
Department of Corrections Policies. DOC has policies for establishing general requirements on who may refer, or receive an extraordinary medical placement. An EMP will not be considered when there is an absence of resources in the community to provide necessary care for the individual.
The secretary of DOC is authorized to allow an EMP for an incarcerated individual when the person has been assessed by two physicians and is determined to be affected by a serious and chronic permanent or degenerative medical condition that substantially limits the incarcerated person's ability to care for themself in total confinement, or is in ill health and is expected to die within approximately 18 months.
The incarcerated individual must be assessed as low risk to the community at the time of placement, using risk factors including the individual's institutional history, programming history, and Washington one score.
Physicians are responsible for diagnosing an incarcerated individual's illness and the appropriate DOC personnel is responsible for assessing any risk level.
Any person seeking an extraordinary medical placement that is denied must be provided a written and individualized explanation for the denial. The incarcerated individual may seek review of the decision from the Office of Corrections Ombuds.
The committee recommended a different version of the bill than what was heard. PRO: When people in custody are looking at their end of life needs and are not a threat to public safety, providing an opportunity to be outside in a facility that's going to actually care for them is what works. The additional extraordinary medical placement is as narrow as possible to be compassionate, and not some sort of privilege. This also ensures that last moments are with families. There was hope that the statutory language that was passed previously would have resulted in an increase of EMPs but it has not led to that outcome. This new pathway for an EMP makes the expectation clear. When men or women are housed in the DOC and are not provided with adequate medical care, DOC needs to have authority, compassion, and courage to grant an EMP. Providing care in DOC is extremely expensive, and this new EMP would shift costs from the state, all while people are receiving better treatment outside of the prison system. Necessary treatments are being delayed for incarcerated people, and DOC medical is not able to accommodate everyone due to policy restrictions. This additional EMP is the humane, smart thing to do, and there is more that could be added to improve this bill. Reviews for EMP have increased, but actual placements have only gone down and any effort to expand the program is needed.
OTHER: The department is committed to continuing to work on policy and work to meet the spirt and intent of the EMP law.
PRO: Senator Rebecca Saldaña, Prime Sponsor; Sarah Leon; Melody Simle; Karen Peacey; Marc Stern; Rachael Seevers, Disability Rights Washington.
PRO: This is about implementing a policy that protects tax payer dollars. Clarifies EMP will parallel the standard for medical malpractice. DOC will be able to sidestep lawsuits that are costing tax payers millions of dollars. Inmates are not getting the medical care that DOC is statutorily required to provide. Recent individual payouts have been $9.9 million, $6 million, $3.25 million, $549 thousand to name just a few of recent settlements. The fiscal note does not fully represent the millions that could be saved on DOC medical expenses and lawsuits. There are 1500 people over 60 years old in DOC. Research shows that caring for older people in prison is three to nine times more expensive, mostly due to medical costs. DOC does not have enough beds, cells or staff to properly care for the population. They are proposing to expand their assisted living beds to larger capacity at massive expense to the state. Rather than that, in 2003 the legislature tried to expand EMP by passing 5101 to allow more safe releases so that people could be cared for in the community and access Medicaid services. Only a very small handful of people are released on EMP each year. Expanded medical criteria will finally address this issue and allow DOC to meaningfully review people for EMP, saving the state millions in the process.
PRO: Rachael Seevers, Disability Rights Washington; Sarah Leon.