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Ga. pardons board granting more medical reprieves

ATLANTA (AP) -- Faced with rising prison costs, Georgia corrections officials are releasing a growing number of sick and elderly inmates to save millions of dollars in medical spending.

The use of medical reprieves has almost doubled since fiscal year 2008, according to state data obtained by The Associated Press. The figures show the number of medical reprieves granted by the Georgia Board of Pardons and Paroles has jumped from 51 in 2008 to 89 in the most recent fiscal year.

Department of Corrections Commissioner Brian Owens said it was part of an effort to build a better relationship with the pardons board. Five years ago, the board approved only about 10 percent of requests to grant medical reprieves to sick inmates. Now, he said, the rate is closer to 70 percent.

"We have a great partnership there saving a tremendous amount of money," he told lawmakers at a meeting earlier this year.

The exact savings is difficult to calculate, but the department said it's helped shave millions of dollars off the cost of medical bills. The 200 sickest inmates cost taxpayers $25 million three years ago, and this year they are expected to cost the corrections department about $14 million.

The corrections department and the pardons board wouldn't provide details about the inmates who have been granted reprieves, citing health privacy laws. The reprieves are typically given to sick inmates deemed unlikely to pose a safety risk and to inmates with terminal illnesses so they can live their final days outside prison.

Eligible candidates are often incapacitated or have a life expectancy of less than a year, said State Pardons Director Michael Nail. He said the board also considers the cost of keeping them behind bars, the response of the victims and prosecutors, the amount of time served and, most importantly, the likelihood a prisoner will commit another crime.

"The cost to continue to incarcerate an individual who has a known life expectancy that's under 12 months is always a consideration, but it will never be the first and foremost consideration," Nail said.

The process to grant medical reprieves has also been streamlined to help reduce the time it takes to process a request from six months to about 30 days, he said. There's now one person on the pardons board who handles these requests, and a clearer understanding of what types of cases would be considered.

"It was a broken process," Nail said. "Now we're all operating off the same sheet of music."

Even with the improvements, the system still doesn't move quickly enough for some inmates. Since July 2011, 14 inmates have died while the pardons board was reviewing their medical reprieve applications, and another 16 died as they were awaiting release after it had been approved, according to state data.

Medical reprieves are part of a broader effort to rein in medical spending, which accounts for roughly one-fifth of Georgia's $1.1 billion annual prison spending. The department is working to negotiate new contracts with hospitals and secure better pricing for HIV pharmaceuticals and other pricey drugs. The system also went tobacco-free in 2011 to help shave medical costs, though the move instantly made cigarettes the most sought-after contraband in prisons.

These efforts have helped reduce medical spending from $220 million in fiscal year 2009 to roughly $208 million the last fiscal year.

The state is on the hook for 100 percent of the medical costs for prisoners behind bars. Once an inmate is released, he or she is eligible for Medicaid and the cost is split with the federal government.

Georgia has long struggled with how to deal with its elderly and sick inmates, a growing sector in the state's prison population.

A report in May showed that a sizable portion of Georgia's prison population of nearly 57,000 prisoners is elderly or infirm. About 1.5 percent of the prisoners -- 924 -- are over 70. About 2 percent of the inmates have either a poorly-controlled chronic illness or significant medical problems that require special housing. Nine inmates have terminal illnesses and are expected to live less than nine months.

Prison rights advocates say it's a long overdue shift that demonstrates compassion toward the sickest inmates.

"It's encouraging that Georgia is granting an increasing number of medical reprieves to people in prison," said Melanie Velez, an attorney with Atlanta-based Southern Center for Human Rights who focuses on challenging prison and jail conditions. "It's a fiscally sound move and it's in line with the governor's aim and commitment to criminal justice reform."