Legislative Analysis
Phone: (517) 373-8080
MEDICAL PAROLES FOR MEDICALLY FRAIL PRISONERS
http://www.house.mi.gov/hfa
Senate Bill 599 (H-1) as reported from House committee Analysis available at
Sponsor: Sen. Erika Geiss http://www.legislature.mi.gov
1st House Committee: Judiciary
2nd House Committee: Criminal Justice
Senate Committee: Civil Rights, Judiciary, and Public Safety
Complete to 6-19-24
(Enacted as Public Act 111 of 2024)
SUMMARY:
Senate Bill 599 would amend the Corrections Code to allow a medically frail prisoner to be
released on medical parole to a placement other than a medical facility as long as the placement
is approved by the parole board and, in certain cases, the parolee is subject to electronic
monitoring. The bill also would change the definition of medically frail that applies to this part
of the code.
Medical paroles
The code allows the parole board to grant a medical parole for a prisoner who is determined to
be medically frail (except those convicted of first degree criminal sexual conduct or a crime
punishable by life without parole). 1 A medical parole must be initiated by the Bureau of Health
Care Services in the Department of Corrections (DOC), which coordinates and monitors health
care services for prisoners and the treatment of seriously mentally ill prisoners. 2 After an
evaluation by an outside medical specialist, the parole board, in consultation with the bureau,
makes the determination of whether the prisoner is medically frail. A proposed medical parole
can be contested by the applicable prosecutor, and the code provides procedures for hearing
and deciding those cases in circuit court and on appeal.
Placement
Currently, a prisoner released on medical parole must be placed in a medical facility 3 approved
by the parole board where medical care and treatment can be provided. The parolee (or their
legal representative) and the medical facility must agree to that placement.
The bill would eliminate the requirement that the parolee’s placement be in a medical facility
and instead require that the parolee’s placement be as approved by the parole board and agreed
to by the parolee (or their representative). If the parolee is placed in a medical facility under
these provisions, the facility would, as currently, have to agree to accept the parolee.
Notifications regarding medical facility placement
Currently, when a medically frail parolee is placed in a medical facility, the parolee or their
legal representative must immediately notify the parole board if any of the following apply:
• The parolee is no longer eligible for care at that medical facility.
1
These provisions were added to the code by 2019 PA 13. See https://www.legislature.mi.gov/documents/2019-
2020/billanalysis/House/pdf/2019-HLA-4129-BAB0CE52.pdf
2
https://www.michigan.gov/corrections/services/health-care-services
3
Defined as a hospital, hospice, nursing home, or other housing accommodation providing medical treatment suitable
to the medically frail parolee’s medical condition.
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 • The parolee must be moved to another location for medical care.
• The parolee is no longer at the medical facility the parole board approved.
• The parolee no longer needs the level of care that resulted in placement at the medical
facility.
The bill would eliminate the above requirements.
The bill also would remove a related requirement that the parole board immediately notify the
applicable prosecuting attorney if the parolee is no longer eligible for care at a medical facility
or no longer needs the level of care they were there to receive.
Electronic monitoring
If both of the following apply, the parole board would have to require the medically frail
parolee to be subject to electronic monitoring: 4
• The parolee is not placed in a medical facility.
• The parolee was determined to be medically frail, at least in part, because they have a
terminal medical or mental health condition resulting in a life expectancy of under 18
months.
However, the parole board could remove a requirement for a parolee to be subject to electronic
monitoring if it determines that electronic monitoring is not necessary to protect public safety.
Definition of medically frail
Currently, medically frail means that an individual meets all of the following:
• The individual is a minimal threat to society as a result of their medical condition.
• The individual has received a risk score of low on a validated risk assessment.
• The individual’s recent conduct in prison indicates that they are unlikely to engage in
assaultive conduct.
• The individual has either or both of the following:
o A permanent or terminal physical disability or serious and complex medical
condition resulting in the inability, without personal assistance, to do one or
more of the activities of walking, standing, or sitting.
o A permanent or terminal disabling mental disorder, including dementia,
Alzheimer’s disease, or a similar degenerative brain disorder that results in the
need for nursing home level of care, and a significantly impaired ability to
perform two or more activities of daily living. 5
Under the bill, medically frail would mean that an individual meets all of the following:
• The individual is a minimal threat to society as a result of their medical condition.
• The individual’s recent conduct in prison indicates that they are unlikely to engage in
assaultive conduct.
4
Defined as a device by which, through global positioning system (GPS) satellite or other means, an individual’s
movement and location are tracked and recorded. The requirement for electronic monitoring under these provisions
would be in addition to any other such monitoring requirement under Michigan law.
5
Defined as basic personal care and everyday activities, such as eating, toileting, grooming, dressing, bathing, and
transferring from one physical position to another (for example, moving from a reclining position to a sitting or
standing position).
House Fiscal Agency SB 599 (H-1) as reported from House committee Page 2 of 4
 • The individual has one or more of the following:
o A permanent physical disability or serious and complex medical condition
resulting in the inability to walk, stand, or sit without personal assistance. 6
o A terminal medical or neurological condition resulting in a life expectancy of
under 18 months.
o A permanent disabling mental disorder, including dementia, Alzheimer’s
disease, or a similar degenerative brain disorder that results in the need for
nursing home level of care, and a significantly impaired ability to perform two
or more activities of daily living. 7
MCL 291.234 and 791.235
BRIEF DISCUSSION:
According to committee testimony, only one person has been paroled under the medically frail
parole provisions added to the code by 2019 PA 13. Reportedly, in some cases, medical
facilities, to which medical parolees must be released, either cannot or will not accept them for
care. Supporters of the bill hope that allowing eligible medically frail parolees to be released
to home care, with electronic monitoring if needed, will allow more individuals to receive
appropriate care outside of the prison system. Relatedly, it is hoped that more clearly defining
terminal conditions for purposes of these provisions could enable more individuals who do not
pose a public safety threat to have appropriate supports at the end of their lives.
FISCAL IMPACT:
Senate Bill 599 would have an insignificant fiscal impact on the state and no fiscal impact on
local units of government. Although the bill would result in additional medically frail prisoners
being eligible for release to homes, the number remains relatively low. According to the
Department of Corrections, it is estimated that between 5 and 10 prisoners would be released
per year. Eligible prisoners are typically in the advanced stages of terminal illnesses and are
primarily receiving only palliative care at the correctional facilities. Palliative care is not
costing the state the same as it would cost the state if these prisoners were receiving advanced
medical treatment for their illnesses.
POSITIONS:
Representatives of the following entities testified in support of the bill (6-18-24):
• Department of Corrections
• Families Against Mandatory Minimums
• Michigan Medicine
• Safe and Just Michigan
6
Note: As written, the bill would require that a prisoner cannot do any (i.e., all) of those three things without personal
assistance, while current law requires only that a prisoner cannot do one or more of them without personal assistance.
This would reduce the number of people who could be defined as medically frail and eligible for a medical parole.
For example, a person who can sit without personal assistance, but who cannot stand or walk without personal
assistance, is medically frail under current law but would no longer defined as medically frail under the bill.
7
Defined as basic personal care and everyday activities, such as eating, toileting, grooming, dressing, bathing, and
transferring from one physical position to another (for example, moving from a reclining position to a sitting or
standing position).
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 The following entities indicated support for the bill (6-18-24):
• ACLU of Michigan
• Alliance for Safety and Justice
• Arnold Ventures
• Law Enforcement Action Partnership
• Michigan League for Public Policy
• Prosecuting Attorneys Association of Michigan
The Michigan Sheriffs’ Association indicated opposition to the bill. (6-18-24)
Legislative Analyst: Rick Yuille
Fiscal Analyst: Robin Risko
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
House Fiscal Agency SB 599 (H-1) as reported from House committee Page 4 of 4


Statutes affected:
Substitute (S-1): 791.234, 791.235
Substitute (H-1): 791.234, 791.235
Senate Introduced Bill: 791.234, 791.235
As Passed by the Senate: 791.234, 791.235
As Passed by the House: 791.234, 791.235
Senate Concurred Bill: 791.234, 791.235
Public Act: 791.234, 791.235
Senate Enrolled Bill: 791.234, 791.235