Challenges of Compassionate Release for Incarcerated Patients

Date: July 20, 2026

ʻAIEA, Hawai’i — Christian Alameda struggled up from his bed with a cane in the Halawa Correctional Facility’s infirmary. After a stroke in January left him mostly paralyzed on the right side, he has been in recovery. Although Hawai’i’s parole board granted him compassionate release in February, he remains there, waiting for a long-term care facility willing to accept him.

Alameda’s case is not unique. As of June, at least three other inmates in similar situations faced indefinite stays in the infirmary. Many facilities reject these prisoners primarily due to their criminal records, despite their medical needs.

This issue affects the whole country, said Molly Crane, an attorney with FAMM.

Every state offers compassionate release, but Hawai’i, unlike other states, operates without a specific law, using an internal policy instead. Typically, these releases apply to prisoners unable to care for themselves or those with terminal illnesses. They often need placement in assisted living, nursing homes, or hospice care.

A nationwide problem arises as these facilities often refuse such cases, keeping inmates confined long past their parole grant. In Rhode Island, rejections increased when nursing homes were notified of a patient’s prison background. Colorado inmates stayed an average of 200 days beyond their release due to facility rejections. New York prisoners have even sued for the inability to secure nursing home placements post-parole.

The One Big Beautiful Bill Act, signed by President Donald Trump, exacerbates the issue. Inmates can’t qualify for Medicaid prior to release and must apply post-parole. The law reduces the timeframe in which facilities can retroactively get Medicaid reimbursement, from three months to 30 days, risking non-payment if applications are delayed.

Challenges Facing Long-Term Care Facilities

Nationally, waitlists for new residents increase the hurdles to placing parolees from prison into nursing homes. In a study, 14% of residents in assisted living facilities experienced aggression, adding to reluctance.

Hawai’i incurs high costs keeping inmates like Alameda in prison. Incarcerating individuals with complex needs can be up to eight times costlier than typical prison housing. Comparatively, the average Medicaid reimbursement for long-term care is around $135,000 annually.

Some U.S. states have found solutions. Connecticut, Georgia, Massachusetts, and Vermont contract with nursing homes to accept parolees. The iCare Health Network operates such homes, with rates higher than average due to the specialized care.

Within Hawaiʻi, parole release depends on finding suitable care facilities. Corey Reincke, head of the Hawaiʻi Paroling Authority, often encounters setbacks due to safety concerns and logistical issues. He has tried calling over 100 facilities, often without success.

Family Support and Legislative Action

Family support sometimes aids in release. Paul Kupihea, aged 69, died soon after his family accepted his compassionate release; they planned to bring him home, but delays were fatal.

Despite repeated attempts, Hawaiʻi lawmakers have not succeeded in passing laws to formalize compassionate release procedures. Without these measures, even family support might not be sufficient.

Cases like Alameda’s highlight difficulties in securing humane treatment for prisoners who need medical care. Former attorney Bob Merce has helped 15 such prisoners, but numerous others await assistance.