Corrections officials may not engage in unconsented “patient dumping” of medically compromised parolees.
The California Department of Corrections and Rehabilitation (CDCR) unsuccessfully attempted to locate skilled nursing facilities to accept four medically compromised inmates approaching their parole dates. CDCR then “paroled” and transported them to the emergency department at Kern Medical Center, a general acute care hospital. Kern County Hospital Authority, which operates the center, sought and obtained a writ of mandate and a permanent injunction barring CDCR from transferring parolees to the authority’s facilities absent advance permission or a medical emergency. CDCR appealed.
The Court of Appeal affirmed, but modified the scope of the injunction. The court recognized the tension between CDCR’s duty to the parolees as patients and the parolees’ liberty interests. Parolees are entitled to be released, yet CDCR retains statutory discretion to determine a parolee’s placement. Some parolees require skilled nursing care. Under California Code of Regulations, title 22, section 79789, however, CDCR may not transfer parolees to another facility unless transfer arrangements are made beforehand. The Court of Appeal rejected CDCR’s argument that this regulation covers only inmates, not parolees, as well as CDCR’s argument that the facility’s advance agreement to accept the parolee was unnecessary. The court also found EMTALA inapplicable because the parolees did not require emergency medical care; they needed only skilled nursing care. To vindicate parolees’ liberty interests, the Court of Appeal modified the injunction to allow a parolee to decline further care and treatment at the correctional facility, enabling the parolee to choose either to be discharged to a hospital emergency room (regardless of the hospital’s prior consent) or continue to receive skilled nursing care at the correctional treatment center while awaiting an agreed placement at a skilled nursing or other medical facility. “What the Department cannot do is drop the parolees off at the emergency department while the parolees remain correctional treatment center patients without making advance arrangements for their admission to the hospital.”
The bulletin describing this appellate decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson, Peder K. Batalden, and Lacey Estudillo at the appellate firm Horvitz & Levy LLP, and is republished with permission.