WILTON — What obligations do we have to those who we imprison? Under the eighth amendment of the U.S. Constitution, prisoners are required to receive adequate health care. But as Wilton resident and Assistant Director of Maine Prisoner Advocacy Coalition (MPAC) Jan Collins explained, even though the legal protections are present, the delivery of health care doesn’t always happen.

Assistant Director of Maine Prisoner Advocacy Coalition Jan Collins is advocating assisted-living care for people in Maine prisons when they are nearing the end of their lives. Photo courtesy of Jan Collins

“Over decades I think there have been issues with health care in the prison, not that people aren’t good intentioned but the system itself makes it difficult sometimes because it’s dependent on the legislature for funding and sometimes dependent on the will of the governor as well,” Collins said. “So in this case, we’ve been advocating for different things like hepatitis C vaccinations because the inmate population has the highest concentration of hepatitis C in the state.”

More recently, MPAC  has been advocating for nursing home/assisted living level of care for prisoners who are nearing their last moments of life. Last year, Collins submitted this concept to Maine’s Revisor of Statutes Office which then molded the idea into a proposed bill, cosponsored by District #33 House Representative Victoria Morales.

“So what this does is it allows that level of care necessary for people who are dying, for people who are severely incapacitated and the policy that governs this is pretty clear that we’re talking about end of life care,” Collins said.

Maine’s 34-A Corrections statute already provides provisions for a supervised community confinement program in section 3036-A under the heading, “terminally ill or incapacitated prisoner.” With the Department of Corrections’ commissioner’s and director of medical care’s approval, a prisoner may “live in a hospital or other appropriate care facility, such as a nursing facility, residential care facility or a facility that is a licensed hospice program.”

The proposed bill titled LD 476 An Act To Provide Licensed Assisted Living and Nursing Facilities Levels of Care for Incarcerated Persons will work within this already established statute. But the proposed act will also allow the prisoner and/or their loved ones to petition for assisted living care.

“This bill in particular would outline that step that you would have to petition, either you or a loved one because some people are incapacitated and they have dementia and they can’t do that for themselves,” Collins said. “So if you can’t do that for yourself, it gives the ability for a loved one or family member or friend to do that for them.” 

This would allow a person to live out their last moments in a more humane way, in a facility where they would receive 24/7 medical care and visit with their loved ones. Collins said this would not only benefit the prisoner, but their families as well as they may need closure before this person passes.

Collins said that geographical placement would still be determined by a victim’s wishes. A prisoner would not be able to enter an assisted living home close to those affected by the crime. The eligibility of placement would still require an assessment by a registered nurse determining the level of care a patient needs based on their current abilities.

Collins stressed that expanding community-level care to Maine’s prison population will only become a more pressing issue as prisons continue to reflect an increasing, aging demographic trend. She said that despite crime in the state steadily decreasing, prison populations have grown due to sentence times increasing. This may be due to the state’s eight-year trend of a decrease in minor crimes but an increase in more serious, violent crimes.  Collins also attributes a growing, aging prison population to Maine’s abolishment of parole in 1976.

Health care becomes an even more pressing issue in correctional facility settings Collins said, explaining that prisoners experience later in life health problems at an earlier age due to the conditions — lack of exercise and sunlight, poor diets and limited social interactions.

The proposed legislation has cost-effective reasoning as well with prisons already relying on contracted services to meet inmates’ health needs on top of the annual cost of sheltering the person. Whereas, an assisted living facility would provide all of these needs under one roof for potentially less.

The proposed bill does not shy away from humane reasons for this legislation either with the tenth point exerting, “It is the right thing to do. No one should die alone.” MPAC has been exploring this concept by partnering with the TUG Arts Collective to interview people with incarceration experiences and asking them what an honorable release from life means.

Throughout these interviews, TUG co-founder Gaelyn Aguilar has been referring back to a book from her graduate studies in anthropology, “Life’s Career-Aging: Cultural Variation on Growing Old.”

“I went back into that book to look again at what are some of those universal trends and the research shows that there are actually five wishes that are shared by everyone, cross-culturally, it seems,” Aguilar said in a Zoom interview. “One of them is to live as long as possible, the second one is to hoard waning energies, the third one is to keep on sharing in the affairs of life, the fourth one is to safeguard seniority rights and then the fifth one is to have an easy and honorable release from life.”

LD 476 was reviewed by the Criminal Justice and Public Safety Committee during a public hearing on March 24. The proposed legislation will undergo a work session on April 9, during which the committee will most likely vote as to whether the document will advance to the house of representatives.

Collins said that people can submit testimony in regards to the proposed bill before the work session by filling out the online testimony submission form found at mainelegislature.org. The testimony can be as short as a sentence and can express a personal connection or simply a statement of support. If the proposed bill advances to the house then people can contact their representatives to express their support for the legislation.