COVID-19 in Correctional Facilities: Documenting Accelerated Release

Documenting the Medical / Public Health Rationale for Accelerated Release to Mitigate Exposure and Adverse Health Consequences Associated with COVID-19

The following guidance is adapted from best practices developed by correctional healthcare providers writing narrative letters of support for patients being considered for compassionate release. Such letters are not typically required for compassionate release hearings but are employed by experienced correctional clinicians with the goal of providing decision-makers with: 

  • A clear understanding of the medical rationale for release
  • An explanation of why the correctional setting and/or the correctional healthcare delivery system is insufficient to deliver a community standard of care in the case. Regardless of the applicant’s outcome, these letters are placed in the patient’s file.

Related resources:

Effective letters documenting decision-making in COVID-19 accelerated release cases should include:

  1. A list of the patient’s medical conditions using lay terminology as much as possible.
  2. A comment on the patient’s general health and prognosis, including:
    • Any health conditions undermining their ability to meet the demands of daily prison life
    • Any demographic or chronic health condition(s) making them vulnerable to serious illness and/or a higher likelihood of ICU need or death from COVID-19, including the following (listed in descending order of risk severity based on knowledge as of the date this document was created):
      • Age 60-69, 70-79, or age 80 or older
      • Cardiovascular disease
      • COPD
      • Cerebrovascular disease, hypertension, diabetes
      • Other major medical conditions such as asthma, chronic kidney disease, cancer, HIV/AIDS, etc.
  3. A comment on relevant critical care capacity, including:
    • A “boilerplate” description of the facility’s critical care capacity
    • A “boilerplate” description of critical care capacity at the area hospital(s) where the facility transfers patients (include any important information about COVID-19 prevalence and/or critical care burden in those communities surrounding area hospitals)
    • An estimate of how patient’s release will free up healthcare staff resource.
  4. A comment on how exposure to COVID-19 for this patient is likely to be reduced outside prison and/or how their treatment for COVID-19 will differ in the community.
  5. A short example describing how the patient’s health condition affects their ability to perform basic tasks in prison, increases their medical or social vulnerability inside, or how their ongoing incarceration increases their health risk and/or health-related suffering