Title: Buckman v. Commissioner of Correction

State: massachusetts

Issuer: Massachusetts Supreme Court

Document:

NOTICE:  All slip opinions and orders are subject to formal 
revision and are superseded by the advance sheets and bound 
volumes of the Official Reports.  If you find a typographical 
error or other formal error, please notify the Reporter of 
Decisions, Supreme Judicial Court, John Adams Courthouse, 1 
Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-
1030; SJCReporter@sjc.state.ma.us 
 
SJC-12725 
 
JOSEPH BUCKMAN & another1  vs.  COMMISSIONER OF CORRECTION  
& others.2 
 
 
 
Suffolk.     October 4, 2019. - January 28, 2020. 
 
Present:  Gants, C.J., Lenk, Gaziano, Lowy, Budd, Cypher, 
& Kafker, JJ. 
 
 
Parole.  Imprisonment, Parole.  Commissioner of Correction.  
Regulation. 
 
 
 
 
Civil action commenced in the Supreme Judicial Court for 
the county of Suffolk on February 19, 2019. 
 
 
The case was reported by Cypher, J. 
 
 
 
Ruth Greenberg (John Reinstein also present) for the 
plaintiffs. 
 
Mary C. Eiro-Bartevyan (Bradley A. Sultan & Richard E. 
Gordon also present) for the defendants. 
 
Pamela Alford, Assistant District Attorney, for district 
attorney for the Norfolk district. 
 
The following submitted briefs for amici curiae: 
 
Jeffrey G. Harris for Committee for Public Counsel 
Services. 
                                                          
 
 
1 Peter Cruz. 
 
 
2 Department of Correction (department); Superintendent, 
Massachusetts Correctional Institution (MCI), Norfolk; and 
Superintendent, MCI, Shirley. 
2 
 
 
Chauncey B. Wood & Donna M. Cuipylo for Massachusetts 
Association of Criminal Defense Lawyers. 
 
Tatum A. Pritchard for Disability Law Center. 
 
Mary Price, of the District of Columbia, David Milton, & 
Rebecca Schapiro for Prisoners' Legal Services of Massachusetts 
& another. 
 
 
 
GANTS, C.J.  As part of the comprehensive criminal justice 
reform legislation enacted in 2018, the Legislature established 
a medical parole program for prisoners in State and county 
custody who are terminally ill or permanently incapacitated.  
See G. L. c. 127, § 119A, inserted by St. 2018, c. 69, § 97.  In 
January 2019, counsel for prisoners Joseph Buckman and Peter 
Cruz filed separate petitions for medical parole on their 
behalf.  Citing Department of Correction (department) policy, 
the superintendent for each prisoner informed counsel that the 
petition was incomplete, returned the petition for the 
resubmission of the required information, and refused to review 
it as submitted.3  On February 19, 2019, Buckman and Cruz brought 
                                                          
 
 
3 The superintendent at MCI, Norfolk, informed counsel for 
Buckman that the petition was incomplete because the medical 
parole plan that was submitted failed to include "documentation 
that medical providers qualified to provide the medical services 
identified in the medical parole plan are prepared to provide 
such services."  The superintendent at MCI, Shirley, informed 
counsel for Cruz that the petition was incomplete because the 
medical parole plan that was submitted failed to include 
"documentation that medical providers qualified to provide the 
medical services identified in the medical parole plan are 
prepared to provide such services," and because the petition 
referenced medical records in the possession of the department 
but did not include a written diagnosis and prognosis by a 
licensed medical provider. 
3 
 
an action in the county court, seeking certiorari review of the 
superintendents' decisions pursuant to G. L. c. 249, § 4, and 
asserting claims for mandamus, injunctive, and declaratory 
relief.  They argued that, under § 119A, a superintendent is 
required to accept a written petition for medical parole and 
make a recommendation within twenty-one days of its receipt, 
regardless of whether the superintendent believes the petition 
is incomplete or inadequate. 
 
The single justice reserved and reported the case to the 
full court, posing three questions concerning the interpretation 
of the medical parole statute: 
"1.  Whether, for purposes of G. L. c. 127, § 119A, a 
written petition for medical parole of a prisoner must 
be considered by the superintendent of the facility 
where the prisoner is incarcerated, regardless of the 
superintendent's view as to the completeness or 
adequacy of the petition. 
 
"2.  Which party bears the burden of preparing or 
procuring '(i) a medical parole plan; (ii) a written 
diagnosis by a physician licensed to practice medicine 
under [G. L. c.  112, § 2]; and (iii) an assessment of 
the risk [for] violence that the prisoner poses to 
society.'  G. L. c.  127, § 119A. 
 
"3.  Whether the Commissioner of Correction 
[(commissioner)], on receipt of the petition and the 
superintendent's recommendation as to release of the 
prisoner, must provide notice to the prisoner of the 
recommendation, as well as a copy of the 
recommendation and any supporting or related 
materials." 
 
 
After the case was reported, the Secretary of the Executive 
Office of Public Safety and Security (EOPSS) promulgated 
4 
 
administrative regulations pursuant to G. L. c. 127, § 119A (h), 
that govern the medical parole application process and that 
replaced the department policy that was in effect at the time 
the superintendents found the written petitions to be 
incomplete.  We consider the reported questions in light of 
these regulations.4,5 
 
After careful examination of the plain language of the 
statute, and its legislative history and purpose, we answer the 
reported questions as follows: 
1.  Under G. L. c. 127, § 119A, a written petition for 
medical parole of a prisoner must be considered by the 
superintendent (or sheriff, where the prisoner is in 
custody in a house of correction) of the facility where the 
prisoner is incarcerated, regardless of the 
superintendent's (or sheriff's) view as to the completeness 
                                                          
 
 
4 The single justice reported this case on April 3, 2019.  
An emergency version of the Executive Office of Public Safety 
and Security regulations was in effect from May 1, 2019, until 
they were formally promulgated on July 26, 2019.  The final 
regulations retained the requirements for a petition for medical 
parole set forth in the department policy that are challenged 
here. 
 
 
5 Cruz suffered from end stage renal disease as well as 
other chronic illnesses, and died on September 9, 2019, during 
the pendency of this appeal.  There has been no motion to 
substitute plaintiffs, nor any request for an executor to 
continue the case on Cruz's behalf, but Buckman suffices as a 
plaintiff in this case.  Regardless, we exercise our discretion 
to address the merits of this case where it concerns important 
legal issues about the application of the medical parole statute 
that are, due to the terminal illness or debilitating physical 
condition of potential plaintiffs, likely to be capable of 
repetition but to evade review.  See Pembroke Hosp. v. D.L., 482 
Mass. 346, 351 (2019). 
5 
 
or adequacy of the petition.6 
 
2.  The superintendent (or sheriff) bears the burden of 
preparing or procuring "(i) a medical parole plan; (ii) a 
written diagnosis by a physician licensed to practice 
medicine under [G. L. c. 112, § 2]; and (iii) an assessment 
of the risk for violence that the prisoner poses to 
society."  G. L. c. 127, § 119A. 
 
3.  The commissioner, on receipt of the petition and 
the superintendent's (or sheriff's) recommendation as 
to release of the prisoner, is not required to provide 
the prisoner with the recommendation, but is required 
to provide the prisoner with all supporting documents 
submitted by the superintendent (or sheriff) with the 
recommendation. 
 
 
To the extent that the regulations promulgated by the 
Secretary of EOPSS (secretary) conflict with the answers to 
the reported questions, the regulations are hereby declared 
void.7 
 
Background.  1.  The statute.  We look first to the 
language of the statute.  Under G. L. c. 127, § 119A, 
medical release is limited to two narrow categories of 
                                                          
 
 
6 Although the reported questions do not address the medical 
parole process for prisoners committed to the custody of a house 
of correction, we hold that the answers to these questions are 
the same regardless of whether a prisoner submits a petition to 
the superintendent of a correctional facility or to a sheriff 
because the language of the statute establishes essentially the 
same process regardless of where an individual is incarcerated.  
Compare G. L. c. 127, § 119A (c), with G. L. c. 127, § 119A (d). 
 
 
7 We acknowledge the amicus briefs submitted by the district 
attorney for the Norfolk district, the Committee for Public 
Counsel Services, the Massachusetts Association of Criminal 
Defense Lawyers, Prisoners' Legal Services of Massachusetts and 
Families Against Mandatory Minimums, and the Disability Law 
Center. 
6 
 
prisoners:  those with "permanent incapacitation," that is, 
"a physical or cognitive incapacitation that appears 
irreversible, as determined by a licensed physician, and 
that is so debilitating that the prisoner does not pose a 
public safety risk"; and those with a "terminal illness," 
that is, "a condition that appears incurable, as determined 
by a licensed physician, that will likely cause the death 
of the prisoner in not more than [eighteen] months and that 
is so debilitating that the prisoner does not pose a public 
safety risk."  G. L. c. 127, § 119A (a). 
 
Because those eligible for medical parole are so ill, 
whether physically or cognitively, the statute does not require 
that a written petition for medical parole be submitted by the 
prisoner; it may also be submitted on his or her behalf by the 
prisoner's attorney or next of kin, a medical provider at the 
correctional facility, or even a member of the department's 
staff.  G. L. c. 127, § 119A (c) (1).  If any of these persons 
submits a written petition, the superintendent (or, where the 
prisoner is in the custody of a house of correction, the 
sheriff) "shall consider" the prisoner for medical parole, and 
"shall review the petition and develop a recommendation as to 
the release of the prisoner."  Id.  The superintendent must 
consider the petition promptly -- the statute provides that the 
superintendent "shall" transmit the recommendation to the 
7 
 
commissioner "not more than [twenty-one] days after receipt of 
the petition."  Id. 
 
"Whether or not the superintendent recommends in favor of 
medical parole," the superintendent must transmit four documents 
to the commissioner with his or her recommendation:  (1) the 
petition itself; (2) "a medical parole plan;" (3) "a written 
diagnosis by a physician licensed to practice medicine"; and (4) 
"an assessment of the risk for violence that the prisoner poses 
to society."  Id.  "Medical parole plan" is the only one of 
these four items statutorily defined in § 119A (a).  It is 
"a comprehensive written medical and psychosocial care plan 
specific to a prisoner and including, but not limited to:  
(i) the proposed course of treatment; (ii) the proposed 
site for treatment and post-treatment care; (iii) 
documentation that medical providers qualified to provide 
the medical services identified in the medical parole plan 
are prepared to provide such services; and (iv) the 
financial program in place to cover the cost of the plan 
for the duration of the medical parole, which shall include 
eligibility for enrollment in commercial insurance, 
Medicare or Medicaid or access to other adequate financial 
resources for the duration of the medical parole." 
 
G. L. c. 127, § 119A (a).  Once the commissioner receives the 
petition and recommendation, he or she is required to notify the 
interested parties -- the prisoner, the person who petitioned 
for medical parole (if it was not the prisoner), the district 
attorney of the jurisdiction where the prisoner's offense 
occurred, and, if applicable, the victim or the victim's family 
-- "that the prisoner is being considered for medical parole."  
8 
 
G. L. c. 127, § 119 (c) (2).  Any of the parties who receives 
notice "shall have an opportunity to provide written statements" 
to the commissioner.  Id.8 
 
The statute requires the commissioner to issue a written 
decision, accompanied by a statement of reasons, "not later than 
[forty-five] days after receipt of a petition."  G. L. c. 127, 
§ 119A (e).  Under the statute, "[i]f the commissioner 
determines that a prisoner is terminally ill or permanently 
incapacitated such that if the prisoner is released the prisoner 
will live and remain at liberty without violating the law and 
that the release will not be incompatible with the welfare of 
society, the prisoner shall be released on medical parole."  Id.  
In essence, in deciding whether to allow medical release, the 
statute requires the commissioner to make three determinations:  
(1) is the prisoner "terminally ill" or "permanently 
incapacitated"? (2) if released, will the prisoner live and 
remain at liberty "without violating the law"?9 and (3) is the 
                                                          
 
 
8 If the prisoner was convicted of and is serving a sentence 
for murder, the district attorney or victim's family may request 
a hearing.  See G. L. c. 127, § 119A (c) (2). 
 
 
9 Where the commissioner determines that the prisoner 
suffers from "permanent incapacitation" or a "terminal illness," 
the commissioner has already determined, based on the definition 
of those statutory terms, that "the prisoner does not pose a 
public safety risk."  G. L. c. 127, § 119 (a).  Because we 
recognize the possibility that a prisoner who does not pose a 
public safety risk may nonetheless violate the law, we do not 
9 
 
prisoner's release "incompatible with the welfare of society"?  
Id.  If the commissioner determines that the answer to the first 
two questions is "yes," and the answer to the third is "no," 
"the prisoner shall be released on medical parole."  Id.  Once 
the commissioner determines that the prisoner shall be released, 
the parole board imposes the terms and conditions for medical 
parole.  G. L. c. 127, § 119A (f). 
 
2.  Legislative purpose.  Because we consider the language 
of a statute in the context of the Legislature's purpose in 
enacting it, we examine the legislative history of the medical 
parole statute to discern its purpose. 
 
Prior to the enactment of the medical parole statute, 
Massachusetts was one of only a handful of States without a 
statutory "compassionate release" or "medical parole" program.10  
                                                          
 
equate "does not pose a public safety risk" with "will live and 
remain at liberty without violating the law," but instead note 
their close interrelationship. 
 
 
10 Testimony of Representative Hannah Kane, Joint Committee 
on the Judiciary, Hearing on Sentencing and Correctional 
Services (June 19, 2017), https://malegislature.gov/Events 
/Hearings/Detail/2662 [https://perma.cc/Y72U-J8QB] ("forty-seven 
out of fifty-two corrections systems in the United States offer 
some procedure" for medical parole).  A June 2018 report by 
Families Against Mandatory Minimums states that forty-nine 
States (now including Massachusetts) and the District of 
Columbia currently provide for compassionate release.  See 
Price, Families Against Mandatory Minimums, Everywhere and 
Nowhere:  Compassionate Release in the States 8 (June 2018), 
https://famm.org/wp-content/uploads/Exec-Summary-Report.pdf 
[https://perma.cc/N768-G73R]. 
10 
 
The only way a dying prisoner could obtain release was to seek 
executive clemency from the Governor on the basis of a "terminal 
illness" or a "severe and chronic debilitating medical 
condition."11  See Office of the Governor, Executive Clemency 
Guidelines § 4.3.3 (Dec. 10, 2015) (guidelines).  See also 120 
Code Mass. Regs. §§ 900.00 (2017).  To petition for commutation 
of a sentence on the basis of a medical illness, a prisoner had 
to produce a "a written diagnosis from at least one licensed 
physician" and "a detailed medical treatment plan setting forth 
how the petitioner will receive care" upon his or her release.  
Guidelines, supra at §§ 4.3.3.1, 4.3.3.3.  When the medical 
parole statute was enacted in April 2018, the executive clemency 
process had proved to be almost invariably an exercise in 
futility for prisoners; "[s]ince 2000, 769 inmates [had] 
requested commutations . . . from the [S]tate Parole Board, but 
only one request [had] been approved by a sitting governor."  
With Aging Prison Population, Massachusetts Looks to Possible 
Cost-Saving, Compassionate Fix, Boston Globe, May 20, 2018. 
 
The Massachusetts prison population, however, was growing 
increasingly older and more costly to incarcerate.  The over-all 
                                                          
 
 
11 There are two types of executive clemency -- pardons and 
commutations.  A petition on the basis of medical illness would 
be a petition for a commutation.  See generally Office of the 
Governor, Executive Clemency Guidelines § 2 (Dec. 10, 2015). 
11 
 
State prison population in Massachusetts dropped from 11,409 in 
2011 to 9,207 in 2018, but the number of incarcerated 
individuals age fifty and over increased by approximately twelve 
percent during that same time period.12  In 2015, the proportion 
of prisoners age fifty-five or older to the total number of 
prisoners in custody in Massachusetts was the highest in the 
country.13  And the population was trending older.  In 2016, 24.5 
percent of the criminal population was age fifty or older, in 
2017 it was 25.8 percent, and in 2018 it was 26.6 percent.14 
 
Older inmates both are more susceptible to chronic medical 
conditions and typically experience the effects of age sooner 
than individuals outside of prison.15  As a result of their 
greater health care needs, older prisoners generally cost more 
to incarcerate, with the cost of providing health care to older 
                                                          
 
 
12 Department of Correction, Inmate and Prison Research 
Statistics, January 1 Snapshot by Age, https://public.tableau 
.com/profile/madoc#!. 
 
 
13 McKillop & Boucher, Pew Charitable Trusts, Aging Prison 
Populations Drive Up Costs, (Feb. 20, 2018), https://www 
.pewtrusts.org/en/research-and-analysis/articles/2018/02/20 
/aging-prison-populations-drive-up-costs [https://perma.cc/V47B-
MJEW]. 
 
 
14 Inmate and Prison Research Statistics, supra. 
 
 
15 L.M. Maruschak, M. Berzofsky, & J. Unangst, United States 
Department of Justice, Bureau of Justice Statistics, Medical 
Problems of State and Federal Prisoners and Jail Inmates, 2011–
12, at 2, 5 (rev. Oct. 4, 2016). 
12 
 
prisoners reported as nearly three times the cost for a typical 
adult prisoner.16  In 2018, the cost to incarcerate an individual 
at one of the State's medium security prisons, Massachusetts 
Correctional Institution, Norfolk, averaged $51,811 per year, 
while the cost to care for an individual at the Lemuel Shattuck 
Hospital Correctional Unit averaged $320,037.17  Older and ill 
prisoners also need specialized housing.  The 2011 Corrections 
Master Plan developed by the Division of Capital Asset 
Management found that "[d]ue to an aging incarcerated 
population," the Commonwealth would need to add beds over the 
next decade for "sub-acute or long-term patients [who] are 
typically not suitable to be housed in the general population 
due to their vulnerability and the disproportionate consumption 
of staff resources."18  The report noted that without enough sub-
acute beds, "these chronically ill inmates frequently occupy 
infirmary beds," hampering the ability of the department and 
                                                          
 
 
16 J. Anno, C. Graham, J.E. Lawrence, & R. Shansky, United 
States Department of Justice, National Institute of Corrections, 
Correctional Health Care:  Addressing the Needs of Elderly, 
Chronically Ill, and Terminally Ill Inmates, at 30 (2004). 
 
 
17 Department of Correction, Research and Planning Division, 
Prison Population Trends 2018, at 2, 4 (Mar. 2019).  
 
 
18 Division of Capital Asset Management, Corrections Master 
Plan, DOC 0801ST1, Final Report, at 11 (Dec. 2011) (Corrections 
Master Plan). 
13 
 
sheriffs to provide acute, short-term crisis care to inmates.19 
 
It was with these trends in mind -- the aging prison 
population, the rising cost of health care, and the fact that 
elderly and infirm prisoners are "considered among the least 
likely to re-offend when released" -- that "the [L]egislature 
decided to include language for a medical parole program within 
An Act relative to criminal justice reform."20  Although the 
focus was on cost savings, there was also a human element to the 
legislation.  Speaking on behalf of the Harm Reduction Caucus, 
Representative Mary S. Keefe, after recognizing the "tremendous 
economic benefits in terms of money that would be saved," added, 
"more to the heart, . . . this is . . . the compassionate thing 
to do."21  See Representative Claire D. Cronin, co-chair of the 
Joint Committee on the Judiciary, Floor Speech, Formal Session 
of House of Representatives, April 4, 2018 (criminal justice 
reform bill "create[s] a mechanism for compassionate medical 
release for ill inmates who pose no public safety threat"). 
                                                          
 
19 Corrections Master Plan, supra at 11. 
 
 
20 Brownsberger, Extraordinary Medical Release in the 
Criminal Justice Package (June 30, 2018), https://willbrowns 
berger.com/extraordinary-medical-release [https://perma.cc/K9SJ-
MLPW]. 
 
 
21 Testimony of Representative Mary S. Keefe, Joint 
Committee on the Judiciary, Hearing on Sentencing and 
Correctional Services (June 19, 2017), https://malegislature 
.gov/Events/Hearings/Detail/2662 [https://perma.cc/Y72U-J8QB]. 
14 
 
 
3.  The regulations.  The medical parole statute requires 
the secretary to "promulgate rules and regulations necessary for 
the enforcement and administration of this section."  G. L. 
c. 127, § 119A (h).  The final regulations were formally 
promulgated on July 26, 2019, and are, in relevant part, similar 
to the earlier department policy that was in effect at the time 
Buckman's and Cruz's petitions were deemed incomplete. 
 
The regulations, if valid, effectively answer each of the 
three reported questions.  As required by § 119A (c) (1), a 
superintendent must consider a written medical parole petition 
upon its receipt, and the petition may be submitted not only by 
a prisoner or his or her attorney, but also by a prisoner's next 
of kin, a medical provider of the correctional facility, or a 
member of the department's staff.  501 Code Mass. Regs. 
§ 17.03(2) (2019).  However, the regulations require that the 
petition be accompanied by four documents:  (1) "a medical 
parole plan developed by the petitioner"; (2) "a written 
diagnosis accompanied by a signed affidavit on letterhead from a 
licensed physician or a medical provider identified by the 
petitioner, if not a medical provider utilized by the 
[d]epartment"; (3) a release form to permit release of the 
petition and all supporting documents to other criminal justice 
agencies and the appropriate district attorney; and (4) a 
release form to permit the department and parole board to assess 
15 
 
the proposed medical parole plan.  501 Code Mass. Regs. 
§ 17.03(3).  If any of these four accompanying documents are not 
submitted, or if the medical parole plan does not include 
specific information required by the regulations, then the 
petition "shall be considered incomplete" and returned to the 
petitioner for resubmission.  501 Code Mass. Regs. § 17.03(5). 
 
Thus, under the regulations the petitioner bears the burden 
of preparing or procuring a medical parole plan and a written 
diagnosis by a licensed physician.  Moreover, the regulations 
introduce the concept of an "incomplete" petition -- treating 
the medical parole plan and written diagnosis as required 
elements of a "complete" petition, and mandating that the 
superintendent return any submission that fails to include these 
documents or fails to sufficiently fulfill the requirements of a 
medical parole plan. 
 
With respect to the third reported question, the 
regulations provide that upon receipt of the petition and 
recommendation, the commissioner shall notify the interested 
parties identified in § 119A (c) (2) that the prisoner is being 
considered for medical parole.  See 501 Code Mass. Regs. 
§ 17.07(1).  Under the regulations, the prisoner is entitled to 
receive nothing more than this notice.  501 Code Mass. Regs. 
§ 17.07(3).  In contrast, upon request, the relevant district 
attorney may receive a copy of the medical parole petition, the 
16 
 
medical parole plan, and all supporting documents; the victim, 
or the victim's family, may receive a copy of the medical parole 
petition and "the most recent clinical assessment of the 
prisoner prepared by the [d]epartment's or [s]heriff's medical 
provider."  Id.  But according to regulation, none of the 
interested parties may receive the superintendent's 
recommendation.  Id. 
 
Discussion.  1.  Standard of review.  Because the 
regulations, if valid, provide answers to each of the reported 
questions, we must determine whether the relevant regulations 
are valid or void.  Where, as here, a statute authorizes the 
secretary of an executive department to "promulgate rules and 
regulations necessary for the enforcement and administration" of 
the statute, G. L. c. 127, § 119A (h), and where, as here, the 
regulations are duly promulgated, they "are presumptively 
valid," Craft Beer Guild, LLC v. Alcoholic Beverages Control 
Comm., 481 Mass. 506, 520 (2019), quoting Pepin v. Division of 
Fisheries & Wildlife, 467 Mass. 210, 221 (2014).  But a 
department or agency does not have the authority to promulgate a 
regulation for the enforcement or administration of a statute 
that "is contrary to the plain language of the statute and its 
underlying purpose."  Massachusetts Teachers' Retirement Sys. v. 
Contributory Retirement Appeal Bd., 466 Mass. 292, 301 (2013), 
quoting Duarte v. Commissioner of Revenue, 451 Mass. 399, 408 
17 
 
(2008). 
 
In determining whether an administrative agency's 
regulation is valid, we look first to the language of the 
statute and, where it speaks clearly on the topic in the 
regulation, we determine whether the regulation is consistent 
with or contrary to the statute's plain language.  See Craft 
Beer Guild, LLC, 481 Mass. at 520.  Where the statute relevant 
to the regulation is ambiguous or where there is a gap in the 
statutory guidance, we determine whether the regulation may "be 
reconciled with the governing legislation."  Id., quoting Taylor 
v. Housing Appeals Comm., 451 Mass. 149, 154 (2008).  In doing 
so, "we accord 'substantial deference' to the agency charged 
with interpreting and administering the statute in question, and 
do not invalidate regulations unless 'their provisions cannot by 
any reasonable construction be interpreted in harmony with the 
legislative mandate.'"  Craft Beer Guild, LLC, supra, quoting 
Taylor, supra.  "But deference does not suggest abdication; 
'[a]n incorrect interpretation of a statute . . . is not 
entitled to deference.'"  Craft Beer Guild, LLC, supra at 512, 
quoting Commerce Ins. Co. v. Commissioner of Ins., 447 Mass. 
478, 481 (2006).  With these principles in mind, we now answer 
the reported questions by determining whether the relevant 
regulations are valid or void. 
 
2.  The initiation of the petition process.  The first 
18 
 
question asks whether a superintendent may reject a petition for 
incompleteness, which causes us to confront the underlying 
question of what exactly is required by statute to initiate the 
petition process -- i.e., what begins the twenty-one day clock 
for the superintendent? 
 
Section 119A (c) (1) plainly states that "[t]he 
superintendent . . . shall consider a prisoner for medical 
parole upon a written petition," and, "the superintendent shall, 
not more than [twenty-one] days after receipt of the petition 
transmit the petition and the recommendation to the 
commissioner" (emphasis added).  It is clear from the language 
of the statute that the Legislature did not consider the medical 
parole plan or written diagnosis to be a document that the 
prisoner was required to submit in order to initiate the 
petition process.  The Legislature clearly refers to the 
petition as a separate document from the medical parole plan and 
written diagnosis.  If the medical parole plan and written 
diagnosis were considered part of the petition, then the 
Legislature would not have needed to require the superintendent 
to transmit these documents to the commissioner along with the 
petition.  See G. L. c. 127, § 119 (c) (1). 
 
The Legislature certainly could have provided that, upon 
receipt of the petition, the medical parole plan, and the 
written diagnosis of a licensed physician, the superintendent 
19 
 
would have twenty-one days to transmit a recommendation; but 
that is not what the statute provides.  "[W]here the language of 
a statute is plain and unambiguous, it is conclusive as to the 
legislative intent."  Sharris v. Commonwealth, 480 Mass. 586, 
594 (2018), quoting Thurdin v. SEI Boston, LLC, 452 Mass. 436, 
444 (2008).  The receipt of the petition alone triggers the 
twenty-one day deadline. 
 
It is equally plain that the regulation requiring the 
medical parole plan and the written diagnosis to be submitted 
with the petition is inconsistent with the legislative purpose 
of the statute.  In medical parole cases, where a petitioner 
might be terminally ill, there is a need for an expeditious 
administrative process -- which the Legislature has determined 
should not exceed sixty-six days -- so that a prisoner may 
promptly be released or appeal from the denial of the petition.  
The preparation of a medical parole plan, as defined in the 
statute, would be a formidable task for even a young and healthy 
prisoner, given a prisoner's limited access to the world outside 
prison.  See, e.g., 103 Code Mass. Regs. § 483.10 (2018) 
(limiting number of preapproved adult visitors prisoner may 
have, and noting that list of preapproved visitors may only be 
revised upon request twice per year); 103 Code Mass. Regs. 
§ 482.06(3)(c) (2017) (limiting prisoner's telephone access to 
fifteen preauthorized telephone numbers, five of which are 
20 
 
reserved for attorneys).  For a prisoner whose condition meets 
the definition of physical incapacitation or terminal illness, 
the preparation of a medical parole plan would be nearly 
impossible without substantial assistance from an attorney or 
relative.  But permanently incapacitated and terminally ill 
prisoners are unlikely to have the financial resources needed to 
retain an attorney, and not all are fortunate enough to have 
relatives willing or able to provide such help.  Such prisoners, 
under the regulations, are given one recourse -- if a prisoner 
provides a written diagnosis and completes the release forms, 
then he or she "may request assistance through parole staff 
assigned to the institution" in completing the medical parole 
plan documents.  501 Code Mass. Regs. § 17.03(3)(d)(2).22  But 
the regulations do not require parole staff to provide such 
assistance, nor do they establish any timeline for doing so. 
 
Therefore, the regulations cannot be reconciled with the 
speedy process enshrined in the statute.  If the medical parole 
plan and written diagnosis were required to be submitted with 
the petition to set the twenty-one day deadline in motion, then 
it might take months for a physically incapacitated or 
                                                          
 
 
22 Even this assistance is limited.  The regulations do not 
permit parole staff to provide the prisoner assistance in 
obtaining a plan for the "proposed course of medical treatment 
following any release on medical parole," even though that is a 
required part of the medical parole plan.  501 Code Mass. Regs. 
§§ 17.03(3)(d)(2), 17.03(4). 
21 
 
terminally ill prisoner to be able to prepare an adequate 
medical parole plan and obtain a written diagnosis, if he or she 
could do so at all before he or she died, frustrating the very 
purpose of the statute. 
 
The regulation that essentially makes a medical parole plan 
and written diagnosis required elements of a "complete" petition 
also gives the superintendent nearly unbridled discretion to 
delay a petition by determining it to be "incomplete."  For 
prisoners with little time left to live, a superintendent's 
delay may be the equivalent of a denial.  But the statute does 
not authorize a superintendent to deny a petition; only the 
commissioner has that authority.  See G. L. c. 127, § 119A (e). 
 
Where the statute provides that the superintendent "shall 
consider a prisoner for medical parole upon a written petition," 
G. L. c. 127, § 119A (c), and where the petition is separate and 
distinct from the medical parole plan and the written diagnosis 
of a licensed physician, we answer the first reported question 
by declaring that a superintendent must consider a written 
petition for medical parole regardless of his or her view of the 
completeness or adequacy of the petition.  To be sure, a more 
complete submission is preferable, but by requiring nothing more 
than that the petition be "written," the Legislature intended to 
make the petition process as accessible as possible and to 
prevent superintendents from refusing to accept petitions based 
22 
 
on form over substance.  As long as the petition is written and 
is unambiguously a petition for medical parole for a particular 
prisoner, signed by a person authorized to make such a petition, 
the superintendent must accept and review the petition upon its 
receipt, and may not return it for incompleteness.23 
 
To the extent the secretary's regulations are contrary to 
the plain language and purpose of the statute, they are hereby 
declared void.  See Noe, Sex Offender Registry Bd. No. 5340 v. 
Sex Offender Registry Bd., 480 Mass. 195, 210 (2018) 
(regulations violated enabling statute where in clear conflict 
with both text and purpose of statute); Spaniol's Case, 466 
Mass. 102, 111 (voiding regulations "not in harmony with the 
legislative mandate").  Specifically, the following regulatory 
provisions are void in their entirety because they cannot be 
reconciled with the answer to the first question:  501 Code 
Mass. Regs. § 17.03(5) (incomplete petitions shall be returned); 
501 Code Mass. Regs. § 17.06(5) (same for county correctional 
                                                          
 
 
23 We recognize that a prisoner will need to execute the 
medical release forms required by the regulations once the 
petition is received, but these release forms are separate and 
distinct from the petition itself.  Section 119 (c) (1) requires 
a superintendent to consider a prisoner for medical parole where 
a written petition has been submitted by a prisoner's next of 
kin, a medical provider at the correctional facility, or a 
department staff member.  Because none of these persons, in the 
absence of separate legal authority, could execute a medical 
release on behalf of the prisoner, the Legislature could not 
have intended a medical release to be a required element of a 
"complete" petition. 
23 
 
facility custody); and 501 Code Mass. Regs. § 17.06(8) 
(incomplete petitions transmitted by sheriff to commissioner 
shall be returned to petitioner). 
 
3.  Which party bears the burden?  The second reported 
question asks which party bears the burden of producing a 
medical parole plan and procuring a written diagnosis.  The 
answer is in some ways dictated by our analysis supra -- where 
the petitioner need not submit the medical parole plan or the 
written diagnosis to begin the process, the Legislature could 
not have intended that the petitioner bear the burden of 
preparing or procuring those documents during the twenty-one day 
time frame the superintendent has to formulate his or her 
recommendation.  Pragmatically, the only way that a 
superintendent can meet his or her statutory obligation to 
transmit with the recommendation "(i) a medical parole plan; 
(ii) a written diagnosis by a physician licensed to practice 
medicine . . . ; and (iii) an assessment of the risk for 
violence that the prisoner poses to society," G. L. c. 127, 
§ 119A (c) (1), is to bear the burden of causing them to be 
prepared or procured. 
 
Moreover, there is no dispute that the statute properly 
places the burden to make an "assessment of the risk for 
violence that the prisoner poses to society" on the 
superintendent.  Id.  Where the statute plainly gives the 
24 
 
superintendent the responsibility to prepare the risk 
assessment, it is reasonable to infer that the Legislature also 
intended the superintendent to prepare or procure the other two 
documents that are required to be transmitted with the 
recommendation. 
 
The department contends that placing this burden on the 
superintendent would be "unworkable" within twenty-one days, and 
that the Legislature could not have intended to require the 
superintendent to develop a medical parole plan where he or she 
might recommend against release.  We recognize that preparing a 
medical parole plan and procuring a written diagnosis within 
twenty-one days of receipt of a petition places a formidable 
burden on a superintendent.  But the superintendent is in a far 
better position to meet this burden than a permanently 
incapacitated or terminally ill prisoner. 
 
While incarcerated, prisoners are entirely dependent on the 
department for access to health care services.  The department's 
contract health care provider maintains records of all on-site 
medical care provided to prisoners, as well as records of 
treatment at outside medical facilities.  See 103 DOC § 607.02 
(2019) ("The inmate medical record shall include documentation 
of all inmate visits or contacts with medical, mental health, or 
dental treatment staff.  The inmate medical record shall also 
contain all reports, records, entries, orders, and written 
25 
 
documentation concerning the inmate's medical, mental health, 
and dental care").  A prisoner's medical records are considered 
the property of the department's health services division, and a 
prisoner must sign a release form to access them.  See 103 DOC 
§ 607.05(1), (7). 
 
Apart from possession of the prisoner's medical records, 
the department also has staff who are dedicated to developing 
individual reentry plans.  Each correctional institution has an 
institutional reentry committee, which includes medical staff 
and "a medical/mental health discharge planner" who is required 
to "schedule appointments with [c]ommunity [p]roviders" and to 
assist prisoners in signing up for MassHealth.  See 103 DOC 
§ 493.03 (institutional reentry committee); 103 DOC § 493.07 
(medical, mental health, and substance abuse treatment).  The 
regulations already provide that, once a prisoner submits a 
medical parole petition, a written diagnosis, and release forms, 
he or she "may request assistance through parole staff assigned 
to the institution in completing [portions of the medical parole 
plan]."  501 Code Mass. Regs. § 17.03(3)(d)(2).  It takes no 
more time to help the superintendent prepare such a plan than it 
would to help the prisoner to do so.  And, to the extent that 
this obligation may require the allocation of additional reentry 
resources, the Legislature would have recognized that such a 
reallocation is well justified economically, given the enormous 
26 
 
cost savings that may accrue to the department from the medical 
release of permanently incapacitated or terminally ill 
prisoners. 
 
In effect, by enacting § 119A, the Legislature intended to 
trigger a collaborative process whereby the health care provider 
for the institution, reentry staff, and the prisoner (or his or 
her attorney or next of kin) work together to prepare a medical 
parole plan for the prisoner and obtain a written diagnosis by a 
licensed physician.  The prisoner, to the extent that he or she 
is able, has every incentive to cooperate, because he or she 
needs a medical parole plan and written diagnosis that will 
convince the superintendent to recommend medical parole and the 
commissioner to approve it.  But the superintendent ultimately 
bears the burden of producing or procuring these documents 
arising from the collaborative process.  To require the 
petitioner -- often the prisoner -- to formulate a medical 
parole plan and obtain a written diagnosis from a licensed 
physician would place that formidable burden on someone who 
claims to be permanently incapacitated or terminally ill, and 
who may suffer from dementia, mental illness, or cognitive 
limitations.  We infer that the Legislature did not intend to 
place this burden on those so poorly able to bear it.  
Therefore, in answer to the second reported question, we 
conclude that the superintendent bears the burden of preparing 
27 
 
or procuring a medical parole plan, a written diagnosis by a 
licensed physician, and an assessment of the prisoner's risk of 
violence.24 
 
To the extent that the secretary's regulations conflict 
with this answer, they are hereby declared void.  Specifically, 
the following regulatory provisions are void in their entirety 
because they cannot be reconciled with the answer to the second 
question:  501 Code Mass. Regs. § 17.03(3) (petition to be 
accompanied by medical parole plan and written diagnosis 
developed by petitioner); 501 Code Mass. Regs. § 17.06(3) (same 
for county correctional facility custody); 501 Code Mass. Regs. 
§ 17.03(4) (medical parole plan to be developed by petitioner); 
and 501 Code Mass. Regs. § 17.06(4) (same for county 
correctional facility custody).  The following regulations are 
void in part to the extent that they declare that the medical 
parole plan or written diagnosis by a licensed physician must be 
provided by the petitioner:  501 Code Mass. Regs. § 17.02 
                                                          
 
 
24 Because we hold that the superintendent, rather than the 
petitioner, bears the burden of producing a medical parole plan 
and procuring a written diagnosis from a licensed physician, we 
need not decide whether the regulations that impose this burden 
on a prisoner who claims to be terminally ill or physically 
incapacitated are in violation of the Americans with 
Disabilities Act, 42 U.S.C. §§ 12101 et seq. (ADA), or art. 114 
of the Amendments to the Massachusetts Constitution.  See 
Crowell v. Massachusetts Parole Bd., 477 Mass. 106, 112 (2017) 
(ADA requires parole board to make reasonable accommodations for 
prisoners with disabilities to give them access to benefits of 
State program). 
28 
 
(definition of multidisciplinary review team); 501 Code Mass. 
Regs. § 17.04 (review conducted by multidisciplinary review 
team); and 501 Code Mass. Regs. § 17.09 (review by parole 
board). 
 
4.  Documents required to be provided to the prisoner.  The 
third reported question asks whether the commissioner, upon 
receiving the recommendation of the superintendent, must provide 
the prisoner with a copy of the recommendation and of any 
supporting materials.  As noted, § 119A (c) (2) does not require 
the commissioner to provide the interested parties with anything 
other than notice that the prisoner is being considered for 
medical parole release.  The regulations expressly prohibit any 
interested party from receiving the superintendent's 
recommendation before the commissioner makes a final decision.  
501 Code Mass. Regs. § 17.07(3).25  Buckman argues that his 
statutory entitlement under § 119A (c) (2) of "an opportunity to 
submit written statements" to the commissioner will be 
"meaningless" if he does not receive a copy of the 
                                                          
 
25 A prisoner would obtain a copy of the recommendation if 
his or her petition for medical release were denied and the 
prisoner petitioned for relief under G. L. c. 249, § 4 (civil 
action in nature of certiorari).  Under the department's 
regulations, where such an action is brought, a prisoner may 
request, and receive within fifteen business days, the entire 
administrative record in the case, which would include the 
superintendent's recommendation.  See 501 Code Mass. Regs. 
§ 17.14. 
29 
 
recommendation.  We recognize that, without knowing whether the 
recommendation favors or opposes release, and without receiving 
a copy, a prisoner cannot effectively support or confront the 
superintendent's recommendation.  However, the recommendation is 
just that -- a recommendation.  The ultimate decision belongs 
solely to the commissioner, who renders a decision de novo and 
need give no deference to the recommendation of the 
superintendent.  Where the Legislature clearly understood that 
the commissioner would receive a recommendation from the 
superintendent, but required the commissioner to do nothing more 
than provide notice, we conclude that the department's 
regulations protecting the recommendation from disclosure are 
not so inconsistent with the plain language or purpose of the 
statute as to warrant a finding of invalidity.  See Taylor, 451 
Mass. at 154 (deferring to agency's interpretation of statute 
unless regulations cannot be harmonized with agency's 
legislative mandate).26 
                                                          
 
26 We recognize that the Committee for Public Counsel 
Services in its amicus brief contends that G. L. c. 127, § 119A, 
creates a constitutional liberty interest by mandating medical 
parole under the circumstances set forth in the statute, and 
that prisoners who are physically incapacitated or terminally 
ill are therefore entitled to due process protections.  The 
prisoners, in their complaint, alleged that their right to 
procedural due process would be violated if the commissioner 
made a final determination of their petition for medical parole 
"without providing reasonable notice of the information on which 
that decision is based."  But the prisoners did not brief 
30 
 
 
The documents accompanying the recommendation, however, 
require separate analysis.  The regulations provide that, upon 
request, the relevant district attorney may obtain all 
"supporting documents" furnished to the commissioner, apart from 
the recommendation itself.  See 501 Code Mass. Regs. § 17.07(3).  
The regulations are silent regarding the access of the prisoner 
to such "supporting documents."  To be fair, when the 
regulations were promulgated, the department assumed that the 
medical parole plan and the written diagnosis would be furnished 
by the prisoner, and therefore reasonably would have understood 
that the prisoner already had a copy of these documents.  
However, that understanding cannot survive this opinion.  Having 
concluded that the Legislature intended that the superintendent 
bear the burden of preparing or procuring the prisoner's medical 
parole plan and written diagnosis, we also conclude that the 
Legislature intended that the prisoner receive a copy of these 
documents. 
 
As to other supporting documents, where a district 
                                                          
 
whether, as a matter of constitutional due process, they are 
entitled to notice of the superintendent's recommendation 
regarding release on medical parole.  Therefore, we do not 
address whether the prisoners are entitled as a matter of 
constitutional law to notice of the superintendent's 
recommendation.  See Craft Beer Guild, LLC, 481 Mass. at 510 
n.5, citing First Nat'l Bank of Boston v. Haufler, 377 Mass. 
209, 211 (1979) (declining to review issue "not briefed and 
argued before us"). 
31 
 
attorney, upon request, can obtain all supporting documents, 
including the assessment of the prisoner's risk for violence, it 
would be fundamentally unfair, and therefore arbitrary and 
capricious, for the department's regulation to deprive the 
prisoner of access to those same documents upon request.  We can 
find no justifiable basis for a regulation that would allow a 
district attorney, having seen the risk assessment, to submit a 
written statement to the commissioner arguing that the risk 
assessment underestimates the prisoner's current risk for 
violence, but would deprive the prisoner, who would not have 
seen the risk assessment, of the opportunity to argue that the 
risk assessment overstates his or her current risk for violence.  
See Salisbury Nursing & Rehabilitation Ctr., Inc. v. Division of 
Admin. Law Appeals, 448 Mass. 365, 374 (2007), quoting Purity 
Supreme, Inc. v. Attorney Gen., 380 Mass. 762, 776 (1980) 
(regulation is arbitrary or capricious where there is "absence 
of any conceivable ground upon which" it may be upheld). 
 
The prisoner does not require a copy of the recommendation 
to be able to marshal his or her facts in support of the 
petition for medical parole, but he or she does need a copy of 
the supporting documents in order to examine and, if necessary 
correct, the accuracy of the information in those documents.  
The unfairness of depriving the prisoner of access to these 
supporting documents is magnified by the regulation that 
32 
 
provides, "No subsequent petitions may be submitted following 
the [c]ommissioner's denial of medical parole, unless the 
prisoner experiences a significant and material decline in 
medical condition."  501 Code Mass. Regs. § 17.14(4).  This 
limitation on a prisoner's ability to submit subsequent 
petitions, the legality of which we do not address in this 
opinion, rests on the premise that the commissioner's denial was 
based on fair and accurate information regarding the physical or 
mental condition of the prisoner and the risk, if any, posed by 
his or her release.  Unless the prisoner has a meaningful 
opportunity to challenge the fairness or accuracy of that 
information in his or her written statement to the commissioner, 
there can be little confidence in that premise.  A regulation 
granting the district attorney access to all supporting 
documents but denying that same access to the prisoner is 
fundamentally unfair and cannot be harmonized with the agency's 
legislative mandate. 
 
Conclusion.  We answer the reported questions as follows: 
1.  Under G. L. c. 127, § 119A, a written petition for 
medical parole of a prisoner must be considered by the 
superintendent (or sheriff, where the prisoner is in 
custody in a house of correction) of the facility where the 
prisoner is incarcerated, regardless of the 
superintendent's (or sheriff's) view as to the completeness 
or adequacy of the petition. 
 
2.  The superintendent (or sheriff) bears the burden of 
preparing or procuring "(i) a medical parole plan; (ii) a 
written diagnosis by a physician licensed to practice 
33 
 
medicine under [G. L. c. 112, § 2]; and (iii) an assessment 
of the risk for violence that the prisoner poses to 
society."  G. L. c. 127, § 119A. 
 
3.  The commissioner, on receipt of the petition and 
the superintendent's (or sheriff's) recommendation as 
to release of the prisoner, is not required to provide 
the prisoner with the recommendation, but is required 
to provide the prisoner with all supporting documents 
submitted by the superintendent (or sheriff) with the 
recommendation. 
 
 
To the extent that the regulations promulgated by the 
secretary conflict with the answers to the reported questions, 
they are hereby declared void.  Specifically, the following 
regulatory provisions are void in their entirety because they 
cannot be reconciled with the answers to the reported questions:  
501 Code Mass. Regs. § 17.03(5) (incomplete petitions shall be 
returned); 501 Code Mass. Regs. § 17.06(5) (same for county 
correctional facility custody); 501 Code Mass. Regs. § 17.06(8) 
(incomplete petitions transmitted by sheriff to commissioner 
shall be returned to petitioner); 501 Code Mass. Regs. 
§ 17.03(3) (petition to be accompanied by medical parole plan 
and written diagnosis developed by petitioner); 501 Code Mass. 
Regs. § 17.06(3) (same for county correctional facility 
custody); 501 Code Mass. Regs. § 17.03(4) (medical parole plan 
to be developed by petitioner); and 501 Code Mass. Regs. 
§ 17.06(4) (same for county correctional facility custody).  The 
following regulations are void in part to the extent that they 
require the medical parole plan or written diagnosis by a 
34 
 
licensed physician to be provided by the petitioner:  501 Code 
Mass. Regs. § 17.02 (definition of multidisciplinary review 
team); 501 Code Mass. Regs. § 17.04 (review conducted by 
multidisciplinary review team); and 501 Code Mass. Regs. § 17.09 
(review by parole board). 
 
 
 
 
 
 
 
So ordered.