Title: Malloy v. Department of Correction
Citation: N/A
Docket Number: SJC-12961
State: Massachusetts
Issuer: Massachusetts Supreme Court
Date: May 19, 2021

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SJC-12961 
 
ROBERT MALLOY & another1  vs.  DEPARTMENT OF CORRECTION 
& another.2 
 
 
 
Suffolk.     October 5, 2020. - May 19, 2021. 
 
Present:  Budd, C.J., Gaziano, Lowy, Cypher, Kafker, Wendlandt, 
& Georges, JJ.3 
 
 
Parole.  Imprisonment, Parole.  Commissioner of Correction.  
Moot Question.  Practice, Civil, Moot case, Action in 
nature of mandamus.  Mandamus. 
 
 
 
Civil action commenced in the Supreme Judicial Court for 
the county of Suffolk on May 6, 2020. 
 
The case was heard by Kafker, J., and questions of law were 
reported by him. 
 
 
Ruth Greenberg for the plaintiffs. 
Christopher Gaskill (Darcy Currey also present) for 
Department of Correction. 
Randall E. Ravitz, Assistant Attorney General, for Parole 
Board. 
 
 
1 Raymond Vinnie. 
 
 
2 Parole Board. 
 
3 Justices Wendlandt and Georges participated in the 
deliberation on this case. 
2 
 
David Milton & Michael J. Horrell, for Prisoners' Legal 
Services of Massachusetts, amicus curiae, submitted a brief. 
Sharon L. Sullivan-Puccini, for James Carver, amicus 
curiae, submitted a brief. 
 
 
 
KAFKER, J.  The plaintiffs, Robert Malloy and Raymond 
Vinnie, are two prisoners recently released under the medical 
parole statute, G. L. c. 127, § 119A.  After they were granted 
medical parole, but before their actual release from 
incarceration, they sought relief from a single justice of this 
court, arguing that the Department of Correction (DOC) illegally 
kept them in custody after a final decision on their petitions 
for medical parole had been made by the Commissioner of 
Correction (commissioner).  They contended that the statute 
imposes an absolute time deadline for release of sixty-six days 
that allows no exceptions.  The DOC argued that the statute 
contains no such deadline and that the timing of the release is 
entirely up to their discretion.  Malloy was eventually released 
114 days after he filed his written petition for release on 
medical parole.  Vinnie was released 103 days after he filed his 
petition. 
 
The single justice denied the plaintiffs' request for 
relief and, separately, reported two questions to this court 
regarding the requirements of finding a suitable placement for a 
prisoner who is granted medical parole, and the timing of a 
prisoner's release after medical parole is granted.  The 
3 
 
plaintiffs have also appealed from the single justice's denial 
of their request for relief. 
 
We dismiss the plaintiffs' appeal as moot, as the prisoners 
were released before they even filed their notice of appeal.  We 
focus instead on the two questions reported by the single 
justice.  In answer to these questions, we conclude that after 
medical parole is granted the DOC must act proactively to 
finalize the comprehensive plan that it prepared within twenty-
one days of the filing of a petition, which was to include a 
proposed course and site of treatment.  We also recognize that 
the proposed course and site of treatment was subject to 
multiple contingencies beyond the DOC's control arising at the 
conclusion of the sixty-six day evaluation and planning process, 
including the availability of beds in private facilities, 
changes in the health care needs of the prisoner, delays caused 
by the COVID-19 pandemic, and conditions of parole.  Although 
time is clearly of the essence, and the statute seeks to ensure 
the petitioner's timely release after the sixty-six day process 
is completed, we conclude that reasonable short-term delays are 
acceptable where they are outside the control of the DOC and 
necessary to ensure appropriate care and placement for the 
4 
 
petitioner and compliance with the terms and conditions of 
parole.4 
 
1.  Statutory provisions.  To answer the reported 
questions, we first review the basic provisions of the medical 
parole statute. 
 
In April 2018, Massachusetts joined the majority of States 
in adopting a medical parole statute.5  See St. 2018, c. 69, 
§ 97.  General Laws c. 127, § 119A, the medical parole statute, 
prescribes a detailed procedure under which committed offenders 
who are terminally ill or permanently mentally or physically 
incapacitated may apply for release on parole.  See generally 
Buckman v. Commissioner of Correction, 484 Mass. 14 (2020).  The 
process is initiated when a written petition for release on 
medical parole is submitted by or on behalf of a prisoner to the 
superintendent of the prison in which he or she is incarcerated.  
 
 
4 We acknowledge the amicus briefs submitted by Prisoners' 
Legal Services of Massachusetts and James Carver. 
 
 
5 See National Conference of State Legislatures, State 
Medical and Geriatric Parole Laws (Aug. 27, 2018), https://www 
.ncsl.org/research/civil-and-criminal-justice/state-medical-and-
geriatric-parole-laws.aspx [https://perma.cc/2XWX-5FR4]; Brennan 
Center For Justice, Reducing Jail and Prison Populations During 
the COVID-19 Pandemic (Oct. 23, 2020), available at 
https://www.brennancenter.org/our-work/research-reports 
/reducing-jail-and-prison-populations-during-covid-19-pandemic 
[https://perma.cc/YA2L-JP7S]. 
 
5 
 
See G. L. c. 127, § 119A (c) (1).6  Within twenty-one days of 
receiving the petition, the superintendent must create a medical 
parole plan for the prisoner's placement and treatment if 
released, obtain a written medical diagnosis and prognosis by a 
physician, and arrange an assessment of the risk to the 
community if the prisoner were to be released.  See Buckman, 
supra at 17, 28-29.  At the end of the twenty-one day period, 
the superintendent must transmit the petition to the 
commissioner, accompanied by a recommendation as to whether it 
should be granted and three supporting documents:  a medical 
parole plan; a written diagnosis by a physician; and an 
assessment of the risk for violence that the prisoner poses to 
society.  G. L. c. 127, § 119A (c) (1). 
 
The medical parole plan is the only one of the supporting 
documents that is defined in the statute.  See G. L. c. 127, 
§ 119A (a).  It consists of 
"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 
 
 
6 General Laws c. 127, § 119A (d), creates a virtually 
identical procedure for petitions to be submitted to a county 
sheriff by prisoners who are being held in houses of correction 
or jails.  We refer only to superintendents in discussing the 
statute, with the understanding that essentially the same 
requirements apply to sheriffs. 
6 
 
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." 
 
Id.  A medical parole plan "shall include specific information 
as to . . . the level of care required and proposed site for any 
continuing medical treatment and post-treatment care (e.g., 
private home, skilled nursing care facility, hospice)."  501 
Code Mass. Regs. § 17.03(4) (2019).7 
 
Within forty-five days of receiving the superintendent's 
recommendation, the commissioner must issue a written decision 
allowing or denying the petition and explaining the reasons for 
the decision.  If the commissioner determines that the prisoner 
is "terminally ill or permanently incapacitated" such that, if 
released, he or she "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."  G. L. c. 127, § 119A (e).8 
 
 
7 Revisions to the regulations implementing medical parole 
were mandated following our decision in Buckman, which 
invalidated several of the existing regulations.  In September 
2020, a public hearing was conducted on proposed new language, 
but, at this point, no new language has taken effect.  In any 
event, the language quoted here does not differ in the two 
versions, although the language of the current (invalidated) 
version places responsibility for development of the medical 
parole plan on the petitioner. 
 
 
8 The statute also requires the commissioner to notify the 
district attorney of the jurisdiction of the offense's location 
7 
 
 
In conjunction with this release, the parole board must 
take steps to prepare for adequate supervision of the prisoner.  
Specifically, the parole board must "verify suitability of . . . 
all proposed residences" for "supervision purposes," "make 
efforts to confirm availability of bed space," and "determine 
whether the medical parole plan is consistent with the medical 
treatment needs of the prisoner."  501 Code Mass. Regs. 
§ 17.10(1) (2019).  The parole board must then "conduct a 
risk/needs assessment" and "set all appropriate terms and 
conditions of release."  501 Code Mass. Regs. § 17.09(4) (2019).  
See G. L. c. 127, § 119A (e) ("parole board shall impose terms 
 
and the victim or victim's family (pursuant to the act 
concerning rights of victims and witnesses of crimes, G. L. 
c. 258B) upon receipt of a petition for medical parole.  See 
G. L. c. 127, § 119A (c) (2), (d) (2).  These parties may make 
timely written statements to the commissioner.  Id.  See 501 
Code Mass. Regs. § 17.07(4) (2019).  "[U]pon request, the 
relevant district attorney may receive a copy of the medical 
parole petition, the 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.'"  Buckman, 484 
Mass. at 23, quoting 501 Code Mass. Regs. § 17.07(3).  If the 
prisoner was convicted of and is serving a sentence for murder, 
the district attorney or the victim's family may request a 
hearing regarding the petition.  See G. L. c. 127, 
§ 119A (c) (2), (d) (2).  Not less than twenty-four hours before 
the date of the prisoner's release on medical parole, the 
commissioner must notify the appropriate district attorney, the 
department of State police, the police department where the 
petitioner will reside, and, if applicable pursuant to G. L. 
c. 258B, the victim or victim's family of the release and terms 
and conditions of parole.  G. L. c. 127, § 119A (e). 
8 
 
and conditions for medical parole that shall apply through the 
date upon which the prisoner's sentence would have expired").9 
 
The DOC must include financial coverage for medical 
services in its proposed plan.  G. L. c. 127, § 119A (a).  For 
prisoners without independent coverage, the DOC must seek health 
insurance through Affordable Care Act or Senior Affordable Care 
Act applications.10  This can be a time-consuming process, with 
the ultimate decisions regarding an inmate's health insurance 
coverage being made by MassHealth and not the DOC. 
 
In January 2020, following a reservation and report by the 
single justice raising numerous issues in the medical release 
process, this court issued its decision in Buckman, 484 Mass. 
 
 
9 The required terms and conditions of parole may include, 
but are not limited to, 
 
"the setting or waiving of any work requirements for the 
prisoner; a determination in the parole officer's 
discretion whether electronic monitoring is necessary; 
supervision for drugs and alcohol as necessary; the 
requirement that the prisoner report to his or her assigned 
Field Parole Officer on the day of release or that the 
Parole Officer visit him or her; establishment of any no 
contact or association requirements with the victim's 
family and/or any witnesses for the Commonwealth; the 
prisoner's execution of all medical parole forms on a 
continuing basis; and the requirement that the prisoner 
make himself or herself available for intake and follow the 
treatment recommendations of the medical providers." 
 
501 Code Mass. Regs. § 17.09(4). 
 
 
10 The specific procedure for securing health insurance 
depends on whether a guardianship is in place and the prisoner's 
age, level of needed care, and assets. 
9 
 
at 14, 29, explaining the burdens on the various entities 
involved in medical release planning.  We clarified that the 
superintendent, and not the inmate petitioner, was responsible 
for drafting the medical release plan, obtaining a medical 
diagnosis for the individual seeking release, and making a 
safety assessment.  In Buckman, supra at 26, we further 
explained 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." 
 
2.  Background.  a.  Index offenses and medical conditions.  
In 2002, Malloy was sentenced to eight concurrent life 
sentences, with the possibility of parole, for multiple rapes 
and sexual abuse of his then-adult daughters committed over a 
period of years when they were children.  He is currently 
seventy-six years old and wheelchair bound; several portions of 
his feet are amputated, and his hands are atrophied so that he 
has no functional ability to grasp objects.  He suffers from 
cardiac and kidney disease, neuropathy, vision and hearing 
deficits, and memory loss. 
 
Vinnie was convicted of murder in the first degree in 1993 
and sentenced to life in prison without the possibility of 
parole.  The victim, then sixteen, was the son of a woman that 
Vinnie had dated, and Vinnie shot him after he and his mother 
asked Vinnie to leave the premises.  Following an apparent 
10 
 
stroke in September 2019, Vinnie was transferred to a hospital 
for rehabilitation.  While there, he experienced severe bleeding 
problems, which resulted in the permanent need for a catheter 
and a feeding tube, although he could eat and drink small 
amounts.  Vinnie is currently seventy-four years old.  He is 
completely dependent on others for activities of daily living 
such as feeding, dressing, and bathing.  He also suffers from 
severe arterial disease.  Despite months of physical therapy to 
assist with Vinnie's sitting, transferring to a wheelchair, and 
balance, a DOC physician opined that Vinnie is likely to remain 
essentially bed bound, and also likely to die within eighteen 
months. 
 
b.  Petitions for medical parole.  Malloy submitted a 
petition for medical parole on February 4, 2020; it was received 
by the superintendent of the facility where he was being held on 
February 7, 2020.  Less than two weeks later, on February 19, 
2020, the superintendent recommended that the petition be 
denied; the superintendent noted that, despite a physician's 
assessment that Malloy was wheelchair bound and had less than 
eighteen months to live, he was able to undertake tasks of daily 
living, such as eating and dressing on his own, and therefore 
might pose a risk to public safety if he were to be released.  
One paragraph of the letter, under the heading, "Medical Parole 
Plan," stated: 
11 
 
"[The petitioner's attorney] states that if released on 
medical parole, Mr. Malloy would be willing to live any 
place that is agreeable to the Department of Corrections.  
Mr. Malloy has been accepted to handicapped accessible 
section 8 housing in Worcester and has documentation for 
it.  His financial source of payment would be through 
Masshealth Medicare." 
 
Although the superintendent's letter of recommendation included 
a number of attachments from Malloy's file, this paragraph 
appears to be the entirety of the medical parole plan submitted 
to the commissioner. 
 
On February 29, 2020, Vinnie petitioned the superintendent 
of the prison where he was incarcerated for medical parole.  On 
March 20, 2020, the superintendent recommended that Vinnie's 
petition be allowed, because he was permanently incapacitated 
within the meaning of 501 Code Mass. Regs. § 17.02 (2019) and 
would remain dependent on others for help in dressing, feeding, 
and bathing.  The superintendent noted as well that, according 
to the DOC physician, Vinnie was at risk of a second stroke.  
The superintendent's letter of recommendation stated that Vinnie 
wished to reside either with his sister in Massachusetts or with 
his daughters in Georgia, and that a member of the 
superintendent's staff had contacted his daughters.  The letter 
discussed in some detail what was learned about the home in 
Georgia where Vinnie might live, as well as his support network 
and access to healthcare in Georgia. 
12 
 
 
c.  Commissioner's decisions.  As an initial matter, we 
note that the superintendent's letter to the commissioner 
recommending denial of Malloy's petition is dated February 19, 
2020.  The commissioner's decision refers to this letter as 
having been received nine days later, on February 28, 2020; that 
date is the limit of the twenty-one day period in which the 
superintendent must make a recommendation.  The commissioner's 
April 13, 2020 decision was made forty-five days after the 
superintendent's deadline of February 28, 2020.  In Vinnie's 
case, the date on the superintendent's letter is twenty days 
after the submission of the petition, and the commissioner 
describes this date as the date of receipt for purposes of 
calculating her own forty-five day deadline. 
 
Turning to the substance of the decisions, on April 13, 
2020, the commissioner granted Malloy's petition and allowed his 
release "conditional on a suitable home care plan."  According 
to the commissioner, Malloy did not, at the time of her 
decision, have a home care plan.  The possibility of Malloy 
living with his sister in New Hampshire had been discussed, and 
the commissioner concluded that release to her home would be "an 
appropriate placement," but DOC staff believed that interstate 
transfers of parolees were then suspended, and that Malloy also 
had a pending application for admission to a Massachusetts 
facility, but had not yet been accepted.  After litigation in 
13 
 
this matter was begun in the county court, and with persistent 
efforts between the Massachusetts parole board, the New 
Hampshire parole board, the DOC, and Malloy's counsel, the 
interstate transfer ultimately was approved, and Malloy was 
released from custody to his sister's house in New Hampshire on 
May 28, 2020. 
 
With respect to Vinnie's petition, on May 4, 2020, the 
commissioner issued a decision stating that she had "reviewed 
the proposed medical parole plan" and approved Vinnie for 
release "on the condition that he is placed in an appropriate 
[long-term care] facility that can meet his medical needs."  The 
commissioner did not mention Vinnie's daughters or the 
possibility of a placement in one of their homes, although, at 
that point, the DOC had information that interstate transfers 
were suspended due to the COVID-19 pandemic.  She did mention an 
outstanding $5,500 fine from a 1993 perjury conviction in 
Georgia, which DOC officials had asserted (inaccurately) meant 
that there was an outstanding warrant for his arrest should he 
return to Georgia.  After Vinnie's release was approved, the DOC 
pursued an admission to the Farren Care Center, while Vinnie's 
counsel acquired further information that Georgia indeed was 
accepting interstate transfers, subject to approval.  On June 
11, 2020, over DOC medical staff objections that he needed a 
greater level of medical care, Vinnie was released to his 
14 
 
daughter's home in Georgia.  His counsel states that his 
daughters transported him from Massachusetts to Georgia, and 
then found a hospital placement for him there. 
 
d.  Proceedings before the single justice.  On May 6, 2020, 
after both plaintiffs had been granted medical parole, but had 
yet to be released from custody, they jointly filed a complaint 
in the county court, seeking relief in the nature of mandamus 
ordering the DOC to prepare adequate plans that would ensure 
their safety, and to release them according to such plans.  On 
May 15, 2020, the single justice issued an initial interim 
order, requesting further information and argument by the 
parties.  In a second interim order on May 22, 2020, the single 
justice denied the relief sought on the ground that 
extraordinary relief was not warranted, as it appeared that both 
plaintiffs in fact would be released soon. 
 
With respect to Malloy, the single justice noted that the 
parole board had at that point begun the process of seeking to 
transfer him to New Hampshire, but that obtaining the necessary 
permissions and finalizing the transfer could take an additional 
forty-five to sixty days.  Meanwhile, the DOC had sought a 
placement for Malloy at the Farren Care Center in the 
Commonwealth, where Malloy's admission "appear[ed] to be 
imminent."  As to Vinnie, the DOC represented that an 
application for placement at the Farren Care Center was 
15 
 
underway.  The DOC further asserted that the placement with his 
daughters in Georgia contemplated in the superintendent's letter 
was not possible, because Vinnie had an outstanding warrant in 
that State that local officials would enforce to collect the 
outstanding $5,500 fine from the 1993 perjury conviction, and 
because DOC medical contractors believed that his daughters 
would be unable to care for him if he continued to need a 
feeding tube. 
 
While denying individual relief to the two plaintiffs, the 
single justice separately reported two questions to this court: 
"1.  What requirements are imposed on the DOC, its 
[c]ommissioner, and the [p]arole [b]oard to find suitable 
placement for a prisoner whose petition for medical parole 
has been granted, including any requirements as to the 
timing of such efforts, and 
 
"2.  What restrictions, if any, the statutory and 
regulatory scheme places on the length of time for which a 
prisoner may remain in custody once his or her petition for 
medical parole has been granted, and the sixty-six days 
referenced in G. L. c. 127, § 119A, have expired?" 
 
The single justice also ordered that the parole board be joined 
as a necessary party, and requested factual information from the 
parties on a range of related topics, including the number of 
prisoners who have applied for medical parole since the statute 
was enacted, the number whose petitions have been granted, the 
number released, the length of time between decision and release 
in each case, the types of issues that prevent timely release, 
and steps being taken to prevent delays. 
16 
 
 
On May 28, 2020, forty-five days after the allowance of his 
petition for medical parole, Malloy was released from custody, 
not, as the DOC had been pursuing, to the Farren Care Center, 
but to his sister's home in New Hampshire.  Vinnie continued to 
pursue the litigation.  He moved for reconsideration of the 
single justice's decision, disputing the DOC's factual claims 
concerning the infeasibility of a home placement in Georgia.  At 
a hearing before the single justice, the DOC clarified that, 
while Vinnie did not face an outstanding warrant in Georgia,11 
the $5,500 fine was still pending, and that, while home care was 
"technically possible" for Vinnie, he would require specialized 
professional attention.  The single justice denied the motion 
for reconsideration, and then denied a second such motion.  On 
June 11, 2020, thirty-eight days after his petition for medical 
parole had been allowed, Vinnie was released.  Despite the fact 
that they had already been released, the plaintiffs nonetheless 
appealed from the various rulings by the single justice to this 
court, and successfully moved to consolidate that appeal with 
the questions reported by the single justice. 
 
 
11 The issue actually had been explained in the 
commissioner's decision, in which she stated that, while the 
fine was outstanding, "there are no active warrants as this is 
not something for which [Georgia officials] would ask for 
rendition." 
17 
 
 
3.  Discussion.  a.  Mootness.  There are two distinct 
aspects of the case before us:  (1) the plaintiffs' appeal and 
(2) the two questions that the single justice reported.  As a 
preliminary matter, given that both of the plaintiffs have now 
been released on medical parole, we address the question of 
mootness. 
"Ordinarily, litigation is considered moot when the party 
who claimed to be aggrieved ceases to have a personal stake in 
its outcome."  Blake v. Massachusetts Parole Bd., 369 Mass. 701, 
703 (1976).  Because the plaintiffs in this case have achieved 
the outcome that they sought in their complaint, the dispute 
between the parties is now moot and the plaintiffs' appeal will 
be dismissed for that reason.12  We therefore focus exclusively 
in this opinion on the reported questions, which, although no 
longer significant to Malloy's or Vinnie's circumstances, were 
reported because they are novel and will be of considerable 
significance in similar cases in the future. 
 
b.  Reported questions generally.  The reported questions 
relate to timing and the tail end of the medical parole process:  
how quickly a prisoner must be released after a final decision 
granting medical parole, and what must be done once parole is 
 
12 The author of this opinion did not participate in the 
decision to dismiss the separate appeal as moot.  An order will 
be issued today by the six other Justices on the quorum 
dismissing the separate appeal. 
18 
 
granted.  The delay of release for Malloy and Vinnie was 
approximately one to one and one-half months.  Data from the DOC 
suggest that while many successful medical parole petitioners 
are released promptly, delays such as those experienced by the 
plaintiffs are not uncommon. 
According to information supplied by the DOC in response to 
the single justice's questions, 337 inmates at DOC facilities 
and county houses of correction have applied for medical parole 
since it became possible to do so in early 2018.  Thirty-four of 
those applications, or approximately ten percent, were 
successful.  The time between the allowance of the application 
and the prisoner's release varied widely, from zero to 210 days.  
In thirteen cases, the time elapsed was less than one week; in 
ten cases, it was more than one month.  For one-half of the 
thirty-four successful petitions, release was to a private home 
in Massachusetts, presumably the simplest scenario if a prisoner 
is fortunate enough to have family members who are able and 
willing to undertake the task of caring for him or her, and in 
the majority of these cases the delay was under a week.13 
 
For terminally ill prisoners entitled to spend their final 
days in freedom, each day is critical.  Delaying release 
deprives prisoners granted medical parole the opportunity to 
 
 
13 The numbers supplied by the DOC are as of the time of 
briefing. 
19 
 
spend their remaining time with their families or friends.  At 
the same time, release or death is often imminent for medical 
parole applicants, so these cases quickly become moot, as they 
ultimately did for Malloy and Vinnie, and evade judicial review.  
The number of similar cases arising in the future can only be 
expected to expand exponentially given that, as of January 1, 
2020, close to 1,000 elderly prisoners were incarcerated in DOC 
facilities. 
 
c.  Responsibility for securing placement.  The first 
question reported by the single justice concerns the particular 
responsibilities placed on the DOC, the commissioner, and the 
parole board, and the timing of these actions, to find a 
suitable placement for a prisoner whose application for medical 
parole has been granted. 
 
General Laws c. 127, § 119A (c) (1), requires that within 
twenty-one days of a petition for medical parole, a prison 
superintendent must submit a recommendation to the commissioner 
accompanied by a medical parole plan.  The statutory scheme and 
regulations require the medical parole plan to include a 
financial coverage plan, documentation regarding the medical 
providers' qualifications, and specific information regarding a 
proposed course and site of treatment and posttreatment care.  
G. L. c. 127, § 119A (a).  501 Code Mass. Regs. §§ 17.02, 
17.03(4). 
20 
 
 
Although we previously addressed the burden imposed by 
G. L. c. 127, § 119A, in Buckman, we have not yet specifically 
addressed the meaning of "proposed" plans and what must be done 
in regard to those proposed plans once the petition has been 
granted.  In the statute and regulations, the placement is 
referred to as "proposed," and not as final or confirmed, 
thereby recognizing that it may not be possible at that point to 
secure admission to a particular facility.  There are a number 
of practical problems that complicate the realization of such 
plans after the petition has been granted and thus render them 
only "proposed plans."  As one affidavit from the DOC notes, 
when an inmate requires care in a skilled nursing home or long-
term care facility, there are causes for delay that are beyond 
the DOC's control.  Specifically, many long-term care facilities 
will not undertake the evaluation process for admission and 
commit to taking in the inmate until the inmate is granted 
medical parole, which will usually not occur until the end of 
the sixty-six day statutory period.  As explained supra, because 
roughly ninety percent of medical parole petitions are 
ultimately denied, facilities cannot leave beds open on an 
indefinite basis for petitioners who will not be released.  
Moreover, because the medical conditions of critically ill 
patients are often rapidly changing, evaluations need to be 
undertaken immediately prior to, or at least very close to, the 
21 
 
date of admission to a placement facility in order to accurately 
determine the inmate's treatment requirements.  Finally, in 
these uncertain times, a COVID-19 outbreak at the inmate's 
correctional institution or the proposed long-term care facility 
could prevent the inmate's immediate release.  Due to the COVID-
19 pandemic, all care facilities now require a negative COVID-19 
test, with some facilities requiring the negative test to have 
been administered within the last forty-eight hours. 
 
As evidenced by the timeline set out by the statute, it is 
certainly true that the DOC is required by the Legislature to be 
proactive, to identify a proposed suitable placement or 
placements in a petitioner's medical parole plan, and not to go 
searching for such placements indiscriminately at the end of the 
sixty-six day period.14  At least for inmates without family 
home-care options, the DOC must identify an appropriate proposed 
site or sites for such placement, which may require not just 
individual locations but also a system monitoring available beds 
for prisoners seeking medical parole and the criteria for 
admission for each of those beds, so that appropriate 
 
 
14 The DOC's response here reflects such indiscriminate 
activity.  As the DOC acknowledges in its brief, it applied to 
and was rejected by numerous hospitals and nursing homes that do 
not accept inmates who were convicted of murder, sex offenses, 
or even any felony.  The inability to find a suitable placement 
for inmates at these facilities would have been readily apparent 
to the DOC had it been proactively evaluating potential 
placements during the sixty-six day statutory period. 
22 
 
alternative sites may be identified quickly if the location 
proposed in the superintendent's plan is unavailable at the 
conclusion of the sixty-six day process.  While the plan must be 
"comprehensive," setting out the proposed course and site or 
sites of treatment, there are obvious circumstances beyond the 
DOC's control, particularly at the very end of the process, when 
a prisoner's petition has been granted. 
 
In addition, an inmate's release can be affected or delayed 
by the imposition and satisfaction of various terms and 
conditions pertaining to parole itself.  The parole board is 
expressly required to verify the suitability of the proposed 
residence of the prisoner for supervision purposes, thereby 
potentially providing for a change in a proposed plan.  See 501 
Code Mass. Regs. § 17.09(4).  General Laws c. 127, § 119A (e), 
also provides that upon a grant of medical parole, the parole 
board "shall impose terms and conditions," which may include a 
determination whether electronic monitoring, supervision for 
drugs and alcohol, visitation by parole officers, and no-contact 
orders to protect victims or witnesses are necessary.  501 Code 
Mass. Regs. § 17.09(4).  These conditions are added at the tail 
end of the sixty-six day period, and they are deemed necessary 
by the parole board, an entity independent of the DOC, to 
protect public safety or prevent the violation of the law.  
Thus, these conditions may also require a reconsideration of the 
23 
 
placement alternative or alternatives proposed in an inmate's 
medical parole plan. 
 
In sum, the statute, the regulations, and our decision in 
Buckman set out an expedited process for evaluating whether a 
prisoner is entitled to medical parole and developing a medical 
care plan that will provide the prisoner with appropriate care 
in an appropriate setting outside of prison.  The proposed plan 
developed by the DOC in this expedited process must be 
comprehensive, but is subject to multiple contingencies at the 
conclusion of this process when medical parole is granted, 
including changes in the medical condition of the prisoners, 
availability of beds in care facilities, and conditions imposed 
by the parole board.  COVID-19 also complicates the conclusion 
of this process. 
 
d.  Timing of release.  The second question reported by the 
single justice asks how long, if at all, a prisoner may continue 
to be held in custody after his or her petition for medical 
parole has been granted.  As explained infra, we conclude that 
the statute as written envisions an expeditious release, but 
allows for short periods of delay, provided the delays are 
necessary to ensure an appropriate placement of the inmate, 
compliance with the terms and conditions of his or her parole, 
and the statutory notice provisions.  Such short-term delays 
must not be the product of failures on the part of the DOC to 
24 
 
proactively meet the particular requirements imposed on it 
during the sixty-six day statutory period, but delays that 
result from the contingencies discussed supra that are beyond 
the DOC's control. 
 
With respect to conditions of parole and notifications to 
certain individuals, the relevant portion of G. L. c. 127, 
§ 119A (e), provides: 
"The commissioner shall issue a written decision not later 
than [forty-five] days after receipt of a petition, which 
shall be accompanied by a statement of reasons for the 
commissioner's decision.  If 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.  The parole board shall impose terms and 
conditions for medical parole that shall apply through the 
date upon which the prisoner's sentence would have expired.  
Not less than [twenty-four] hours before the date of a 
prisoner's release on medical parole, the commissioner 
shall notify, in writing, the district attorney for the 
jurisdiction where the offense resulting in the prisoner 
being committed to the correctional facility occurred, the 
department of state police, the police department in the 
city or town in which the prisoner shall reside and, if 
applicable . . . , the victim or the victim's family of the 
prisoner's release and the terms and conditions of the 
release." 
 
 
The question we must address is whether this portion of the 
statute envisions that the release of a prisoner on medical 
parole will immediately follow the commissioner's issuance of a 
written decision granting medical parole.  The plaintiffs argue 
that the mandate that "[i]f the commissioner determines" that 
25 
 
medical parole is appropriate then the prisoner "shall be 
released" means that the DOC has no authority to hold a prisoner 
after the issuance of the commissioner's decision.  The sixty-
six day deadline, they argue, is absolute and applies not only 
to the commissioner's decision, but also to the prisoner's 
release.  The DOC, by contrast, argues that neither the medical 
parole statute nor due process mandate any specific deadline for 
the release of a prisoner, and that the release date should 
therefore be completely within its discretion. 
 
In interpreting a statute, we look not only to the specific 
words at issue but also to other sections, and "construe them 
together . . . so as to constitute an harmonious whole 
consistent with the legislative purpose."  Pentucket Manor 
Chronic Hosp., Inc. v. Rate Setting Comm'n, 394 Mass. 233, 240 
(1985).  "If a statute is simply silent on an issue, we 
interpret the provision in the context of the over-all objective 
the Legislature sought to accomplish" (quotations and citation 
omitted). Charbonneau v. Presiding Justice of the Holyoke Div. 
of the Dist. Court Dep't, 473 Mass. 515, 519 (2016).  We must 
interpret the statute in a manner that "render[s] the 
legislation effective, consonant with reason and common sense" 
(citation omitted), Rotondi v. Contributory Retirement Appeal 
Bd., 463 Mass. 644, 648 (2012), and we will not construe a 
statute such that "the consequences . . . are absurd or 
26 
 
unreasonable," Attorney Gen. v. School Comm. of Essex, 387 Mass. 
326, 336 (1982). 
 
We begin with the text of the statute, which states that 
the prisoner "shall be released" on medical parole.  G. L. 
c. 127, § 119A (e).  Unlike other provisions that precede it, 
the statute does not expressly state the date upon which the 
release shall occur.  Compare G. L. c. 127, § 119A (c) (1) 
("superintendent shall, not more than [twenty-one] days after 
receipt of the petition, transmit the petition and the 
recommendation to the commissioner"); G. L. c. 127, § 119A (e) 
("The commissioner shall issue a written decision not later than 
[forty-five] days after receipt of a petition . . . .  Not less 
than [twenty-four] hours before the date of a prisoner's release 
on medical parole, the commissioner shall notify, in writing" 
district attorney and victim).  The release provision also does 
not state that the release will occur immediately.  In contrast, 
the language of immediacy is employed in the very next 
subsection of the statute in a different context.  See G. L. 
c. 127, § 119A (f) (stating parole officer "shall immediately" 
arrest and bring prisoner before parole board if prisoner fails 
to comply with medical parole conditions or becomes ineligible 
for medical parole due to improved health).  Cf. Plumb v. Casey, 
469 Mass. 593, 598 (2014) (interpreting term "shall" in "a 
directive sense, rather than in a mandatory sense, where doing 
27 
 
so is necessary to effectuate the primary purpose of the 
statute").  "[W]here the Legislature has employed specific 
language in one paragraph, but not in another, the language 
should not be implied where it is not present" (citation 
omitted).  Souza v. Registrar of Motor Vehicles, 462 Mass. 227, 
232 (2012). 
The release provision must, however, be read in the context 
of the Legislature's purpose.  The Legislature established a 
sixty-six day time frame for this complex, comprehensive 
evaluation and planning process to occur.  It did so to ensure 
the expedited release of prisoners on medical parole so that 
they can spend their final days outside of prison.  Timely 
release was clearly of great importance to the Legislature. 
Buckman, 484 Mass. at 25-26.  Accordingly, the Legislature 
certainly did not contemplate, as the DOC argues, that the 
timing of an inmate's actual release is left entirely to the 
DOC's discretion.  Delaying release indefinitely, subject to the 
DOC's discretion, would defeat the Legislature's intent. 
We conclude, therefore, that any delays beyond the sixty-
six days must be necessary to serve other purposes set out in 
the statute, and caused by conditions beyond the DOC's control.  
We emphasize that the statute does not just provide for release; 
it provides for release with appropriate care in an appropriate 
setting.  If the prisoner cannot be released with such care and 
28 
 
in such a setting, the critically ill prisoner cannot simply be 
released.  This is not what the Legislature intended, as it 
would leave a critically ill prisoner unprotected. 
In evaluating the failure to secure appropriate care in an 
appropriate setting within sixty-six days, we focus on the 
contingencies outside the DOC's control, particularly those that 
must occur in the very final days of the sixty-six day process.  
These include the evaluation by skilled nursing facilities for 
admission, if that is the only placement available, as may be 
the case where there is no willing or capable family placement.  
Such evaluations must take into account the health conditions of 
the prisoner at the time of release and, during the COVID-19 
pandemic, the risk of exposure for both the facility and the 
prisoner.  The MassHealth decision-making process regarding a 
prisoner's health insurance application may extend beyond the 
sixty-six days even if the DOC is proactive in seeking coverage 
soon after receipt of a petition.  These contingencies may 
justify short-term delays. 
Other contingencies beyond the DOC's control are necessary 
to protect the public.  These include parole conditions imposed 
at the tail end of the process deemed necessary to ensure public 
safety.  See 501 Code Mass. Regs. § 17.09(4) (authorizing parole 
board to verify suitability of proposed residence, conduct 
risk/needs assessment, and set all appropriate terms and 
29 
 
conditions of release).  The implementation of a parole plan is 
further complicated when a prisoner will be released to an out-
of-State placement, a process that is managed in part by a 
separate agency, the Interstate Commission for Adult Offender 
Supervision (ICAOS).  If parole conditions require a change in 
placement, or if the parole finalization is delayed by another 
entity, these circumstances may also justify a short delay in 
release.15 
In sum, the statute contemplates an expedited release of 
prisoners to an appropriate setting with appropriate care.  Such 
 
 
15 The commissioner must also comply with statutory 
requirements to notify the district attorney and victim or 
victim's family in writing of the decision to release.  See 
G. L. c. 127, § 119A (e).  As the commissioner is required to 
notify these persons upon initial receipt of the petition, see 
G. L. c. 127, § 119A (c) (2), (d) (2), the location of the 
victim must occur in the beginning of the process.  Tracking 
down the victim may be difficult given the great passage of time 
between conviction and release of many of these prisoners.  
Given the importance of the victim notification responsibility, 
we emphasize that the DOC must be proactive in its initial 
location and notification of victims.  As this is to occur at 
the beginning of the sixty-six day process, it should not be a 
justification for delay in release.  We do note, however, that 
the news of a prisoner's actual release at the end of the sixty-
six day process may nonetheless be traumatic to victims, 
requiring that such notification be undertaken carefully and 
sensitively.  The statutory requirement that a victim be 
notified of the terms and conditions of release contemplates 
that this final notification will be made only when the full 
details of the conditions of release are available.  G. L. 
c. 127, § 119A (e).  Therefore, final victim notification, like 
the release itself, is contingent on finalization of the terms 
and conditions of parole, another critical responsibility 
imposed at the very end of the sixty-six day process. 
30 
 
releases are intended to occur within the sixty-six day time 
frame set out in the statute, but reasonable delays may be 
justified by contingencies beyond the DOC's control, 
particularly those that occur in the final days of the 
evaluation and planning process that are necessary to protect 
the prisoner or the public as set out in the statute. 
Recognizing these contingencies, the statute does not 
impose an absolute release requirement, regardless of the 
circumstances.  Cf. Massachusetts Gen. Hosp. v. C.R., 484 Mass. 
472, 482 (2020) ("expedited, emergency process" interpreted to 
provide for reasonable delays absent express language to 
contrary).  There are at least three components to a release on 
medical parole:  it must be timely, it must provide appropriate 
care in an appropriate setting, and it must comply with 
conditions of parole.  The DOC cannot simply release prisoners 
somewhere on the sixty-sixth day regardless of these other 
requirements.  Cf. id. at 484 (hospitals "understandably 
concerned about simply releasing [mentally ill] patients, as 
they fear being sued if harm befalls such patients or the 
public").  Nor should the DOC be in any way required or 
encouraged to do so, as it would endanger the prisoners 
themselves, and possibly the public.  The statute must therefore 
be interpreted to impose reasonable, not absolute, time 
requirements for release. 
31 
 
 
That is not to say that anything longer than a reasonable, 
short-term delay would be justified.16  In enacting the medical 
parole statute, the clear objective of the Legislature was to 
release the parolee as soon as possible.  We also recognize that 
the deadlines set out in the statute do not mean that, if a 
decision can be made earlier about medical parole and 
appropriate care upon release, such decisions should be delayed 
at any stage of the process.  Indeed, to do so is contrary to 
the purpose and intent of the medical parole statute, which 
proposes an expedited time schedule to allow prisoners granted 
medical parole to spend their final days appropriately cared 
for, and not behind bars. 
 
Finally we emphasize, consistent with the Legislature's 
intent, that the timely release of these critically ill inmates 
to safe and appropriate placements ultimately depends upon a 
highly collaborative process involving not only the DOC and the 
prisoner and his or her family and representatives, but also the 
parole board, ICAOS, MassHealth, and the numerous private sector 
nursing and long-term care facilities.  See Buckman, 484 Mass. 
at 29 ("by enacting § 119A, the Legislature intended to trigger 
a collaborative process").  Without such collaboration, the 
 
 
16 Based on the record before us, seven out of ten inmates 
who were placed in skilled nursing or long-term care facilities 
were released within an average of twenty-one days following the 
grant of medical parole. 
32 
 
medical parole process envisioned by the Legislature will be 
inevitably disrupted and delayed. 
 
4.  Conclusion.  Because Malloy and Vinnie were released on 
medical parole before they filed their notice of appeal, an 
order will issue today dismissing their appeal as moot.  See 
note 12, supra.  With respect to the two questions reported by 
the single justice, we answer as follows: 
 
1.  The medical parole statute requires the DOC -- in 
particular, the superintendent -- to develop comprehensive plans 
that include a proposed course of treatment, a proposed site for 
treatment, and proposed financial coverage during the first 
twenty-one days of the sixty-six day window within which a 
decision on the petition must be made.  The proposed plan must 
provide for appropriate care in an appropriate setting, but is 
subject to multiple contingencies at the conclusion of the 
sixty-six day window beyond the control of the DOC, including 
changes in the medical condition of the prisoners, availability 
of beds in care facilities, conditions imposed by the parole 
board, and the COVID-19 pandemic. 
 
2.  Once a final, favorable decision by the commissioner 
has been issued allowing release on medical parole, the DOC must 
be proactive in working to release the prisoner expeditiously.  
However, reasonable short-term delays are acceptable where they 
are outside the control of the DOC, and necessary to ensure 
33 
 
appropriate care in an appropriate setting and compliance with 
the terms and conditions of parole. 
 
 
 
 
 
 
 
So ordered. 
 
GAZIANO, J. (concurring, with whom Budd, C.J., and Georges, 
J., join).  In this case, the court confronts two questions 
reserved and reported by the single justice concerning the 
interpretation of the medical parole statute, G. L. c. 127, 
§ 119A.  The questions relate, first, to the requirements 
imposed on the Department of Correction (DOC) and the parole 
board to find a suitable placement for a prisoner who applies 
for medical parole,1 and, second, to the length of time a 
prisoner may be kept in custody after medical parole has been 
granted.2  The second questions asks, specifically, "[w]hat 
restrictions, if any, the statutory and regulatory scheme places 
on the length of time for which a prisoner may remain in custody 
 
 
1 General Laws c. 127, § 119A (c) (1), provides that "the 
superintendent shall, not more than [twenty-one] days after 
receipt of the petition, transmit the petition and the 
recommendation to the commissioner.  The superintendent shall 
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."  General Laws 
c. 127, § 119A (d) (1), contains a virtually identical provision 
for sheriffs. 
 
 
2 General Laws c. 127, § 119A (e), states that the 
"commissioner shall issue a written decision not later than 
[forty-five] days after receipt of a petition, which shall be 
accompanied by a statement of reasons for the commissioner's 
decision.  If 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." 
2 
 
once his or her petition for medical parole has been granted, 
and the sixty-six days referenced in G. L. c. 127, § 119A, have 
expired." 
 
With respect to the first question, the court concludes 
that the medical parole plan3 to be attached to the 
recommendation sent to the Commissioner of Correction 
(commissioner) actually is one of a series of "proposed plans" 
to be created both before submission to the commissioner and 
after the commissioner has approved the petition for release on 
medical parole.  Ante at    .  Among other things, these 
conclusions, including the timeline, appear to be inconsistent 
with the statutory language and the mandates of Buckman v. 
Commissioner of Correction, 484 Mass. 14, 25-26, 28-29 (2020). 
 
With respect to the second question, on the existence of 
any time restrictions after medical parole has been granted 
before release must take place, the court apparently concludes 
that the answer is "none."  Notwithstanding the sixty-six days 
 
 
3 A "medical parole plan" is defined in G. L. c. 127, 
§ 119A (a), as "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." 
3 
 
clearly specified in the statute, the court states that "the 
statute must . . . be interpreted to impose reasonable, not 
absolute, time requirements for release," ante at    , and to 
require "practical" solutions, thus permitting "short-term 
delays" in response to "contingencies outside the DOC's 
control," id. at    ,    , so long as the "short-term" delays 
are not due to a failure by the DOC to be "proactive" in its 
efforts, id. at    .  This, too, is contrary to this court's 
prior holding in Buckman, 484 Mass. at 26 (discussing "speedy 
process enshrined in the statute," and rejecting process that 
would add "months" to creation of medical parole plan, thus 
"frustrating the very purpose of the statute"). 
 
In my view, to allow the release of severely, often 
terminally, ill prisoners to be delayed indefinitely -- as long 
as the delays can be characterized as "reasonable," 
"practicable," "short-term," or beyond the control of the DOC -- 
is to impose too lax a standard for compliance with the 
statute's strict timelines.  This lack of any defined standard 
likely will propagate further delay and produce arbitrary 
results.  Although I share my colleagues' concerns about the 
complexities involved in implementing releases on medical parole 
for seriously ill individuals, their open-ended interpretation 
of the statute will frustrate the intent of the Legislature in 
creating the opportunity for release on medical parole.  See 
4 
 
Buckman, 484 Mass. at 19-22.  The limitless, discretionary time 
the court envisions in which the DOC will create the actual 
medical parole plan, obtain conditions of release from the 
parole board, arrange medical insurance, and update the 
documents on the appropriate facility needed to handle the 
individual's deteriorating medical condition, all after some 
form of medical parole plan has been approved by the 
commissioner, cannot be what the Legislature intended when it 
said that a medical parole plan, a written diagnosis by a 
licensed physician, and a recommendation by the superintendent 
"shall" be transmitted to the commissioner, along with the 
petition, within twenty-one days of receipt of the petition; the 
commissioner "shall" make a written decision on those documents 
within forty-five days of receipt; and, if the commissioner 
determines that the petitioner meets the statutory requirements, 
the individual "shall be released on medical parole."  G. L. 
c. 127, § 119A (c) (1)-(2), (d) (1)-(2), (e). 
 
I agree with the court that the medical parole statute 
imposes a clear sixty-six day deadline for a decision by the 
commissioner on a petition for medical parole.  See G. L. 
c. 127, § 119A (c), (e).  I also agree with my colleagues that 
"[f]or terminally ill prisoners entitled to spend their final 
days in freedom, each day is critical."  Ante at    .  At the 
same time, I agree that the burden on the DOC and the sheriffs 
5 
 
to implement release on medical parole is enormously complex and 
subject to factors sometimes beyond their control.  And, 
naturally, the DOC cannot be required by law to do the 
impossible.  I reject, as does the court, the plaintiffs' 
understanding of the statute, according to which under 
absolutely no circumstances may the DOC hold successful medical 
parole petitioners beyond the sixty-six day limit, such that, as 
the plaintiffs' counsel suggested at oral argument, prisoners 
who have been granted medical parole but are without a suitable 
placement at the time of the statutory deadline would have to be 
summarily deposited at the nearest emergency room.  Such a 
reading is incompatible with the compassionate purpose of the 
medical parole statue.  See Wallace W. v. Commonwealth, 482 
Mass. 789, 793 (2019), quoting Matter of E.C., 479 Mass. 113, 
118 (2018) ("When interpreting a statute, our primary duty is to 
'effectuate the intent of the Legislature in enacting it'"); 
Commonwealth v. Mogelinski, 466 Mass. 627, 633 (2013), quoting 
Wright v. Collector & Treas. of Arlington, 422 Mass. 455, 457–
458 (1996) ("Of course, this meaning must be reasonable and 
supported by the purpose and history of the statute"). 
 
Fundamentally, however, in light of the Legislature's 
purpose in enacting the medical parole statute, it would make 
little sense to establish a detailed, and carefully constrained, 
timeline for consideration of a petition for medical parole by 
6 
 
an incapacitated or terminally ill prisoner, but then give the 
DOC essentially full discretion, with no guidance, as to when a 
petitioner actually should be released from incarceration.  See 
Bellalta v. Zoning Bd. of Appeals of Brookline, 481 Mass. 372, 
378 (2019) ("Specific provisions of a statute are to be 
understood in the context of the statutory framework as a whole, 
which includes the preexisting common law, earlier versions of 
the same act, related enactments and case law, and the 
Constitution," such that court "avoid[s] any construction of 
statutory language which leads to absurd result, or that 
otherwise would frustrate the Legislature's intent" [quotations 
and citations omitted]).  Rather than permit delays as long as 
they are "reasonable" and due to "factors beyond" the DOC's or 
the sheriffs' control, I would allow brief delays in release 
only in truly extraordinary circumstances.  
 
The court already applies such a standard in a variety of 
other contexts.  For instance, with respect to the sixty-day 
commitment and evaluation period to determine whether someone is 
a sexually dangerous person (SDP), G. L. c. 123A, § 13 (a), if 
temporary commitment for evaluation exceeds sixty days, the 
Commonwealth must dismiss its petition "unless there are 
extraordinary circumstances justifying an extremely brief 
delay."  Commonwealth v. Parra, 445 Mass. 262, 265 (2005).  In 
that case, the court noted that the SDP statute contained no 
7 
 
special exceptions to the sixty-day limit; the court therefore 
rejected the view that different violations should be viewed on 
a "sliding scale."  Id. at 265-266.  See Commonwealth v. Blake, 
454 Mass. 267, 268 (2009) (verdicts in jury-waived trials under 
SDP statute must be rendered within thirty days "absent 
extraordinary circumstances"); Mailer v. Mailer, 387 Mass. 401, 
406 (1982) (excusable neglect of procedural rules requires 
"unique or extraordinary circumstances"). 
 
Such a standard would provide workable guidance for 
corrections officials and for courts in considering whether a 
particular delay in the release of a prisoner granted medical 
parole rose to the level of a statutory violation, rather than 
leaving them rudderless in the face of unbridled discretion.  
"Extraordinary circumstances" do not include issues that 
typically or frequently arise in the process of obtaining a 
suitable placement for an individual seeking medical parole.  
One example of a situation in which "extraordinary 
circumstances" indeed might arise is the COVID-19 pandemic, 
which struck Massachusetts with particular severity during 
precisely the period in which the plaintiffs in this case were 
seeking release on medical parole.  By contrast, many of the 
obstacles cited by the DOC -- for instance, logistical issues in 
securing the admission of a prisoner to a long-term care 
facility, obtaining health insurance through MassHealth, and 
8 
 
setting conditions of parole by the parole board -- would not 
count as "extraordinary circumstances."  Undoubtedly, such 
obstacles are real and significant.  But if they are acceptable 
grounds for delay, as the opinion of the court would permit, 
delays in release will be likely to occur in virtually every 
case. 
 
Even given the acknowledged complexities in implementing a 
release on medical parole, the DOC could do much to make timely 
release a reality and not, as the court would have it, begin to 
address numerous statutory requirements "at the tail end of the 
process deemed necessary to ensure public safety," ante at    , 
because that is how such petitions ordinarily have been handled 
by the DOC.  The difficulty in securing placements in long-term 
care facilities likely would be mitigated by earlier 
investigation of possible placements for issues such as whether 
they accept individuals convicted of particular offenses, and 
determination of any obstacles, such as, here, an interstate 
transfer compact.  In particular, if release seems "likely," 
under the DOC's regulations, the commissioner is to refer the 
entire petition to the parole board within thirty days of 
receiving it, 501 Code Mass. Regs. § 17.09(1)-(3) (2019), so 
that the parole board can determine appropriate conditions of 
release within fifteen days of receipt of the referral, 501 Code 
9 
 
Mass. Regs. § 17.09(4) (2019), and thus before the sixty-six day 
statutory deadline. 
 
Indeed, the approach taken in the regulations suggests that 
the simplest avenue for the DOC to comply with the terms of the 
statute would be to expedite the process of deciding whether to 
grant medical parole.  In the cases before the court, for 
example, the commissioner's decision to approve medical parole 
for Malloy was issued precisely sixty-six days after submission 
of the petition and her decision with respect to Vinnie was 
issued sixty-five days after submission of his petition, where 
both Malloy and Vinnie were being treated for terminal illnesses 
at DOC facilities and had been certified to be terminally ill by 
day twenty-one after the filing of their petitions.4  Otherwise 
put, the deadline to issue a decision on a petition for medical 
parole should be considered an outer limit rather than a goal, 
given the often dire condition of the petitioners. 
 
 
4 The DOC states in its brief that 337 inmates have 
submitted petitions for medical parole since the statute was 
adopted in 2018, and, as of September 2020, thirty-four of those 
petitions have been approved, a success rate of approximately 
ten percent.  Where, as the DOC asserts, petitions present 
illnesses such as allergies, asthma, or acid reflex, even though 
the DOC is required to prepare a medical parole plan, G. L. 
c. 127, § 119A (c) (1), it need not tarry long in seeking out 
potential institutional placements among scarce institutional 
beds if a petitioner's medical condition is neither 
incapacitating nor terminal, and should be able to make a 
recommendation to the commissioner within the twenty-one day 
period. 
10 
 
 
Data from the DOC suggest that almost one-third of 
prisoners granted medical parole experience delays in release of 
more than one month.  The approach taken in the opinion of the 
court risks permitting this state of affairs, at best, to 
continue uninterrupted.