Report: Older inmates dying in Nebraska prisons unnecessarily

A new report from the Inspector General for Nebraska’s prison system says many older inmates are dying in prison who don’t have to.

The report found that approximately half of the 30 people who died in custody from October 2023 through early 2025 were eligible for medical parole.

Medical parole allows offenders who are terminally ill or permanently incapacitated to serve the remainder of their sentences in the community, as long as they are not serving a life sentence or facing the death penalty.

Those inmates can in some cases cost the Nebraska Department of Correctional Services as much as $100,000 a year in health care costs, the report said.

The report found that there is a lack of tracking by the prison system as to who is eligible for medical parole as well as barriers in access to housing and long-term care.

“We have people who meet the criteria for medical parole or even were tentatively granted parole by the Parole Board, but who end up dying in prison, largely because they have no place else to go,” Interim Inspector General Zach Pluhacek said in a news release. “In the meantime, NDCS is trying to accommodate these individuals in a prison environment.”

NDCS and the Board of Parole have since taken steps to improve tracking, awareness and communication related to these cases, the report said, noting that the system is, “notably better than in past years.”

However, the report said there are still many areas for improvement. Among them:

• Medical parole statutes do not define terms such as “terminally ill” and “permanently incapacitated,” leaving them open to interpretation.
• Although statute directs that NDCS “shall” identify inmates eligible for medical parole, departmental policy appears to treat this affirmative duty as optional.
• A tool NDCS adopted to help determine eligibility for medical parole, the Karnofsky Performance Scale, may prevent some eligible individuals from being considered by the Board of Parole, which encroaches on the board’s statutory discretion.

The report recommended that the prison system should revise its policy to clarify that medical providers and administrators have an affirmative obligation to identify those who might be eligible for medical parole, and it also recommended the system discontinue use of the Karnofsky Score for determining incapacitation.

The report also examined geriatric parole, which the Legislature authorized in 2023. It is available to some offenders 75 and older who have served at least 15 years of their sentences. In addition to not serving a life sentence or facing the death penalty, inmates also cannot have been convicted of violent felonies or sexual assaults.

The inspector general reviewed 239 people in NDCS custody who were 65 or older and found that 16 of them might be eligible for geriatric parole sometime in the next decade.

NDCS officials could not be reached for comment Thursday morning, but in a letter included with the report, Corrections Director Rob Jeffreys rejected both of the report’s recommendations on medical parole.