Originally published August 3, 2020. Statements about the law were updated in October 2026; the box below gives today’s rules.
For years, the Bureau of Prisons (BOP) turned down almost every compassionate release request. A 2018 report found it denied 94 percent of them, and hundreds of people died waiting. The First Step Act changed this by letting people go to court themselves.
What the report found
In March 2018, the Marshall Project and the New York Times released a report on the BOP’s indifference toward releasing aging and dying prisoners. The First Step Act, passed later, partly fixed the problem by giving prisoners a real chance at early release.
The report recommended expanding compassionate release beyond people near the end of their lives. That would also help reduce overcrowding and health care costs for low-risk people whose imprisonment no longer made sense.
Between 2013 and 2017, the report said, the BOP received 5,400 compassionate release applications. It approved only 312 and denied the vast majority, 94 percent. A 94-year-old prisoner was turned down. And 266 people who applied died in custody. Half of those who died had been convicted of nonviolent fraud or drug crimes.
Anthony Bell had served 15 years of a 16-year sentence when he applied in October 2014. Prison doctors were treating him for lupus and liver failure and estimated he had less than six months to live. After months of review, BOP officials decided Bell still had more than 18 months to live and turned him down. He died two days later.
“I begged them to please get him home,” Bell’s sister, Denise Littleford, said.”And while the blood was still warm in his body, instead of sending him home in a body bag.”
A process that was ignored
Compassionate release was created as a safety valve when federal parole was abolished in 1984. Lawmakers designed it as a path to early release for people with “extraordinary and compelling” circumstances that did not exist when they were sentenced.
Before the First Step Act, prisoners could not go to the courts directly. Instead, the BOP acted as judge, jury and executioner, so to speak. It decided what qualified someone for compassionate release, and more often than not it said no.
At the time, rather than acting as a responsible filter for the courts, the BOP was a roadblock. The law allowed release for non-medical reasons, but the BOP approved only prisoners who were near death or completely disabled. In 2013, the Inspector General found that the Bureau had not approved a single non-medical case in six years.
Kevin Zeich had less than four years left on a 27-year sentence for selling methamphetamine. He was fighting cancer, was nearly blind, and could not eat. He applied for compassionate release three times, and the BOP rejected him each time. The reason it gave: his “life expectancy is currently indeterminate.”
Zeich was approved only on his fourth try. In March 2016, his daughter, Kimberly Heraldez, finally got the call she had been waiting for: her father would soon be on a plane home. Her joy did not last. The very next day, she got another call telling her that her father had died.
Why requests got stuck
“We brought him home,” Heraldez said, “but not the way we wanted to.”
At the time, the BOP’s compassionate release process took a very long time. First, doctors at the prison decided whether the person met the criteria, and the warden approved the request. The warden then sent the records to the BOP’s Central Office. The BOP’s Medical Director reviewed the request, which could take up to six months. If the Central Office approved, the request went to the Deputy Attorney General for a decision. Only after that was the request presented to a judge for a final decision.
Calls for change from both parties
Members of both parties in Congress called for changes. In 2013, then-Attorney General Eric Holder urged widening the criteria to include prisoners over age 65. The BOP supported the idea at the time. Holder’s recommendation was part of his “Smart on Crime” initiative to “use our limited resources to house those who pose the greatest threat.”
In 2016, before the Sentencing Commission, the BOP cited public safety as its reason for not allowing a “broad reduction” in the huge prison population. The Commission then issued new guidelines meant to ease the BOP’s bottleneck. Under those guidelines, the BOP would decide whether a prisoner met the criteria, such as being old enough, sick enough, or the only caregiver for someone outside. Courts, the Commission said, would decide whether the prisoner posed a public safety risk.
In 2017, a bipartisan group of senators led by Sen. Brian Schatz (D-HI) wrote to the BOP. Their letter expressed “deep concern” that the Bureau was failing to carry out its duties under the compassionate release program. In a report filed with the 2018 appropriations bill, Sen. Richard Shelby (R-AL) pressed the Bureau for details on how it was improving the process.
In February 2018, Schatz introduced a bill co-sponsored by Sens. Mike Lee (R-UT) and Patrick Leahy (D-VT). It let prisoners ask the courts directly if the BOP denied or ignored their requests. That idea became part of the First Step Act and is now the law.
“It makes sense to release prisoners who present very little danger to society,” Schatz said. “It’s the humane thing to do, and it’s the fiscally responsible thing to do.”
Congress created compassionate release to relieve prisons when it becomes “inequitable” to keep certain people locked up. Releasing terminally ill and elderly prisoners poses little risk to public safety and cuts prison health care costs. But compassionate release is about more than money. It gives people the humane care they deserve.
How the First Step Act helps
More and more money is being spent on a growing number of older prisoners who need more health care. The First Step Act helps unclog the compassionate release pipeline. That eases the burden on prisoners near the end of life and on their families, as Congress intended more than 30 years ago.
Criminal Center handles federal post-conviction work, including compassionate release.
If you want help with a compassionate release request, book a consultation.
Src: www.themarshallproject.org/2018/03/07/old-sick-and-dying-in-shackles