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First Step Act

The First Step Act Leaves Sick, Older Prisoners Behind

August 8, 2026 · 12 min read

The First Step Act Leaves Sick, Older Prisoners Behind

The Bureau of Prisons Has a Dark Secret

The Bureau of Prisons has a dark secret. It isn't that compassionate release doesn't exist. It's the same institution holding a dying prisoner that controls the diagnosis, the medical records, the release plan, and often the clock. I served federal time. One thing I learned is that the system can turn the most urgent human emergency into a routine piece of paperwork. To the dying man, every day is part of what he has left. To the institution, it's Tuesday. Today we're pulling back the curtain on why compassion can arrive too late, and why one man received his freedom only 9 days before he died.

The Case of Frederick Bardell

Read the official court documents from February 2021 and the compassionate release of Frederick Bardell looks like the federal system working as intended. The proper forms were filed, the judge gave the order, and a sick inmate was allowed to go home. But if you look at the timeline of his sentence, you see the immediate contradiction. Bardell spent a massive stretch of time in federal custody followed by exactly 9 days of freedom. On the 10th day, he died from advanced metastatic colorectal cancer. The entire purpose of compassionate release is to offer a measure of mercy to an inmate facing the end of their life. When the administrative process drags on for months, it quietly consumes the very time the policy is meant to give back.

Two Competing Timelines

To understand how the system broke down, we have to look at two competing timelines. On one side is the government's legal stance. While Bardell was fighting to get out, prosecutors told the court there was no indication that he couldn't receive adequate medical care in custody. On the other is his actual medical reality, beginning when he first reported symptoms. A CT scan clearly showed a mass indicating stage four colon cancer. The medical file explicitly marked his need for follow-up colonoscopy as urgent. But due to severe prison understaffing and strict COVID-19 protocols, that urgent procedure didn't happen the next week or even the next month.

73 Days of Medical Delay

73 days passed between the urgent scan and the actual colonoscopy. The Inspector General later concluded that this massive gap in care was driven by job performance and management failures stretching from the medical line staff all the way up to the prison's warden. The legal filings presented a bureaucratic facade of adequate health inside the prison walls while a stage four cancer was growing unchecked.

The Unread Court Order

Despite the delays, the legal system eventually reached a resolution. Once the US Probation Office approved a release plan, a federal judge ordered Bardell released immediately. The Bureau of Prisons did not release him immediately. According to the Inspector General's report, at least nine separate BOP employees failed to read or failed to fully read the judge's order. A direct command from the federal court sat unread in an inbox, stalling the release of a dying man for the sake of an unclicked email.

An Unsafe Transport Out of Custody

That negligence bled into his physical exit. When Bardell was finally moved, the Inspector General called the handling of his transport "extremely concerning," noting the prison failed to ensure his trip out of custody was safe and compassionate given his severe condition. At the administrative level, bureaucracy became a physical barrier, effectively neutralizing a federal judge's direct command for mercy.

Dying Inside an Institution

Inside a prison, dying is an inherently institutional process. It is dictated by the rigid schedule of the daily count, the pill line, the sick call, and heavily monitored visitation rules. Every deeply personal moment is scheduled, searched, and approved. The fundamental purpose of compassionate release is to remove those physical and administrative barriers. Dying at home or in hospice is still terrible, but it allows a person a familiar room, a hand to hold, and enough unmonitored time to say what needs to be said.

The Grim Paradox of Delay

This creates a grim paradox for a dying inmate. Under the legal standard, every single week of institutional delay actually makes their case for release stronger, but the biological cost of that delay is absolute. As the legal argument for release gets undeniably stronger, the human being gets irrevocably weaker. By the time the bureaucracy can no longer deny that a prisoner is dying, there's almost no life left to release.

9 Days of Freedom

Frederick Bardell endured ignored scans, 73 days of medical delay, unread court orders, and an unsafe transport process — that gauntlet culminated in just 9 days of freedom. Allowing paperwork and delays to consume an inmate's final days turns the system's eventual mercy into a documented failure.

Before the First Step Act

Before December 2018, the agency holding a federal prisoner decided whether or not a judge would ever even hear a plea for mercy. If a person was terminally ill, the director of the BOP functioned as the sole gatekeeper for compassionate release. The First Step Act removed that barrier. It allows a prisoner to bypass the warden and go straight to the sentencing court, provided they've exhausted their administrative remedies or waited 30 days after their initial request.

The Hallway Leading to the Courtroom

This was a significant reform, but it left one major lever in the BOP's hands. While the agency can no longer stop the motion from being filed, it retains control over the evidence required to win the case. The institution still manages the official diagnosis, the medical records, and the internal reviews. If a court needs to see proof of a terminal condition, they have to get it from the very agency the prisoner is trying to leave. The Bureau lost its absolute power to block the entrance to the courtroom. It simply kept control of the hallway leading to it.

Deadlines That Haven't Started Yet

Current policy outlines a timeline for terminal cases. Family notification within 72 hours, an in-person visit within 7 days, and processing within 14 days. But these deadlines remain dormant until a specific event occurs — the prison's clinical director makes an official terminal diagnosis. When a specialist appointment is pushed back, a scan is postponed, or a man knows his body's failing but is repeatedly sent back from sick call with routine medication, the clock isn't violated. Technically, the clock hasn't even started yet. A deadline can look impressive on a policy memo while offering no protection to a person waiting for a diagnosis.

The Test of Physical Utility

Even when a diagnosis is made, the institution applies subjective standards to evaluate eligibility. They use clinical terms like "terminal," "debilitated," and "serious deterioration." Inside a prison, these categories often shift away from a holistic medical assessment and toward a simple test of physical utility. The questions become literal. Can he feed himself? Can he dress himself? Can he stand for count or walk to the pill line? A person can be in a state of fatal decline, but if they can still perform these basic tasks, they can be deemed functional enough to remain in their cell.

The Greater vs. Less Gap

Federal guidelines allow elderly release after serving 10 years or 75% of the sentence, whichever is less. But Bureau policy requires serving whichever is greater. That single word difference can cost years of a life. The Department of Justice's own Inspector General identified the gap, noting that Bureau policy has fallen behind the legal standards used in the courtroom. A sick person who's denied internally based on the greater rule may stop their appeal there, never realizing that a judge would have applied a more lenient standard.

The Release Plan Burden

If an inmate manages to clear those hurdles, they must still produce a comprehensive release plan, proving exactly where they live, how they'll pay for medical care, and securing approval from probation. Building this plan is a massive logistical undertaking for someone with no internet access and limited monitored communication. It requires coordinating with outside doctors and insurance providers while trapped in a cell. The bureaucracy places the heaviest administrative burden on the person with the least physical strength.

The 14% Success Rate

The outcome of the process is visible in the data. In fiscal year 2025, federal courts decided nearly 2,800 compassionate release motions. They granted 394. That's a success rate of about 14%. Public safety and the nature of the original crime are legitimate reasons for denial, but a case should be decided on those merits, not because medical records and signatures move slower than a disease.

Bureaucracy as a Weapon

This is how bureaucracy becomes a weapon without any individual taking responsibility for it. No one has to write a memo saying, "Let him die in custody." They only have to write, "awaiting review" or "follow up pending." While the paperwork remains in a state of neutral administrative limbo, the human body absorbs the cost of the delay.

The System Only Has to Outlast Him

The First Step Act gave dying prisoners a path to a judge. But when a person dies before the court sees the evidence, the system never has to formally deny compassion. It only has to outlast him.

Accountability Still Matters

I want to be clear. I don't believe that every elderly prisoner should be released. Age doesn't erase the crime. It doesn't erase the harm done to the victims. I served federal time, and accountability has to mean something. But prison is supposed to carry out the sentence that the judge imposed. It's not supposed to improvise an end-of-life policy through medical neglect and administrative delay.

Three Honest Questions

Compassionate release should ask three honest questions. Is the person truly dying or seriously deteriorating? Would releasing him pose a danger to the public? And is there a safe, realistic plan to care for him outside? What it should not ask is whether a dying man can survive the paperwork long enough to prove that he's dying.

What Needs to Change

Congress opened the courtroom door. Now the system needs independent medical review when a serious diagnosis is disputed, immediate access to complete medical records, emergency legal assistance, deadlines with actual consequences, and public reporting when prisoners die with compassionate release requests still pending. Because freedom 9 days before death is not a success story. It's institutional failure with a release date.

For Families Dealing With This

For families dealing with this, keep proof of the date the warden received the request. Don't assume that an institutional denial ends the case. The First Step Act allows a motion to the sentencing court after administrative exhaustion or 30 days from the warden's receipt of the request. But the details matter and families should speak with a qualified federal lawyer. This is education, not legal advice.

This article is for educational purposes and is not legal advice.