MA H2604

Redefines "terminal illness" as a condition reasonably likely to cause death within 18 months, and "permanent incapacitation" as irreversible physical or cognitive incapacitation determined by a licensed physician

Requires annual cognitive decline assessments for all prisoners aged 55 and older using standardized tools, with referrals to Prisoners' Legal Services and next of kin for those showing moderate or severe decline

Mandates medical parole be granted unless the Commissioner finds by clear and convincing evidence that the prisoner would violently recidivate even with community supervision and reasonable accommodations

Establishes strict timelines: superintendent recommendations due within 21 days of petition receipt, commissioner decisions within 45 days, and release within 7 days of approval

Expands who may petition for medical parole to include the prisoner, their advocate, next of kin, medical providers, or facility staff, and requires the department to petition on behalf of cognitively incapacitated prisoners