Motion for Furlough - North Dakota

SHORT LEAVE, RELEASE PROGRAM, AND MEDICAL PAROLE REQUEST COMPANION

REMOVE BEFORE SUBMISSION — ROUTING CONTROL SHEET

North Dakota's cited statutes do not create one generic court-ordered furlough motion. Select the applicant's custody and the actual decision-maker before drafting:

Do not use the former citations for unrelated relief:

• N.D.C.C. § 12-44.1-07.1 requires a local correctional facility's governing body to develop an inmate population plan that includes potential custody alternatives. It does not itself grant an individual home-detention or furlough application.
• N.D.C.C. § 12-44.1-19 requires facility staff to move inmates to safety when fire or another facility emergency exposes them to danger. It is not a medical-leave or funeral-leave procedure.
• N.D.C.C. § 12.1-32-09.1(1) begins with an exception for § 12-48.1-02, and § 12-59-08 expressly includes inmates whose sentences are subject to § 12.1-32-09.1. Do not treat the 85-percent statute as an automatic bar to every route in this packet.

Before submission:

• ☐ Confirm whether the applicant is in DOCR custody or a local correctional facility.
• ☐ Obtain the current agency or facility application, policy, required approvals, address, deadline, and medical-record process.
• ☐ Confirm the sentence calculation and whether the applicant has ten years or less, or more than ten years, remaining.
• ☐ For an outside program, address the statutory security-risk, violence-risk, and rehabilitation determinations.
• ☐ For a short leave, ensure the requested period does not exceed 72 hours.
• ☐ For medical parole, document a serious or terminal medical condition and route the request to the Parole Board.
• ☐ For local work release, confirm that the facility offers the program and that no court order prohibits participation.
• ☐ Delete unused routes, instructions, brackets, and this control sheet.

APPLICANT AND SENTENCE INTAKE

ROUTE SELECTED

• ☐ Part A — DOCR outside employment, education, or rehabilitation program
• ☐ Part B — DOCR short leave not exceeding 72 hours
• ☐ Part C — Medical parole
• ☐ Part D — Local correctional facility work release

PART A — DOCR OUTSIDE-PROGRAM APPLICATION COMPANION

1. Program Requested

• ☐ Gainful employment
• ☐ Educational program
• ☐ Other rehabilitation program: [________________]

Program provider: [________________]

Address and contact: [________________]

Proposed start, schedule, and duration: [________________]

Housing or return arrangement: [________________]

Transportation plan: [________________]

2. Eligibility and Decision Route

N.D.C.C. § 12-48.1-02(1) excludes an offender sentenced to life imprisonment without an opportunity for parole as the result of conviction of a class AA felony under § 12.1-20-03 or murder under § 12.1-16-01 from the outside-program eligibility described there.

• ☐ That exclusion does not apply. Basis: [________________]
• ☐ The exclusion may apply and requires legal review.

The statutory determinations are addressed as follows:

Years-remaining route:

• ☐ Ten years or less remain; Director authorization is requested.
• ☐ More than ten years remain; Parole Board authorization with Director approval is requested.

3. Program Plan and Agreement

Proposed terms and conditions: [SCHEDULE, MOVEMENT, REPORTING, SUPERVISION, CONTACT, TESTING, COSTS, EMPLOYMENT OR EDUCATION DUTIES, AND OTHER CURRENT REQUIREMENTS]

Applicant states that the information supplied is accurate and agrees to abide by all terms and conditions of the particular plan adopted for Applicant.

Applicant signature: _________________________________________

Date: [__/__/____]

PART B — DOCR SHORT-LEAVE APPLICATION COMPANION

Requested purpose: [________________]

Requested departure: [DATE AND TIME]

Requested return: [DATE AND TIME]

Total requested time: [____] hours

• ☐ The request does not exceed 72 hours.

Decision route:

• ☐ Applicant has been committed to DOCR custody for ten years or less; the request is directed to the Director.
• ☐ Applicant has been committed to DOCR custody for more than ten years; Parole Board approval with Director approval is requested.

Short-Leave Plan

Applicant agrees to comply with every term and condition of any approved plan and to return as directed.

Applicant signature: _________________________________________

Date: [__/__/____]

PART C — MEDICAL-PAROLE REQUEST COMPANION

N.D.C.C. § 12-59-08 permits the Parole Board to grant medical parole when an inmate—including an inmate subject to § 12.1-32-09.1 or sentenced under § 12.1-32-01(1)—has a serious or terminal medical condition.

1. Medical Condition

• ☐ Serious medical condition
• ☐ Terminal medical condition

Diagnosis and date: [________________]

Prognosis: [________________]

Current treatment and functional limitations: [________________]

Treating professional and contact: [________________]

Attached medical evidence and authorization: [________________]

2. Proposed Care and Placement

Applicant acknowledges that a person receiving medical parole remains under Parole Board jurisdiction until expiration of the maximum term or terms of imprisonment, less any sentence reduction received.

Applicant signature: _________________________________________

Date: [__/__/____]

PART D — LOCAL CORRECTIONAL FACILITY WORK-RELEASE REQUEST

Facility and administrator: [________________]

• ☐ The facility currently provides a work-release program.
• ☐ No court order prohibits Applicant from receiving work release.
• ☐ The facility's current application and rules are attached or incorporated.

Employment or Project Plan

Applicant acknowledges that the facility administrator determines meal and lodging costs. While confined in a correctional facility, the statutory cap is the lesser of twenty dollars per day or funds earned; while placed in a residential halfway house or similar alternative facility, the cap is the lesser of actual daily cost or funds earned.

Applicant signature: _________________________________________

Date: [__/__/____]

WORK-RELEASE EARNINGS CHECK — DOCR PROGRAM

For work release under Chapter 12-48.1, § 12-48.1-03 directs earned funds in this order:

1. Support of dependents;
2. Necessary applicant expenses, including institutional room and board;
3. Any administration fee and fine;
4. Restitution if part of the sentence; and
5. Any balance to the applicant's account for payment under § 12-48-15.

Proposed or current allocation: [________________]

ATTACHMENT CHECKLIST

• ☐ Current agency or facility application
• ☐ Judgment and sentence calculation
• ☐ Institutional conduct and classification records
• ☐ Program, employment, or education acceptance
• ☐ Detailed schedule and transportation plan
• ☐ Residence or placement confirmation
• ☐ Medical records and care plan, if applicable
• ☐ Signed releases or authorizations, if required
• ☐ Support letters tied to a statutory determination
• ☐ Other current-policy requirement: [________________]

SUBMISSION RECORD

Submitted to: [DOCR DIRECTOR / PAROLE BOARD / FACILITY ADMINISTRATOR / OTHER VERIFIED RECIPIENT]

Submission method and address: [________________]

Date submitted: [__/__/____]

Submitted by: [________________]

Attachments: [________________]

Follow-up date and contact: [________________]