With the Texas Legislature set to begin the state review process for the Texas Department of Criminal Justice and the Board of Pardons and Paroles in January, advocacy groups have already begun lobbying the Sunset Advisory Commission, which will conduct the review.

"As a human rights organization, our perspective is that these conditions are cruel and unusual, they violate the Constitution, and that it's illegal to house prisoners in these conditions," said Scott Medlock of the Texas Civil Rights Project.

Audio: Ben Philpott's story for KUT News

The group has already sent a letter to the Sunset Advisory Commission noting what it considers inadequate health care for prisoners.

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But Medlock knows arguing for prisoners' rights doesn't always get far in tough-on-crime Texas. So he's also proposing measures he says could improve prisoner conditions while cutting costs for the state, like reviewing sentencing policies that keep geriatric inmates behind bars, where they disproportionately use up the prison system’s limited health care dollars.

"So that results in old and frail prisoners who have already served an extremely long time in prison that then become very expensive to care for as they reach their later years," Medlock said.

Marc Levin of the Texas Public Policy Foundation, a conservative think tank, agrees that sentencing and the prison population should be reviewed. He said the state must prioritize its prison space to keep threats to society behind bars but should steer lower-level offenders, like individuals convicted of minor drug possession, out of jail.

"We have about 17,000 low-level drug possession offenders in our Texas prisons right now," Levin said. "Not all of them would be eligible under this because it excludes those with prior significant felony convictions and so forth. But it certainly would save several hundred millions of dollars."

But even with the lure of saving state money, it can be tough to convince Texas officials to change sentencing policy. Levin counters that state incarceration rates and crime rates have declined over the last six years. And he isn't just saying that people shouldn't be sent to prison no matter what: If they don't pose a threat, he said, put them in a strict probation program with monitoring and even treatment options. Levin said that will lower costs and recidivism rates.

The Sunset Advisory Commission is expected to hold its first meeting sometime in January to cover the 24 agencies it's expected to review this year.

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