As inmates age, prisons face increase in health-care costs

Some states are grouping older prisoners to consolidate medical services.
RAIFORD, Fla. (AP) -- For 44 years, Dennis Whitney's world has consisted largely of steel bars, razor wire and a metal bed with a 3-inch mattress. He has grown old in prison, doing hard time for two murders committed when he was 17.
And with time have come the ravages of age: Whitney, 61, has undergone two angioplasties at state expense to clear narrowed or blocked blood vessels, and he needs a third such procedure. The first two cost a total of nearly $9,000.
Whitney and others like him represent a growing burden for the nation's prisons: The number of elderly inmates is rising fast, and so are their health-care costs.
"It's a hidden problem in the system that's going to grow into a dinosaur soon. The cost and numbers are getting out of hand," said Herb Hoetler, chief executive of the National Institute on Institutions and Alternatives in Alexandria, Va.
The numbers
As of 2002, the most recent year for which statistics are available, 121,000 inmates age 50 and over were in state or federal prisons, more than twice as many as a decade earlier, according to the U.S. Justice Department.
Largely because of health-care expenses, the average cost of housing an inmate over 60 is $70,000 a year, or about three times the average cost for prisoners overall, said John Mills, a researcher at the Centers for Disease Control and Prevention in Atlanta.
The rapidly aging prison population is attributed to a number of factors: the graying of the baby boom population; tough-on-crime measures that impose longer sentences and mandatory terms; and an increasing number of older people being convicted of sex crimes and murder.
The old inmates cannot simply be set free. Some are serving life sentences or long terms and are not entitled under the law to release. And many of those who are up for parole are considered too dangerous to let out.
Curbing costs
Across the country, states are taking steps to hold down the costs of elderly inmates.
At least 16 states, including Florida, have established separate facilities to house older inmates, and many are offering hospice care for dying prisoners, according to a 2001 summary in the industry journal Corrections Compendium. In Texas, about 200 inmates over 65 receive round-the-clock nursing care. Nebraska offers nursing-home living for some inmates, and Oklahoma is setting up a prison unit for elderly inmates.
Florida is opening special units for elderly inmates at five of its prisons to consolidate medical services and situate the prisoners near big-city hospitals.
At the Union Correctional Institution near Raiford, home of Florida's death row, about 800 of the 1,550 beds are set aside for older inmates -- a practice that officials say not only reduces costs but puts like-minded inmates together and has a calming effect on the hard-core younger men.
However, many of the older men are too old or too ill to hold jobs, and there are not enough jobs available for those who can work.
Robert Doyle, a 67-year-old convicted killer serving a life sentence at Union Correctional, said many older inmates struggle to survive because there is "absolutely nothing for them to do."
"You see people go downhill. They actually give up," he said. "This is a warehousing situation."

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