CSG Webinar: Aging Inmates: The Continual 'Graying' of America's Prisons. May 30, 2013
This webinar examined trends and corresponding state policies to address the most dramatic change in the U.S. prison system, one that is having far-reaching effects on all components of the criminal justice system: the increasing number of elderly inmates.
Dr. Aday highlighted the rapid growth of this population, which has grown from 33,499 in 1991 to more than 250,000 today—a number that is expected to rise to 400,000 by 2030. This dynamic presents a variety of challenges for policymakers, perhaps the most important of which concerns the special needs and health concerns of geriatric offenders. In general, older offender needs more medical and mental health services. Approximately 45 percent of inmates over the age of 50, and 82 percent of those ages 65 and up, have three chronic health problems on average.
Dr. Aday emphasized the consolidation of medical staff as one way to address this problem, but there are pros and cons to segregated housing for older offenders. One huge advantage is cost, since infrastructure and staff can be assigned to a particular facility, wing or unit. It also provides an optimal environment for frailer inmates, and creates a supportive climate. Negative factors include the reality that in most states, beds are extremely limited in such facilities. In addition, if removed from the general prison population, many inmates may feel isolated, bored or depressed, leading to exacerbated mental health and socialization problems.
For elderly inmates who will be released from prison, reintegration programs are imperative, according to Dr. Aday, and have proven to be very successful in helping older inmates rejoin society outside of prison. Many effective programs utilize volunteers for teaching, ministries and employment services. Dr. Aday concluded with a discussion on future challenges, which include siting prisons and availability of community partnerships; grouping special needs inmates and the availability of space; limits on financial and staff resources; and access to geriatric programming.
Dr. Suttmiller highlighted some of the programs being advanced in Oklahoma, which has 4,223 inmates over the age of 50, or 17 percent of the incarcerated population. This number has increased from 1,700 in 1980, or 5 percent of the prison population. Of these, 1,934 are serving an 85 percent, life, life-without-parole, or death sentences. In other words, the elderly inmate population will continue to increase in the state, as will the average age of the prison population.
The state has established some unique and innovative policies and programs to address this change in inmate population. For instance, although state facilities only provide a small number infirmary beds, the Department of Corrections has partnered with a rural hospital and the University of Oklahoma to provide additional beds, as well as tertiary and outpatient care. The DOC has emphasized the importance of design when locating elderly inmate facilities or units. For example, old schools or hospitals with limited surrounding hills or fewer steps can be more easily adapted to the needs of the elderly population. In 2007, the DOC established at one of its prisons the 248-bed “J Unit” specifically for older prisons. It has its own satellite health facility, which has reduced the need for transportation to the main medical facility and to outside hospitals. It also contains a chronic disease clinic, as well as modified infrastructure to accommodate older offenders. The state has experimented with medical parole or “compassionate release” as well. Since 2008, 80 older inmates have been paroled, with a peak of 27 released in 2010 alone. The state did a survey this year to assess, using Medicaid criteria, the number of offenders who would immediately qualify for nursing home placement, infirmary care, or medical and disability unites, such as the J Unit. More than 800 qualified for such programs. These results will inform the policies of the DOC.
Dr. Suttmiller also stressed the continued challenges that the state faces, including the huge number of prescriptions processed by the Department of Corrections—now more than 47,000 per month, with 12,700 offenders taking medications, and the more than 8,800 with chronic medical illnesses—attributed in large part to the aging of the prison population. Dr. Suttmiller noted that approximately 89 percent of operational expenditures are due to outside medical care and pharmaceutical costs. In addition, he cited staffing challenges, and the difficulty of competing for doctors and nurses, particularly since the cost of primary care is increasing. Further innovations will be necessary to address these challenges moving forward.
Aging Inmates: The Continual 'Graying of America's Prisons