Pubdate: Tue, 01 Jul 2003 Source: Tennessean, The (TN) Copyright: 2003 The Tennessean Contact: http://www.tennessean.com/ Details: http://www.mapinc.org/media/447 Author: Kelli Samantha Hewett AGING INMATES, GROWING COSTS With tougher sentencing in the 1990s and an aging baby boomer population, Department of Correction faces a new challenge: the rise in elderly prisoners There was a time when the hot prison issues were violence and overcrowding. These days, they also include toilet safety rails and security-approved wheelchairs. With the wave of 1990s "truth-in-sentencing" laws and a baby boomer population edging toward 65, the state Department of Correction is confronting a new challenge: the rise in elderly inmates during the next 20 years. Bob Wayman, 66, is part of the new face of state corrections. A double-amputee and former steamfitter, Wayman is serving four years for vehicular homicide in a skilled medical wing of DeBerry Special Needs Facility in Nashville. He is scheduled for release in 2004. Wayman loves to visit the gym or sun himself in the concrete-and-fence recreation yard with his roommate Phil Kress, 66, a convicted rapist who has Parkinson's disease. They watch for squirrels and skunks, wave to other inmates who walk by or ponder life on the outside. "There's some people who should be home," not in prison, Wayman said. Tennessee spends about $20,000 a year on the average prisoner. A sick, aging inmate can cost the state as much as $60,000 a year, the state says. "I think there will be a real crisis for states to deal with" in the next 20 years, said Ron Aday, a Middle Tennessee State University professor who has studied aging inmates since the 1970s. About 10% of Tennessee prison inmates are older than 50 - slightly more than the national 9% average, state prison officials say. But research is under way to avoid any crisis, state Correction Commissioner Quenton White said. "There are going to be some very significant issues, especially the health-care costs," White said. "We are beginning the process of addressing it." Aging behind bars Every year, more inmates need treatment for hypertension, arthritis, Alzheimer's and emphysema and require physical therapy and hospice care. Many old or feeble inmates also must be housed separately because they can become targets for younger, tougher prisoners. The 50-plus set is considered "senior" by prison standards because hard lifestyles before prison often cause inmates to age about 10 years faster, experts say. "You have got to keep up with their needs; it's not just warehousing prisoners anymore," said Gabrielle Chapman of the state Department of Correction. Chapman said the state is looking to lead the nation in elder-care corrections. Officials are tracking details of the 50-plus inmates and working on plans to handle physical disabilities, life skill issues, elderly support groups and hospice care. Court rulings say that inmates deserve all the health-care opportunities of anyone in the community. Tennessee is one of 16 states with facilities for frail and aging inmates, and it was among the first to establish them. Many of the state's healthier senior inmates are at the Wayne County Boot Camp. The DeBerry Special Needs Facility oversees the sickest prisoners, many of them seniors. DeBerry has 800 beds to house prisoners whose medical problems range from amputation to dementia to cancer. White said 300 more beds are needed for the expected rise in elderly inmates. That could mean an expansion or a whole new prison facility, but prison officials are not sure what they will do. From the outside, DeBerry has all the guards, cameras and razor wires of most any other prison, but maximum security here is not the stuff of blockbuster films. This is a place where walkers and canes are weapons and riots are all but impossible. A lot of prisoners can take care of themselves, but others need diaper changes or help with spoons and forks. Special equipment at DeBerry includes Velcro sneakers, plastic mattress covers and shower chairs. "It's terribly expensive. The public needs to be informed on the cost," said Jimmie Tittle, 73, who is serving 16 years at DeBerry for attempted murder in Sullivan County. He will be 81 when his sentence ends in 2011. Tittle has had a stroke in prison. He says he has high cholesterol, is partially crippled and has had infections in his legs. "There are a tremendous amount who are old, who have served their time and can be released; they can be checked on an individual basis," said Tittle, who would like to spend time with his four children and four grandchildren. Prison workers say they face a tough balance between the criminal need and the geriatric one. In their younger days, these were violent criminals. Some still are. But others are simply old-timers now, relics of their ugly pasts. They become disoriented in the night, they cannot walk to the meal hall and they fuss about noise and cool conditions. "In many instances, they may not pose as much of a threat as they did 20 years ago; they may have softened," White said. In the long term, caring for senior inmates could involve investing in new facilities, such as secured halfway houses or secured nursing homes, that are cheaper than traditional prisons. No plans have been formally proposed, White said. In the short run, some prison officials say that meeting senior needs in the cheapest way is not always possible when public sympathy runs dry. Health-care workers say spending money on developing wellness programs or dietary supplements could reduce other medical costs. Rob Moore turned 79 on Sunday and is serving a life sentence at DeBerry for first-degree murder. He has survived open-heart surgery and triple-bypass surgery and battles ongoing back, nerve and hip problems that he says are aggravated by the standard-issue prison mattresses. "It's just so hard. I can't roll over, and I can't hardly sit up," Moore said. But public sympathy often runs low for prison inmates convicted of violent crimes. Moore has been imprisoned since 1983 and is up for parole in 2006. "In an environment where money is very, very tight, it's hard to convince people that different mattresses or better beds might benefit the community in cost-cutting," said Pat Walker, acting deputy health administrator at DeBerry. To help control costs, the state contracted inmate health care to a private managed-care company, saving money but drawing some criticism from inmates. White is exploring similar plans for bulk or group rates on prescriptions. Rethinking tough justice All across the country, the changing face of corrections and its rising costs could force prison officials, politicians, maybe even taxpayers to reshape their ideas of tough justice, some experts say. The state corrections budget comes from the state's general fund, which also pays for education, social services programs and road work. "Many states have gone with these 'get tough' sentencing policies, but now it's coming back to haunt them," Aday said. "I think we will see (many states) in the future going back and addressing sentencing policies." Cost, Aday said, has been a major reason other states have revisited the issue. A rise in senior crime also may play a part. Some experts say more older people are being convicted of felonies, such as drug crimes or physical attacks or murder, most often against a spouse or a neighbor. Some theories on the increase point to money problems, loneliness, depression or alcohol and drug abuse problems. "As people live longer, are in better health and have more energy, they are also involved in things that get them in trouble or to make some extra bucks," Aday said. These are different kinds of criminals than most corrections systems were designed to handle. States such as Georgia and California have reduced medical costs with early-release programs for some elderly inmates who are a low risk to society. Other states have created geriatric justice systems, modeled after juvenile justice systems, to help meet seniors' special needs. White said he has no plans for any such early release but remains convinced that new ideas will be part of the future of Tennessee corrections. "A society is as good as it treats its seniors - whether they are in prison or out of prison," he said. - --- MAP posted-by: Tom