Pubdate: Fri, 15 May 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Sari Horwitz, The Washington Post

HEALTH COSTS SOAR BEHIND PRISON WALLS

Aging Population of Inmates Serving Long Sentences Takes a Toll on Budgets

COLEMAN PRISON, Fla. - Twenty-one years into his nearly 50-year 
sentence, the graying man steps inside his stark cell in the largest 
federal prison complex in America. He wears special medical boots 
because of a foot condition that makes walking feel as if he's 
"stepping on a needle." He has undergone tests for a suspected heart 
condition and sometimes experiences vertigo.

"I get dizzy sometimes when I'm walking," says the 63-year-old 
inmate, Bruce Harrison. "One time, I just couldn't get up."

In 1994, Harrison and other members of the motorcycle group he 
belonged to were caught up in a drug sting by undercover federal 
agents, who asked them to move huge volumes of cocaine and marijuana. 
After taking the job, making several runs and each collecting $1,000, 
Harrison and the others were arrested and later convicted. When their 
sentences were handed down, however, jurors objected.

"I am sincerely disheartened by the fact that these defendants, who 
participated in the staged off-loads and transports ... are looking 
at life in prison or decades at best," said one of several who wrote 
letters to the judge and prosecutor.

In recent years, federal sentencing guidelines have been revised, 
resulting in less severe prison terms for lowlevel drug offenders. 
But Harrison, a decorated Vietnam War veteran, remains one of tens of 
thousands of inmates who were convicted in the "war on drugs" of the 
1980s and 1990s and whoare still behind bars.

Harsh sentencing policies, including mandatory minimums, continue to 
have lasting consequences for inmates and the nation's prison system. 
Today, prisoners 50 and older represent the fastest-growing 
population in crowded federal correctional facilities, their ranks 
having swelled by 25 percent to nearly 31,000 from 2009 to 2013.

Some prisons have needed to set up geriatric wards, while others have 
effectively been turned into convalescent homes.

The aging of the prison population is driving health care costs being 
borne by American taxpayers. The Bureau of Prisons saw health care 
expenses for inmates increase 55 percent from 2006 to 2013, when it 
spent more than $1 billion. That figure is nearly equal to the entire 
budget of the U.S. Marshals Service or the Bureau of Alcohol, 
Tobacco, Firearms and Explosives, according to the Justice 
Department's inspector general, who is conducting a review of the 
impact of the aging inmate population on prison activities, housing and costs.

"Our federal prisons are starting to resemble nursing homes 
surrounded with razor wire," said Julie Stewart, president and 
founder of Families Against Mandatory Minimums. "It makes no sense 
fiscally, or from the perspective of human compassion, to incarcerate 
men and women who pose no threat to public safety and have long since 
paid for their crime."

The Obama administration is trying to overhaul the criminal justice 
system by allowing prisoners who meet certain criteria to be released 
early through clemency and urging prosecutors to reserve the most 
severe drug charges for serious, high-level offenders.

But until more elderly prisoners are discharged either through 
compassionate release programs or the clemency initiative started by 
then-Attorney General Eric Holder last year, the government will be 
forced to spend more to serve the population.

"Prisons simply are not physically designed to accommodate the 
infirmities that come with age," said Jamie Fellner, a senior adviser 
at Human Rights Watch and an author of a report titled "Old Behind Bars."

"There are countless ways that the aging inmates, some with dementia, 
bump up against the prison culture," she said. "It is difficult to 
climb to the upper bunk, walk up stairs, wait outside for pills, take 
showers in facilities without bars and even hear the commands to 
stand up for count or sit down when you're told."

For years, state prisons followed the federal government's lead in 
enacting harsh sentencing laws. In 2010, there were some 246,000 
prisoners age 50 and older in state and federal prisons combined, 
with nearly 90 percent of them held in state custody, the American 
Civil Liberties Union said in a report titled "At America's Expense: 
The Mass Incarceration of the Elderly."

On both the state and federal level, the spiraling costs are eating 
into funds that could be used to curtail violent crime, drug cartels, 
public corruption, financial fraud and human trafficking.

For now, however, prison officials say there is little they can do 
about the costs.

Edmond Ross, a spokesman for the Bureau of Prisons, said: "We have to 
provide a certain level of medical care for whoever comes to us."

The average cost of housing federal inmates nearly doubles for aging 
prisoners. While the cost of a prisoner in the general population is 
$27,549 a year, the price tag associated with an older inmate who 
needs more medical care, including expensive prescription drugs and 
treatments, is $58,956, Justice Department officials say

At Federal Medical Center Devens, a prison near Boston, 115 aging 
inmates with kidney failure receive treatment inside a dialysis unit.

"Renal failure is driving our costs up," said Ted Eichel, the health 
services administrator for Devens. "It costs $4 million to run this 
unit, not counting medications, which is half our budget." Devens 
also employs 60 nurses, along with social workers, dietitians, 
psychologists, dentists and physical therapists. They look like 
medical workers, except for the cluster of prison keys they're carrying.

Although the prison houses about 1,000 low-to high-security inmates, 
they are not handcuffed or shackled, except when being transferred 
outside the facility. A golf cart has been redesigned into a mini-ambulance.

At prisons such as Devens, younger inmates are sometimes enlisted as 
"companion aides," helping older inmates get out of bed, wheeling 
them down the halls to medical appointments and helping them take 
care of themselves.

John Thompson, a patient care technician who works with Devens' 
dialysis patients, said he knows a number of people who "want no part 
of" providing medical care to prisoners.

"But I just feel like they're good people," Thompson said. "And 
they're doing their time."

Jesse Owens, a dialysis patient serving about 12 years for cocaine 
charges, said he's grateful for the care. "They're keeping us alive," he said.
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MAP posted-by: Jay Bergstrom