Reports on Elderly Prisoners Spur Call for Reforms

An increasing number of advocacy groups are calling for reforms in the wake of three reports that found the nation’s aging prison population is reaching record levels at growing expense to taxpayers, mostly due to the high cost of medical care for geriatric prisoners.

The studies noted that the vast majority of elderly prisoners pose a low risk of reoffending but were caught in the peak years of “get tough on crime” sentencing during the 1980s and ‘90s. As a result, more prisoners are growing older in prison. [See: PLN, Dec. 2010, p.1].

An October 2013 report by The Pew Charitable Trusts identified the aging prison population as the primary factor behind a median 52% jump in prisoner healthcare spending in 42 states between 2001 and 2008.

“Health care is consuming a growing share of state budgets, and corrections departments are not immune to this trend,” said Maria Schiff, who heads the State Health Care Spending Project, an initiative of The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation.

The Pew report analyzed data on prison healthcare spending collected from 44 states by the U.S. Department of Justice. Those states spent $6.5 billion on prisoner healthcare in 2008 – a $2.3 billion increase compared to 2001. During the same time period, healthcare spending per prisoner also increased in 35 of the states.

The study reported a 94% increase in the number of state and federal prisoners age 55 and older during the seven-year period. Healthcare costs for older prisoners with chronic illnesses were an average of two to three times higher than the cost for younger prisoners, the report stated.

The Pew findings echo those of a June 2012 report by the American Civil Liberties Union, which found that of the nation’s 1.5 million state and federal prisoners, around 246,600 were age 50 and over – about 16% of the overall prison population. The National Institute of Corrections (NIC) classifies prisoners over 50 as “aging” due to the stress of incarceration and typical lack of appropriate healthcare prior to and during incarceration. [See: PLN, April 2013, p.24].

The cost of keeping aging prisoners behind bars? An estimated $16 billion per year, including $3 billion in medical care, according to the ACLU.

“The number of elderly prisoners has absolutely exploded,” stated Inimai Chettiar, who co-authored the ACLU report. Chettiar is a director at the Brennan Center for Justice at the NYU School of Law. She said by the year 2030, nearly a third of the entire prison population in the U.S. – upwards of 400,000 prisoners – will be elderly.

“Our extreme sentencing policies and a growing number of life sentences have effectively turned many of our correctional facilities into veritable nursing homes – and taxpayers are paying for it,” the study noted.

“Incarceration is expensive,” said David Fathi, who heads the ACLU’s National Prison Project, “and incarcerating the elderly is extraordinarily expensive.”

While it costs taxpayers approximately $34,100 per year on average to incarcerate a prisoner, it costs twice as much – $68,270 per year – to care for elderly prisoners. That is a major reason for state corrections spending growing by 674% over the last 25 years, the ACLU study determined. [See: PLN, Nov. 2012, p.22].

A 2012 report by Human Rights Watch reached similar conclusions. For example, in Georgia, the report said, the annual average cost of medical care for elderly prisoners was $8,565 compared to an annual average cost of just $961 for prisoners under age 65. In Michigan, the report documented healthcare for prisoners age 80 and older as high as $40,000 each.

The ACLU study identified five states with the highest percentages of aging prisoners: West Virginia (20%), New Hampshire (20%), Massachusetts (19%), Florida (18%) and Texas (18%). In fact, the report said, California, Texas and Florida combined accounted for 43% of the nation’s entire elderly prison population.

Some older prisoners are serving short sentences for nonviolent crimes such as burglary or drug possession, the ACLU found; many are repeat offenders caught in the “revolving door” of the criminal justice system. Increasingly, the aging prison population is comprised of offenders who received long sentences for nonviolent crimes and are thus remaining in prison into their old age.

From 1986 to 1995, what the ACLU calls “the apex of the tough-on-crime period” of the U.S. criminal justice system, the number of prisoners sentenced to 20 or more years more than tripled, while from 1984 to 2002, life sentences – with or without parole – more than quadrupled.

“When you have people serving life sentences, they’re going to die in prison, just like people serving 20-, 30- and 40-year sentences are inevitably going to grow old behind bars,” noted Jamie Fellner, senior advisor of the U.S. Program at Human Rights Watch, in an interview with IPS News.

The majority of aging prisoners, according to the ACLU, are not serving time for murder. About 65% of Texas’ elderly prisoners, for example, were incarcerated for drug and property offenses and other nonviolent crimes. In North Carolina, 26% of prisoners age 50 and over were incarcerated under habitual offender laws or for drug crimes, while another 14% were in prison for fraud, larceny, and traffic and public order offenses.

“Many individuals who would have been sentenced to shorter periods of incarceration for repeat crimes before 1979 are now caught in the net of later-enacted habitual offender laws and given punishments of 20 years or more,” the ACLU report observed.

While the ballooning expense of caring for a geriatric prison population has state and federal prison officials searching for ways to cope with the problems of providing – and paying for – healthcare for elderly prisoners, the ACLU and other advocacy groups have proposed alternatives to solve the growing dilemma.

Research has shown that by age 50, people are far less likely to commit crimes. Arrest rates are just over 2% at age 50 and almost nil at age 65. Prisoners age 50 or older are far less likely to recidivate than younger offenders. In New York, for example, only 7% of ex-offenders age 50 to 64 return to prison for new convictions. In Virginia, only 1.3% of ex-offenders over 55 committed new crimes and were re-incarcerated.

“The risk of re-offense is much lower” after age 50, said Fathi. “Elderly prisoners are generally past their crime-prone years.”

Fellner agreed, stating in an August 18, 2013 editorial in The New York Times, “Those who are bedridden or in wheelchairs are not likely to go on crime sprees.”

She added, “It is worth asking: What do we as a society get from keeping these people in prison? People like the 87-year-old I met who had an ‘L’ painted on his left shoe and an ‘R’ on his right so he would know which was which and who didn’t even seem to know he was in prison. Or the old men I watched play bingo in a prison day room who needed staff members to put the markers on the bingo cards for them.”

The ACLU report recommended that parole boards grant conditional releases to elderly prisoners, using a “peer-reviewed, evidence-based risk assessment” to determine whether they pose a substantial risk to public safety. States should also “utilize and expand” medical parole, which usually requires prisoners to be terminally ill or physically incapacitated to be considered for release. While many states provide for medical parole, also known as compassionate release, they are rarely granted. [See: PLN, Feb. 2014, p.30; Jan. 2013, p.22; March 2012, p.12; Feb. 2012, p.16].

In one small step towards reform, U.S. Attorney General Eric Holder announced on August 12, 2013 that the Bureau of Prisons would institute new compassionate release policies for federal prisoners. Under the revised policies, elderly and infirm prisoners who have served a significant portion of their sentences, and who pose no danger to society, would be eligible for early release.

However, such measures have sparked resistance from victims’ rights advocates. “There are many criminals, especially violent criminals, for whom recidivism rates are very high and the propensity for reoffending is very high,” stated Kristy Dyroff, a spokeswoman for the National Organization for Victim Assistance.

“Our first priority is that victims are protected. It may be reasonable for a non-violent offender to be paroled,” Dyroff said, “but when there’s a possibility of violent re-offense, then we don’t support that.”

Beyond expanding the use of medical parole and compassionate release, more systemic reforms that would reduce the number of elderly prisoners include the repeal of mandatory minimum sentencing laws, habitual offender statutes and so-called truth-in-sentencing laws that require offenders to serve lengthy prison terms, the ACLU report concluded.

Several advocacy organizations have formed specifically to address issues related to elderly prisoners, such as Release Aging People in Prison, which focuses on older prisoners in New York, and the Project for Older Prisoners (POPS) at the George Washington University in Washington, D.C.

Sources: “Managing Prison Health Care Spending,” The Pew Charitable Trusts (Oct. 2013); “At America’s Expense: The Mass Incarceration of the Elderly,” American Civil Liberties Union (June 2012); “Old Behind Bars: The Aging Prison Population in the United States,” Human Rights Watch (Jan. 2012); www.usnews.nbcnews.com; The New York Times; www.truth-out.org; http://nationinside.org/campaign/release-of-aging-people-in-prison

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