Aging in prison
A	
  human	
  rights	
  problem	
  we	
  must	
  fix	
  

Photo:	
  Nikki	
  Khan	
  

THE	
  AMERICAN	
  FRIENDS	
  SERVICE	
  COMMITTEE	
  
Prison	
  Watch	
  Project	
  
	
  
Developed	
  by	
  
Mary	
  Ann	
  Cool,	
  Bonnie	
  Kerness,	
  Jehanne	
  Henry,	
  Jean	
  Ross,	
  Esq.,	
  	
  
AFSC	
  student	
  interns	
  Kelsey	
  Wimmershoff	
  and	
  Rachel	
  Frome,	
  	
  
and	
  those	
  people	
  inside	
  who	
  gave	
  this	
  issue	
  voice	
  and	
  vision	
  
	
  
	
  
	
  
	
  

1	
  

	
  
	
  
	
  
	
  
	
  
	
  

Table	
  of	
  contents	
  
	
  
	
  
	
  

1. 	
  	
  Overview	
  
	
  
	
  
	
  
	
  
	
  
	
  
2. 	
  	
  Testimonials	
   	
  
	
  
	
  
	
  
	
  
	
  
3. 	
  	
  Preliminary	
  recommendations	
  for	
  New	
  Jersey	
  	
  
	
  
4. 	
  	
  Acknowledgements	
   	
  
	
  
	
  
	
  
	
  
	
  

	
  

	
  	
  3	
  
	
  	
  6	
  
11	
  
13	
  

2	
  

Overview	
  	
  
	
  
The	
  population	
  of	
  elderly	
  prisoners	
  is	
  on	
  the	
  rise	
  
The	
  number	
  and	
  percentage	
  of	
  elderly	
  prisoners	
  in	
  the	
  United	
  States	
  has	
  grown	
  dramatically	
  in	
  past	
  
decades.	
  In	
  the	
  year	
  2000,	
  prisoners	
  age	
  55	
  and	
  older	
  accounted	
  for	
  3	
  percent	
  of	
  the	
  prison	
  population.	
  
Today,	
  they	
  are	
  about	
  16	
  percent	
  of	
  that	
  population.	
  Between	
  2007	
  and	
  2010,	
  the	
  number	
  of	
  prisoners	
  
age	
  65	
  and	
  older	
  increased	
  by	
  an	
  alarming	
  63	
  percent,	
  compared	
  to	
  a	
  0.7	
  percent	
  increase	
  of	
  the	
  overall	
  
prison	
  population.	
  At	
  this	
  rate,	
  prisoners	
  55	
  and	
  older	
  will	
  approach	
  one-­‐third	
  of	
  the	
  total	
  prison	
  
population	
  by	
  the	
  year	
  2030.1	
  	
  
What	
  accounts	
  for	
  this	
  rise	
  in	
  the	
  number	
  of	
  elderly	
  prisoners?	
  	
  
The	
  rise	
  in	
  the	
  number	
  of	
  older	
  people	
  in	
  prisons	
  does	
  not	
  reflect	
  an	
  increased	
  crime	
  rate	
  among	
  this	
  
population.	
  Rather,	
  the	
  driving	
  force	
  for	
  this	
  phenomenon	
  has	
  been	
  the	
  “tough	
  on	
  crime”	
  policies	
  
adopted	
  throughout	
  the	
  prison	
  system,	
  from	
  sentencing	
  through	
  parole.	
  In	
  recent	
  decades,	
  state	
  and	
  
federal	
  legislators	
  have	
  increased	
  the	
  lengths	
  of	
  sentences	
  through	
  mandatory	
  minimums	
  and	
  three-­‐	
  
strikes	
  laws,	
  increased	
  the	
  number	
  of	
  crimes	
  punished	
  with	
  life	
  and	
  life-­‐without-­‐parole	
  and	
  made	
  some	
  
crimes	
  ineligible	
  for	
  parole.	
  	
  
Even	
  when	
  release	
  becomes	
  judicially	
  permissible	
  parole	
  boards	
  focus	
  on	
  long-­‐past	
  offenses	
  without	
  
giving	
  sufficient	
  weight	
  to	
  individual	
  and	
  statistical	
  evidence	
  of	
  decreased	
  risk.	
  Many	
  states	
  have	
  also	
  
adopted	
  harsh	
  parole	
  revocation	
  policies,	
  which	
  cause	
  more	
  parolees	
  to	
  return	
  to	
  prison	
  for	
  technical	
  
violations	
  of	
  parole	
  rules,	
  not	
  new	
  crimes.	
  As	
  a	
  result,	
  more	
  people	
  are	
  serving	
  longer	
  sentences;	
  they	
  
are	
  aging	
  and	
  dying	
  in	
  prison.	
  	
  
What’s	
  the	
  situation	
  in	
  New	
  Jersey?	
  
New	
  Jersey	
  tracks	
  the	
  national	
  trends.	
  The	
  state	
  has	
  taken	
  important	
  steps	
  to	
  reduce	
  its	
  prison	
  
population	
  by	
  reducing	
  the	
  scope	
  and	
  magnitude	
  of	
  mandatory	
  minimum	
  sentences	
  for	
  narcotics	
  
offenses.	
  But	
  the	
  Department	
  of	
  Corrections	
  does	
  not	
  adequately	
  address	
  the	
  needs	
  of	
  the	
  rising	
  
proportion	
  of	
  older	
  prisoners	
  who	
  cannot	
  benefit	
  from	
  these	
  changes.	
  Eligibility	
  criteria	
  in	
  the	
  laws	
  
permitting	
  the	
  parole	
  or	
  release	
  of	
  medically	
  compromised	
  prisoners	
  are	
  narrow	
  and	
  strict.	
  As	
  a	
  result,	
  
the	
  New	
  Jersey	
  Department	
  of	
  Corrections	
  reports	
  that	
  there	
  were	
  445	
  more	
  prisoners	
  over	
  age	
  55	
  in	
  
2016	
  than	
  in	
  2011.2	
  	
  
New	
  Jersey’s	
  No	
  Early	
  Release	
  Act	
  limits	
  parole	
  eligibility	
  for	
  people	
  convicted	
  of	
  certain	
  serious	
  
crimes.3	
  But	
  long-­‐term	
  elderly	
  prisoners	
  who	
  pass	
  these	
  legislatively	
  imposed	
  benchmarks	
  are	
  still	
  likely	
  
to	
  be	
  denied	
  release	
  by	
  a	
  Parole	
  Board	
  which	
  gives	
  undue	
  weight	
  to	
  their	
  decades	
  old	
  offenses.	
  
Moreover,	
  the	
  Board	
  also	
  imposes	
  long	
  periods	
  between	
  parole	
  hearings,	
  leaving	
  elderly	
  persons	
  to	
  
await	
  death	
  in	
  prison.	
  Equally	
  troubling,	
  people	
  with	
  serious	
  mental	
  illness	
  are	
  kept	
  in	
  prison	
  rather	
  than	
  
being	
  paroled	
  under	
  commitment	
  to	
  mental	
  health	
  institutions.	
  When	
  these	
  elderly	
  ill	
  prisoners	
  are	
  
finally	
  released	
  at	
  the	
  end	
  of	
  their	
  maximum	
  sentences,	
  they	
  are	
  returned	
  to	
  the	
  community	
  without	
  
adequate	
  provision	
  for	
  mental	
  health	
  supervision	
  and	
  treatment.4	
  

	
  

3	
  

What	
  is	
  the	
  impact	
  of	
  imprisonment	
  on	
  aging	
  prisoners?	
  
The	
  physical	
  and	
  mental	
  health	
  consequences	
  of	
  aging	
  in	
  prison	
  can	
  be	
  devastating.	
  The	
  full	
  range	
  of	
  
ailments	
  normally	
  associated	
  with	
  aging	
  may	
  be	
  accelerated	
  or	
  compounded,	
  as	
  prisoners	
  often	
  lack	
  the	
  
appropriate	
  medical	
  care,	
  food,	
  socialization,	
  and	
  exercise	
  facilities	
  needed	
  to	
  keep	
  aging	
  people	
  
healthy.	
  The	
  psychological	
  impact	
  of	
  aging	
  in	
  prison	
  is	
  also	
  an	
  important	
  factor	
  affecting	
  prisoners'	
  
health	
  status,	
  since	
  depression	
  and	
  other	
  psychological	
  effects	
  can	
  undermine	
  good	
  health.5	
  These	
  
factors	
  account	
  for	
  a	
  consensus	
  that	
  age	
  55	
  delineates	
  the	
  elderly	
  population	
  in	
  prison.6	
  
The	
  impact	
  of	
  the	
  conditions	
  of	
  confinement	
  on	
  New	
  Jersey’s	
  aging	
  prisoners	
  is	
  clear:	
  many	
  of	
  those	
  
interviewed	
  reported	
  facing	
  difficulties	
  in	
  access	
  to	
  basic	
  services	
  and	
  as	
  a	
  result	
  their	
  health	
  was	
  
deteriorating.	
  Many	
  also	
  talked	
  about	
  the	
  psychological	
  impact	
  of	
  long	
  sentences.	
  [For	
  more	
  details	
  
about	
  these	
  problems,	
  please	
  see	
  the	
  testimonials	
  below.]	
  	
  
Although	
  there	
  is	
  a	
  medical	
  building	
  for	
  seriously	
  ill	
  or	
  disabled	
  people	
  in	
  one	
  state	
  prison,	
  there	
  are	
  no	
  
special	
  units	
  for	
  the	
  many	
  frail,	
  sickly	
  and	
  poorly	
  functioning	
  elderly	
  people	
  in	
  the	
  rest	
  of	
  the	
  system.	
  
These	
  people	
  are	
  often	
  double-­‐celled	
  with	
  younger	
  adults,	
  who	
  may	
  either	
  help	
  care	
  for	
  them,	
  or	
  who	
  
place	
  them	
  at	
  risk	
  of	
  harm.	
  
Can	
  aging	
  prisoners	
  apply	
  for	
  “geriatric”	
  release?	
  
Only	
  15	
  states	
  and	
  the	
  District	
  of	
  Columbia	
  have	
  a	
  process	
  for	
  releasing	
  geriatric	
  prisoners.	
  These	
  
policies	
  vary,	
  but	
  they	
  generally	
  involve	
  parole,	
  furloughs	
  and	
  medical	
  or	
  compassionate	
  release	
  and	
  
might	
  include	
  various	
  criteria	
  including	
  age,	
  amount	
  of	
  time	
  served,	
  medical	
  condition	
  and	
  risk	
  to	
  public	
  
safety.	
  In	
  many	
  states	
  these	
  procedures	
  are	
  rarely	
  used,	
  and	
  specifically	
  exclude	
  people	
  with	
  violent	
  and	
  
sex	
  offense	
  histories.	
  Since	
  prisoners	
  over	
  55	
  are	
  often	
  in	
  for	
  long	
  sentences,	
  based	
  on	
  serious	
  offenses,	
  
they	
  may	
  be	
  less	
  likely	
  to	
  qualify	
  for	
  these	
  programs.7	
  	
  
In	
  New	
  Jersey,	
  the	
  rules	
  are	
  very	
  strict	
  for	
  applying	
  for	
  medical	
  parole,	
  medical	
  release	
  and	
  clemency.	
  In	
  
general,	
  prisoners	
  have	
  to	
  demonstrate	
  they	
  have	
  a	
  terminal	
  condition	
  with	
  less	
  than	
  six	
  months	
  to	
  live,	
  
or	
  have	
  not	
  been	
  convicted	
  of	
  a	
  serious	
  crime.	
  Most	
  elderly	
  prisoners	
  do	
  not	
  qualify	
  for	
  this	
  narrow	
  
condition	
  for	
  release.	
  In	
  2015,	
  New	
  Jersey	
  Governor	
  Chris	
  Christie	
  vetoed	
  a	
  bill	
  that	
  would	
  have	
  
expanded	
  the	
  criteria	
  for	
  medical	
  release	
  to	
  prisoners	
  with	
  a	
  permanent	
  physical	
  incapacity.8	
  	
  Without	
  
any	
  special	
  provisions	
  for	
  "geriatric	
  release,"	
  older	
  prisoners	
  are	
  subject	
  to	
  general	
  parole	
  practices	
  that	
  
keep	
  many	
  people	
  in	
  prison	
  unnecessarily.	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
What	
  is	
  the	
  cost	
  of	
  caring	
  for	
  the	
  aging	
  prisoner	
  population?	
  
One	
  profound	
  impact	
  of	
  an	
  aging	
  prison	
  population	
  is	
  the	
  enormous	
  cost	
  in	
  housing	
  and	
  care	
  for	
  elderly	
  
prisoners.	
  Aging	
  prisoners	
  require	
  more	
  medical	
  care,	
  making	
  them	
  a	
  costlier	
  segment	
  of	
  the	
  prison	
  
population.	
  According	
  to	
  the	
  Journal	
  of	
  the	
  American	
  Medical	
  Association,	
  prisoners	
  older	
  than	
  55	
  have	
  
an	
  average	
  of	
  three	
  chronic	
  conditions,	
  and	
  as	
  many	
  as	
  20	
  percent	
  of	
  them	
  have	
  a	
  mental	
  illness.	
  Their	
  
need	
  for	
  medical	
  services,	
  including	
  medications	
  and	
  devices	
  such	
  as	
  walkers,	
  wheelchairs,	
  hearing	
  
devices	
  and	
  breathing	
  aids	
  is	
  significant.	
  Therefore,	
  older	
  prisoners	
  are	
  at	
  least	
  two	
  to	
  three	
  times	
  as	
  
expensive	
  to	
  imprison	
  as	
  younger	
  prisoners,	
  chiefly	
  because	
  of	
  their	
  greater	
  medical	
  needs.9	
  	
  

	
  

4	
  

As	
  a	
  matter	
  of	
  criminal	
  justice	
  policy,	
  the	
  cost	
  of	
  imprisoning	
  elderly	
  and	
  sick	
  prisoners	
  cannot	
  be	
  
justified	
  because	
  they	
  generally	
  do	
  not	
  pose	
  a	
  risk	
  to	
  the	
  outside	
  world	
  and	
  are	
  unlikely	
  to	
  re-­‐offend.	
  
What	
  does	
  international	
  human	
  rights	
  law	
  say	
  about	
  imprisoning	
  elderly	
  people?	
  	
  
While	
  international	
  human	
  rights	
  law	
  does	
  not	
  preclude	
  imprisonment	
  of	
  older	
  people,	
  the	
  practice	
  of	
  
doing	
  so	
  raises	
  two	
  major	
  concerns.	
  	
  
First,	
  the	
  conditions	
  of	
  confinement	
  should	
  be	
  consistent	
  with	
  the	
  requirements	
  of	
  human	
  rights	
  law.	
  
Older	
  prisoners,	
  like	
  all	
  prisoners,	
  have	
  the	
  right	
  to	
  be	
  treated	
  with	
  respect	
  for	
  their	
  humanity	
  and	
  
inherent	
  human	
  dignity,	
  to	
  be	
  free	
  from	
  torture	
  or	
  other	
  cruel,	
  inhuman,	
  or	
  degrading	
  treatment	
  or	
  
punishment,	
  to	
  receive	
  appropriate	
  medical	
  and	
  mental	
  health	
  care,	
  to	
  have	
  reasonable	
  
accommodation	
  for	
  their	
  disabilities	
  and	
  to	
  be	
  provided	
  activities	
  and	
  programs	
  to	
  support	
  their	
  
rehabilitation.10	
  	
  
In	
  New	
  Jersey	
  and	
  many	
  states	
  across	
  the	
  country,	
  conditions	
  are	
  clearly	
  not	
  adequate	
  to	
  deal	
  with	
  the	
  
infirmities	
  that	
  come	
  with	
  age.	
  Human	
  Rights	
  Watch	
  research	
  found	
  that	
  in	
  many	
  states	
  the	
  rights	
  of	
  
elderly	
  prisoners	
  were	
  violated	
  by	
  a	
  combination	
  of	
  limited	
  resources,	
  resistance	
  to	
  changes	
  in	
  
longstanding	
  rules	
  and	
  policies,	
  lack	
  of	
  support	
  from	
  elected	
  officials	
  and	
  insufficient	
  internal	
  attention	
  
to	
  the	
  unique	
  needs	
  of	
  older	
  prisons.11	
  	
  
Secondly,	
  aside	
  from	
  the	
  conditions	
  of	
  confinement,	
  a	
  prisoner’s	
  sentence	
  should	
  not	
  impose	
  a	
  
disproportionately	
  severe	
  punishment.	
  Yet	
  in	
  many	
  cases,	
  the	
  length	
  of	
  a	
  prisoner's	
  sentence	
  bears	
  an	
  
insufficient	
  relationship	
  to	
  the	
  harm	
  caused	
  to	
  others	
  or	
  the	
  community.	
  International	
  law	
  states	
  that	
  
disproportionately	
  lengthy	
  prison	
  sentences	
  may	
  violate	
  the	
  prohibition	
  on	
  cruel	
  and	
  inhuman	
  
punishment	
  and	
  can	
  amount	
  to	
  arbitrary	
  deprivation	
  of	
  liberty.	
  	
  
Even	
  if	
  the	
  length	
  of	
  the	
  sentence	
  were	
  proportionate	
  at	
  the	
  time	
  of	
  sentencing,	
  the	
  analysis	
  of	
  
proportionality	
  changes	
  with	
  age.	
  When	
  prisoners	
  have	
  grown	
  old	
  and	
  frail	
  or	
  ill,	
  the	
  purposes	
  of	
  
imprisonment—deterrence,	
  incapacitation,	
  rehabilitation,	
  and	
  retribution—are	
  no	
  longer	
  met	
  through	
  
continued	
  incarceration.	
  Older	
  prisoners	
  are	
  less	
  likely	
  to	
  commit	
  additional	
  crimes	
  after	
  their	
  release	
  
than	
  are	
  younger	
  prisoners;	
  they	
  are	
  often	
  incapacitated	
  due	
  to	
  frailty,	
  disability	
  or	
  illness;	
  long	
  
imprisonment	
  impedes	
  rehabilitation;	
  and	
  the	
  retributive	
  purpose	
  of	
  their	
  imprisonment	
  could	
  be	
  
achieved	
  through	
  alternatives	
  controls,	
  such	
  as	
  conditional	
  release.	
  	
  

	
  

5	
  

Testimonials	
  
Our	
  interviews	
  with	
  14	
  men	
  and	
  women,	
  between	
  the	
  ages	
  of	
  52	
  and	
  79	
  and	
  who	
  are	
  currently	
  in	
  or	
  
were	
  recently	
  released	
  from	
  prison	
  in	
  New	
  Jersey,	
  show	
  how	
  the	
  state’s	
  prisons	
  have	
  failed	
  to	
  provide	
  
appropriate	
  conditions	
  for	
  the	
  aging	
  population.	
  They	
  described	
  a	
  lack	
  of	
  appropriate	
  medical	
  care,	
  diet	
  
and	
  exercise	
  and	
  the	
  trauma	
  of	
  being	
  in	
  prison	
  for	
  prolonged	
  periods.	
  	
  
OL,	
  a	
  71-­‐year-­‐old	
  man	
  who	
  has	
  served	
  28	
  years	
  in	
  state	
  prison,	
  described	
  the	
  inadequate	
  care	
  for	
  aging	
  
prisoners:	
  	
  
“In	
  prison	
  the	
  elderly	
  need	
  more	
  care	
  in	
  terms	
  of	
  both	
  operations	
  and	
  medications	
  than	
  the	
  average	
  
younger	
  prisoner.	
  The	
  system	
  doesn’t	
  want	
  to	
  spend	
  the	
  money	
  they	
  need	
  to	
  on	
  older	
  prisoners.	
  So	
  
they’d	
  get	
  third	
  or	
  fourth	
  rate	
  drugs	
  to	
  treat	
  your	
  ailments.	
  They’ll	
  put	
  off	
  a	
  surgery	
  you	
  need	
  for	
  years	
  
and	
  years.	
  […]	
  Say	
  a	
  prisoner	
  loses	
  control	
  of	
  their	
  body	
  functions	
  they	
  might	
  be	
  in	
  a	
  hospital	
  unit	
  sitting	
  
in	
  their	
  waste	
  because	
  no	
  one	
  wants	
  to	
  change	
  them.	
  Nurses	
  don’t	
  want	
  to	
  deal	
  with	
  prisoners	
  that	
  way	
  
because	
  they	
  say	
  it’s	
  a	
  dirty	
  job.	
  	
  So	
  they’ll	
  have	
  the	
  prison	
  interns	
  do	
  it.	
  	
  If	
  it’s	
  overnight,	
  the	
  prisoner	
  will	
  
have	
  to	
  sit	
  in	
  it	
  all	
  night	
  until	
  the	
  following	
  day.	
  	
  It’s	
  a	
  terrible	
  thing	
  to	
  go	
  to	
  prison	
  but	
  it’s	
  worse	
  to	
  
grow	
  old	
  in	
  prison.”	
  
DG,	
  age	
  54	
  who	
  served	
  21	
  years,	
  recounted	
  how	
  he	
  was	
  denied	
  prompt	
  treatment:	
  	
  
“I	
  suffer	
  from	
  a	
  herniated	
  spine	
  and	
  scoliosis.	
  In	
  2002	
  I	
  was	
  in	
  a	
  prison	
  fight	
  on	
  the	
  yard	
  where	
  I	
  was	
  
injured	
  and	
  put	
  in	
  the	
  hole	
  for	
  a	
  fight	
  I	
  did	
  not	
  cause.	
  I	
  was	
  in	
  the	
  whole	
  for	
  two	
  weeks	
  the	
  guards	
  did	
  let	
  
me	
  see	
  the	
  medical	
  staff	
  after	
  a	
  week	
  of	
  the	
  incident.”	
  
MU,	
  a	
  54-­‐year-­‐old	
  woman	
  who	
  spent	
  ten	
  years	
  in	
  state	
  prisons,	
  described	
  how	
  medical	
  care	
  could	
  be	
  
used	
  to	
  discriminate	
  against	
  some	
  prisoners.	
  	
  	
  
“The	
  medical	
  situation	
  in	
  prison	
  is	
  political.	
  	
  […]	
  	
  If	
  a	
  person	
  has	
  a	
  medical	
  condition	
  to	
  be	
  checked	
  on	
  or	
  if	
  
they	
  have	
  to	
  do	
  their	
  annual	
  to	
  check	
  on	
  their	
  health	
  the	
  process	
  is	
  they	
  can	
  use	
  it	
  as	
  a	
  form	
  of	
  
punishment.	
  	
  […	
  ]There	
  is	
  a	
  list	
  of	
  people	
  and	
  your	
  name	
  didn’t	
  come	
  up	
  yet	
  and	
  you	
  will	
  be	
  damn	
  near	
  
dead	
  before	
  you	
  are	
  seen.	
  	
  For	
  example,	
  what’s	
  happening	
  with	
  Mumia.	
  	
  We	
  know	
  they	
  are	
  using	
  the	
  
medical	
  thing	
  as	
  a	
  form	
  of	
  punishment	
  with	
  him.	
  	
  This	
  is	
  what	
  they	
  do.	
  	
  There	
  are	
  other	
  prisoners	
  who	
  
probably	
  could	
  be	
  healed	
  or	
  diagnosed	
  with	
  something	
  at	
  an	
  early	
  stage	
  and	
  because	
  of	
  their	
  political	
  
affiliation	
  or	
  the	
  politics	
  in	
  prison	
  they	
  won’t	
  be	
  seen.”	
  
LS,	
  a	
  63-­‐year-­‐old	
  man	
  who	
  has	
  served	
  34	
  years	
  in	
  state	
  prison,	
  has	
  seen	
  chronically	
  ill	
  prisoners	
  die:	
  	
  
“Everyone	
  that	
  I’ve	
  known	
  here	
  that	
  contracted	
  a	
  serious	
  disease	
  such	
  as	
  cancer,	
  just	
  about	
  all	
  of	
  them	
  
have	
  died.	
  	
  I	
  don’t	
  know	
  anyone	
  here	
  that	
  survived	
  cancer	
  and	
  has	
  been	
  here	
  over	
  the	
  years.	
  	
  	
  I	
  know	
  
that’s	
  not	
  consistent	
  with	
  the	
  care	
  people	
  get	
  in	
  society.”	
  
GU,	
  a	
  69-­‐year-­‐old	
  man	
  who	
  spent	
  41	
  years	
  in	
  state	
  prison,	
  also	
  saw	
  prisoners	
  die:	
  	
  	
  

	
  

6	
  

“I’ve	
  actually	
  seen	
  a	
  man	
  have	
  a	
  heart	
  attack,	
  laid	
  on	
  the	
  floor;	
  the	
  corrections	
  officer	
  blew	
  the	
  
whistle.	
  	
  They	
  call	
  it	
  a	
  medical	
  emergency	
  code	
  22.	
  	
  They	
  came	
  up	
  to	
  the	
  unit	
  and	
  watched	
  him	
  and	
  said	
  
they	
  couldn’t	
  do	
  anything	
  for	
  him	
  until	
  medical	
  staff	
  came.	
  	
  Medical	
  staff	
  came	
  twenty	
  minutes	
  after	
  
they	
  came	
  in	
  the	
  room.	
  	
  This	
  man	
  was	
  in	
  shock.	
  	
  He	
  died.	
  	
  I	
  watched	
  him	
  lie	
  on	
  the	
  floor	
  and	
  die.	
  	
  That’s	
  
how	
  poor	
  the	
  medical	
  treatment	
  is	
  in	
  the	
  prison.	
  […]	
  I	
  had	
  a	
  heart	
  attack	
  at	
  37	
  years	
  old.	
  	
  I	
  laid	
  in	
  the	
  
yard	
  45	
  minutes	
  to	
  an	
  hour	
  before	
  they	
  took	
  me	
  out	
  of	
  the	
  yard.	
  	
  […]	
  They	
  then	
  had	
  to	
  get	
  approval	
  for	
  
me	
  to	
  be	
  taken	
  from	
  the	
  prison	
  to	
  the	
  hospital	
  because	
  I	
  was	
  in	
  a	
  close	
  custody	
  unit.	
  	
  I	
  wound	
  up	
  not	
  
getting	
  to	
  the	
  hospital	
  until	
  two	
  hours	
  later.	
  	
  I	
  think	
  had	
  I	
  not	
  been	
  exercising	
  and	
  eating	
  a	
  good	
  diet	
  I	
  
would	
  have	
  died.”	
  	
  
Lack	
  of	
  adequate	
  diet	
  and	
  exercise	
  
ML,	
  a	
  42-­‐year-­‐old	
  man	
  who	
  served	
  more	
  than	
  a	
  decade	
  in	
  state	
  prisons,	
  observed	
  how	
  poor	
  
diet	
  contributes	
  to	
  poor	
  health	
  in	
  aging	
  prisoners:	
  	
  
“Most	
  people	
  I	
  knew	
  as	
  they	
  aged	
  in	
  prison	
  developed	
  some	
  type	
  of	
  ailment	
  whether	
  it	
  was	
  kidney	
  
failure,	
  high	
  cholesterol,	
  high	
  sugar	
  because	
  the	
  food	
  they	
  serve	
  is	
  the	
  worst	
  of	
  the	
  worst.	
  	
  You	
  can’t	
  even	
  
identify	
  it.	
  	
  A	
  long-­‐term	
  diet	
  of	
  that	
  is	
  not	
  good.	
  	
  So	
  not	
  only	
  are	
  you	
  doing	
  time,	
  you	
  are	
  also	
  going	
  to	
  
have	
  medical	
  expenses.	
  	
  That	
  just	
  compounds	
  things	
  because	
  you	
  are	
  not	
  even	
  going	
  to	
  get	
  adequate	
  
medical	
  services.	
  […]	
  In	
  prison	
  you	
  deteriorate	
  because	
  you	
  get	
  inadequate	
  medical	
  assistance	
  and	
  at	
  the	
  
same	
  time	
  you’re	
  eating	
  a	
  diet	
  that’s	
  unhealthy.	
  	
  Even	
  if	
  you	
  go	
  to	
  commissary,	
  the	
  only	
  type	
  products	
  
they	
  offer	
  in	
  commissary	
  are	
  potato	
  chips,	
  snacks,	
  soups	
  that	
  are	
  high	
  in	
  sodium.	
  	
  There	
  are	
  no	
  
alternatives	
  to	
  an	
  unhealthy	
  diet.	
  	
  You	
  are	
  aging	
  in	
  prison,	
  you’re	
  not	
  getting	
  a	
  proper	
  diet,	
  and	
  you	
  don’t	
  
get	
  medical	
  assistance	
  so	
  the	
  combination	
  of	
  those	
  things	
  leads	
  to	
  the	
  deterioration.”	
  
GU,	
  a	
  69-­‐year-­‐old	
  man	
  who	
  spent	
  41	
  years	
  in	
  state	
  prison,	
  described	
  poor	
  diet:	
  	
  	
  
“There	
  are	
  not	
  very	
  many	
  healthy	
  options	
  in	
  terms	
  of	
  diet	
  in	
  prison.	
  	
  The	
  diet	
  consists	
  of	
  basically	
  sugar	
  
and	
  starch.	
  	
  The	
  meat	
  products	
  are	
  of	
  the	
  lowest	
  quality.	
  	
  The	
  diet	
  is	
  very	
  deficient	
  of	
  all	
  the	
  daily	
  
requirements	
  a	
  person	
  would	
  need	
  for	
  a	
  healthy	
  aging	
  process.	
  	
  They	
  are	
  basically	
  starving	
  people	
  
nutritionally.	
  	
  It’s	
  a	
  form	
  of	
  genocide	
  the	
  way	
  that	
  they	
  feed	
  prisoners.”	
  
MU,	
  a	
  54-­‐year-­‐old	
  woman	
  who	
  spent	
  ten	
  years	
  in	
  state	
  prisons,	
  described	
  lack	
  of	
  exercise:	
  	
  	
  
“When	
  you	
  are	
  incarcerated	
  you	
  have	
  one	
  hour	
  of	
  rec	
  and	
  if	
  you	
  are	
  in	
  administrative	
  segregation	
  you	
  
probably	
  have	
  none.”	
  	
  
RC,	
  a	
  57-­‐year-­‐old	
  woman	
  who	
  served	
  four	
  years	
  in	
  prison,	
  described	
  how	
  prison	
  officials	
  have	
  limited	
  
prisoners’	
  movement:	
  	
  
“You	
  can	
  only	
  go	
  out	
  for	
  an	
  hour	
  a	
  day.	
  They	
  don't	
  even	
  go	
  out	
  anymore	
  to	
  walk	
  over	
  to	
  the	
  mess	
  hall.	
  
They	
  bring	
  the	
  food	
  to	
  eat	
  on	
  the	
  tier.	
  Wherever	
  you	
  live	
  that	
  is	
  where	
  you	
  eat.	
  The	
  only	
  time	
  you	
  may	
  go	
  
out	
  is	
  if	
  you	
  have	
  classes.	
  You	
  can	
  go	
  to	
  class	
  and	
  come	
  back	
  or	
  whatever.	
  Or	
  the	
  groups,	
  whatever	
  the	
  
groups	
  are	
  that	
  may	
  be	
  offered	
  now.	
  They	
  can	
  go	
  to	
  those	
  and	
  come	
  back.	
  That's	
  basically	
  it.”	
  	
  
	
  

7	
  

Lack	
  of	
  appropriate	
  care	
  for	
  mental	
  disability	
  and	
  disease	
  
GU,	
  a	
  69-­‐year-­‐old	
  man	
  who	
  spent	
  41	
  years	
  in	
  state	
  prison,	
  described	
  an	
  over-­‐reliance	
  on	
  psychotropic	
  
drugs	
  and	
  long	
  periods	
  of	
  confinement	
  of	
  people	
  with	
  mental	
  illness:	
  	
  	
  
“The	
  drugs	
  will	
  make	
  you	
  docile	
  and	
  then	
  they	
  put	
  you	
  in	
  a	
  closed	
  confinement	
  unit.	
  They	
  may	
  leave	
  you	
  
in	
  the	
  closed	
  confinement	
  unit	
  for	
  up	
  to	
  25	
  years.	
  	
  I’ve	
  seen	
  it	
  done	
  in	
  so	
  many	
  instances.	
  	
  […]	
  Not	
  only	
  do	
  
you	
  have	
  elderly	
  people	
  with	
  mental	
  health	
  concerns	
  but	
  you	
  also	
  have	
  the	
  young	
  kids	
  who	
  come	
  in	
  now	
  
who	
  are	
  on	
  these	
  crazy	
  types	
  of	
  drugs.	
  	
  In	
  a	
  general	
  population	
  of	
  1,600	
  people	
  I	
  would	
  say	
  800	
  of	
  them	
  
are	
  on	
  some	
  form	
  of	
  psychotropic	
  drugs.	
  	
  It’s	
  a	
  huge	
  problem.”	
  	
  	
  	
  
LS,	
  a	
  63-­‐year-­‐old	
  man,	
  recalled:	
  	
  	
  
“They	
  really	
  don’t	
  care	
  for	
  people	
  with	
  a	
  mental	
  illness.	
  	
  A	
  lot	
  of	
  people	
  in	
  this	
  environment	
  mentally	
  
deteriorate.	
  […]	
  They	
  don’t	
  do	
  anything	
  for	
  mental	
  health	
  in	
  this	
  place	
  other	
  than	
  giving	
  people	
  
medication	
  …	
  but	
  there	
  is	
  very	
  little	
  therapy	
  that	
  people	
  get	
  that	
  can	
  be	
  conducive	
  to	
  your	
  well-­‐being.”	
  
MU,	
  a	
  54-­‐year-­‐old	
  woman	
  who	
  spent	
  10	
  years	
  in	
  prison,	
  described	
  neglect	
  of	
  the	
  mentally	
  disabled	
  or	
  
diseased:	
  	
  
“I	
  would	
  see	
  mentally	
  ill	
  patients	
  sitting	
  in	
  their	
  feces	
  and	
  throwing	
  their	
  food	
  around.	
  	
  Sleeping	
  in	
  slop	
  
and	
  that’s	
  a	
  form	
  of	
  illness.	
  […]	
  The	
  way	
  they	
  treat	
  mentally	
  ill	
  and	
  people	
  who	
  are	
  ill	
  in	
  general	
  whether	
  
they	
  are	
  elderly	
  or	
  young	
  is	
  an	
  abomination.”	
  
OL,	
  a	
  71-­‐year-­‐old	
  man	
  who	
  has	
  served	
  28	
  years	
  in	
  state	
  prison,	
  described	
  neglect	
  of	
  the	
  mentally	
  
disabled	
  or	
  diseased:	
  	
  	
  
“The	
  medical	
  unit	
  in	
  prison	
  is	
  horrible.	
  	
  A	
  guy	
  might	
  go	
  down	
  for	
  medical	
  care	
  with	
  dementia	
  and	
  they’d	
  
say	
  there’s	
  nothing	
  we	
  can	
  do.	
  	
  With	
  Alzheimer’s	
  they	
  would	
  just	
  put	
  you	
  in	
  a	
  cell	
  and	
  forget	
  about	
  
you.	
  	
  In	
  South	
  Woods,	
  we	
  call	
  it	
  the	
  death	
  camp,	
  because	
  that’s	
  where	
  they	
  send	
  you	
  to	
  die,	
  because	
  they	
  
supposedly	
  have	
  the	
  facilities	
  to	
  accommodate	
  them	
  but	
  they	
  just	
  end	
  up	
  throwing	
  you	
  in	
  a	
  cell	
  to	
  waste	
  
away.”	
  
Lack	
  of	
  special	
  provisions	
  for	
  elderly	
  prisoners	
  
MU,	
  a	
  54-­‐year-­‐old	
  woman	
  who	
  spent	
  10	
  years	
  in	
  prison,	
  said	
  the	
  prison	
  officials	
  treated	
  the	
  elderly	
  
prisoners	
  the	
  same	
  as	
  the	
  others:	
  	
  
“They	
  treat	
  the	
  elderly	
  like	
  any	
  other	
  inmate.	
  	
  The	
  idea	
  of	
  any	
  special	
  treatment	
  for	
  the	
  elderly	
  is	
  out	
  the	
  
door.	
  	
  Prison	
  is	
  prison.	
  	
  How	
  they	
  run	
  the	
  prison	
  is	
  inhumane,	
  the	
  same	
  for	
  everyone.	
  	
  It	
  means	
  you	
  are	
  
faced	
  with	
  unprofessional	
  guards.	
  	
  The	
  word	
  elderly	
  is	
  out	
  of	
  their	
  vocabulary.	
  	
  You	
  are	
  a	
  prisoner,	
  plain	
  
and	
  simple.	
  	
  They	
  treat	
  you	
  like	
  any	
  other	
  inmate.”	
  
RC,	
  a	
  57-­‐year-­‐old	
  woman	
  who	
  served	
  four	
  years,	
  added:	
  

	
  

8	
  

“Mostly	
  what	
  I	
  saw	
  were	
  women	
  who	
  came	
  in	
  aged.	
  They	
  came	
  in	
  wheelchairs.	
  They	
  were	
  expected	
  to	
  
do	
  everything	
  as	
  we	
  were	
  doing.	
  They	
  didn't	
  get	
  any	
  special	
  help	
  or	
  consideration,	
  nothing.	
  If	
  they	
  had	
  to	
  
go	
  to	
  medical	
  one	
  of	
  the	
  girls	
  from	
  on	
  the	
  tier	
  would	
  push	
  them	
  over.	
  They	
  had	
  no	
  one	
  to	
  help	
  them	
  or	
  
special	
  accommodations.”	
  
MLR,	
  a	
  42-­‐year-­‐old	
  man	
  who	
  spent	
  more	
  than	
  10	
  years	
  in	
  various	
  prisons,	
  described	
  how	
  aging	
  prisoners	
  
face	
  difficulties	
  with	
  bunk	
  beds:	
  	
  	
  
“No	
  matter	
  how	
  old	
  you	
  are	
  they’ll	
  make	
  you	
  get	
  up	
  on	
  the	
  top	
  bunk.	
  	
  You	
  can	
  have	
  an	
  obvious	
  back	
  
injury	
  and	
  they	
  will	
  basically	
  make	
  you	
  jump	
  through	
  hoops	
  to	
  get	
  any	
  consideration.	
  	
  You	
  basically	
  have	
  
to	
  have	
  recent	
  back	
  surgery	
  and	
  be	
  damaged	
  goods	
  just	
  to	
  get	
  approval	
  for	
  a	
  bottom	
  bunk.	
  	
  A	
  guy	
  sixty	
  
or	
  seventy	
  years	
  old	
  has	
  to	
  jump	
  up	
  and	
  down	
  off	
  the	
  top	
  bunk	
  with	
  a	
  mattress	
  being	
  too	
  small.”	
  
GU,	
  a	
  69-­‐year-­‐old	
  man	
  who	
  spent	
  41	
  years	
  in	
  prison,	
  also	
  saw	
  a	
  pressing	
  need	
  for	
  special	
  
accommodations:	
  
“The	
  elderly	
  prisoners	
  are	
  usually	
  thrown	
  in	
  with	
  the	
  younger	
  prisoners	
  in	
  double	
  lock	
  situations.	
  	
  The	
  
conditions	
  for	
  most	
  older	
  men	
  are	
  terrible	
  because	
  they	
  live	
  in	
  the	
  cells	
  with	
  these	
  young	
  kids.	
  	
  And	
  these	
  
young	
  kids	
  are	
  so	
  disrespectful	
  to	
  these	
  older	
  men.	
  	
  Many	
  of	
  them	
  suffer	
  from	
  mental	
  illness	
  if	
  not	
  
physical	
  sickness.	
  	
  […]	
  	
  Clearly	
  there	
  should	
  be	
  special	
  housing	
  for	
  older	
  prisoners.	
  	
  They	
  need	
  special	
  
medical	
  care,	
  they	
  need	
  special	
  exercises,	
  and	
  they	
  need	
  counseling—all	
  of	
  things	
  that	
  are	
  not	
  provided	
  
in	
  the	
  general	
  population	
  for	
  that	
  age	
  level.	
  	
  Sanitary	
  conditions	
  are	
  horrendous	
  because	
  most	
  older	
  men	
  
can’t	
  properly	
  clean	
  themselves.	
  	
  They	
  don’t	
  care;	
  they	
  just	
  put	
  them	
  in	
  a	
  cell	
  with	
  another	
  person.”	
  	
  
JS,	
  a	
  60-­‐year-­‐old	
  man	
  who	
  served	
  30	
  years	
  in	
  Northern	
  State	
  prison,	
  expressed	
  the	
  same	
  view:	
  	
  
“There	
  should	
  be	
  a	
  special	
  area	
  for	
  older	
  prisoners.	
  	
  There	
  should	
  be	
  an	
  area	
  where	
  they	
  can	
  confide	
  with	
  
each	
  other	
  about	
  health	
  issues	
  and	
  work	
  amongst	
  each	
  other.	
  	
  When	
  you	
  get	
  older	
  your	
  movement	
  slows	
  
down.	
  In	
  the	
  population	
  younger	
  prisoners	
  think	
  older	
  prisoners	
  slow	
  things	
  down	
  at	
  work.”	
  
Impact	
  of	
  poor	
  conditions	
  and	
  long	
  sentences	
  	
  
LS,	
  a	
  63-­‐year-­‐old	
  man	
  who	
  has	
  served	
  34	
  years	
  of	
  his	
  sentence,	
  currently	
  in	
  Trenton	
  State	
  prison,	
  
described	
  the	
  impact	
  of	
  long	
  sentences:	
  
“They	
  have	
  some	
  astronomical	
  sentences	
  in	
  these	
  prisons.	
  If	
  you	
  gave	
  a	
  20-­‐year-­‐old	
  a	
  sentence	
  of	
  60	
  or	
  
70	
  years	
  you’re	
  telling	
  them	
  that	
  they	
  are	
  going	
  to	
  die	
  in	
  there.	
  […]	
  A	
  lot	
  them	
  didn’t	
  realize	
  they	
  would	
  
be	
  here	
  that	
  long.	
  Sometimes	
  it	
  takes	
  them	
  a	
  long	
  time	
  to	
  realize	
  they	
  have	
  a	
  death	
  sentence	
  if	
  they	
  
don’t	
  get	
  their	
  sentence	
  reduced	
  or	
  their	
  convictions	
  reversed.”	
  	
  	
  
He	
  also	
  observed	
  how	
  poor	
  conditions	
  cause	
  prisoners	
  to	
  age	
  faster:	
  	
  
“I	
  started	
  seeing	
  people	
  being	
  affected	
  medically	
  usually	
  around	
  their	
  mid-­‐30s	
  in	
  here.	
  Because	
  first	
  the	
  
lack	
  of	
  mobility	
  and	
  the	
  lack	
  of	
  nutritious	
  diet.	
  They	
  buy	
  the	
  lowest	
  cost	
  food	
  products	
  they	
  can	
  find.	
  So	
  
lack	
  of	
  nutritious	
  diet	
  and	
  lack	
  of	
  movement	
  is	
  detrimental	
  to	
  everybody	
  young	
  or	
  old.	
  You	
  see	
  the	
  effects	
  
	
  

9	
  

of	
  it	
  on	
  men	
  with	
  rampant	
  high	
  blood	
  pressure,	
  heart	
  disease	
  and	
  other	
  diseases	
  of	
  obesity	
  and	
  even	
  
cancer.”	
  
GU,	
  a	
  69-­‐year-­‐old	
  man	
  who	
  spent	
  41	
  years	
  in	
  prison,	
  described	
  the	
  psychological	
  impact:	
  	
  	
  
“As	
  you	
  get	
  older	
  in	
  prison	
  you	
  may	
  no	
  longer	
  have	
  the	
  support	
  of	
  people	
  who	
  were	
  there	
  when	
  you	
  first	
  
came	
  to	
  prison.	
  	
  People	
  and	
  family	
  begin	
  to	
  die.	
  	
  You	
  don’t	
  know	
  how	
  to	
  develop	
  resources	
  to	
  sustain	
  
yourself	
  so	
  your	
  spirit	
  begins	
  to	
  dwindle.	
  	
  Your	
  physical	
  health	
  begins	
  to	
  dwindle.	
  	
  I’ve	
  seen	
  brothers	
  in	
  
lockups	
  who	
  never	
  come	
  out	
  of	
  their	
  cells.	
  	
  They	
  never	
  come	
  out	
  to	
  the	
  yard	
  to	
  exercise.	
  	
  They	
  never	
  do	
  
anything	
  that	
  is	
  constructive	
  or	
  productive	
  for	
  their	
  minds,	
  bodies	
  or	
  their	
  spirit.”	
  
SA,	
  a	
  79-­‐year-­‐old	
  man	
  who	
  has	
  spent	
  43	
  years	
  in	
  prison,	
  contracted	
  tuberculosis	
  from	
  poor	
  conditions:	
  	
  	
  
“I	
  was	
  locked	
  down	
  in	
  one	
  of	
  the	
  oldest	
  parts	
  of	
  the	
  prison	
  that	
  was	
  infested	
  with	
  rats	
  and	
  tuberculosis	
  
bacteria	
  in	
  the	
  walls,	
  floors,	
  cracks	
  and	
  crevices.	
  	
  Around	
  age	
  40	
  or	
  so,	
  I	
  began	
  to	
  suffer	
  lower	
  back	
  pains	
  
sometimes	
  so	
  severe	
  that	
  the	
  only	
  remedy	
  was	
  ten	
  straight	
  days	
  of	
  bed	
  rest.	
  	
  […]	
  	
  I	
  was	
  transferred	
  into	
  
the	
  federal	
  system’s	
  highest	
  security	
  prison	
  and	
  my	
  entrance	
  physical	
  exam	
  showed	
  that	
  I	
  was	
  infected	
  
with	
  tuberculosis.”	
  	
  
LC,	
  a	
  55-­‐year-­‐old	
  woman	
  who	
  spent	
  five	
  years	
  in	
  jails	
  and	
  prisons,	
  also	
  described	
  the	
  social/family	
  
impact:	
  
“Most	
  women	
  who	
  spend	
  decades	
  in	
  prison	
  have	
  no	
  family	
  left,	
  no	
  knowledge	
  of	
  the	
  current	
  outside	
  
world.	
  We	
  spend	
  decades	
  being	
  told	
  not	
  only	
  how	
  to	
  behave,	
  but	
  when	
  to	
  wake,	
  sleep,	
  eat,	
  move,	
  where	
  
to	
  walk,	
  and	
  how	
  and	
  whom	
  to	
  talk	
  with.	
  To	
  then	
  expect	
  someone	
  at	
  70	
  to	
  successfully	
  transition	
  back	
  
into	
  society	
  in	
  a	
  recipe	
  for	
  disaster.	
  They	
  have	
  no	
  experience	
  left	
  in	
  basic	
  decision	
  making,	
  and	
  no	
  
guidance	
  either	
  before	
  or	
  after	
  they	
  are	
  released.”	
  	
  

	
  

10	
  

Preliminary	
  recommendations	
  for	
  New	
  Jersey12	
  
Based	
  on	
  the	
  testimonies	
  in	
  this	
  report,	
  we	
  recommend	
  that	
  New	
  Jersey	
  develop	
  and	
  support	
  laws	
  and	
  
policies	
  that	
  enable	
  the	
  safe	
  care,	
  custody,	
  and	
  treatment	
  of	
  older	
  prisoners,	
  and	
  facilitate	
  the	
  release	
  of	
  
older	
  prisoners	
  who	
  have	
  completed	
  the	
  mandatory/punitive	
  part	
  of	
  their	
  sentences.	
  These	
  
recommendations	
  are	
  based	
  on	
  the	
  testimonies	
  of	
  this	
  report	
  and	
  are	
  modeled	
  after	
  recommendations	
  
made	
  in	
  the	
  2015	
  report,	
  “Aging	
  in	
  Prison”	
  from	
  the	
  Center	
  for	
  Justice	
  at	
  Columbia	
  University.	
  
Specifically,	
  we	
  recommend	
  the	
  following:	
  	
  
Sentencing	
  
• Amend	
  extended	
  sentencing	
  laws	
  to	
  require	
  the	
  presumptive	
  (i.e.,	
  presumed	
  but	
  rebuttable)	
  parole	
  
of	
  elderly	
  prisoners.	
  
During	
  incarceration	
  
• Enact	
  a	
  Bill	
  of	
  Rights	
  specifically	
  for	
  elderly	
  prisoners	
  that	
  incorporates	
  standards	
  for	
  appropriate	
  
conditions	
  of	
  confinement,	
  health	
  care,	
  diet,	
  hygiene,	
  recreation,	
  socialization	
  and	
  family	
  contacts.	
  
•

Prohibit	
  the	
  solitary	
  confinement	
  of	
  elderly	
  prisoners.	
  

•

Adopt	
  comprehensive	
  geriatric	
  assessment	
  tools.	
  	
  

•

Give	
  greater	
  weight	
  to	
  age	
  and	
  disability	
  in	
  classification	
  rules,	
  so	
  that	
  elderly	
  prisoners	
  are	
  placed	
  in	
  
prison	
  facilities,	
  units	
  and	
  single	
  or	
  double	
  cells	
  that	
  are	
  safe	
  and	
  appropriate	
  to	
  their	
  condition.	
  	
  

•

Designate	
  specific	
  facilities	
  and	
  programs	
  that	
  can	
  accommodate	
  older	
  prisoners	
  with	
  special	
  needs.	
  

•

Provide	
  comprehensive	
  training	
  to	
  prison	
  staff	
  on	
  geriatric	
  care	
  and	
  treatment.	
  

For	
  release	
  
• Establish	
  broader	
  criteria	
  for	
  medical	
  release,	
  medical	
  transfer,	
  and	
  medical	
  parole	
  that	
  authorize	
  
these	
  changes	
  in	
  status	
  on	
  the	
  basis	
  of	
  mental	
  as	
  well	
  as	
  physical	
  conditions.	
  
•

Establish	
  a	
  specific	
  presumption	
  for	
  the	
  parole	
  release	
  of	
  elderly	
  prisoners,	
  as	
  soon	
  as	
  they	
  have	
  
served	
  the	
  punitive	
  part	
  of	
  their	
  sentences.	
  (See,	
  e.g.,	
  the	
  New	
  York	
  Safe	
  and	
  Fair	
  Evaluation	
  (SAFE)	
  
Parole	
  Act	
  pending	
  (S01728/A02930),	
  which	
  bars	
  parole	
  denial	
  on	
  the	
  grounds	
  of	
  the	
  “nature	
  of	
  the	
  
original	
  crime,”	
  after	
  the	
  minimum	
  sentence	
  has	
  been	
  completed.)	
  

•

Promulgate	
  parole	
  standards	
  that	
  properly	
  balance	
  risk	
  factors	
  in	
  making	
  parole	
  release	
  and	
  "future	
  
eligibility	
  term"	
  (FET)	
  determinations,	
  by	
  ensuring	
  that	
  age,	
  low	
  recidivism	
  rates	
  for	
  older	
  prisoners,	
  
and	
  the	
  length	
  of	
  time	
  since	
  the	
  underlying	
  offense	
  are	
  explicitly	
  considered;	
  ensure	
  that	
  fixed	
  
factors,	
  such	
  as	
  the	
  underlying	
  offense,	
  are	
  not	
  given	
  undue	
  or	
  presumptive	
  weight	
  in	
  the	
  face	
  of	
  the	
  
dynamic	
  factors	
  of	
  institutional	
  history;	
  ensure	
  reasonable	
  time	
  frames	
  for	
  prisoners	
  to	
  make	
  
necessary	
  changes	
  in	
  factors	
  affecting	
  risk.	
  

	
  

11	
  

•

Promulgate	
  guidelines	
  for	
  reentry	
  plans	
  for	
  older	
  prisoners	
  that	
  require	
  the	
  involvement	
  of	
  the	
  
prisoner	
  in	
  developing	
  the	
  plan,	
  and	
  include	
  primary	
  community	
  support	
  family	
  and	
  others	
  in	
  
planning,	
  with	
  the	
  prisoner's	
  consent.	
  

•

Provide	
  referrals	
  to	
  appropriate	
  community-­‐based	
  service	
  providers,	
  to	
  ensure	
  safe	
  transitions	
  and	
  
continuity	
  of	
  care.	
  

	
  
Oversight	
  
• Require	
  that	
  prison	
  systems,	
  in	
  coordination	
  with	
  other	
  human	
  service	
  public	
  agencies,	
  meet	
  the	
  
United	
  Nations	
  Standard	
  Minimum	
  Rules	
  for	
  the	
  Treatment	
  of	
  Prisoners.	
  
	
  
• Establish	
  a	
  statewide	
  office,	
  independent	
  of	
  the	
  Department	
  of	
  Corrections,	
  to	
  develop	
  and	
  monitor	
  
prison	
  standards.	
  

	
  

12	
  

Acknowledgements	
  	
  
The	
  AFSC	
  Prison	
  Watch	
  Program	
  and	
  its	
  director,	
  Bonnie	
  Kerness,	
  cannot	
  express	
  enough	
  gratitude	
  to	
  
everyone	
  for	
  their	
  constant	
  dedication	
  and	
  commitment	
  over	
  the	
  process	
  of	
  this	
  project.	
  AFSC’s	
  Prison	
  
Watch	
  Program	
  has	
  always	
  been	
  a	
  team	
  effort	
  including	
  volunteers,	
  students	
  and	
  activists	
  on	
  both	
  sides	
  
of	
  the	
  prison	
  walls.	
  To	
  those	
  Prison	
  Watch	
  “staff”	
  who	
  were	
  involved,	
  thank	
  you,	
  including	
  AFSC	
  
volunteer	
  MaryAnn	
  Cool	
  and	
  AFSC	
  interns	
  Kayla	
  Stepinac,	
  Rachel	
  Frome	
  and	
  Kelsey	
  Wimmershoff.	
  The	
  
patience,	
  research,	
  writing	
  and	
  guidance	
  of	
  Jehanne	
  Henry	
  was	
  loving	
  and	
  invaluable.	
  Without	
  the	
  
wisdom	
  and	
  mentorship	
  of	
  Jean	
  Ross,	
  this	
  document	
  would	
  not	
  have	
  flourished.	
  	
  A	
  special	
  thank	
  you	
  for	
  
the	
  encouragement	
  of	
  Tina	
  Maschi	
  of	
  Fordham,	
  School	
  of	
  Social	
  Service,	
  and	
  Laura	
  Whitehorn	
  and	
  
Mujahid	
  Farid	
  of	
  the	
  New	
  York	
  Chapter	
  of	
  Release	
  Aging	
  People	
  in	
  Prison	
  Campaign.	
  Finally,	
  we	
  are	
  most	
  
grateful	
  to	
  the	
  elderly	
  prisoners	
  whose	
  voices	
  are	
  suppressed	
  every	
  day	
  and	
  who	
  refuse	
  to	
  be	
  silent.	
  
Without	
  their	
  courageous	
  voices	
  and	
  insistence	
  that	
  we	
  share	
  them,	
  we	
  on	
  the	
  outside	
  would	
  know	
  
nothing.	
  	
  
AFSC	
  Prison	
  Watch	
  
The	
  American	
  Friends	
  Service	
  Committee	
  (AFSC)	
  is	
  a	
  Quaker	
  organization	
  that	
  includes	
  people	
  of	
  various	
  
faiths	
  who	
  are	
  committed	
  to	
  social	
  justice,	
  peace	
  and	
  humanitarian	
  service.	
  Prison	
  Watch	
  is	
  a	
  healing	
  
justice	
  program	
  that	
  challenges	
  the	
  effectiveness	
  of	
  many	
  of	
  the	
  conditions	
  of	
  confinement	
  in	
  the	
  U.S.	
  
prison	
  system.	
  	
  
Prisoners	
  and	
  their	
  families	
  inform	
  our	
  efforts,	
  as	
  we	
  work	
  with	
  policymakers,	
  coalitions,	
  other	
  
advocates	
  and	
  the	
  legal	
  community	
  to	
  change	
  the	
  paradigms	
  of	
  punishment	
  to	
  one	
  of	
  healing	
  and	
  
transformation	
  that	
  seeks	
  to	
  restore	
  wholeness	
  to	
  individuals	
  and	
  communities.	
  We	
  advocate	
  for	
  
alternatives	
  to	
  incarceration,	
  better	
  mechanisms	
  for	
  reintegration	
  after	
  prison,	
  and	
  more	
  humane	
  
conditions	
  of	
  confinement.	
  
We	
  offer	
  educational	
  opportunities	
  for	
  young	
  people,	
  including	
  academic	
  internships	
  and	
  advocacy	
  
training.	
  We	
  reach	
  thousands	
  of	
  individuals	
  each	
  year	
  through	
  presentations	
  to	
  faith	
  communities,	
  
universities,	
  and	
  others.	
  We	
  also	
  provide	
  informational	
  resources	
  on	
  topics	
  such	
  as	
  surviving	
  solitary	
  
confinement,	
  sentence	
  planning,	
  and	
  parole	
  readiness	
  to	
  those	
  incarcerated,	
  their	
  families,	
  and	
  other	
  
advocates.	
  	
  

	
  

	
  
	
  
Prison	
  Watch	
  Program	
  
89	
  Market	
  Street,	
  6th	
  Floor	
  
Newark,	
  NJ	
  07104	
  
Phone:	
  973-­‐643-­‐3192	
  
Email:	
  bkerness@afsc.org	
  

	
  
	
  
	
  

13	
  

End	
  notes	
  
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
1

	
  	
  	
  See	
  Human	
  Rights	
  Watch,	
  “Old	
  Behind	
  Bars:	
  The	
  Aging	
  Prison	
  Population	
  in	
  the	
  United	
  States,”	
  January	
  2012,	
  at	
  
https://www.hrw.org/report/2012/01/27/old-­‐behind-­‐bars/aging-­‐prison-­‐population-­‐united-­‐states	
  	
  
2

	
  	
  	
  New	
  Jersey	
  Department	
  of	
  Corrections,	
  http://www.state.nj.us/corrections/pages/offender_stats.html	
  

3

	
  	
  	
  See	
  N.J.S.	
  2C:	
  43-­‐7.2.	
  

4

	
  	
  	
  See	
  e.g.	
  http://www.pewtrusts.org/~/media/assets/2014/06/04/maxout_report.pdf,	
  	
  People	
  who	
  complete	
  
their	
  sentences	
  leave	
  prison	
  without	
  any	
  authority	
  for	
  supervision.	
  
5

	
  	
  	
  Human	
  Rights	
  Watch,	
  ibid.	
  

6

	
  See	
  JOANN	
  B.	
  MORTON,	
  U.S.	
  DEP'T	
  OF	
  JUSTICE,	
  AN	
  ADMINISTRATIVE	
  OVERVIEW	
  OF	
  THE	
  OLDER	
  INMATE	
  1,	
  4	
  
(1992);	
  Herbert	
  J.	
  Hoelter	
  &	
  Barry	
  Holman,	
  National	
  Center	
  on	
  Institutions	
  and	
  Alternatives,	
  Alexandria,	
  VA,	
  
IMPRISONING	
  ELDERLY	
  OFFENDERS:	
  MEDICAL	
  CARE	
  AND	
  PHYSICAL	
  ENVIRONMENTS	
  ARE	
  OF	
  SPECIAL	
  CONCERN	
  
(Dec.	
  1998)	
  note	
  1,	
  at	
  4.	
  While	
  age	
  fifty	
  seems	
  closer	
  to	
  middle	
  age	
  than	
  to	
  elderly,	
  the	
  socioeconomic	
  status,	
  lack	
  
of	
  access	
  to	
  medical	
  care,	
  and	
  lifestyle	
  of	
  older	
  criminals	
  may	
  create	
  a	
  ten	
  year	
  differential	
  between	
  the	
  health	
  of	
  
inmates	
  in	
  the	
  Bureau	
  of	
  Prisons	
  and	
  the	
  general	
  population.	
  Id.;	
  Joanne	
  O'Bryant,	
  
7

	
  	
  	
  	
  Vera	
  Institute	
  of	
  Justice,	
  “It’s	
  About	
  Time:	
  Aging	
  Prisoners,	
  Increasing	
  Costs,	
  and	
  Geriatric	
  Release,”	
  April	
  2010,	
  
at	
  http://archive.vera.org/sites/default/files/resources/downloads/Its-­‐about-­‐time-­‐aging-­‐prisoners-­‐increasing-­‐
costs-­‐and-­‐geriatric-­‐release.pdf	
  
8

	
  	
  	
  Matt	
  Friedman,	
  “More	
  inmates	
  would	
  be	
  eligible	
  for	
  medical	
  parole	
  under	
  NJ	
  legislation,”	
  June	
  18,	
  2015,	
  NJ	
  
Advance	
  Media	
  for	
  NJ.com	
  
9

	
  	
  	
  Human	
  Rights	
  Watch,	
  ibid,	
  p.	
  72	
  

10

	
  	
  	
  	
  International	
  Covenant	
  on	
  Civil	
  and	
  Political	
  Rights	
  (ICCPR),	
  arts.	
  7	
  and	
  10;	
  International	
  Covenant	
  on	
  
Economic,	
  Social	
  and	
  Cultural	
  Rights	
  (ICESCR),	
  art.	
  12;	
  Convention	
  Against	
  Torture,	
  art.	
  16;	
  	
  Convention	
  on	
  the	
  
Rights	
  of	
  Persons	
  with	
  Disabilities.	
  
11

	
  	
  	
  Human	
  Rights	
  Watch,	
  ibid.	
  pp.	
  43-­‐71	
  

12

	
  	
  	
  Center	
  for	
  Justice	
  at	
  Columbia	
  University,	
  “Aging	
  in	
  Prison:	
  Reducing	
  Elder	
  Incarceration	
  and	
  Promoting	
  Public	
  
Safety,”	
  November	
  2015,	
  pp	
  XXVIII-­‐XIX.	
  
	
  
	
  
	
  
	
  
	
  

	
  

14	
  

	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
   	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  

Suggested	
  Reading	
  
Tina	
  Maschi,	
  PhD,*	
  Deborah	
  Viola,	
  PhD,	
  and	
  Fei	
  Sun,	
  PhD.	
  	
  (2012).	
  “The	
  High	
  Cost	
  of	
  the	
  International	
  Aging	
  
Prisoner	
  Crisis:	
  Well-­‐Being	
  as	
  the	
  Common	
  Denominator	
  for	
  Action.”	
  The	
  Gerontologist	
  Advance	
  Access.	
  	
  
Tina	
  Maschi,	
  George	
  Leibowitz,,	
  and	
  Joanne	
  Rees3	
  &	
  Lauren	
  Pappacena.	
  (2016).	
  “Analysis	
  of	
  US	
  Compassionate	
  
and	
  Geriatric	
  Release	
  Laws:	
  Applying	
  a	
  Human	
  Rights	
  Framework	
  to	
  Global	
  Prison	
  Health.”	
  Journal	
  for	
  Human	
  
Rights	
  Social	
  Work.	
  	
  
Tina	
  Maschi,	
  Lindsay	
  Koskinen.	
  (2015).	
  “Co-­‐Constructing	
  Community:	
  A	
  Conceptual	
  Map	
  for	
  Reuniting	
  Aging	
  People	
  
in	
  Prison	
  with	
  Their	
  Families	
  and	
  Communities.”	
  Traumatology.	
  
Tina	
  Maschi,	
  Lindsay	
  Koskinen,	
  Deborah	
  Viola.	
  (2015).	
  “Trauma,	
  Stress,	
  and	
  Coping	
  Among	
  Older	
  Adults	
  in	
  Prison:	
  
Towards	
  a	
  Human	
  Rights	
  and	
  Intergenerational	
  Family	
  Justice	
  Action	
  Agenda.”	
  Special	
  Issue	
  on	
  Trauma,	
  Aging,	
  and	
  
Well-­‐Being:	
  American	
  Psychological	
  Association.	
  	
  

	
  

15