Parole debate points to rising medical costs.
By Renee Lee/
Updated 11:56 p.m., Sunday, May 15, 2011
A growing population of elderly inmates is driving up prison medical care costs to the point that some Texas lawmakers would like to see more of those who are feeble and chronically ill released early.
In the last decade, the number of inmates 55 and older has spiked as much as 8 percent each year, growing to about 12,500, while the general inmate population has remained fairly flat.
In prisons throughout the country, inmates grow old serving longer sentences and enter prison at an older age. Between 1999 and 2008, the number of inmates 55 and older in state and federal prisons increased by 76 percent to 76,400 inmates, according to the Federal Bureau of Justice Statistics. The general population grew by 18 percent.
With rising medical care costs and dwindling state budgets, policy-makers and prison officials have struggled to keep pace. Elderly inmates in Texas make up 8 percent of the state's prison population, yet they account for more than 30 percent of prison hospitalization costs.
In fiscal year 2010, the state spent more than $545 million on inmate health care. It paid $4,853 per elderly offender for inpatient and outpatient care compared with $795 for inmates under 55, according to the Correctional Managed Health Care Committee.
Legislators this session considered a bill that would have required release of certain elderly and sick inmates to community settings, such as nursing homes and assisted living facilities. Outside prison, many inmates would qualify for Medicaid, lessening the state's financial burden.
The legislation died after failing to make last week's calendar deadline. But lawmakers grapple with the issue every session. Inmates are constitutionally entitled to receive medical care, so states must balance the quality of care with its cost.
State Sen. John Whitmire, D-Houston, chairman of the Senate Criminal Justice Committee, said he would like to see prison space freed up for more dangerous criminals and the cost savings used for law enforcement.
“We certainly need to continue to be sensitive and smart about who becomes old and invalid and doesn't pose a public danger,” Whitmire said. “In times of fiscal concern, we're spending $1 million or more on inmates who can't get out of bed or are really sick individuals. It's just nuts.”
Research shows that most elderly offenders experience an average of three chronic illnesses while incarcerated. Among the most common are arthritis, hypertension, ulcers, heart attacks, diabetes, hepatitis C and cancer, according to the National Institute of Corrections.
Many prisons are not properly equipped to care for the elderly, said Robert Aday, a professor at Middle Tennessee State University and author of a book on aging prisoners. Some states group them in special needs facilities or in centralized geriatric wings to reduce medical costs, he said.
“The sheer numbers are overwhelming them,” Aday said. “A convergence of trends, including enhanced sentencing, more prisons built, and the graying of American people, it's created this crisis.”
In Texas, more than 1,000 offenders are identified each year as being eligible for medical parole, according to a Legislative Budget Board report. About a third of those are processed and presented to the state parole board, which approves 25 percent of those cases each year. Since 1991, 1,287 offenders have been released under the program — about 64 prisoners per year, the report said.