the aging inmate population: southern states outlook

8/20/2019 The Aging Inmate Population: Southern States Outlook

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Introduction

In recent years, the largest and fastest growingnumber of incarcerated inmates over the age of 50

in United States’ prisons has continued to shape

the demographic of prison systems throughout

the country. The perpetual explosion of elderly

persons in the general American population, and the

repercussions of the “tough-on-crime” laws during

the 1980s and 1990s, have led to a current increase of

approximately 675,000 arrests of elderly persons every

year in the United States.1 Experts assert that this is

not attributable to an elderly crime wave, but rather to

several factors that will continue to put more elderly

people behind bars and continue to keep these persons

behind bars longer.

According to the Criminal Justice Institute, in

1992 inmates over the age of 50 made up 5.7 percent

of the total inmate population. Only a decade later

that percentage had increased to 8.6 percent,

which amounted to almost 121,000 elderly

inmates in prison, more than double the

number in 1992.2 Elderly inmates are now

the fastest growing cohort of the inmate popu-

lation in most states throughout the country.3

Specically, across the 16 Southern Legisla-

tive Conference (SLC) states – Alabama,

Arkansas, Florida, Georgia, Kentucky, Loui-siana, Maryland, Mississippi, Missouri,

North Carolina, Oklahoma, South Carolina,

Tennessee, Texas, Virginia, and West Virginia

– this growth rate has escalated by an average

of 145 percent since 1997, prompting state

corrections systems to address the ramica-

tions of this upsurge.

Although states have various deni-

tions of “elderly” with regard to inmates

Te Aging Inmate PopulationSouthern States Outlook

By Jeremy L. Will iams, Policy Analyst

Southern Leg is lat ive Conference

DECEMBER 2006

– the term connoting different age groups dependingon the state – the statistics, along with general uses of

the term “elderly,” in this report are based on inmates

who are 50 years of age or older. Six of the 16 SLC

states distinguish an inmate as “elderly” if he or she

is 50 years of age or older, but nine others dene the

term using the ages 55, 60, or 65 years of age, 65 being

the traditional demarcation for characterizing elderly

persons in society at large. The reason many states,

and a large portion of experts, use the adjusted age of

50 to dene an elderly inmate is due to the existence of

several factors that typically lower the life expectancy

and, correspondingly, the point at which “old age” is

reached of persons in prison. One of these factors isthe basic stress of prison life, which includes anxiety

associated with a change in environment; isolation and

often ostracism from family and friends; the prospect of

living a large portion or one’s life in connement; and

Alabama • Arkansas • Florida • Georgia • Louisiana • Kentucky • Maryland • Mississippi • MissouriNorth Carolina • Oklahoma • South Carolina • Tennessee • Texas • Virginia • West Virginia

S o u t h e r n L e g i s l a t i v e C o n f e r e n c e

Southern Legislative Conference

The Council of State GovernmentsSharing capitol ideas

Characterization of

Elderly Inmates by StateFigure 1»

“Today’s inmates are older, sicker, and staying longer behind bars than ever before.”

–U.S. Department of Justice



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e A g i n g P r i s o n P o p u l a t i o n : S o u

t h e r n S t a t e s O u

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the threat of victimization, which disproportionately

affects older inmates.

Other factors that contribute to an accelerated

aging of inmates include lifestyle choices that are

common among prisoners, both before and after incar-

ceration. These include drug and alcohol abuse; risky

sexual behavior; lack of preventive healthcare; and

other causes that also can be associated with poverty

and lack of education. In fact, the combination of

these patterns is unique to this group4 and can be

used to forecast patterns of physical deterioration for

elderly inmates. Just as the facultative age 65, which

indicates entrance into old age for the average person

outside of prison, has been adopted by habit,5 age 50

is an equally arbitrary margin between middle and old

age for inmates. However, this boundary is meant to

classify aging patterns in inmates that are particular to

this cohort. In other words, although not an absolute

or rigid boundary, the chronological age 50 is a helpful

indicator of the physical age of inmates, just as thechronological age 65 indicates a similar physical state

for persons outside of prison.

This 15-year gap may seem excessive, but experts

contend that it conveys a useful comparison between

elderly persons in prison and those not in prison. In

fact, the distinction between the health of someone

entering prison and the rest of society is so pronounced

that differences often have been noted between those

being admitted into prison and those spending time in

local jails. Sheriff Daron Hall of Davidson County

Tennessee, which includes Nashville, says of the

difference between jail and prison inmate intakes

“[T]he emotional and physical health of those admitted

into jail, in most cases, are extremely different from

those being transferred to prison.”6 Likewise, there

are epidemiological considerations because of the

overall severely lessened health of the average elderly

inmate, which is coupled with the dangers created by

conning large numbers of people to restrained living

quarters. Due to the environment produced by these

connes, institutionalization drastically increases the

probability that infectious, communicable diseases wil

spread. Although not all chronically and terminallyill inmates are elderly, there is a distinct overlap that

Elderly and Non-elderly Inmates

in SLC StatesFigure 1»



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most correctional healthcare programs acknowledge

as signicant.7

The SLC began closely examining this issue

during the 1990s. From information gathered from

state corrections department through 1997, the SLC

published a report, The Aging Inmate Population, on

the topic in 1998, noting that many states “have found

that the increase in the geriatric inmate population has

been far greater than anticipated.”8 As an update to the

1998 report, this SLC Regional Resource explores the

increase of the elderly prison population in Southern

states and the nuances of this development, focusing

particularly on changes since 1997. It examines poli-

cies and procedures employed by each state, as well

as facilities and programs that are geared toward

accommodating this growing population. Also, this

report addresses the concerns of corrections ofcials

regarding the future of the elderly inmate population

within their states. Information was gathered through

polling corrections departments in the 16 SLC member

states. In addition, information was amassed from

existing research projects and studies.



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The Increasing Elderly Inmate Population

The Graying of America

The aging of the general American public isa dynamic that has had the most obvious

and ubiquitous effect on the elderly inmate

population. Persons over the age of 65 are

the most rapidly increasing age group in the United

States. This largely is due to the ability of people

to live much longer than preceding generations. In

fact, according to Dr. Ronald Aday, director of Aging

Studies at Middle Tennessee State University, about

20 percent of all human beings in the world who have

ever lived to be 65 years of age or older currently are

alive.9 Moreover, there are no indications of this rapid

development slowing. By 2030, it is projected that

approximately 80 million people living in the UnitedStates will be 65 years of age or older, making up as

much as 20 percent of the population.10

Although this expeditious increase in the age of

the general population has been noticeable in recent

years, and although it was not until recently that

the effects of this dynamic became importunate and

alarming, the gradual increase has been documented

through the course of the last century. According to

the U.S. Census Bureau, in 1900, only one in every

25 people in the United States was over the age of 65.

By 2000, that number had reached one in every eight.

The aging of the baby boomer population (anyone born between the years 1946 and 1964) has contributed

greatly to this dynamic. In 2005, there were approxi-

mately 78 million baby boomers alive in the United

States, with approximately 7,900 people turning 60

years of age every day.11

While the baby boomers reaching retirement age

will continue to augment the elderly population in the

United States, this is not the only contributing factor

inuencing the “graying” of America. Another factois that more people in general are living longer lives

The U.S. Department of Health and Human Services

Administration on Aging estimated that those 65 years

of age and older numbered 36.3 million in 2004, an

increase of more than 9 percent since the mid-1990s

Also, by way of example, the Administration on Aging

projects that the over-85 population in the United States

will reach about 9 million by 2030.12 Correspondingly

these trends are reected in the growing percentage

of elderly persons in prison, which has been steadily

increasing since the early 1980s and, particularly

over the last decade. The older the general population

becomes, the older the prison populations will becomeas well.

Tough-on-Crime Laws

There has been concern regarding the aging of

America’s prisoners since the early 1980s

Therefore, this trend has been anticipated

although remedies for it are varied and often

conjectural. One of the most obvious reasons for the

aging of the inmate population, apart from the aging

of the general population, is tougher sentencing laws

passed by states during the late 1980s and early 1990s

This time period is characterized by the war on drugs, a

time when great attention was paid to escalating crimerates in almost all states. Two- and three-strikes laws

along with truth-in-sentencing laws, became popular

during this period in an effort to dissuade criminal

behavior. The swell of incidences of heinous crimes

committed against people, such as murder and rape, led

to the advent of this type legislation in many states. The

strand of such laws culminated with the federal Violen

Crime Control and Law Enforcement Act of 1994, the

country’s most comprehensive crime bill ever passed



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While the goal of this legislation was to stie

criminal behavior, particularly violent and drug-related

crime, it has led to an inux of prisoners incarcerated

in state and federal prisons. Most of the prisoners

sentenced under these laws spend large portions of their

lives, if not their entire lives, behind bars. At mid-year

2005, the U.S. Department of Justice calculated that

prisons and jails throughout the country incarcerated

2,186,230 persons. Two-thirds of these, or 1,438,701

inmates, were incarcerated in state and federal jails (the

remainder housed in local jails or in release programs).

From 1995 to 2005, incarceration rates have risen an

average of 14 percent, from 379 to 433 prisoners for

every 100,000 U.S. residents.13

Due largely to these stricter sentencing laws, more

inmates are remaining in prison until they are older, and

more inmates are dying in prison. For instance, at the

state penitentiary in Angola, Louisiana, 97 percent of

the inmates die in prison. In Texas, more than 100

inmates a year die in prison, each death costing the stateapproximately $1,500. Nationwide, the U.S. Justice

Department has estimated that, in 2002, almost 4,000

inmates died in prison from all causes.14 Most of these

inmates are elderly; meaning conversations regarding

the number of inmates dying in prison must involve

the prospect of alternative programs for early parole or

special release as alternatives to these inmates spending

the end of their lives in prison.

Another version of truth-in-sentencing laws that

signicantly impacts the increasing likelihood that

inmates will spend more time in prison is the abolition

of parole for individuals who commit certain crimes.More young persons are receiving sentences of life

without parole, which will continue to contribute to

the already escalating prison population as a whole,

and to the number of inmates who will grow old in

prison. Equally disconcerting is the fact that elderly

persons are committing more serious crimes. The

reasons for this are unclear, but experts speculate that

causes can range from an increasing neglect in society

for elderly persons in general, to other social and

psychological factors that often affect criminology.

It is clear, however, that elderly persons commit

offenses for different reasons than younger ones. This

rise in serious crimes by the elderly is contrary to thestereotype that elderly individuals always are frail and

defenseless, and almost always the victim of misdeed.

However, while the elderly population is not exempt

from participation in serious criminal behavior, that

is not to say that there is or has been, in recent years,

a signicant elderly crime wave. Statistics show that

elderly persons are becoming less likely to commit

crimes in general. Unfortunately, the crimes they do

commit are becoming much more serious.

Many states have eliminated parole programs

for prisoners who have committed ruthless crimes,

while other states have abolished parole programs

altogether.15 For example, Georgia enacted a law in

1995 that mandates a prisoner serve a minimum of

10 years for the rst offense from the list of seven of

the most egregious crimes, dubbed “the seven deadly

sins.” Furthermore, under a two-strikes amendment to

this law, a second conviction of a “deadly sin” yields a

mandatory life sentence. In addition, the constitutional

amendment that established this law abolished parole

for those convicted of a crime covered under the “deadly

sins” categories. This legislation soon made Georgia

fourth in the nation for the amount of time served in

prison for most violent offenses.16 What has resulted

from these laws are a greater number of people being

proscribed to, and fewer people being discharged from,

state prisons. The dramatic effects tough-on-crime

legislation has had on the length of time a prisoner is

incarcerated continue to be felt. Truth-in-sentencing

laws, for instance, have added an average of 15 monthsto prison sentences for violent crimes, nationwide, and

the prisoners becoming elderly in prison due to such

laws are beginning to add up.

Various organizations have attempted to address

potential solutions for problems associated with aging

inmate populations by evaluating the pros and cons

of these more stringent sentencing laws. The Coali-

tion for Federal Sentencing Reform, for instance, has

worked to encourage federal legislation that would

permit managed release for elderly inmates who have

not committed violent or sex-based crimes. Such

organizations encourage states to reevaluate guidelinesfor mandatory sentences as a means of reducing the

number of elderly inmates who are entering prison,

as well as the number of inmates who will grow old

in prison.

Now many states are attempting to combat prob-

lems associated with tough-on-crime legislation that

has produced prison overcrowding and longer prison

sentences for criminals. California, as an example,

which initiated the tough on crime movement in

1994 by passing its “three strikes, you’re out” law,

has considered amending this legislation in order to

prohibit judges from sentencing offenders to life in prison for their third offense unless the offense is a

violent or other serious crime. California, whose state

jails are built to accommodate a total of 100,000 pris-

oners, has a growing 170,000-inmate prison popula-

tion. In addition, in 2005, approximately 60 percent

of California’s inmates who were sentenced for their

third offense were sentenced for nonviolent or non-

serious crimes. Correspondingly, it costs the state

approximately $31,000 a year to house a non-elderly

prisoner.



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The Condition of Elderly Inmates

Many elderly inmates have numerous

chronic diseases requiring extensive

care and treatment that can become

very expensive for state corrections

departments. A major component of this problem is

the sheer number of mentally and developmentally ill

inmates in prison. Currently, there are more mentally

ill individuals in correctional facilities than in mental

hospitals and institutions throughout the United States,

amounting to more than 200,000 inmates with severe

mental illnesses being housed in state prisons or jails.17

Reecting on the link between mental illness and crime,

Robert Hofacre, nursing director of the Ohio Depart-ment of Youth Services, has stated, “The increase of

mentally ill offenders within correctional systems is

directly proportionate to the deinstitutionalization of

the mentally ill in public psychiatric hospitals.”18 It

is not uncommon for elderly inmates to suffer from a

variety of mental illnesses, ranging from various forms

of depression and anxiety disorders, to ailments that are

more specic to this age group, such as Alzheimer’s

disease. Moreover, prison systems were not originally

designed to address the needs of such a large and

diverse population of chronically ill inmates.

Since women typically need more medicalservices throughout their lifetime than men, it follows

that the average elderly woman prisoner will utilize

more medical services than their male counterparts. In

fact, elderly female inmates use more medical services

than any other prison cohort.19 Therefore, states have

begun to give considerable attention to programs that

specically address concerns regarding the medical

needs of elderly female prisoners. Although there

are far more men incarcerated in state prisons than

there are women, the aging female population in state

prisons will bring with it a continued need for betterhousing and medical services, as well as the need for

more medical staff, in order to meet the needs of this

population.

Likewise, African American men are more likely

than other male inmate groups to spend large portions

of their lives in prison. Therefore, elderly African

American men will continue to be disproportionately

represented in the elderly prison population. Overall

Southern states have greater percentages of African

American inmates – male and female – than other

regions of the country. As an example, 52 percen

of the 5,600 elderly inmates incarcerated in Georgiaare African American.20 By 2005, approximately

12 percent of all black males in their late 20s were

in prison or jail, compared to less than 2 percent of

whites in this same age group. This makes African

American males in this group ve to seven times more

likely to be incarcerated.21 The overall percentage o

elderly African American prisoners is much lower than

the percentage of young African American prisoners

however, these statistics that reect higher incar

ceration rates for young African Americans, involving

serious crimes, predict that an incommensurate number

of African American men likely will spend their later

years behind bars.

There are three types of elderly inmates: rst-time

offenders, recidivists and long-term servers. First-time

offenders are elderly criminals who are incarcerated

for the rst time. Approximately 45 percent of elderly

inmates now in prison are rst-time offenders. Recidi

vists are habitual offenders, in prison for a second or

more time. Long-term servers are elderly prisoner

who were not elderly when they entered prison, but

have matured to an elderly age within prison. There

Challenges



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are signicant differences between these three groups.

For instance, both recidivists and long-term servers

are more institutionalized than rst-time offenders,

and long-term servers are more institutionalized than

recidivists. First-time offenders are less likely to adapt

to prison life and typically are in greater threat of

victimization, a problem addressed later in this report.

Recidivists generally have chronic behavioral patterns

and have more complicated behavioral patterns than

rst-time offenders and often long-term servers.22

Housing: Costs, Overcrowding,

and Victimization

The cost of housing the average prisoner in the

South continues to rise. According to Adult

Correctional Systems, an annual compara-

tive date report submitted to the Fiscal

Affairs and Government Operations Committee of the

SLC, prison spending in Southern states has increased

by more than 51 percent over the last decade. The

average cost for housing an inmate for one year inthe South is approximately $18,864, with some states

spending more than $30,000 per inmate.23 While

increasing medical costs for elderly inmates were the

most frequently mentioned major problem by state

corrections departments, the cost of housing healthy

inmates is exorbitant as well. The National Council

on Crime and Delinquency estimates that it costs more

than $1 million to house an inmate for 30 years, which

is the average span of a life sentence, and more than

$2 million to house an inmate for 50 years.24 These

astronomical expenditures are estimates calculated by

basic housing costs and do not include expenses for

medical treatment for that inmate.

In order to address problems associated with

overcrowding, as well as the cost of housing, many

states are examining the benets of alternative housing

for elderly inmates, either by maintaining separate

prisons for these inmates, or by having partitioned

prison wings or units in which to sequester them. One

of the benets to this is reduced costs associated with

consolidated staff for inmates in these areas. Since the

elderly inmate population has distinct medical needs,

training for staff in these prisons or facilities can be

more focused, just as training for staff in other prisons

or prison units can be tailored to best accommodate theneeds of their populations. Also, the facilities them-

selves can be customized to meet the needs of these

inmates. Just as the infrastructure of maximum-secu-

rity prisons is modied to minimize the potential for the

most dangerous inmates to escape, prisons for elderly

inmates would be designed to best accommodate the

prisoners there. For instance, facility alternatives can

be prisons that are restricted to only elderly prisoners.

Therefore, other prisons that do not house inmates with

severe mobility restrictions could forego providing

wheelchair ramps, handicap bathroom stalls, and the

like, for their prison populations. Such modications

could drastically restrict and reduce costs for state

corrections departments.

The level of care provided in these prisons or

prison units for the various needs of the elderly inmate

population can be tiered as well. While many elderly

inmates require nursing-home caliber care, many do

not. There are other elderly inmates who do not require

a nursing-home environment, but would benet from

a more protected location that can better meet their

needs. The extensiveness to which elderly inmates

need adaptive services, more so than almost any other

single prison group, makes the rationality behind sepa-

rate facilities that much more plausible. In general,

studies have shown that most elderly inmates react well

to congregate living communities. 25

Housing elderly inmates in separate facilities also

would address another problem associated with this prison population: the view that conates the physical

problems associated with old age with the justice of

punishment in prison. Many states are attempting to

reform the perspective that any suffering or distress

experienced by an inmate is duly deserved because

of wrongs that the prisoner committed. Educating

communities in general is important, but training staff

who interact with these inmates on a daily basis is

even more imperative to ensure that inmates receive

respectful supervision. As noted, consolidating staff to

one prison, or one area of a prison, would make goals

such as these much more attainable.26

Housing issues also are relevant to the persistent

problem of victimization of elderly inmates by younger

inmates. Elderly inmates often become targets of

prison violence and abuse due to their physical frailty

and lack of ability to defend themselves. Although

many states in which elderly prisoners are housed in the

general population reported that victimization is not a

problem in their prisons, such occurrences are particu-

larly debilitating to elderly inmates when they do occur,

raising humanitarian concerns in many correctional

systems. Again, this problem can be addressed, if not

completely remedied, through separate housing for

frail, elderly inmates – another reason states are inves-tigating the benets of this option.

Parole and Recidivism Issues

Overall, elderly inmates have lower recidi-

vism rates than younger inmates. The 16

SLC states reported varying recidivism

rates for elderly inmates. Little research

has been conducted to examine the reasons for these

varying rates, but what information is available is

of great relevance to existing and prospective parole



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programs. Part of the difculty in gauging the potential

for retrogression into criminal behavior, specically

for this age group, is that the causes for recidivism

cover a variety of psychological and social reasons.

There are trends being evaluated that may begin to help

decipher more denitive, potential causes, and many of

these trends will prove helpful to states in structuring

parole programs for elderly parolees. For instance,

it is known that often elderly inmates released from

prison commit crimes in order to intentionally return to

prison, out of a social need to return to a safe, familiar

environment, rather than a tumultuous, unfamiliar one.

Another known cause of increased recidivism rates

for elderly inmates is lack of belonging or purpose in

society. Inmates reluctant to become involved in civic

activities, such as religious organizations, volunteer

programs, or work programs, are more likely to return

to criminal behavior. The lack of social responsibility

makes the paroled or released inmate less connected to

society and, therefore, more likely to act disobediently

toward the rules of that society.

Such behavior should be addressed by parole

programs to curb greater potential for recidivism and

re-incarceration. These causes can be evaluated and

dissected, and the results used to construct more effec-

tive parole programs. Recidivism also can be affected

by patterns of behavior that cannot be so easily linked

to a succinct origin or basis. Repeat offenders, for

instance, often continue in their patterns of behavior.

Elderly rst-time offenders of nonviolent crimes do

not always commit further crimes when released but,

for varying reasons, sometimes they do. In order

to address increased rates of recidivism, states must

implement programs that provide an individualized

approach that will increase the chances for an inmate

to rejoin society in a positive manner.

There are organizations that are attempting to

address parole problems associated with elderly inmate

parole and special-release programs. The Project for

Older Prisoners (POPS) is an organization that seeks to

address prison overcrowding, in general, and the needs

of elderly and disadvantaged inmates, specically, since

its inception in 1989. Developed by Jonathan Turley

at the George Washington University School of Law

the program actively campaigns for the early release o

elderly inmates with serious or life-threatening health

conditions, and low-security-risk prisoners who have

the means of working and supporting themselves in

society. For high-risk elderly prisoners who have little

or no possibility of being released, POPS advocates the

availability of acceptable nursing-home care within

the prison. POPS was initiated in response to a casein Louisiana involving an elderly man convicted of

a minor felony, but sentenced to a 37-year term due

to state tough-on-crime laws. Since then, POPS ha

orchestrated the release of 500 elderly inmates.27 In

a critique of the general environment of most curren

state prisonS, as well as the inadequacy of many prison

programs for elderly inmates, Jonathan Turley, head

of POPS, has stated, “Prisons make perfectly lousy

nursing homes and, as a result, prisons do things that

are not just inadequate but prohibitively expensive.”2



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Methodology

I

n order to collect information regarding elderly

prisoners in the South, surveys were sent to correc-

tions departments in all 16 SLC member states. 29

Participants responded to questions concerning

ve major areas of investigation regarding their state’selderly prison population: general statistics, specic

criminal statistics, policies, facilities, and concerns.

There was an additional section provided for any

information each department considered relevant and

Southern State Profiles

important to a characterization of their state’s strategy

regarding elderly inmates. Reponses were received

from all 16 states. This information was coupled with

information gleaned from general research. Unless

explicitly stated otherwise, the following state sectionsreect the survey responses submitted by each state

corrections department. The 1997 data in each state

table was taken from The Aging Inmate Population

SLC Special Series Report by Todd Edwards.

1997 2006 1997-2006

State

Total Inmates

in Institutions

Elderly

Inmates

% of

Elderly

Inmates

Total Inmates

in Institutions

Elderly

Inmates

% of

Elderly

Inmates

% Increase

of Inmates in

Institutions

% Increase

Elderly

Inmates

Alabama 21,761 1,223 5.62% 28,050 3,588 12.79% 28.90% 193.38%

Arkansas 10,221 563 5.51% 13,494 1,271 9.42% 32.02% 125.75%

Florida 63,763 3,985 6.25% 86,559 9,168 10.59% 35.75% 130.06%

Georgia 36,972 2,082 5.63% 51,484 5,658 10.99% 39.25% 171.76%

Kentucky 12,910 936 7.25% 19,925 2,216 11.12% 54.34% 136.75%

Louisiana 26,779 1,356 5.06% 39,039 4,060 10.40% 45.78% 199.41%

Maryland 22,109 869 3.93% 22,607 1,947 8.61% 2.25% 124.05%

Mississippi 14,032 730 5.20% 20,891 1,916 9.17% 48.88% 162.47%

Missouri 22,025 1,189 5.40% 30,997 3,512 11.33% 40.74% 195.37%

North Carolina 31,764 1,451 4.57% 36,663 3,769 10.28% 15.42% 159.75%

Oklahoma 20,316 1,430 7.04% 24,146 2,651 10.98% 18.85% 85.38%

South Carolina 20,604 901 4.37% 23,657 1,761 7.44% 14.82% 95.45%

Tennessee 18,795 1,116 5.94% 27,964 2,741 9.80% 48.78% 145.61%

Texas 132,394 7,923 5.98% 151,852 16,622 10.95% 14.70% 109.79%

Virginia 28,408 1,411 4.97% 30,704 3,134 10.21% 8.08% 122.11%

West Virginia 2,755 235 8.53% 5,390 641 11.89% 95.64% 172.77%

Total/Total % 485,608 27,400 5.64% 613,422 64,655 10.54% 26.32% 135.97%

*Note: Includes all inmates under the state’s corrections department, which would comprise all those in prison, jails, and

in parole or other community-release programs, such as nursing homes or half-way houses.

Source: The 1997 statistics were taken from the SLC Special Series Report The Aging Inmate Population. The 2006

statistics were received from surveying the corrections department in each state.

How Southern States CompareTable 1»



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General Statistics Total Inmates Elderly Inmates % of Elderly Inmates

1997 21,761 1,223 5.62%

2006 28,050 3,588 12.79%

% Increase: 1997-2006 28.90% 193.38%

Crime Statistics Total Inmates Elderly Inmates % of Elderly Inmates Convicted of Violent Crime 14,846 2,301 15.50%

Convicted of Sex-based Crime 3,234 732 22.63%

Rate of Recidivism 28.8% NA

Policies: The Department of Corrections

considers inmates 65 years of age and older to be

elderly. Upon admission into a facility, inmates receive

a medical screening and are evaluated annually or

biannually, depending on their medical condition

upon arrival. There are no furlough or medical-release

programs for elderly inmates at this time.

Facilities: The Department of Corrections

maintains an 80-bed prison for elderly and inrm

inmates at the Hamilton Aged and Inrmed Center

(HAIC) in Hamilton, a facility purchased from the

Alabama Mental Health Department in 1981. Although

this prison does not exclusively house elderly inmates,

it is designed to meet the needs of older inmates with

more serious medical and physical needs. The facility

comprises ve acres of housing units and can accom-

modate minimum- and medium-security inmates.

Security and medical policies are coordinated at HAIC

in order to provide adequate safety along with ample

medical care to the individuals housed there.

Challenges: According to Adult Correctiona

Systems, Alabama is at 199 percent capacity for their

overall prison population, the most severe of the inmate

housing crises in the 16 SLC states.30 The Departmen

of Corrections has experienced a 193 percent increase

in elderly inmates in its prisons since 1997, one of the

most drastic increases among the 16 SLC states. Rising

medical costs are of grave concern to the Department ofCorrections. Lack of proper and prompt identication

of chronic illness before admission to prison greatly

contributes to this problem. Also, readily accessible

medical care for the elderly inside prison currently is

in the process of being optimized, particularly with

regard to diseases associated with this group, such as

Alzheimer’s and other forms of dementia.

Alabama



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1997 10,221 563 5.51%

2006 13,494 1,271 9.42%

% Increase: 1997-2006 32.02% 125.75%



Rate of Recidivism 51.4% 8.0%

Policies: The Department of Corrections has a

variety of programs that prompt prisons to screen for

inmates who are mentally and/or physically disabled,

chronically or terminally ill, or have other special

medical needs. Since the Department of Corrections

does not have an established denition of elderly, the

community standard of equal to or greater than 65 years

of age has been adopted as a standard for classifyinggeriatric inmates. Likewise, the Department does not

use any cohort based on age as a standard for health-

care policy. However, such policies are designed to

accommodate many of the needs that elderly inmates

often have. The Department of Corrections has special-

release programs designed to accommodate elderly

inmates who have been diagnosed with a terminal

illness or a permanent physical or mental disability.


accommodates the needs of elderly inmates through the

availability of several separate living areas specically

designed for the needs of inrm and elderly inmates.The Diagnostic Unit and the Jefferson County Jail and

Correctional Facility, both in Pine Bluff, house many

of the elderly inmates in the state. These two facilities

can accommodate 120 inmates who have medical and

mental health needs, many of whom are elderly. One

prison, the McPherson Unit in Newport, houses elderly

female inmates. This facility provides services for

four female inmates with physical needs and 11 female

inmates with mental health needs. Increasing the

number and quality of special needs beds, for both men

and women, is an important part of the Department of

Corrections’ 2007 legislative agenda, with the prospect

of gaining funding for a maximum 800-bed special

needs facility to be constructed during 2008-09.

Challenges: With the second highest percentage

of elderly violent crime offenders among the 16 SLC

states, efforts to curb this trend have been undertaken

by the Department of Corrections as well as the

General Assembly and other government bodies. The

Department of Corrections maintains that increased

operational and budgetary support is necessary in order

to adequately accommodate the increasing popula-

tion of elderly inmates in state prisons. As in many

other states, longer sentences have contributed to the

ever-increasing demand for special accommodations

similar to those found in skilled level or nursing homeenvironments, which are very expensive to maintain

and operate. The construction of the highly anticipated

special needs facility, which has been an operational

need and a topic of discussion since the early 1990s,

would alleviate many of these difculties associated

with accommodating elderly inmates.

Arkansas



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1997 63,763 3,985 6.25%

2006 86,559 9,168 10.59%

% Increase: 1997-2006 35.75% 130.06%


Convicted of Sex-based Crime 9,630 2,139 22.21%

Rate of Recidivism NA NA

signicant mental health needs or who have physica

disabilities that can be addressed by institution staff

The Reception and Medical Center in Lake Butler

can accommodate approximately 100 elderly inmates

with complex medical issues and who require long-

term medical care. Lowell Correctional Institution in

Ocala houses approximately 15 elder female inmates

Finally, the South Florida Reception Center in Dorahouses approximately 600 elderly inmates who have

general needs. Most facilities in the state are capable o

housing mobility-impaired inmates, regardless of age

These facilities have produced the opportunity for more

specialized care and, among other accomplishments

have reduced the levels of victimization for inmates

Also, in other facilities throughout the state, specialized

training is conducted for both healthcare and security

staff regarding the needs of specic inmates.

Challenges: The Department of Corrections has

indicated that rising medical costs have become a major

issue for elderly inmate healthcare. The increasednumber of aging inmates in Florida has dramatically

intensied this problem. Paradoxically, advancements

in technology and medical treatment regimens have

increased the level of care for older inmates, but have

contributed to the problems associated with increased

costs. As a result, prisons are forced to rely on commu

nity healthcare services in order to obtain the requisite

level of services. Shortages in nursing and other

specialized staff also are a major concern.



elderly. Every newly committed inmate arriving at

a Florida prison receives complete health appraisals

by a clinical associate, an advanced registered nurse

practitioner, or physician. These evaluations, carried

out within 21 working days of a prisoner’s arrival, are

reported and documented. General medical plans forinmates are not predicated upon age, but are based on

the individual inmate’s needs, although factors such as

age, gender, and medical history are considered in the

evaluation. Although the Department of Corrections

does have a medical furlough program, like the medical

plan, age is not a determining factor in qualifying for

the program.


maintains six facilities designed to house elderly

inmates. River Junction Work Camp in Chattahoochee

is designed as a male inmate, elder care facility. It

accommodates approximately 400 elderly inmates whodo not have housing restrictions, such as convictions of

sex-related crimes or who suffer from advanced disease

that requires more extensive medical care. Union

Correctional Institution in Raiford is a maximum-

security prison that houses elderly male inmates who

require higher level security arrangements and who

have more austere housing restrictions. Zephyrhills

Correctional Institution in Zephyrhills has approxi-

mately 75 beds for elderly male inmates who have

Florida



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1997 36,972 2,082 5.63%

2006 51,484 5,658 10.99%

% Increase: 1997-2006 39.25% 171.76%


Convicted of Sex-based Crime 7,137 1,471 20.61%

Rate of Recidivism* 37.0% NA

*Statistics are based on repeat offenses within a three-year period.



elderly. All elderly inmates housed by the Department

are given a physical examination at the time of intake.

Mirroring the medical testing recommendations that

are followed in regular prisons, post-intake examina-

tions for elderly inmates include more frequent colon-oscopies, prostate-specic antigen tests, and other tests

which help to identify diseases that are more prevalent

in older persons. These examinations are performed

through a medical reprieve from the Board of Pardons

and Paroles. Special needs are addressed based on

specic diagnoses. Meals for inmates are designed by

a nutritionist, and special diets are available for inmates

with conditions such as diabetes or other ailments that

are adversely affected by diet. Also, there are specic

exercise curricula for inmates over the age of 50,

such as a wellness walk program. The Department of

Corrections is continuing to evaluate the benets of

early-release programs which have saved the state a

great deal of money in housing costs.

Facilities: Although separate facilities speci-

cally for elderly inmates are not maintained, pris-

oners with particular medical needs, such as mobilityrestrictions, can be transferred to facilities that can

adequately accommodate them. The Department of

Corrections maintains several such facilities. Men’s

State Prison and Bostick State Prison, both in Hard-

wick; Johnson State Prison in Wrightsville; Metro State

Prison in Atlanta; and Augusta State Medical Prison in

Grovetown all contain physical adaptations, such as

wheelchair ramps and specialized staff, that are able to

meet the needs of the population.

Challenges: None indicated in survey response.

Georgia



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KentuckyGeneral Statistics Total Inmates Elderly Inmates % of Elderly Inmates

1997 12,910 936 7.25%

2006 19,925 2,216 11.12%

% Increase: 1997-2006 54.34% 136.75%

Crime Statistics Total Inmates Elderly Inmates % of Elderly Inmates Convicted of Violent Crime 6,911 906 13.11%



in these areas. Specically, the State Reformatory

in LaGrange, which houses the majority of inmates

with medical or mental health concerns and has a bed

capacity of 1,996, allows staff to focus attention toward

the needs of elderly inmates in a way that would not

otherwise be feasible without this consolidation. In

addition, the prison maintains a nursing care facility

for inmates with special and debilitating medicaconditions that warrant continuous supervised care

This division accommodates approximately 58 inmates

with intensive-care caliber conditions. Also, the refor

matory has 90 beds designated for inmates who have

moderate special medical needs, and 150 beds for those

with strictly mental health concerns.

Challenges: Like most states, Kentucky has

concerns regarding the rapidly escalating costs o

housing elderly inmates. For instance, the cost for

housing these inmates at the State Reformatory, $70 per

day, exceeds the housing cost for an inmate at the state’s

maximum-security prison, which is approximately$65 per day. Increased cost for professional medica

care for all inmates, regardless of age, is severely

exacerbated by the increasing elderly inmate popula

tion and will only continue to worsen. The rising cos

of healthcare is partly attributable to the rising cost of

pharmaceuticals. The State Reformatory, for instance

has a $200,000-a-month pharmaceutical bill. Also

the availability of medical and mental healthcare staff

has become problematic for the Department of Correc

tions. Maintaining an adequate variety of medica

and mental health professionals who are equipped to

address a multiplicity of diseases and disorders is a

challenge for any healthcare facility, but has becomeeven more challenging in the prison setting. Further

the growing percentage of sex-based crimes being

committed by elderly persons is a dynamic that must be

addressed from a policy perspective. The percentage o

elderly criminals convicted of sex-based offenses has

now reached more than 23 percent, the second highes

among the 16 SLC states.



elderly. All elderly inmates entering prison must be

screened immediately and have an applicable health-

care plan constructed within 48 hours of entry. All

inmates are assessed for general medical and mental

health concerns, and an individual health plan is estab-

lished for each inmate, including treatment proposalsfor chronic and intermittent diseases. All major

correctional facilities have on staff several physicians;

psychiatrists and psychologists; nurse practitioners and

full-time nursing staff; as well as support staff, such

as dental hygienists, physical therapists, and dialysis

staff. The Department of Corrections requires that all

elderly inmates receive an annual health examination.

The Department employs an early medical parole,

which must be recommended by a physician, based on

a prognosis that the inmate has less than a year to live or

is unable to live without signicant medical assistance,

such as reliance on a life-support system. Another

consideration for early medical parole considerationfor elderly inmates is severely limited mobility due

to paralysis or other conditions that often result from

stroke or other trauma. Currently, there is a policy

under review that allows furlough for catastrophic

medical issues or the existence of other medical condi-

tions that are not necessarily fatal in nature but cannot

be adequately treated within prison facilities. All these

considerations are inuenced by the inmate’s likely

threat to society.

Facilities: Various facilities that can accom-

modate elderly inmates are available. Most major

facilities have provisions that address the needs ofinmates over the age of 50, with special training for

medical and security staff for interaction with and

understanding the needs of an aging inmate population.

Staff is made cognizant, for instance, of the potential

for victimization. Also, the safety of elderly inmates

is better secured by facilities that separate inmates

from the rest of the prison population, thus allowing

a more homogeneous approach for staff working



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1997 26,779 1,356 5.06%

2006 39,039 4,060 10.40%

% Increase: 1997-2006 45.78% 199.41%



Rate of Recidivism* 47.90% 1.5%

*Statistics are based on repeat offenses within a ve-year period.



elderly. Initially, all elderly inmates entering Louisiana

prisons are screened for physical and mental disabili-

ties. After admission, routine annual examinations

are carried out for elderly inmates in order to address

conditions specic to this age group. The Departmentof Public Safety and Corrections has a program that

allows for medical parole or medical furlough for

terminally ill inmates. Also, medical parole is available

for inmates who have permanent incapacities and are

not a likely threat to society. Eligibility is contingent

upon the severity of the inmate’s illness or condition.

Many of the state’s policies have been revised in

recent years to include updates recommended by the

Centers for Disease Control and Prevention, American

Correction Association’s performance-based medical

standards, and the Health Insurance Portability and

Accountability Act Guidelines. These changes

include: encouraging a heightened awareness by staffof victimization of elderly inmates, increased sensi-

tivity to condentiality standards, and general quality

of care improvement by staff.

Facilities: Although age alone does not deter-

mine housing assignments anywhere in the system,

most frail elderly inmates are housed at one of four

institutions. The Elayn Hunt Correctional Center in

St. Gabriel provides for geriatric inmates who require

specialized housing and care. It maintains a 28-bed

general inrmary, medical dormitory, and 98-bed

mental health unit. The Martin L. Forcht, Jr., Clinical

Treatment Unit of the David Wade CorrectionalCenter, in Homer, can accommodate approximately

338 inmates who need special attention due to age or

physical impairment. Also, a 50-bed skilled nursing

unit has been completed at this facility and awaits

budget funding in order to begin operations. The State

Penitentiary in Angola maintains a 34-bed medical

dormitory in the R. E. Barrow, Jr., Treatment Center for

geriatric inmates who have signicant medical needs

or are too frail to be in the general population. The

Treatment Center contains a 64-bed physical disability

dormitory for inmates. It also offers a certied hospice

program for up to six inmates. Prisoners in this

program are allowed to have two visitors for two-hour

intervals daily. The Correctional Institute for Women

in St. Gabriel contains an 8-bed ward for female

inmates with especially acute medical needs. This

facility also accommodates approximately 43 womenwho are unable to live in the general prison population

due to signicant medical or mental health disabilities.

It houses inmates with severely limited mobility in a

centrally located dormitory, bringing them closer to

medical care, food services, and program activities. All

institutions under the Department of Public Safety and

Corrections satisfy the Americans with Disabilities Act

standards for inmates with mobility impairments.

Challenges: Generally, many of Louisiana’s

problems involving elderly inmates stem from its

high overall incarceration rate. Almost 1 percent of

Louisiana’s entire population is in prison, the highestincarceration rate in the nation. The percentage of

elderly inmates has grown almost 200 percent since

1997, more than any other of the 16 SLC states. Rising

medical costs have become a severe problem for the

state, particularly due to the rising cost of services,

supplies, and prescriptions. The increasing number of

inmates requiring these services continues to strain the

system as well. Louisiana has experienced particular

difculties in the wake of Hurricanes Katrina and Rita.

For instance, the entire medical infrastructure of the

state’s charity hospital system, upon which services

for state and pre-trial inmates heavily relied, was nega-

tively impacted and portions must be rebuilt. Addition-ally, the Department of Public Safety and Corrections

lost access to the Medical Center of Louisiana in New

Orleans, one of four main referral hospitals in the state

for inmates. With decreased hospital-based beds and

services, there are longer waiting periods at hospitals

that are attempting to accommodate larger numbers

of incarcerated persons, and longer hospitalization

periods for inmates due to treatment delays associated

with hospital staff and resource shortages. The state

also has experienced problems that are present in the

Louisiana



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rest of the nation’s general aging inmate population,

such as increased rates of depression, senile dementia,

substance abuse, and other sicknesses prevalent in the

elderly population. Also, stigma related to mental

health issues often creates reluctance among inmates to

request or accept treatment. This is a major factor that

has stagnated the otherwise expeditious and affective

medical care for elderly inmates. Overall quality o

care has been affected by budget cuts for the Depart

ment of Corrections. However, negative impacts due

to budgetary restrictions have been offset in part by

enhanced training.



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1997 22,109 869 3.93%

2006 22,607 1,947 8.61%

% Increase: 1997-2006 2.25% 124.05%




Policies: The Department of Public Safety and

Correctional Services considers an elderly inmate to

be someone 60 years of age or older. Screenings are

conducted for all incoming elderly inmates, testing

for overall physical and visual and hearing disabilities

in order to establish a level of functionality for each

inmate. This information is used in classifying inmates

for housing assignments, which is stratied based onthe level of care needed to maintain the physical and

mental health of the inmates. After admission, elderly

inmates are provided physical examinations annually,

with specic monitoring when medically necessary

and appropriate. Inmates who are terminally ill or who

have other serious medical problems who could be

better served in the community are eligible for medical

parole. Comprehensive policies regarding the treat-

ment of hepatitis C inmates recently have been devel-

oped in order to more adequately identify and treat this

population among the elderly in prisons.

Facilities: As mentioned, most state prisons have

segregated housing units, which are designed to better

accommodate elderly inmates, making facility staff

and the environment more congruous for the group.Adjustments in services range from modication of

lunch lines for physically disabled inmates to more

readily available medical services. Also, various loca-

tions throughout the state have hospice or palliative

care facilities in prison inrmaries for inmates who

have terminal illnesses but are unable to be released

into the community.

Challenges: None indicated in survey response.

Maryland



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1997 14,032 730 5.20%

2006 20,891 1,916 9.17%

% Increase: 1997-2006 48.88% 162.47%

Crime Statistics Total Inmates Elderly Inmates % of Elderly Inmates Convicted of Violent Crime 6,948 684 9.84%




considers an elderly inmate to be one over the age of

65. All elderly inmates are given physical examina-

tions during their initial days of entry into the prison

system. Inmates are separated based on different

levels of physical and mental capacity, with frailer

inmates routed to chronic care units. The Department

of Corrections does not provide any medical-releasefurlough programs for older inmates at this time.

Facilities: Although Mississippi prisons do not

have facilities specically for elderly inmates, they

do have special units for inmates who have degenera-

tive diseases. These facilities have readily available

nursing staff and special care accommodations that can

address the needs of these inmates.

Challenges: According to Adult Correctiona

Systems, over the last decade Mississippi has had a

growth rate of 118 percent for inmates housed in state

facilities, the highest among the 16 SLC states.31 The

increased number of elderly inmates and, correspond-ingly, the increased medical costs for these inmates

has strained the medical budgets for state prisons. The

Department of Corrections anticipates that these costs

will only continue to escalate.

Mississippi



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1997 22,025 1,189 5.40%

2006 30,997 3,512 11.33%

% Increase: 1997-2006 40.74% 195.37%




*Statistics are based on repeat offenses within a two-year period.

offenders and others who are considered a further threat

to society.


maintains an elderly unit in a medium-security facility,

Moberly Correctional Center, in Moberly, designed

specically for elderly inmates who are ambulatory.The unit entails two oors and accommodates 22

single-bed cells, all of which are currently full. The

purpose of the unit is to give as much individualized

care to these inmates as possible. Additionally, the

Department of Corrections has 11 different prison

facilities designed to accommodate inmates with

physical disabilities.

Challenges: The Department of Corrections

is attempting to give more attention to the specic

difculties experienced by elderly inmates related to

the aging process. With the second fastest-growing

elderly inmate population among the 16 SLC states,a growth of more than 195 percent since 1997, and

the third largest overall percentage of inmates that are

elderly, the Department of Corrections is evaluating

policies that address this population shift. Given these

statistics, problems associated with this cohort will

only continue to worsen if they are not addressed.



elderly. The Department of Corrections screens all

elderly inmates within seven days of admission into

the prison system. These evaluations focus on ensuring

that serious physical and mental health needs, including

developmental disabilities and alcohol or drug addic-tion, are properly identied and corresponding treat-

ments are authorized. Elderly inmates are reexamined

annually once they are admitted. Although most of the

Department of Corrections’ general policies regarding

the health and wellbeing of elderly inmates are covered

under the same policies that apply to younger inmates,

there are specic policies that acknowledge the unique

needs of elderly inmates. For instance, the Depart-

ment of Corrections has a specic policy that mandates

ample communication between facility administration,

health services staff, and clinicians regarding the health

needs of all inmates, but expressly remarks upon the

distinctive health requirements for the elderly inmatecohort. This ensures that elderly inmates receive

proper treatment in regard to clothing, healthcare

needs, mobility, and bathroom assistance. Medical

parole is granted to elderly inmates who are in need

of long-term, specialized nursing or extensive pallia-

tive care. Medical parole excludes capital punishment

Missouri



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1997 31,764 1,451 4.57%

2006 36,663 3,769 10.28%

% Increase: 1997-2006 15.42% 159.75%



Rate of Recidivism NA NA



elderly. The elderly inmate population in North Caro-

lina has increased faster than any other inmate age group

in the state over the past ve years. In July of 2005, the

director of prisons initiated a study, the “Aging Inmate

Population Study,” on the aging inmates in the state.

In May of 2006, the Department of Corrections’ Divi-sion of Prisons issued their ndings from this study.

The report is a descriptive commentary that provides

information regarding the status of the aging inmate

population. It primarily explores the characteristics

of this population, as well as the challenges facing

the Department of Corrections in providing sufcient

services for elderly inmates.

Facilities: Although there are no prisons in

North Carolina designated exclusively for the elderly

inmate population, many prisons have geriatric, skilled

medical and mental health units. Three prisons in

the state with units designed specically for elderlyinmates are McCain Correction Hospital in Raeford;

Randolph Correctional Center in Asheboro; and Pender

Correctional Institution in Burgaw. McCain has both

acute care and skilled nursing care beds, and offers

laboratory, x-ray, respiratory therapy and pharmacy

services. The medical staff totals more than 135 health

care professionals, including four full-time physicians

There are 222 beds dedicated to the disabled, elderly

and others with physical and mental needs. Randolph is

a minimum-security prison that houses 135 adult males

with no serious medical needs. This includes 57 elderly

inmates. Pender is a medium-security prison housing764 inmates; 138 of those are elderly. Like Randolph

inmates at Pender must not require signicant daily

medical attention.

Challenges: Accelerated medical and menta

health issues and costs have caused serious problems

for the Department of Corrections. The cost of housing

elderly inmates is almost four times that of younger

inmates. The 2006 “Aging Inmate Population Study”

found that in scal year 2004-2005, the cost of housing

an elderly inmate was approximately $7,159, as

compared to an average of $1,919 for inmates younger

than 50. The study also found that the myriad of needsassociated with elderly inmates, such as required

mobility assistance or special diets, makes maintaining

proper housing facilities for these inmates much more

difcult.32

North Carolina



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1997 20,316 1,430 7.04%

2006 24,146 2,651 10.98%

% Increase: 1997-2006 18.85% 85.38%




*Statistics are based on a four-year period and represent scal year 2002.

cation level, and physical activity score. For instance,

if an inmate is diagnosed as having a severe physical

impairment, that inmate will be sent to the facility that

can best accommodate that inmate’s mobility needs.

Oklahoma has 14 different prisons that can adequately

house inmates with physical disabilities.

Challenges: Escalating healthcare costs for

elderly inmates are becoming increasingly worrisome.

Increased utilization of medication is one reason for

this. The number of prescriptions for inmates under

the age of 55 averages 3.9 per inmate, compared to

5.4 per inmate for those over the age of 55. Specialty

care and hospitalization costs average $4,911.43 per

inmate for those under the age of 55 and $6,230.98 for

those over the age of 55. Housing also presents chal-

lenges for the Department of Corrections. Although

Oklahoma has the lowest rate of increase of the elderly

prison population among the 16 SLC states, it has

experienced an 85 percent increase since 1997. Eleven percent of the entire prison population in Oklahoma

is elderly. Currently, there are 85 vision-impaired

inmates; 95 hearing-impaired inmates; 283 inmates on

walkers, canes or crutches; and 159 inmates in wheel

chairs in prison. It is approximated that 32 percent of

all elderly male inmates, and 72 percent of all female

inmates, have a history of or current symptomology of

serious mental disability. All of these inmates require

special facilities and staff, increasing the already

escalating costs associated with overcrowding. The

Department of Corrections cited parole problems as a

major concern, particularly in regard to three things:

employment, housing, and medical needs. The Depart-ment of Corrections noted that these three areas are

inextricably connected. By way of example, an elderly

prisoner who has trouble gaining employment likely

will have difculty nding housing and affording the

variety of medical needs that elderly parolees typically

have. Consequently, if a parolee is ill because of lack

of medication, then he or she will be unable to work,

and therefore unable to afford housing.

Policies: While not explicitly stated in the

policies of the Department of Corrections, elderly

inmates generally are considered those at or above the

age of 55. All inmates ages 50 to 64 have physical

examinations every one to three years, depending on

their overall health, and all inmates ages 65 and older

typically have annual physical examinations. Thereare medical parole programs for elderly inmates and,

in order for inmates to qualify for these programs, a

recommendation must be made by a facility physician.

Acceptance of parole is based on the inmate’s diag-

nosis, disciplinary record, amount of time remaining

to serve, employment history, a veriable offer of

residence, acquiescence of the inmate, and the severity

of his or her crime. There are a variety of crimes that

exclude prisoners from medical parole consideration.

Offenders who are not eligible for medical parole

are those who have not served at least 85 percent

of a sentence for truth-in-sentencing crimes, those

who have been sentenced to life without parole, and prisoners who have been sentenced to death. There

are specic qualications for offenders who have

committed the most severe crimes such as assault with

a deadly weapon. Such inmates must be terminally ill

with a life expectancy of one year or less, and whose

medical condition has rendered them no longer a threat

to society. A secure nursing home must be available

in order for these inmates to be released. Likewise,

qualications for lesser crimes mirror the severity of

the crime (i.e., there are less stringent qualications

for criminals who have committed less serious, and

less dangerous, crimes). Recommendations must be

approved by the chief medical ofcer, director of theDepartment of Corrections, Pardon and Parole Board,

and the governor’s ofce.

Facilities: In August, 2005, the Department of

Corrections initiated the Health Assessment for Inmate

Transfers, a program that provides guidelines for evalu-

ating an inmate’s general physical and mental health for

appropriate programs and facility placement. Inmates

are routed based on medical acuity, mental health classi-

Oklahoma



22

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1997 20,604 901 4.37%

2006 23,657 1,761 7.44%

% Increase: 1997-2006 14.82% 95.45%


Convicted of Sex-based Crime 3,294 447 13.57%Rate of Recidivism* 32.00% 16.50%

*Statistics are based on repeat offenses within a three-year period.

Policies: The Department of Corrections classi-

es an elderly inmate as one over the age of 55. This

number was adopted by a classication system used to

characterize elderly inmates for housing purposes, but

it no longer is used. The Department of Corrections

does employ medical release furloughs for terminally

ill elderly inmates. In order to be considered the paroleemust have a diagnosis of one year or less to live, with

two physicians concurring on the gravity of the illness.

Additionally, there must be a physician to provide care

outside the prison, as well as some demonstration by

the inmate of planned nancial support. The likely

threat the prisoner poses on society also is considered.

In addition, the Department of Corrections adjusts

work duties for inmates based on age and maintains a

“retirement” policy, by which inmates are allowed to

stop working when they reach age 65.

Facilities: Various prisons have facilities that

can accommodate inmates with physical or mentaldisabilities. Such prisons provide mobility assis-

tance and healthcare centers with medical staff. The

Department of Corrections initiated in 1970 one of

the rst programs to accommodate elderly inmates

by providing separate facilities for them. In 1983

the program moved to a former tuberculosis hospita

in State Park, establishing the State Park Correctiona

Center. The facility provides 24-hour nursing care for

inmates.

Challenges: Rising healthcare costs continueto strain the healthcare budget for the Department of

Corrections, which already constitutes a large portion

of the agency budget. Specic conditions that ai

elderly inmates, such as menopause-related needs

in female inmates, were cited by the Department as

posing particular difculties. Improved understanding

of the aging process and the needs of elderly inmates

such as attention to safety issues, was noted as an

area of concern for the Department of Corrections

Currently, there are no such programs to address

the impact the aging inmate population will have on

prisons. Problems associated with available housing

for elderly inmates have arisen due to the variety ofindividual needs, such as special healthcare provisions

and will continue to pose difculties for the Depart

ment of Corrections’ budget and planning.

South Carolina



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1997 18,795 1,116 5.94%

2006 27,964 2,741 9.80%

% Increase: 1997-2006 48.78% 145.61%


Convicted of Sex-based Crime 3,131 NA NA


Policies: Under the Department of Correction,

inmates over the age of 55 are considered to be elderly.

The Department of Correction employs a medical

furlough program, which is a time-limited or indetermi-

nate release from institutional custody into supervised

probation or parole, for inmates “in imminent peril of

death” or inmates who no longer are able to care for

themselves in a prison environment as a result of severe physical or mental disability. Medical furloughs must

be approved by the warden of the respective prison

and the Department of Correction commissioner, and

are contingent on a notarized report from an attending

physician. The Department of Correction has a policy

that denes the levels of care that are appropriate for

disabled inmates. For instance, the transfer of inmates

from one facility to another requires that inmates who

are physically disabled, seriously mentally and/or

physically ill, or developmentally disabled can be

accommodated in a new housing unit. They are

reviewed by a clinician who estimates whether or not

the receiving institution can provide the appropriatelevel of care to the inmate. Furthermore, any restric-

tions regarding daily activities, such as those applying

to workload or diet, are indicated by the physician and

conveyed to staff at the receiving institution.

Facilities: All Tennessee prisons have chronic

care clinics for addressing the special medical needs

of all inmates, regardless of age. Several prisons do

contain segregated geriatric facilities, and two prisons

maintain programs that specically address the needs

of inmates who are over the age of 55. Wayne County

Boot Camp in Clifton maintains a geriatric program

for “healthy, self-sufcient” elderly male inmates. The

DeBerry Special Needs Facility focuses on assisting

especially fragile elderly inmates who require assis-

tance with daily activities and supports a sheltered

living unit for particularly vulnerable elderly inmates.Additionally, most facilities are designed to accom-

modate inmates with mobility restrictions and other

general needs of elderly prisoners.

Challenges: In 2005, a task force was formed

to study the special needs populations in Tennessee

prisons, and currently is evaluating the prospect of

creating a geriatric facility. In the past, age alone has

not been a sufcient criterion for maintaining a separate

prison, but as the elderly inmate population in the state

increases, the creation of such a facility may be more

viable than before. Rising medical costs in general

have been enough to have serious budgetary impacts.The distinct rise in medical costs for elderly prisoners

and the ability to consolidate services for them may be

great enough to warrant separate geriatric prisons in

the future. Also, the sheer number of elderly inmates

entering, remaining, and returning to the prison system

is especially acute in Tennessee. There is a 24 percent

recidivism rate among elderly inmates, meaning that

one-fourth of all elderly inmates who are paroled or

complete their sentences return to prison during their

lifetime.

Tennessee



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Policies: According to the Department of Crim-

inal Justice, an elderly inmate is classied as one over

the age of 55. The Department of Criminal Justice has a

policy that screens incoming elderly inmates for phys-

ical and mental disabilities, and places such prisoners

in appropriate facilities. There is a screening for elderlyinmates being transferred from one facility to another

in order to ensure that the receiving facility can accom-

modate these prisoners. Elderly inmates’ work duties

may be adjusted based on age as well. The Depart-

ment of Criminal Justice’s Rehabilitation and Re-entry

Division recently began working to develop specic

programs for elderly inmates who will be returning to

society. Elderly inmates are eligible for early parole

under the Medically Recommended Intensive Supervi-

sion (MRIS) program if the offender is diagnosed with

a terminal disease; requires long-term care for a degen-

erative disease; is severely physically handicappedand cannot be sufciently accommodated by prison

facilities; is diagnosed with a severe mental illness; or

is mentally retarded. Such inmates are supervised by a

Special Needs Offender Program of the Parole Division

upon release. Since 1997, several changes have been

made to the MRIS program. For instance, the program

now excludes all sex offenders and offenders sentenced

to death. The provision to include the terminally ill

and those who require long-term care was enacted in

2003. Also in 2003, a requirement that offenders be

placed in a skilled nursing facility upon release was

repealed, allowing for expanded placement options

in the community for prisoners. The Department ofCriminal Justice mandates the availability of special

recreational services for some geriatric prisoners, such

as outdoor walking, horseshoes, arts and crafts, and

various table games.

Facilities: The Department of Criminal Justice

provides two types of geriatric housing facilities for

inmates. Type I Geriatric Facilities, which are located

in eight different state prisons, provide accommoda-

tions for offenders who are 60 years of age or older and


1997 132,394 7,923 5.98%

2006 151,852 16,622 10.95%

% Increase: 1997-2006 14.70% 109.79%

Crime Statistics Total Inmates Elderly Inmates % of Elderly Inmates Convicted of Violent Crime* 74,257 8,667 11.67%

Convicted of Sex-based Crime* 24,841 4,936 19.87%

Rate of Recidivism** 28.30% 20.20%

*Offense is based on inmate’s offense that incarcerates the offender for the longest period of time.

**Statistics are based on repeat offenses within a three-year period.

who have specic difculties regarding daily activities

These are segregated areas of the prison that allow

geriatric prisoners to have longer periods of time to

dress, eat, move from place to place, and shower. They

also have special accessibility accommodations for pil

and food lines. Inmates in these facilities are groupedwith inmates who have similar medical conditions

in order to consolidate focus for staff and to provide

an environmental semblance for inmates. The state

also has a second type of geriatric housing unit, Type

II Geriatric Facilities, which characterize outpatien

sheltered housing facilities. Currently, there is only

one such facility in the state, the Estelle Unit in Hunts-

ville, which maintains 60 beds for male inmates. It is

located next to the Estelle Regional Medical Facility

for accessibility to clinical staff. This unit provide

access to multiple special medical services, such as

physical, occupational, and respiratory therapy; speciawheelchair accommodations; temperature-adjusted

environments; dialysis; and services for inmates with

hearing and vision impairments.

Challenges: Healthcare costs for elderly inmates

are 3.5 to 4 times more than those of the average pris-

oner. The estimated healthcare costs for non-elderly

inmates was approximately $7.46 per offender per day

in FY 2005, compared to $26.11 per offender per day

for elderly inmates. Although elderly inmates represen

only 5.4 percent of the inmate population, they accoun

for more than 25 percent of hospitalization costs for the

Department of Criminal Justice. This discrepancy is

anticipated to increase as the cost of healthcare and the

number of elderly inmates continues to increase. There

are more than 16,000 elderly inmates in Texas, making

up almost 11 percent of the entire prison population in

the state, and totaling more than the total inmates in

both Arkansas and West Virginia. General resource

for elderly inmates, including staff and housing accom

modations, will continue to escalate in cost, as wel

as training expenses for staff regarding the needs of

elderly inmates. Parole problems for elderly inmates

Texas



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accept offenders, thus hindering early-release program

goals. The problem of inadequate prison space in Texas

will continue to worsen as the elderly inmate popula-

tion continues to increase.

have been associated with housing facilities, such as

half-way houses, that are inadequate to accommodate

the health needs of elderly inmates. Without medical

health coverage, many nursing homes are unwilling to



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VirginiaGeneral Statistics Total Inmates Elderly Inmates % of Elderly Inmates

1997 28,408 1,411 4.97%

2006 30,704 3,134 10.21%

% Increase: 1997-2006 8.08% 122.11%






elderly. The Department requires a medical examina-

tion for all elderly prisoners upon admission into state

prisons. The nutritional needs of elderly inmates are

documented and forwarded to the appropriate staff

at the time of this examination. The Department of

Corrections offers a medical-release program forelderly inmates, whereby prisoners are allowed to

petition the state’s Parole Board for furlough on the

grounds that he or she has been diagnosed with a

terminal or severely debilitating illness. Decisions

regarding release are based largely on the prisoner’s

age and the amount of the prisoner’s sentence that has

been served. Also, eligibility for release is based on the

severity of the crime for which the prisoner is incarcer-

ated. In 2001, the Department of Corrections organized

a task force to study issues involving the needs of geri-

atric prisoners. Recommendations regarding housing,

medical care, and stafng for elderly inmates have been

made by the task force to the director of the Departmentof Corrections regarding their ndings.

Facilities: The Deereld Correctional Center in

Capron is the state’s only facility designed specically

for elderly inmates. It is a one-story dormitory tha

houses 497 of the state’s elderly prisoners. In January

2007, the Center will be expanded to a 1,100-bed

facility, making it possible to lodge over one-third of

the state’s elderly inmate population in a central loca-

tion. Other prisons in the state are able to accommodateelderly inmates on a smaller scale.

Challenges: As the elderly inmate population in

the state continues to increase, rising medical costs wil

continue to be a formidable burden for the Departmen

of Corrections. Another major problem is release plan

ning. Difculties associated with the prisoner’s ability

to secure or maintain a job in society is one example

of the many barriers that inhibit the elderly inmate’s

capacity for adapting once he or she is released into

the community. Also, high recidivism rates for elderly

inmates in the state raise questions regarding the

likelihood for released or paroled inmates to return to prison. Virginia has a reported 24 percent recidivism

rate for elderly inmates, one of the highest in the 16

SLC states.



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Policies: The Division of Corrections considers

the age of an elderly inmate to be 65, the highest char-

acterization among states. All elderly inmates have

annual or bi-annual physical examinations, depending

on the individual health level of the inmate and includes

annual dental and eye examinations. There also is close

monitoring of inmates with chronic conditions throughmonthly checkups. Medical diets can be arranged at

most facilities and are coordinated according to the

health needs of elderly inmates. There are no special-

release programs for elderly inmates at this time;

however, inmates can be moved from prison grounds

to off-site hospitals for observation or specialized care

if necessary.

Facilities: Although inmates are not segregated

by age, they are assigned to housing facilities based on

their health needs. This is to say that, if elderly inmates

have specic health concerns, they can be routed to a

facility that can accommodate these needs.


1997 2,755 235 8.53%

2006 5,390 641 11.89%

% Increase: 1997-2006 95.64% 172.77%

Crime Statistics Total Inmates Elderly Inmates % of Elderly Inmates Convicted of Violent Crime* 2,147 489 22.78%

Convicted of Sex-based Crime* 881 268 30.42%Rate of Recidivism 11% NA

*Offense is based on inmate’s offense that incarcerates the offender for the longest period of time.

West Virginia

Challenges: Rising medical costs for elderly

prisoners have become a signicant burden in the state.

It is a policy of the Division of Corrections that inmates

receive necessary medical treatment, regardless of

cost; therefore, healthcare for inmates can become

quite extensive. Currently, the Division is researching

the possibility of assisted living units and hospice programs to house terminally or severely ill inmates.

According to the Division of Corrections, the problem

of employment of elderly inmates who have completed

their sentence or have been paroled is a concern

regarding the ability of elderly inmates to re-acclimate

themselves to society. Often, such inmates have dif-

culty accessing federal medical coverage unless they

have some type of disability. Lack of medical care

only exacerbates already dismal living circumstances

for elderly inmates, and prison space continues to be

a problem as the elderly inmate population continues

to increase. Also, the large percentage of violent and

sex-based crimes committed by elderly persons hasraised concerns in the state. Almost 23 percent of all

inmates convicted of violent crimes, and more than 30

percent of all inmates convicted of sex-based crimes,

are elderly – the highest percentage in both categories




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The average percentage of elderly inmates in

the SLC states was 10.44 percent – slightly

higher than the national average, which

is approximately 9 percent. Alabama had

the highest percentage with 12.79 percent of its

inmate population at 50 years of age or older. Just

as the general elderly inmate populations in state

prisons are increasing, so is the elderly percentage of

inmates convicted of violent and sex-based offenses.

According the Federal Bureau of Investigation, nation-

wide, there are almost 40,000 arrests of persons overthe age of 50 for violent and sex-based crimes every

year, amounting to almost 6 percent of all persons in

this age bracket who are arrested.33 The 16 SLC states

reported a remarkably higher percentage of elderly

inmates convicted of these type offenses. All but one

of the reporting SLC sates indicated that at least 25

percent of their elderly inmates were convicted of

violent or sex-based crimes – South Carolina being the

exception. West Virginia had the highest rate, reporting

53 percent of its elderly prison population serving time

for violent or sex-based crimes. Overall, the 16 SLC

states averaged 34 percent.34

Since these crimes typically carry longer prison

sentences than other crimes, such as crimes against

property, it is important for states to evaluate what

percentage of total inmates are serving sentences for

violent and sex-based crimes. This cohort likely will

comprise the population that will grow old in prison.

According to a 2004 U.S. Department of Justice report,

there were just under 625,000 persons in state prisons

across the nation serving time for violent and sex-based

offenses as of 2002 (the latest available data). At that

time, this was slightly more than one-half the entire

prison population. Also, of the 14 states with the highes

incarceration rates, 10 were in the South.35Although i

is speculated that this national percentage may have

slightly increased since 2002, on average the 16 SLC

states exceeded this percentage, with 58 percent of their

total prison population incarcerated for violent or sex-

based crimes. According to the SLC survey, Virginia

reported that more than 70 percent of the state’s prison

population is incarcerated for these crimes, the highes


It should be noted that, overall, Southern states

incarcerate more people than other regions of the

country. It is possible that higher percentages of violen

and sex-based crime convictions may simply reect a

greater percentage of overall convictions in the South

Regardless of the causes, these statistics reect the

greater number of inmates in Southern states who wil

be serving longer sentences, and be more likely to serve

the remainder of their lives in prison. It is anticipated

that this high percentage of overall inmates incarcer-

ated for violent and sex-based crimes will continue to

contribute to the number of elderly inmates that residein state prisons in the South.

When examining the inmates currently classied

as elderly, it is obvious that length of prison sentence

has been a major factor in the number of prisoners who

spend the remainder of their lives in prison. All SLC

reporting states indicated that at least 30 percent of

their elderly inmate populations are serving sentences

that are at least 20 years in duration, including life

sentences. Six states indicated numbers that were above

Summary



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50 percent of their elderly inmate population. These

were: Alabama, Arkansas, Oklahoma, South Carolina,

Texas, and Virginia. While this trend emphasizes the

extended longevity of prison sentences, and the rising

number of inmates that will serve such sentences, this

trend parallels the rising number of inmates who will

require medical treatment, as well as special housing

and other accommodations which must be provided by

the state prison system.

The most obvious concern associated with aging

inmate populations, and the one most frequently

mentioned by state corrections departments in this

survey, is the cost of healthcare for this population.

In Estelle v. Gamble (1976), the U.S. Supreme Court

mandated that a prison’s control over an inmate’s body

demands that the prison provide adequate medical care

for that inmate, care that reects the services that would

otherwise be available in the community. Failure to

provide such a level of care, according to the Court,

violates the Eighth Amendment’s prohibition of “crueland unusual punishment.” As the level of care in

society increases, so should that provided by prisons.

The cost of maintaining this ever-increasing level of

medical attention can become very daunting and very

expensive for state corrections departments. Ironi-

cally, with increased care comes increased duration

of treatment for inmates, i.e. the better the treatment

the inmate receives the longer that inmate will live,

and the longer the prison system will have to care for

him or her. As preventive care improves, the lives of

inmates will lengthen, increasing both the number of

elderly inmates living in prison as well as the length

of time the elderly inmate will live in prison. This

phenomenon alone deserves attention by those who

are investigating the most scally prudent means of

housing elderly inmates while maintaining sufcient

care and supervision for prisoners, as well as retaining

ample prison security.

Striving for a better environment for prisoners

often becomes difcult because of common stereo-

types, such as that prisoners, particularly elderly ones,

are of little or no value to society. Prisons are viewed

as places of punishment, and so notions of reha-

bilitation for elderly prisoners often are overlooked or

disregarded. Typically, prisons are designed to house

young, aggressive offenders. This trend yields prisons

systems that are ill-equipped to meet the needs of frail,

sickly inmates, elderly or otherwise. Moreover, prisons

are designed to produce an environment of castiga-

tion rather than one of comfort. There seems to be a

concerted effort among Southern states’ corrections

departments to address this perception by bolstering

staff education and training with regard to the needsof the elderly and the place of the prisoner in society.

Many states have initiated programs for medical as well

as security staff that will encourage a rehabilitative,

rather than a punitive, approach to care for the elderly

in state prisons.

According to the Americans with Disabilities

Act of 1990, all prisoners with disabilities must have

access to the same services that other prisoners have.36

Since disabilities are more prevalent among older

inmates, the increase in the number of these prisoners

has increased the demands on prison environments.

Therefore, many Southern state prison systems are

Ranking Total Inmates

% Increase of Total

Inmates 1997-2006 % Elderly Inmates

% Increase of Elderly

Inmates 1997-2006

1 Texas (151,852) West Virginia (95.64%) Alabama (12.79%) Louisiana (199.41%)

2 Florida (86,559) Kentucky (54.34%) West Virginia (11.89%) Missouri (195.37%)

3 Georgia (51,484) Mississippi (48.88%) Missouri (11.33%) Alabama (193.38%)

4 Louisiana (39,039) Tennessee (48.78%) Kentucky (11.12%) West Virginia (172.77%)

5 North Carolina (36,663) Louisiana (45.78%) Georgia (10.99%) Georgia (171.76%)

6 Missouri (30,997) Missouri (40.74%) Oklahoma (10.98%) Mississippi (162.47%)

7 Virginia (30,704) Georgia (39.25%) Texas (10.95%) North Carolina (159.75%)

8 Alabama (28,050) Florida (35.75%) Florida (10.59%) Tennessee (145.61%)

9 Tennessee (27,964) Arkansas (32.02%) Louisiana (10.40%) Kentucky (136.75%)

10 Oklahoma (24,146) Alabama (28.90%) North Carolina (10.28%) Florida (130.06%)

11 South Carolina (23,657) Oklahoma (18.85%) Virginia (10.21%) Arkansas (125.75%)

12 Maryland (22,607) North Carolina (15.42%) Tennessee (9.80%) Maryland (124.05%)

13 Mississippi (20,891) South Carolina (14.82%) Arkansas (9.42%) Virginia (122.11%)

14 Kentucky (19,925) Texas (14.70%) Mississippi (9.17%) Texas (109.79%)

15 Arkansas (13,494) Virginia (8.08%) Maryland (8.61%) South Carolina (95.45%)

16 West Virginia (5,390) Maryland (2.25%) South Carolina (7.44%) Oklahoma (85.38%)

SLC RankingTable 2»



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examining alternatives to general housing for elderly

inmates. These alternative-housing projects often

involve early release and furlough programs, or the

consolidation of the elderly inmate housing into one or

two main facilities within the state prison system.

Many Southern states that do not have free-

standing prisons exclusively for elderly inmates have

developed separate quarters in which elderly inmates

may be separated from the rest of the prison population.

These facilities often will include hospice services

for terminally ill elderly inmates. Although there

are arguments against segregating elderly inmates

from the rest of the prison population, there are many

advantages Southern states have begun to examine.

These type facilities have proven to drastically reduce

costs for states and allow elderly prisoners to be in

an environment with prisoners that are their own age.

This reduces the possibility that elderly inmates will

become victims of younger, more aggressive inmates

by restricting or eliminating close proximity to theseyounger inmates. They make it easier for specialized

staff to be consolidated at a central location. Also, such

facilities eliminate or reduce the costs associated with

off-site medical care, which often requires security

personnel to leave the prison in order to accompany

the patient, straining the availability of on-site secu-

rity staff. Beyond ensuring the safety and wellness

of elderly inmates who have been separated, housing

these prisoners in separate facilities creates more space

in areas such as high-security prisons or quarters that

house more violent prisoners requiring special atten-

tion by guards and other staff.

Although many states separate inmates according

to their medical needs, the survey found it often is

the case that an elderly inmate remains in the general

population until he or she develops some ailment that

requires transfer to another facility or facility divi-

sion. In other words, while elderly inmates often are

separated from the general population, these inmates

are divided based on frailness or disability, as opposed

to age. Since the entire elderly inmate population wil

not qualify for such categorization, and since many

non-elderly inmates will meet these qualications

this does not necessarily yield a system where elderly

inmates are housed together. All of the SLC states

polled separate inmates based on physical and menta

condition. However, only six of these states have

either prisons or prison units designed exclusively for

geriatric prisoners. Since inmates in these other states

are separated due to medical reasons, rather than by age

alone, many healthy, elderly inmates are left within the

general prison population. The Southern states are no

alone in their lack of specialized prison units for elderly

inmates. In a 2002 nationwide report by the Crimina

Justice Institute, it was noted that only 15 states in the

country had special housing areas for elderly inmates

and about half of these were available only for elderly

inmates with special medical conditions.37

A similar disparity is found in the basic way tha

state corrections departments classify elderly inmates

The age of categorization ranges from 50 to 65. Four

states – Arkansas, Alabama, Mississippi, and Wes

Virginia – consider elderly inmates to be ones over the

age of 65. Maryland alone accepts 60 as the distin

guishing age. Oklahoma, South Carolina, Tennessee

and Texas consider 55 to be the age of elderly inmates

Seven of the SLC states – Florida, Georgia, Kentucky

Louisiana, Missouri, North Carolina, and Virginia

– have adopted the adjusted age of 50 for characterizing

elderly inmates.



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Recommendations

There are several trends that many states have

recognized as helpful practices regarding

how corrections systems address the needs

of elderly inmates. These are summarized

as follows:

» Compose general policies that recognize the aging

trends in America, trends that are being reected in

the inmate population.

» Consider lowering the age threshold for character-izing inmates as elderly as a basis for formulating

accurate and realistic policies as an archetype for

matching the health patterns of these inmates (ap-

plicable to states with higher chronological age

thresholds).

» Consider the advantages of partitioning inmates

into separate facilities or units based on age. Sepa-

rate housing facilities and units for elderly inmates

assist in reducing victimization; allow for the con-

solidation of specialized staff, therefore reducing

healthcare costs; and provide a more appropriate

environment for elderly inmates as an age group.

» Consider reforms that would curb the number of

prisoners incarcerated for committing non-seri-

ous crimes from being sentenced to lengthy prison

terms.

» Evaluate parole and probation programs, ensur-

ing that they accommodate the specic needs of

elderly inmates regarding access to medical care,

affordable housing, and employment opportuni-

ties. Availability to these greatly affects recidivism

rates.

» Evaluate existing laws and sentencing guidelines

resulting in long-term incarceration and dispropor-

tionately long sentences for older or elderly crimi-

nals.

The dynamic of aging prison populations is one

that is evident in all 16 Southern states, yet it is one that

requires diligent, innovative efforts by state corrections

departments and lawmakers to advance their prison

systems in ways that effectively and sensibly address

the needs of elderly inmates. Although Southern states

will continue to grapple with many of the difcultiesassociated with elderly and perpetually aging inmate

populations, corrections departments should continu-

ally work to assess what programs and policies best

serve these inmates and, correspondingly, the societies

to which they belong.



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Name:

Title:

Agency Name:

State:

Address:

Phone #:

Email:

1. General Statistics

a) What does your state consider the age of an “elderly” inmate to be?

b) What is the total number of inmates currently incarcerated under

your department?c) What is the total number of inmates over the age of 50?

d) What is the total number of inmates over the age of 50 that are lifers?

e) What is the total number of inmates over the age of 50 that are

natural lifers?

f) What is the total number of inmates over the age of 50 with

sentences of 20 years or more?

2. Crime Statistics

a) How many total inmates are serving time for violent crimes?

b) How many inmates over the age of 50 are serving time for violent

crimes?

c) How many total inmates are serving time for sex-based crimes?

d) How many inmates over the age of 50 are serving time for sex-based

crimes?e) What is the overall recidivism rate for inmates in your department?

f) What is the recidivism rate for inmates over the age of 50 in your

department?

g) How many inmates over the age of 50 are repeat offenders?

3. Policies

a) What policies does your department have regarding screening

inmates for special medical needs?

b) What general medial plans, if any, does your department have

regarding inmates over the age of 50 once they are admitted into a

prison (nutrition, exercise, frequent diagnostic testing, etc.)?

c) Is there a special medical release furlough program(s) for inmates

over the age of 50, or other inmates? If so, what are the directives of

that program(s)?d) What, if any, general policy changes has your department

implemented since 1997?

Sharing capitol ideas

The Council of State Governments

Southern OfficeP.O. Box 98129

Atlanta, GA 30359

1946 Clairmont Road

Decatur, Georgia 30033

404/633-1866

Fax 404/633-4896

www.slcatlanta.org

s e r v i n g t h e s o u t h


Speaker Glenn RichardsonGeorgiaChair

Representative Julia C. HowardNorth Carolina

Chair Elect

Senator Jeff Wentworth Texas

Vice Chair

Senator Noble Ellington

LouisianaChair, Agriculture & Rural DevelopmentCommittee

Senator Mark Norris

TennesseeChair, Economic Development,Transportation & Cultural AffairsCommittee

Senator Gerald Theunissen

Louisiana

Chair, Education Committee

Representative Ron Peters

OklahomaChair, Energy & EnvironmentCommittee

Senator Jack Hill

Georgia

Chair,Fiscal Affairs & Government Operations Committee

Representative George Flaggs, Jr.

Mississippi

Chair, Human Services & Public Safety

Committee

Colleen Cousineau

Executive Director

Kenneth Fern, Jr

Deputy Director

Alabama • Arkansas • Florida • Georgia • Kentucky • Louisiana • Maryland • Mississippi • Missouri • North Carolina • Oklahoma • South Carolina • Tennessee • Texas • Virginia • West Virginia

Survey QuestionnaireAppendix»

s e r v i n g t h e s o u t h



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4. Facilitiesa) Do any special geriatric facilities exist in your department for accommodating

the needs of inmates over the age of 50?

1. If yes, please describe the facility and the number of inmates or

beds involved.

2. If no, have such facilities been proposed but failed to win

legislative, gubernatorial, departmental or public approval?

b) Do any programs within standard prisons exist in your department for

accommodating the needs of inmates over the age of 50?

1. If yes, please describe the unit, wing, oor, or division and the

number of inmates or beds involved?

2. If no, have such programs been proposed but failed to win

legislative, gubernatorial, departmental or public approval?

c) What other, if any, programs exist for segregating inmates over the age of 50

from the rest of the prison population?

5. Concerns

Please respond to the difculties, if any, associated with the following issues, and

what role those difculties play in the overall operation of your department:

a) Rising medical costs for prisoners over the age of 50.

b) Readily accessible medical care for prisoners over the age of 50.

c) Depression and/or other mental problems of prisoners over the age of 50.

d) Stafng and staff preparedness for prisoners over the age of 50.

e) Victimization of prisoners over the age of 50 from younger inmates.

f) Parole problems associated with prisoners over the age of 50.

g) Prison space and prisoners over the age of 50.

h) Facilities accessible for the mobility-impaired prisoner over the age of 50.6. Other

Please provide any other information you consider relevant and important in

examining the responsibilities associated with elderly inmates in your system.

Thank you for returning your completed survey by May 5, 2006.

Jeremy Williams The Southern Legislative Conference

Policy Analyst P.O. Box 98129

[email protected] (Email) Atlanta, GA 30359

404/633-1866 (Phone)

404/633-4896 (Fax)

www.slcatlanta.org



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Brian Corbett

Public Information Manager

Department of Corrections

301 South Ripley Street

Montgomery, AL 36130

ArkansasJohn Byus III

Administrator of Medical

Services


P.O. Box 8707

Pine Bluff, AR 71611-8707

Florida

David EnsleyChief of Bureau of Research &

Data Analysis


2601 Blair Stone Road

Tallahassee, FL 32399-2500

Georgia Nancy Phillips


2 Martin Luther King, Jr.

Drive, SE, 952-East

Atlanta, GA 30334

KentuckyCharles E. Williams

Director of Operations and

Programs


P.O. Box 2400

Frankfort, KY 40602-2400

LouisianaJean Wall

Executive Management Ofcer

Department of Public Safety &

Corrections504 Mayower Street

Baton Rouge, LA 70802

MarylandDorothy Strawsburg

Director of Social Work

Department of Public Safety &

Correctional Services

6776 Reisterstown Road, Suite

210

Baltimore, MD 21215

MississippiBill Greenleaf

Branch Director


723 North President Street

Jackson, MS 39202

Missouri Nancy Roberts

Research Analyst


2729 Plaza Drive

Jefferson City, Missouri 65102

North CarolinaRichard Burkart

Policy Development Analyst

Department of Correction

4221 MSC, 2020 Yonkers

Road

Raleigh, NC 27699-4221

OklahomaChristopher Hyde

Data Management Coordinator


3400 Martin Luther King

Avenue

Oklahoma City, OK 73111-

4298

South CarolinaJohn Ward

Director of Division ofResource and Information

Management


P.O. Box 71787

Columbia, SC 29221-1787

TennesseeCile Crowder

Department Policy and Surve

Manager

Department of Correction

320 6th Avenue, N

Nashville, TN 37243

TexasDavid Standlee

Manager II of Executive

Support

Department of Criminal Justi

P.O. Box 99

Huntsville, TX 77342-0099

VirginiaScott Richeson

Statewide Program Director


P.O. Box 26963

Richmond, VA 23261

West VirginiaJared C. Bauer

Research Analyst

Division of Corrections

112 California Avenue, Bldg

Charleston, WV 25305

Survey Respondents and Report

Contributors by State



35

T h e


o ok

1 Crime in the United States, 2005, (Federal Bureau of

Investigation, U.S. Department of Justice, 2005).

This report measures the number of arrests each year,

not the number of incarcerations.2 Camille Graham Camp, The Corrections Yearbook, 2002,

(Middleton, CT: Criminal Justice Institute, 2002), p.32.

3 B. Jayne Anno, Camelia Graham, James E. Lawrence,

Ronald Shansky, eds., Correctional Healthcare:

Addressing the Needs of Elderly, Chronically Ill, and

Terminally Ill Inmates, (Washington, DC: National

Institute of Corrections, U.S. Department of Justice,

2004) p. 29.

4 Rear Admiral Newton E. Kendic, M.D., “Correctional

Health Care Today,” Corrections Today, July, 2006,

(Alexandria, VA: American Correctional Association,

2006).

5 This point of demarcation at which old age is reached is

based largely on social legislation of the late 19th

andearly 20th centuries.

6 Daron Hall, “Jails vs. Prisons,” Corrections Today,

February, 2006, (American Correctional Association,

February, 2006).7 Anno, p. viii.8 Todd Edwards, The Aging Inmate Population: SLC

Special Series Report , (Atlanta: The Southern

Legislative Conference of The Council of State

Governments, 1998), p. 5.9 Ronald H. Aday, Aging Prisoners: Crisis in American

Corrections, (Westport, Connecticut: Praeger

Publishers, 2003), p. 2.

10 Federal Interagency Forum on Aging-Related Statistics ,

Older Americans 2004: Key Indicators of Well-Being ,

(Washington, DC: U.S. Government Printing Ofce,

November 2004), p. 2.11 U.S. Census Bureau, “Oldest Baby Boomers Turn 60!,”

Facts for Features, (January, 2006).12 U.S. Administration on Aging, “A Statistical Prole of

Older Americans Aged 65+” (Washington, DC: U.S.

Department of Health and Human Services, 2006).13 Paige M. Harrison and Allen J. Beck, “Prison and

Jail Inmates at Midyear 2005,” Bureau of Justice

Statistics Bulletin, (Washington, DC: U.S.

Department of Justice, 2006), pp. 1, 4.14 Christopher J. Mumola, “Suicide and Homicide in State

Prisons and Local Jails,” Bureau of Justice Statistics

Bulletin, (Washington, DC: U.S. Department of

Justice, August, 2005), p. 1.15 Aday, pp. 10-11.16 U.S. Bureau of Justice Statistics, “Truth in Sentencing in

State Prisons,” (1999), p. 1.

17 Aday, p. 22.

18 Robert Hofacre, “The Correctional Health Care Debate,”

Corrections Today, October, 2003, (American

Correctional Association, October, 2003).

19 Aday, p.174.

20 Georgia Department of Corrections, “Active Offender

Population Statistics,” (2006).21 Harrison, p. 10.

22 Anno, p. 10.

23 Kristy F. Gary, Adult Correctional Systems, (Atlanta: The

Southern Legislative Conference of The Council of

State Governments, 2006), p. 15.24 Alexandra Pelosi, “Age of Innocence: A Glut of Geriatric

Jailbirds,” The New Republic, (May, 1997), p. 15.

25 Anno, p. 33, 50-51.26 Anno, p. 48.27 George Washington University, “POPS Program Gives

a Second Chance.” http://www.gwu.edu/~ccommit/

law.htm.28 Scott Angus, ed., “Number of Older Inmates in Sate

Prisons Tripled in Last Decade,” The Janesville

Gazette, August 9, 2006, (Janesville, Wisconsin: Bliss

Communications, Inc, 2006).29 See Appendix A.30 Gary, p. 11.31 Gary, p. 4.32 Charlotte A. Price, “Aging Inmate Population Study,”

(Raleigh: North Carolina Department of Correction,

2006), p. 2.

33 Since this report measures number of arrests, rather than

the number of persons incarcerated for these offenses,the percentage of incarcerations for these crimes may

be less than the percentage of those arrested.

34 This statistic does not distinguish between criminals

that were elderly when the crime was committed

and inmates that committed the crime as a younger

age, but grew old in prison. Since criminals who

commit violent and sex-based crimes are, based on

most state laws, the least likely inmates to be paroled

the statistic is meant to reect the growing inmate

population that is least likely to be paroled, rather

than a trend that would disproportionately associate

violent and sex-based crime with the elderly.35

U.S. Department of Justice, “Bureau of Justice StatisticsBulletin: Prisoners in 2004,” (Washington, DC: U.S.

Department of Justice, 2004).36 The American’s with Disabilities Act of 1990,

(Washington, DC: Employment Standards

Administration, U.S. Department of Labor, 1990).

37 Camp, p. 74.

Endnotes and References



For a number of years the Human Services

and Public Safety Committee of the Southern

Legislative Conference (SLC), currently

chaired by Representative George Flaggs, Jr.,

Mississippi, has been examining Southern states’ poli-

cies regarding aging inmates. This Regional Resource

investigates the continued trends concerning the South’s

prison population and resumes the analysis initiated by

the 1998 SLC Special Series Report, The Aging Inmate

Population, conducted by Todd Edwards.


The Council of State GovernmentsSharing capitol ideas


of The Council of State Governments

P.O. Box 98129

Atlanta, GA 30359

www slcatlanta org

The Committee extends a special thanks to the

corrections ofcials in the South and other participants

who contributed information for this report.

This report was prepared by Jeremy L. Williams

Policy Analyst for the Southern Legislative Conference

of The Council of State Governments, under the chair

manship of Speaker Glenn Richardson, Georgia.

Te Aging Inmate PopulationSouthern States Outlook

the aging inmate population: southern states outlook

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