Affordable Care Act would cover almost all Oklahoma inmates, study

10-20-2012 Oklahoma:

OKLAHOMA CITY - Practically all of Oklahoma's costs for hospitalizing prison inmates would be picked up by the federal government if the state accepts funding under the Affordable Care Act, a Department of Corrections analysis shows.

In fiscal year 2012, the state prison system spent $13 million on hospital bills for inmates, DOC spokesman Jerry Massie said.

Under the federal law, practically all of those costs would be picked up by Medicaid starting in 2014, he said.

There's one catch, however: The state would have to accept the federal government's money.

When the U.S. Supreme Court upheld the constitutionality of the law, it struck a provision that mandated that every state accept an expansion of its Medicaid program to cover households earning as much as 133 percent of the federal poverty level.

The decision essentially made the Medicaid expansion optional.

Several states, including Texas, have announced that they aren't interested in cooperating with the federal program, but Oklahoma has not made a decision.

Gov. Mary Fallin, who has called the Affordable Care Act unworkable and unaffordable, has delayed making a choice on the Medicaid expansion until after November's presidential election.

Fault Lines - Dying Inside: Elderly in prison

6-6-2010 National:

The US' massive prison population is getting older.

Long sentences that were handed out decades ago are catching up with the American justice system.

Prisons across the country are dedicating entire units just to house the elderly.

During difficult economic times, the issue has hit a crisis point. Estimates are that locking up an older inmate costs three times as much as a younger one.

How are prisons dealing with this issue? Who are the prisoners that are turning gray behind bars?

Josh Rushing gains exclusive and unprecedented access to jails and prisons across the country to tell the story. ..Source.. by Fault Lines

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Dying on the State's Dime

6-3-2010 Texas:

A gaunt old man, thick with whiskers and stricken with dementia, writhes under the covers of his bed. Down the hall, doctors monitor elderly diabetics with recently amputated limbs, medicate terminal cancer patients shuffling by with walkers and tether shivering dialysis patients to blood-cleaning machines.

Despite the pacing guards, the handcuffs and the bars on the windows, the geriatric and medical wing at the Estelle Unit in Huntsville looks more like a nursing home than a maximum-security prison.

Prison doctors routinely offer up the oldest and sickest of these inmates for medical parole, a way to get those who are too incapacitated to be a public threat and have just months to live out of medical beds that Texas’ quickly aging prison population needs. They’ve recommended parole for 4,000 such inmates within the last decade. But the state parole board, which makes the final decision on “medically recommended intensive supervision,” has only agreed in a quarter of these cases, leaving the others to die in prison — and on the state’s dime.

Texas’ “geriatric” inmates, classified as those 55 and older, make up just 7.3 percent of Texas’ 160,000-offender prison population. But they account for nearly a third of the system’s hospital costs and make three times as many visits to prison medical departments as younger inmates. Elderly inmates have average annual hospitalization costs of $4,700, compared to $765 for inmates under 55. In total, providing inmate medical care costs the state correctional health care system — already facing hundreds of employee layoffs amid a budget shortfall — nearly half a billion dollars a year.

Ohio prison system liable for injuries of rapist, 80, who fell out of top bunk, court rules

2-15-15 Ohio:

COLUMBUS, Ohio -- The Ohio Department of Rehabilitation and Correction is liable for the injuries of an 80-year-old inmate who fell out of his top bunk, a state court says.

A ruling by Ohio Court of Claims magistrate earlier this month says the state prison system knew the risks and shouldn't have assigned inmate Roy Buchanan to a top bunk.

The order does not rule on amount of monetary damages, which would be determined in a separate proceeding, the Ohio Supreme Court's news service said (See News Service of case below).

Buchanan's complaint said he lost his balance and fell out of his bunk onto the concrete floor of the dorm where he lived at the Hocking Correctional Facility in December 2012.

Aging Prisoners Shackle State Budgets

11-10-2014 California:

The nation’s graying prison population will strain the corrections system. There are ways to keep costs down, but they’re not often used.

Nearly 10 percent of inmates housed in California state prisons were age 50 or older in 2003. About a decade later, that percentage has doubled. Thanks to an aging prison population and a 2011 prison realignment bill that sent lower-level and typically younger offenders to county jails, about 21 percent of the total state prison population today is over age 50.

While the circumstances in California are unique, the predicament is not. As baby boomers age nationally, America’s prison population is graying. What’s less understood, though, is the full extent of the demands an older prison population will place on corrections systems and just how much it will end up costing.

DOC Discussing Possible Nursing Home For Aging Prison Population

10-29-2014 Oklahoma:

The Department of Corrections has begun preliminary talks with a nursing home operator concerning the possibility of contracting with a facility to house aging state inmates, the Senate Public Safety Committee was told Tuesday.

Dr. William Cooper, the department’s chief medical officer, said the department was approached by a nursing home operations firm about the possibility of contracting with the department. The discussions are in the very early stages.

According to Wes Bledsoe, a nursing home client advocate with the group A Perfect Cause, legislation passed in 2008 permits the department of contract with a nursing home for the housing registered sex offenders. “That could be expanded to cover other offenders,” he said.

The men testified during a hearing on Interim Study S14-039, a study on the impact of an aging prison population at the Department of Corrections. The study was requested by Sen. Wayne Shaw, R-Grove.

Why Did Colorado Shut Down Its Most Successful Parole Program?

9-24-2014 Colorado:

A highly successful parole program that helped inmates serving decades-long sentences transition back to society -- and had the potential to save the Colorado Department of Corrections millions of dollars each year in reduced housing and medical care costs for geriatric prisoners -- has been scuttled without adequate explanation, say supporters of the program.

"First, it was on hold," says Habe Lawson, one of the volunteer mentors for the Long-Term Offender Program, or LTOP -- and, like many of the program's core group, an ex-con himself. "Then it was suspended. Then it was outright thrown away."

We first reported on the mysterious demise of LTOP a few weeks ago in "After Tom," a cover story examining events surrounding the 2013 murder of prison chief Tom Clements and the impact of his death on the reforms he'd launched. Clements had declared that reducing the DOC's overuse of solitary confinement was one of his top priorities, and his successor, Rick Raemisch, has made dramatic strides in bringing those numbers down. At the same time, some re-entry programs Clements had backed as promising ways to keep parolees from cycling back into prison seem to have been stalled or shelved, and LTOP is Exhibit A.

The innovative program was designed to identify longtime inmates who had demonstrated good behavior and posed little risk to public safety but were ill-prepared to return to a world that had changed radically during their decades behind bars. Candidates went through an elaborate selection process, were prepped for re-entry in a special unit at the Sterling prison, then assigned mentors on the street who had been through similar experiences and were eager to help. (The mentoring program was an exception to the usual "no association" rule that keeps parolees from receiving aid or advice from other parolees.)

America's Prisons Have Turned Into Really Awful Nursing Homes

8-8-2013 National:

America's prisons have an exploding population of old (and sick) prisoners who get shoddy medical care and often spend their last days behind bars, Emma Quail writes in the nonprofit investigative news site City Limits.

One prisoner profiled by City Limits, a 67-year-old named Phil, died at an upstate New York prison hospice after doctors allegedly delayed biopsying a spot on his lung until five months after it was originally found.

New York's "compassionate release program" supposedly grants parole to very sick or dying inmates, but in practice it is so bureaucratic that three times as many prisoners die in prison than get released, Quail writes.

Compassionate release isn't properly used in the rest of the country, either. This spring, a report by the Justice Department's Inspector General recommended that U.S. prisons release more sick and dying prisoners. The Inspector General said they should also be released more promptly.

In 13% of cases approved for compassionate relief by a warden, the inmate died before the Bureau of Prisons director signed off on the release, according to a New York Times article on the report.

Compassionate release could be a useful tool in reducing prison overcrowding and saving taxpayer money given how many old people there are in prison these days. The number of prisoners over 55 in America quadrupled between 2005 and 2010, according to Human Rights Watch. (The surge in old prisoners could be a result of lengthy sentences handed out during the "war on drugs" in the 1970s and 1980s.)

As a result of this older population, prisons have turned into "quasi-nursing homes," Quail writes — except they don't have the resources necessary for the long-term care of the sick and elderly.

Carrie Tyler-Stoafer knows about the poor health care offered in prisons all too well. I interviewed her recently about her brother, Timothy, who's serving a life sentence on a third drug offense from his early 20s. Her father, also named Timothy, took part in the drug deal and was given a 10-year-sentence.

The elder Timothy had a bad heart and died after being forced to have surgery in prison eight years into his sentence, when he was 53. When he got convicted, he told her, "This is a life sentence for me."

Head over to City Limits for a more detailed look at what it's like for older inmates to navigate prison health care.

..source.. by Erin Fuchs

VA- Growing old behind bars

1-4-2009 Virginia:

The number of older prisoners in Virginia has more than doubled in the past 10 years, creating new issues for the state's prison system.

CAPRON Winter sunshine slices through a narrow security window and falls on Aloysius Joseph Beyrer's white hair, slight shoulders and the linen covering his fractured hip.

Like the rest of the country, Virginia is coping with a growing number of aging inmates. Beyrer, 84, is the state's oldest and his home, the Deerfield Correctional Center, focuses on geriatric inmates.

In 1999, Virginia had 2,015 prisoners 50 or older. Today, there are almost 4,700, and by 2011, state officials expect there to be 5,057.

A drop in the number of paroles granted to inmates who remain eligible is a factor in Virginia's increasing number of older inmates. Truth-in-sentencing reforms that in 1995 led to stiffer, no-parole sentences for violent crimes are expected to contribute to Virginia's aging prison population in coming years.

At Deerfield, wheelchairs and walkers line aisles in the secured assisted-living dormitory, where it would be easy to confuse the frail residents with those in nursing homes. But it would be a mistake to do so.

Beyrer, a veteran of prisons in Virginia and elsewhere, thinks Deerfield, "is pretty good," though security comes first there, even for octogenarians like Beyrer, who is serving 100 years for sex crimes. The prison's goal is to provide older inmates care and some dignity, not freedom.

The warden, Keith W. Davis, who has a master's degree in social work, makes it clear he is not running a spa for the golden years. "This is not a perfect world. We do not have unlimited resources," he said.

Even with a blank check to meet all their medical and mental-health needs, Davis said no one wants to grow old or die in a prison. "That's a big challenge for the staff. . . . We do what we can do, but we can't cure oldness," he said.

"Offenders are like the rest of us. We get old, we get ill, we die," he said. Deerfield provides a continuing-care community, he said, "so they can reach what we believe is their fullest potential -- body, mind and soul."

. . .

Experts say substance abuse, little or no health care before imprisonment and the stress of living behind bars can leave a 50-year-old inmate physiologically 10 to 15 years older than his chronological age.

In general, older inmates require more supervision and medical and mental-health care, as well as special diets, mobility aids and special housing.

Deerfield, Virginia's only prison dedicated to geriatric inmates and inmates with special medical needs, accommodates 1,080 inmates, 90 of them in wheelchairs and 65 percent over the age of 50.

Other older inmates and older female inmates are in prisons such as the Fluvanna Correctional Center for Women and the Greensville and Powhatan correctional centers.

Critics point out that many older inmates are far less likely to commit new crimes and could be released at great savings. Prison officials, however, believe their care would largely be at public expense in or out of prison.

And though older people are less likely to commit crimes, some still do. Beyrer was 67 when he was convicted in Virginia Beach of statutory rape, aggravated sexual battery and forcible sodomy.

Deerfield's head nurse, Bonita Badgett, said 800 of the inmates there have at least one chronic medical condition such as diabetes, high blood pressure or asthma. The prison psychiatrist, Dr. Amit Shah, said the major problem he treats is depression.

In October alone, the prison handled 5,200 prescriptions.

Badgett has a staff of 14 registered nurses, 25 licensed practical nurses and 21 nursing assistants. Two physicians are at the prison three days a week and the psychiatrist visits once a week. At least one registered nurse is on hand at all times.

. . .

Deerfield was selected 10 years ago as the site for older offenders. An expansion opened in 2007 and there is now an 18-bed infirmary, a 57-bed assisted-living dorm, a larger ancillary-care dorm, a dorm for diabetics and a dorm for other special-needs inmates.

More than 75 percent of Deerfield's prisoners have violent records and nearly 30 percent are sex offenders. Security measures are complicated by health-care needs, said Maj. Stanley Mayes, chief of security for the prison.

"These guys have a lot of serious medical needs and . . . there are a lot of unusual [and potentially dangerous] pieces of equipment or property that we will allow them to have that you typically wouldn't see in another prison," he said.

Officers must be sensitive to prisoners who are gravely ill, suffering a heart attack or a stroke. "But not be deceived by someone who is faking to get an advantage to facilitate an escape," Mayes said.

Not everyone at Deerfield is happy. More than 200 inmates signed a letter to Gov. Timothy M. Kaine last year complaining about the parole board's low grant rate. One inmate claims staff stole his pain medication as he recovered from an injury.

Parole issues aside, inmates interviewed during a recent tour said they liked Deerfield.

James Henry Tinsley, 59, and partially paralyzed, has been there since 2003. "I been locked up 26 years," said Tinsley, convicted of 55 felonies, including capital murder, robbery and burglary.

"You've got some good people here. I ain't got nothin' bad to say about'em. . . . As far as the medical, I give it a double A plus," he said.

Another well-traveled inmate, William H. Glazebrook, 74, has been in the state system for 25 years and at Deerfield for a year and a half. "This is Boy Scout Camp compared to the rest of'em. This is a hell of a lot better," he said.

The Rev. Lynn Robinson, the prison chaplain, says, "These guys here, man, this is a special group of fellows." He said the inmates recently arranged to have Thanksgiving food baskets sent to five families and raised $500 for breast-cancer research.

"The one thing, I think, the community can be aware of is that . . . they need support when they come home," Robinson said.

Also, he said, "Saturdays and Sundays are visiting days, and some of them have family in the general area, and for some reason they don't come to see them. They need to stay in contact with [their] children."

. . .

Beyrer, Virginia's oldest inmate, was a resident of Deerfield's infirmary in November. Aside from six 1992 felony convictions, little information was available about Beyrer because of privacy rules.

He says that he was a once a prisoner at California's San Quentin State Prison. California authorities could not confirm they had ever held him, but New York state archives show he was released from Attica Correctional Facility in 1956.

Dawn Mosena, the nurse manager of the infirmary, said inmates are held there for observation and treatment before and after hospitalization, in addition to long-term care and special-needs inmates such as Beyrer.

She said the staff is planning how to make room for what is expected to be more long-term patients such as Beyrer.

Last year, an inmate's mother was allowed to be with her son in the infirmary when he died. "We want the patient to feel comfortable and the family to feel comfortable and know that they can be with them in those last hours," Mosena said.

"We want to get a hospice program going," she added.

Davis said another problem is that, "a lot of these guys have outlived their families. . . . We could open the door to let them go, and where would they go?"

Badgett, Deerfield's head nurse, agreed. "Some of them we had to keep beyond their release date because we couldn't find a placement for them. There was no family out there, no home, there was nowhere to send them," she said.

Sex offenders, particularly, are difficult to place. Most nursing homes do not want them, and families often reject them because of their crimes, or, "the families simply cannot take care of the needs and medications."

. . .

At Deerfield, younger and healthier inmates -- dubbed "pushers," short for wheelchair pushers -- assist the older inmates and perform a wide variety of essential jobs for 45 cents an hour, primarily janitorial and in health care, that help keep the prison running.

One "pusher," James Lee Wainwright, 47, imprisoned in 1990 for armed robbery, helps in the infirmary. He said he has also assisted with health care at another prison before arriving at Deerfield.

"I plan on taking it up when I get out of here," he said.

An infirmary nurse said, "We couldn't function without these guys, literally, without their eyes and their help."

William Robison, chief psychologist at Deerfield, said some inmate helpers perform odious jobs, peculiar to hospitals and rest homes, for infirm inmates. A program has been set up to help the helpers, Robison said.

"The caregivers support group is . . . for guys who are caring for other guys here. You know, if that isn't therapeutic education, what the hell is?" Robison asked.

"It's a little different here, the way we even think of mental health. We try and redeem a guy."

Said Robinson: "What we do is to find them a purposefulness in living in prison and maybe dying in here." He is familiar with programs in other states and said, "I think we're light years ahead."

"We're not soft on crime. Tough love'em, and they could still die here with some atonement . . . with a sense of humanity and self worth." ..Source.. by Frank Green

MO- Missouri uses special unit to cope with growing numbers of geriatric inmates

8-17-2008 Missouri:

Missouri inmate Larry Burton, 66, has just one crime on his record, but it is as dark as dried blood.

“I’m in here for killing my wife,” the former St. Louis area engineer said in a prison visiting room.

“I’m not proud of it, but it was a shotgun,” he said. “She was asleep at night and never knew what hit her.”

That was in 1990, when Burton was 48. He got life plus 15 years and is now part of the nation’s growing population of aging prisoners with costly health-care needs.

As states and the federal government struggle to deal with the result of inmates serving more time, corrections experts seek solutions or at least ways to cope. One is the “Old Timer’s Unit” at Moberly Correctional Center. Burton is one of 22 prisoners there. The average age is 63.

Kansas provides hospice care at prisons and is building a $6 million clinic at Lansing that will house its sickest male prisoners. Florida has geriatric wings in four prisons.

In California’s huge penal system, a federal receiver who oversees prisons recently asked a judge to seize $8 billion from the state to build medical units for sick and mentally ill inmates.

In light of the mounting costs, some experts suggest releasing far more of these older inmates. Research shows older inmates are much less likely than younger ones to commit crimes again after leaving prison.

In a balance between high costs and fear, society needs to take a smarter approach, said Lonn Lanza-Kaduce, chairman of the criminology department at the University of Florida. But, he said, “some old codger is going to get released and do damage” and become a Willie Horton-like “attention grabber.”

“People should look systematically at what is happening instead of the dramatic exception,” he said.

In a December hearing before a U.S. House committee, a Justice Department representative presented another view. He attacked a bill that would have allowed the release of nonviolent criminals who were at least 45 years old and had served half their sentences.

“This legislation would be completely contrary to the longstanding policy of the United States government,” said Drew Wrigley, U.S. district attorney of North Dakota and “subvert … the federal government’s criminal justice system of truth in sentencing.”

There are other tough issues. Does letting killers out early show a lack of respect for dead victims and heinous crimes? Are the many older sex offenders still a threat, especially ones whose crimes came later in life?

“It seems like nothing is cut-and-dried,” said Bill Miskell, a spokesman for the Kansas corrections department.

Meanwhile, more prisoners are aging behind bars. Only 5.24 percent of Missouri inmates were over the age of 50 in 1995, compared with 13.4 percent last year. In Kansas it was 6.1 percent in 1995 and twice that last year.

A cell to themselves

The Old Timer’s Unit could be one way to cope. It is in a small section of the sprawling acreage of brick and glistening razor wire of the Moberly prison. It opened in 1994 for well-behaved older and sicker inmates. Partly, it protects them from younger bullies.

The old prison has no air conditioning. Only huge fans in hallways and small fans in the tiny cells cool the sultry Midwestern air. A cage separates the old timers from other inmates. A stroll along the unit’s catwalk found many of the gray solid-steel doors open.

Like the younger prisoners, the old timers work and can leave their cells during the day.

Each cell is a steel-walled room, 7 1/2 feet by 9 feet, with a small louvered glass window on one wall that lets in wisps of outside air. Some prisoners place their fans and cassette tape players on their small desks. A few books line up on some desks. Shirts or other clothes somehow hang neatly from the steel walls.

Unlike the other inmates, these men do not share their cells. Perhaps most important to them, they have their own toilet and a small sink.

Each cell has a button that can be used to call for medical help.

Fred Givens, 67, shot and wounded his girlfriend and a man with her in 1984 in Kansas City. He suffers from chronic asthma and said the unit was the best thing that could have happened to him.

“You don’t have to walk to a toilet and you have hot and cold water right there.”

And people there get along. Givens said: “I’ve never seen fights up there. We don’t think about violence.”

Few are released

The Old Timer’s Unit remains the only one of its kind in the state, but that could change, Warden Dean Minor said. He is on a corrections department task force studying how to handle the aging prisoner problem.

Putting them in a cell alone made obvious sense because some could not climb to a top bunk, he said, and the personal toilet and sink give them privacy.

“At that juncture in life,” he said, “privacy becomes more of an issue.”

Reducing problems for prisoners reduces problems for the staff, he said. “We’re not trying to give them special favors, but we’re trying to meet their special needs,” Minor said.

Occasionally a man placed there does not work out, he said, and it becomes obvious. “I don’t mean to say we’ve got a bunch of grumpy old men up there, but it just takes one to irritate them all.”

A long list of inmates awaits entry into the unit, but once there, few get released.

Only two have been freed directly from it, the warden said. Also, some sex offenders were moved from the unit to an 18-month sex offender treatment program elsewhere for possible release. A dozen of about 150 men who have spent time in the unit died there or at hospitals, he said.

In general, Minor breaks down older prisoners this way:

•One third are aging lifers.

•Another third are there for crime after crime — “life on the installment plan.”

•The final third enter prison later in life, usually for serious crimes like sex offenses or murder.

“Once you get over 60, you don’t see many petty thieves,” Minor said.

Parole denied twice

The guards who usher Burton into the visiting room said the wife-killer was a hard man to dislike. Friendly and bright-eyed behind thick glasses, he made no excuses.

In 13 miserable years of marriage, he and his wife argued often at home but not in front of others. “The marriage wasn’t working; she didn’t believe in divorce.”

One day he was upset and distraught and he killed, he said. He’s sorry, remorseful, and now knows: “There are a lot of ways to end a relationship without killing your wife.”

Burton first came up for parole in 2003 and didn’t get it. He failed again two months ago.

“All they tell you is if they release you now, it would depreciate the seriousness of the crime,” he said.

Burton illustrates the dilemma that parole boards face.

What does society do with an aging killer, like Burton, who expresses remorse? ..News Source.. by JOE LAMBE, The Kansas City Star