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August 2, 2014

Documenting the high health-care costs of an aging prison population in Oklahoma

This notable article from Oklahoma, headlined "Inmate health costs rise, prisons scramble for solutions," highlights a modern corrections reality facing more and more jurisdictions as the economic costs of tough-on-crime policies come into focus. Here are excerpts:

Taxpayers forked over nearly $1 million last year to buy inhalers to treat asthma and emphysema among inmates in state prisons. The state also paid for 530,647 inmate prescriptions.

Those represent just a fraction of the health expenses for the state’s approximately 25,000 inmates, which cost $36.6 million last year, according to a review by the State Auditor and Inspector’s office.

That total amounts to an 11 percent increase from 2010 to 2013, and experts say the number likely is to keep swelling, especially as the inmate population ages. “That is something Oklahoma has in its future, and it’s definitely something to keep an eye on,” said Maria Schiff, director of Pew Charitable Trust’s State Healthcare Project, which recently researched prison health care costs.

According to the Pew report, Oklahomans paid the least in the nation in prisoner medical expenses, at $2,558 per inmate, while Californians spend the most at $14,495. That was based on expenses in fiscal year 2011. But that number is growing. By fiscal 2013 — the most recent year for which data is available — Oklahomans spent an average of $7.58 per inmate per day in medical expenses, said Department of Corrections spokesman Jerry Massie.

A prison’s health care spending usually depends on the size of its prisoner population and its age, Schiff said. Oklahoma’s percentage of inmates 55 and older was near the top in the nation, the Pew researchers found. That trend also was detected by the state’s audit, which found that nearly 43 percent of the state’s inmates are older than 40. That percentage has been steadily growing.

That’s a key finding, the audit noted, because older inmates typically have more illnesses and infirmities, and they cost taxpayers at least double what’s spent on their younger counterparts. The number of older inmates sentenced for the first time has grown nationally, Schiff said. They join inmates sentenced in the 1980s who simply are aging in prison....

Finding a balance in funding can be complex, Gary Jones, state auditor and inspector, noted in the report. That’s because the Corrections Department has no control over criminal laws, who gets prosecuted, the length of sentences imposed or the number of people entering its system. “Proponents of ‘tough-on-crime’ and policymakers advocating rigorous sentencing laws must act responsibly and commit sufficient financial resources to fund the infrastructure, operations and specialized programs needed to accommodate the resultant expansion of a demographically demanding inmate population, or find ways in which to be smart on crime, keeping in mind the ever-increasing cost to Oklahoma taxpayers,” Jones wrote in his report.

There may be no easy solution, but Jones’ staff proposed one alternative in the audit — releasing older and terminally ill inmates. That’s not a popular choice, as legislator Jeannie McDaniel, D-Tulsa, discovered. She proposed a bill that could have led to the release about 600 or 700 inmates age 65 or older if they met certain conditions, including conviction for a non-violent crime. The Parole Board ultimately would have made the decision, she said.

McDaniel said she got the idea from Louisiana’s early release for an aging population at its Angola prison. “Their success was great, and they saved the money,” she said. “These were people that were not threats to society. Their costs were eating up the prison budget.”

But McDaniel said she met resistance from prosecutors who felt the Parole Board shouldn’t be able to overturn sentences handed down by a judge or jury. She hopes to introduce a similar bill during this coming session, she said.

Schiff said a number of states have passed guidelines for geriatric release. Among the advantages of those programs is expense: While freed inmates likely end up on Medicaid, the state shares those costs with the federal government. Also, the state doesn’t need to pay to drive freed inmates to appointments. But early release is controversial in many places where lawmakers struggle to decide which prisoners should qualify and under what circumstances, Schiff said.

August 2, 2014 at 04:03 PM | Permalink

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Comments

The role of the prosecutor should begin and end with a trial. It should not be their role to determine a sentence or length of custody. Jeannie McDaniel's proposal was entirely reasonable. Legislators should not allow themselves to become puppets of prosecutors, and prosecutors should have the grace and professionalism to mind their own business.

Posted by: peter | Aug 3, 2014 9:41:20 AM

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