The Real Cost of Prisons Weblog

    His ashy gray hair combed back, Owens' eyes swell with tears behind his large gold-framed glasses as he talks about his 83-year-old wife, also a diabetic, who lives alone in their Hyrum home.

    "I'd give anything to be out if I could live a couple of years with her on the outside. I'd die a happy man," said Owens, who has been in prison for five years.

    On both sides of the prison walls, demographics are changing. The baby boomers are graying. And while they're under-represented in prison, their numbers are growing, sending the prison's medical costs soaring, said Richard Garden, clinical director for the Utah Department of Corrections.
    "The fact that a larger proportion of our inmate population is aging is going to mean a tremendous burden for us," he said.

    The problem is only expected to get worse. By 2030, Utah's 65 and older population is expected to increase by 155 percent compared with the same population in 2000, according to a report by the state Department of Human Services' Utah Aging Initiative.

    In just the past six years, the number of elderly inmates at the prison has risen 67 percent while the overall population increased just 11 percent.
    The impact on the Corrections budget is significant, Garden said. While per capita medical costs for younger inmates typically range from $400 to $600, older inmates' per capita costs range between $2,000 and $12,000.

   On average, inmates 55 and older cost 16 times more for medical care, he said.

    "That is a cost to us that is real and currently unfunded."
    Complicating the problem is medical premiums, which continue to rise steeply - about 8 percent to 10 percent each year, Garden said.

    Val Green, 68, who was locked up in February 2002 on two counts of sexual abuse and two counts of forcible sex abuse, had quadruple bypass surgery in 1999. The cost: $27,000.

    These days, Green is fighting off a cold that settled into his lungs and triggers coughing fits. And he has pains and discoloration in his legs. Green, whose sentence expires in February 2007, said he'll live to get out and be with his family. Other inmates won't.

    "I feel sorry for the people who stay here," he said.
    Some inmates, such as 99-year-old Bert Jackson, who is scheduled to be paroled next month, rely on younger inmates to help make their beds, eat their meals and return to their cells.

    Those who die there, and who don't have families to provide for funeral expenses, are cremated and their ashes are buried in a cemetery, said Warden Clint Friel.

    "It's pretty unceremonial," he said.

    Such is Garth Justet's fate, a 75-year-old inmate who was locked up six years ago for a sex offense and has no parole date in sight.
    He has stopped going to mail call because his family has cut off all communication with him.
    "I'm assuming I will be here for the rest of my life," said Justet, who uses a wheelchair and relies on an oxygen tank.
    He took off his orange knit hat, revealing his salt and pepper-colored buzz cut hair.
    "I've accepted I'm no longer wanted or needed," he said.

    Justet's list of ailments is long: his arteries have hardened. He has a blockage in his shoulder. He has had three growths removed from one ear. He has the flu and takes pills for an ear infection.

    "I sneeze, I cough, my nose runs," he said.

    The Department of Corrections defines "elderly inmates" as those who are 55 and above, because most are physiologically older than their age after years of drug and alcohol abuse. They are more likely to suffer from heart disease, high blood pressure, diabetes and strokes.

    Most of them were 55 or older when they were sentenced to prison, according to the Utah Aging Initiative report. About 61 percent were convicted of a sex offense.

    Based on the shifting population and medical inflation, Garden estimates that for every 0.1 percent increase in elderly inmates, Corrections can expect a 1.3 percent increase in medical costs.

    Corrections, which is required by federal law to provide medical care, is tightening its belt in other areas of prison operations to make up for the climbing costs.

    Fewer medical staff members are taking on more responsibilities, Garden said. Some services have been privatized. Inmates' outside medical treatment is being more closely reviewed and scrutinized, and Corrections has taken on the role of a managed health care system.

    "There is not too much more to squeeze from the turnip here," he said.
    Yet another option is early parole for those inmates who are chronically or terminally ill and no longer pose a threat to society, Garden said.
    The Legislature is considering a bill that would require Corrections to disclose inmates' criminal history to health care facilities that accept those who get an early parole.

    House Bill 125, sponsored by Rep. Jackie Biskupski, D-Salt Lake City, also would require Corrections to provide health care for inmates who are chronically or terminally ill - something the department is already doing, Garden said.

    The prison infirmary, where inmates used to stay for a few days while they recovered from surgeries, now houses the terminally ill. Whereas before it operated as a clinic, it now serves as a round-the-clock nursing care facility for the sick.

    "It's a tremendous drain on the health-care staff," Garden said.
    In the coming years, Garden expects the prison will begin exploring the possibility of an actual geriatric unit at the prison.

    "I really think it will happen in a few years. Our problem is the bed crunch. The beds are so tight, we can't afford to have a section dedicated to geriatric inmates and then have a few beds open and no one qualifies [for them]," he said.
    lrosetta@sltrib.com
http://www.sltrib.com/ci_3428919