California already has a compassionate-release law on the books, but it is restricted to terminally ill patients who are “permanently unable to perform activities of basic daily living,” and the release must be approved by a judge. Two prisoners were released last year under this law.
Oftentimes, inmates qualify for compassionate release but die just prior to getting out because the current process can take many months, says Luis Patino, spokesman for Kelso, the California prison health receiver.
Meanwhile, 1% of the state's inmate population last year accounted for one-third of the cost for outside medical costs, including those for specialists and other care, or $135 million, Patino says.
“Texas medically paroles 170 inmates per year and has dramatically cut costs that way,” Patino says. Among those who would be eligible under the new proposed statute would be prisoners with severe Alzheimer's disease, those in comas and those on ventilator support, he says.
Other states are moving even more aggressively to parole the sickest inmates. In 2007, Michigan started on a path to reduce the number of state inmates by 10% and close some prisons altogether. The prisoner reduction effort is mostly targeting the elderly and infirm as well as deportations. In the past year the Michigan Corrections Department has closed three prisons and five camps. The state is also using rehabilitation programs for some prisoners to reduce recidivism.
Michigan has released more than 100 elderly and infirm prisoners since mid-2008, which has resulted in healthcare cost savings, says John Cordell, spokesman for the corrections department. “It gives the prisoner an opportunity to be in the community during that end-stage period,” he says. The release program has not been without controversy, and some victims and their families have opposed the prisoner releases, Cordell adds. “But it is probably the more ethical thing to do.”
Many older inmates simply cannot be released into society. Pennsylvania conducted a profile of inmates over age 50 in 2001 and found they were more likely to be jailed for violent offenses—including sexual offenses—than younger inmates. Similarly, in North Carolina, a 2005 report showed that more than half of inmates age 50 and older were in prison for sexual or other violent crimes.
“There's a lot of third-strikers (in California), but many have more severe sentences because they have more severe crimes,” Patino says.
Some states are trying other tactics to lower healthcare costs and improve quality for aging prisoners. Washington state, for instance, is congregating some of its aging prison populations apart from younger offenders.
While there are some concerns that elderly prisoners could lose access to social services, such as drug treatment or educational programs because of their different locations, under this approach, the tactic can improve health and safety issues and therefore lower costs.
“The good news is that with the financial crisis, many states are realizing that the current system is unsustainable,” Fathi says. “We may actually see this trend starting to turn.”