Health care in America: The challenge of aging inmates

As publicly funded agencies, prisons and jails in America are required to maintain standards of health care, no different from services available in the community

Because prison populations are merely a representation of the public at large, it’s no wonder similar, costly social challenges are being shared and tackled by decision makers on both sides of the razor wire. One of the most significant is the management of health care in America, specifically with regard to aging, incarcerated inmates.

The staggering cost of treatment and medication, coupled with the need for appropriate housing and security, as well as the need for specialized staff training, have caused correctional professionals to consider innovative options.

As publicly-funded agencies, prisons and jails in America are required to maintain standards of health care, no different from services available in the community. However, high-risk lifestyles, history of criminal behavior, years of substance abuse and other reasons have led to a number of offenders reaching “geriatric” status much sooner than what is typically thought of as the common age for the “elderly” in America.

In fact, most statistical reports draw the line at age 55 and above, for the group considered geriatric. And, those numbers for both male and female offenders are increasing nation-wide. When discussing the best ways to manage and care for aging prison populations, leaders recognize their complex responsibilities.

Preserving public safety, remembering victims’ needs, and implementing requirements associated with CRIPA (Civil Rights for Institutional Persons Act, 1980); ADA (Americans With Disabilities Act, 1990); ADAAA (Americans With Disabilities Act Amendment Act, 2008); ACA Standards (American Correctional Association); NCCHC (National Commission on Correctional Health Care); and APHA (American Public Health Association) are just some of these challenges.  Architectural design, transportation, special diets, infirmaries, and the recruitment/retention of licensed health care staff are other overwhelming concerns.

Agencies are discovering the need to engage in legislative dialogue for topics associated with prison hospice services, early release policies, early parole and exploring the idea of assisted living and perhaps contracted nursing home services.

As a result, sentencing and time computation methodologies are being reviewed, as well as inmate classification. Historically, legislators and other government officials have learned these ideas may not be popular with the public. Echoes of “not in my back yard” have been heard throughout the country, along with “this is not our problem; find a solution elsewhere.”

State budgets are being sliced into slivers of the larger pie, with all parts of government competing for every dollar. While criminal justice agencies may locate money-saving strategies on one side, the costs of caring for an aging population creep steadily upward on the other side of the ledger sheet, to off-set potential savings.

It should be noted as health care and medication costs increase for members of the general public, similar increases are passed along to corrections agencies to absorb. And, during budget review cycles, few legislatures are willing to fund for inflation to cover increasing food and medical costs.

Most correctional institutions in this country were never designed to house and manage a growing population whose health care and end of life needs are becoming acute. As the inmate population continues to age, a multidisciplinary approach for seeking solutions becomes significant.

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