AGING INMATES, GROWING COSTS

With tougher sentencing in the 1990s and an aging baby boomer population,
Department of Correction faces a new challenge: the rise in elderly prisoners

There was a time when the hot prison issues were violence and overcrowding.
These days, they also include toilet safety rails and security-approved
wheelchairs.

With the wave of 1990s "truth-in-sentencing" laws and a baby boomer
population edging toward 65, the state Department of Correction is
confronting a new challenge: the rise in elderly inmates during the next 20
years.

Bob Wayman, 66, is part of the new face of state corrections. A
double-amputee and former steamfitter, Wayman is serving four years for
vehicular homicide in a skilled medical wing of DeBerry Special Needs
Facility in Nashville. He is scheduled for release in 2004.

Wayman loves to visit the gym or sun himself in the concrete-and-fence
recreation yard with his roommate Phil Kress, 66, a convicted rapist who
has Parkinson's disease. They watch for squirrels and skunks, wave to other
inmates who walk by or ponder life on the outside.

"There's some people who should be home," not in prison, Wayman said.

Tennessee spends about $20,000 a year on the average prisoner. A sick,
aging inmate can cost the state as much as $60,000 a year, the state says.

"I think there will be a real crisis for states to deal with" in the next
20 years, said Ron Aday, a Middle Tennessee State University professor who
has studied aging inmates since the 1970s.

About 10% of Tennessee prison inmates are older than 50 - slightly more
than the national 9% average, state prison officials say. But research is
under way to avoid any crisis, state Correction Commissioner Quenton White
said.

"There are going to be some very significant issues, especially the
health-care costs," White said. "We are beginning the process of addressing
it."

Aging behind bars

Every year, more inmates need treatment for hypertension, arthritis,
Alzheimer's and emphysema and require physical therapy and hospice care.

Many old or feeble inmates also must be housed separately because they can
become targets for younger, tougher prisoners. The 50-plus set is
considered "senior" by prison standards because hard lifestyles before
prison often cause inmates to age about 10 years faster, experts say.

"You have got to keep up with their needs; it's not just warehousing
prisoners anymore," said Gabrielle Chapman of the state Department of
Correction.

Chapman said the state is looking to lead the nation in elder-care
corrections. Officials are tracking details of the 50-plus inmates and
working on plans to handle physical disabilities, life skill issues,
elderly support groups and hospice care.

Court rulings say that inmates deserve all the health-care opportunities of
anyone in the community.

Tennessee is one of 16 states with facilities for frail and aging inmates,
and it was among the first to establish them. Many of the state's healthier
senior inmates are at the Wayne County Boot Camp.

The DeBerry Special Needs Facility oversees the sickest prisoners, many of
them seniors. DeBerry has 800 beds to house prisoners whose medical
problems range from amputation to dementia to cancer.

White said 300 more beds are needed for the expected rise in elderly
inmates. That could mean an expansion or a whole new prison facility, but
prison officials are not sure what they will do.

From the outside, DeBerry has all the guards, cameras and razor wires of
most any other prison, but maximum security here is not the stuff of
blockbuster films.

This is a place where walkers and canes are weapons and riots are all but
impossible. A lot of prisoners can take care of themselves, but others need
diaper changes or help with spoons and forks. Special equipment at DeBerry
includes Velcro sneakers, plastic mattress covers and shower chairs.

"It's terribly expensive. The public needs to be informed on the cost,"
said Jimmie Tittle, 73, who is serving 16 years at DeBerry for attempted
murder in Sullivan County. He will be 81 when his sentence ends in 2011.

Tittle has had a stroke in prison. He says he has high cholesterol, is
partially crippled and has had infections in his legs.

"There are a tremendous amount who are old, who have served their time and
can be released; they can be checked on an individual basis," said Tittle,
who would like to spend time with his four children and four grandchildren.

Prison workers say they face a tough balance between the criminal need and
the geriatric one. In their younger days, these were violent criminals.
Some still are.

But others are simply old-timers now, relics of their ugly pasts. They
become disoriented in the night, they cannot walk to the meal hall and they
fuss about noise and cool conditions.

"In many instances, they may not pose as much of a threat as they did 20
years ago; they may have softened," White said.

In the long term, caring for senior inmates could involve investing in new
facilities, such as secured halfway houses or secured nursing homes, that
are cheaper than traditional prisons. No plans have been formally proposed,
White said.

In the short run, some prison officials say that meeting senior needs in
the cheapest way is not always possible when public sympathy runs dry.
Health-care workers say spending money on developing wellness programs or
dietary supplements could reduce other medical costs.

Rob Moore turned 79 on Sunday and is serving a life sentence at DeBerry for
first-degree murder. He has survived open-heart surgery and triple-bypass
surgery and battles ongoing back, nerve and hip problems that he says are
aggravated by the standard-issue prison mattresses.

"It's just so hard. I can't roll over, and I can't hardly sit up," Moore said.

But public sympathy often runs low for prison inmates convicted of violent
crimes. Moore has been imprisoned since 1983 and is up for parole in 2006.

"In an environment where money is very, very tight, it's hard to convince
people that different mattresses or better beds might benefit the community
in cost-cutting," said Pat Walker, acting deputy health administrator at
DeBerry.

To help control costs, the state contracted inmate health care to a private
managed-care company, saving money but drawing some criticism from inmates.
White is exploring similar plans for bulk or group rates on prescriptions.

Rethinking tough justice

All across the country, the changing face of corrections and its rising
costs could force prison officials, politicians, maybe even taxpayers to
reshape their ideas of tough justice, some experts say. The state
corrections budget comes from the state's general fund, which also pays for
education, social services programs and road work.

"Many states have gone with these 'get tough' sentencing policies, but now
it's coming back to haunt them," Aday said. "I think we will see (many
states) in the future going back and addressing sentencing policies."

Cost, Aday said, has been a major reason other states have revisited the issue.

A rise in senior crime also may play a part. Some experts say more older
people are being convicted of felonies, such as drug crimes or physical
attacks or murder, most often against a spouse or a neighbor. Some theories
on the increase point to money problems, loneliness, depression or alcohol
and drug abuse problems.

"As people live longer, are in better health and have more energy, they are
also involved in things that get them in trouble or to make some extra
bucks," Aday said.

These are different kinds of criminals than most corrections systems were
designed to handle.

States such as Georgia and California have reduced medical costs with
early-release programs for some elderly inmates who are a low risk to society.

Other states have created geriatric justice systems, modeled after juvenile
justice systems, to help meet seniors' special needs.

White said he has no plans for any such early release but remains convinced
that new ideas will be part of the future of Tennessee corrections.

"A society is as good as it treats its seniors - whether they are in prison
or out of prison," he said.