Aging inmates burden budget in Georgia

Medical release rules gaining new attention

ATLANTA --- As state officials learn to cope with the reality of long-term budget difficulties, they are also dealing with a wave of prisoners whose health care is the most expensive: geriatric inmates.

In 2000, just 3.5 percent of the state's 44,000 prisoners were 55 or older. Today, that percentage has doubled to 7 percent as the total prison population grew, too, by 10,000.

Georgia has 27 inmates in their 80s, 218 in their 70s, and their numbers are a ripple compared with the tidal wave of prisoners sentenced to life as young adults under the two-strikes-and-you're-out legislation who are approaching middle age.

Georgia's Constitution empowers the Board of Pardons and Paroles to release any prisoner older than 62 or a younger one who is "entirely incapacitated." The definition of incapacitated, though, is subject to interpretation.

"Georgia could apply an expansive definition of who is eligible," said Melanie Velez, a lawyer with the Southern Center for Human Rights. "There is a growing number of people who would not pose a threat to society."

Legislation stalled this year in the House, after passing the Senate unanimously, that would put into law the definition used by the parole board. It uses the same rules the Department of Community Health uses for nursing-home patients.

An inmate needing assistance with two daily life activities -- eating, breathing, using the toilet, walking or bathing -- is a candidate.

Thirty-five states have similar provisions for a medical release, and six relaxed them in the past three years, according to Alison Lawrence, a policy specialist with the National Conference of State Legislatures. Compassion and costs are driving the trend.

GEORGIA HAS FREED 180 "incapacitated" inmates in the past three fiscal years. Though the numbers of those applying for release has fluctuated between 100 and 128, the percentage of those gaining release has steadily risen from 42 percent three years ago, to 55 percent last year and up to 65 percent in the fiscal year that ended June 30.

Each application is reviewed individually based on information compiled by the warden and the Department of Corrections.

"It's not routine," said Walt Davis, the director of clemency for the parole board. "The board is concerned with pubic's safety first."

In recent years, the Corrections Department has been seeking out prisoners who could be candidates rather than waiting for them to apply, said Dr. Sharon Lewis, the statewide medical director for the department.

"The wardens are aggressively asking physicians if there are prisoners who qualify," she said.

ONE OF THE ISSUES the parole board must consider is where a prisoner released for medical reasons will go. Few have money or family, Jones notes. Releasing them might mean simply shifting which state agency covers their medical bills.

At least the transition from Corrections to Medicaid means the federal government begins picking up a share of the cost. Release to a nursing home raises the question of where.

"If they have been in prison for a long time, then they probably did something very bad, and people are skittish about admitting them to their facilities," said Steven Burke, a nursing-home consultant with Burke and Associates of Peabody, Mass. "Generally, from my experience it hasn't been a major issue because they're too old to do whatever they were imprisoned for."

As the state heads into a legislative session with the prospect of a slumping revenues and more spending cuts, some policymakers might consider further relaxing the guidelines for medical releases, but not Gov. Sonny Perdue.

"Even given the way the budget is, I think he's very comfortable in leaving the decision about releases to the (parole) board," Perdue spokesman Bert Brantley said.

The cost of inmate care

The cost for providing medical care for a prisoner older than 65 is nearly nine times higher, averaging $8,500 per year compared with just $961 for younger inmates, according to state figures.

"That's a big part of these older prisoners. The medical expenses just eat the state budget alive," said Mark Jones, an author and professor of criminal justice at East Carolina State University.

-- Morris News Service

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