Bren Gorman

In an effort to slow ballooning incarceration costs, a growing number of states are releasing older, chronically ill offenders into the community. Studies show that geriatric inmates (who develop an average of three chronic illnesses while imprisoned) cost the states an average $70,000 per year—two to three times the cost of imprisoning a younger inmate. Research also documents that older inmates are unlikely to re-offend.

In June, North Carolina Governor Mike Easley signed SB 1480, creating an early release program for "no-risk" inmates who are over 65 years of age and completely incapacitated by a chronic illness or disease. Because these inmates could not care for themselves upon release, the law requires that they have a comprehensive "medical release plan" detailing who will provide what type of medical treatment, where it will be provided and how it will be funded.

"We looked at the numbers and from 2005 to 2006, the state spent $60 million for outside medical services for the 100 costliest prisoners, many of whom pose no threat to public safety because of advanced illness," said North Carolina Senate Majority Leader Tony Rand, the bill's primary sponsor. Prisoners incarcerated for violent or sexual offenses are not eligible for the program.

At least 37 states have set up early release programs for geriatric, ill inmates. None of them allow inmates who have been convicted of violent or sexual offenses to participate. Because state definitions of the age at which prisoners are categorized as "geriatric" varies from 50 in Ohio to 65 in New York, the exact number of older prisoners is not known.

In California, the question may no longer be whether to release prisoners, but rather which ones to release. In 2007, the Golden State spent $2.1 billion dollars on health care for its roughly 172,000 inmates. “California is in the middle of a crisis in its state prisons," said California Assemblyman Sandré Swanson.  "In addition to issues of overcrowding, the state spends the most money on prisoners who pose the least threat to public safety… housing aged prisoners with chronic illness does nothing but waste precious resources."

Assemblyman Swanson has introduced a bill (AB 1965) that would establish one of the nation's broadest early release program for chronically ill geriatric prisoners. Like the North Carolina bill, inmates would not qualify if they are serving time for a violent or sexual offense. Unlike the North Carolina program, however, California inmates could qualify at age 55 and would not need to be incapacitated by their chronic illness. Before release, inmates would have to show proof that they qualify for Medicare, Medi-Cal or private health insurance coverage. Shifting the cost burden to Medi-cal or Medicare would allow California to use federal matching funds to ensure that the health-care needs of program participants are met.

Controversy Continues
Opponents of early release programs cite public safety issues. "Having a medical condition that requires ongoing medical attention should not give a person the green light to commit crimes and then go free," said San Bernardino County Sheriff Gary Penrod. "This is not a positive deterrent to crime prevention."

But proponents point to research that shows prisoners over 55 have recidivism rates of 2 percent to 8 percent, compared to 70 percent for the general population. Early release is not a "get out of jail free card," they add—in California, inmates must have completed at least 50 percent of their sentence before they are eligible to be considered for early release.

In fiscal year 2007, state spending on corrections increased at a higher rate than spending on education and Medicaid and accounted for an average of 6.8 percent of state general funds. Oregon spent the highest percentage of general revenue funds on corrections—10.9 percent—while Florida and Vermont, the next highest, spent 9.3 percent. Minnesota and Alabama spent the least—less than 3 percent of general revenues.

The California Legislative Analysts Office estimates that the costs for health care for prisoners over the age of 55 range up to $138,000 a year per inmate, nearly triple the cost for average prisoners. The state Department of Corrections and Rehabilitation estimates that in 2007, approximately 10,500 prisoners over age 55 were incarcerated; that number is expected to climb to over 30,000 by 2020. It is not clear how many of these older prisoners would be eligible for the early-release program proposed in AB 1965 but if just 500 eligible prisoners were freed, Assemblyman Swanson estimates that at least $6.8 million would be saved per year, and says the net savings would accrue to a much higher number over time.

Assemblyman Swanson concluded, "My bill is designed to inject some compassionate relief into our overcrowded system. If we’re able to effect the compassionate release of prisoners to their family and to outside medical care, then it will ease overcrowding and bring greater economic relief to the financially overburdened prison system in the state of California."