Congress workshops examine a variety of topics.

Black, White and Gray All Over: New York Cares for its Elderly

Inmates are growing old in our facilities, and it is our duty to find ways to appropriately care for them, said Dr. Lester Wright. The number of elderly inmates in the New York State Department of Correctional Services has been increasing steadily in recent years, and because New York is one of the few states with a declining inmate population, the percentage of elderly inmates--those 55 and older--has been increasing even more rapidly. As deputy commissioner of health services and chief medical officer for the DCS, Wright helped implement a unit within the system to care for inmates with cognitive impairments. The Unit for the Cognitively Impaired (UCI), located within the Fishkill Correctional Facility, has been housing patients with various forms of dementia since it opened in October 2006. The deputy superintendent for health at Fishkill, Elizabeth Williams, RN, helps oversee UCI, and she explained later in the workshop how the unit came to be and some of the services it provides.

Wright opened with some background information on the experience of aging, focusing particularly on some of the difficulties of aging in a correctional environment. Elderly people do not hear, see, walk or digest dinner as well as younger people, and they suffer from such ailments as tooth decay, depression and lethargy. Elderly patients sometimes require wheelchairs and walking devices; often cannot climb to the top bunk; and need warmer uniforms in the winter. Older inmates are often intimidated by younger inmates, he noted, and older inmates can be more vulnerable to attack. So, should they be housed in separate facilities once they reach a certain age? The flip side to that is older inmates can have a calming effect on younger inmates, Wright said, which is one reason he prefers to keep them with the general population.

"Is it a burden or an opportunity to care for inmates?" Wright asked. Because most inmates return back to the community, he views incarceration as a time to improve the health of inmates and send them back to the community in better shape then when they came in. Wright listed the host of services that corrections provides to inmates. Care for the elderly is imperative, Wright said, and because it is more expensive to care for older inmates, we must come up with creative, cost-effective ways to keep them healthy and active. The common age in the community in which a person is designated as elderly is usually 65, Wright said, but because inmates are harder on their bodies than the average person, their physiological ages are often greater than their chronological ages, making elderly an accurate description for 55-and-over inmates.

Services. Williams explained some of the outpatient medical services provided at Fishkill, one of five regional medical units within the DCS. Fishkill contracts with a variety of vendors on site, enabling 93 percent of inmates' medical appointments to occur at a secure facility. Inmates from all over the region travel to Fishkill to receive dialysis, dental, phlebotomy, ophthalmology and X-ray services. The facility has a contract with Erie County Medical Center, whereby staff dial into Erie's emergency room, and doctors at that facility assess Fishkill patients via telemedicine equipment. Williams said it is very popular with the medical staff who like having another set of eyes to help diagnose patients, and it has proved cost effective. Wright chimed in that it prevents 20 percent of patients from going out to receive services unnecessarily, and when a patient does need to be transferred to a hospital, the Erie County doctors will call the nearest hospital to prep its staff on the inmate they are about to receive. At Fishkill's 20-bed infirmary and 30-bed long-term unit, a multitude of in-patient services are provided to inmates. The long-care unit admits patients with chronic, terminal diseases, and as such, provides a hospice program for dying inmates. Three years ago DCS adopted the slogan "No one dies alone" and began employing inmate hospice aides--a needed addition, according to Williams. She was first hired as a nurse in the 1980s at Fishkill, where she worked on the unit for immune-compromised inmates. The AIDS epidemic had just hit, and Williams recalled that it was not unusual to have several patients die a week at the facility. And at that time, "the nurses were the hospice program," Williams said, so "to have this program available now is a wonderful thing."

UCI. Fishkill's recently opened, 30-bed Unit for the Cognitively Impaired houses inmates with various degrees of dementia. Williams explained the concept behind the unit, crediting Wright for recognizing the need for this unit in New York. She pointed to statistics predicting that Alzheimer's will be the leading cause of death by 2050 if no cure is found for the disease.

UCI was designed to be a bright space, with lots of windows and a patio for inmates to sit on and enjoy the landscape. The inmates are kept engaged with plenty of staff contact and programs like Puppies Behind Bars, which Williams credits with helping even the most guarded inmates open up. Fishkill hired a full staff, comprising psychologists, nurses, doctors, social workers, pastors, administrators and security, who went through a week-long intense training that focused specifically on the diseases affecting UCI patients. Now that the unit has been running for two years, Williams finds one of the biggest challenges is placing inmates in the community upon release. The unit developed a multidisciplinary discharge team that networks statewide because UCI brings in patients from all over New York.

"Fishkill is a model," Williams said. And DCS is hoping to open more like it in other parts of the state, specifically at Bedford Hills, one of the state's women's facilities. "You know, this is what this conference is about. ... I'm sharing with you what we have available at Fishkill Correctional Facility and how we got it to where it is. And hopefully it gives you some ideas on how you can start a unit where you are," Williams said.

--Lia Gormsen

Gidgets and Gadgets and Precision Detection

How does your agency decide what new security technologies to invest in? If your answer to that question does not include a detailed evaluation policy, then your agency may be wasting time--and money--investing in costly, ineffective products. Don't worry, though, if yours is an agency lacking in the sort of evaluation process that reveals the true worth of a product, resident tech geeks Alexander Fox and Jim Mahan are here to help. Fox, director of security technology for the Massachusetts Department of Corrections, and Mahan, senior technologist for the Federal Bureau of Prisons, presented a workshop on their efforts to identify, evaluate and share the latest developments in correctional technology.

NTPAC: A Multistate Resource. Fox and MDOC began an initiative eight years ago to connect technology staff from agencies in the Northeast and facilitate information sharing on the latest products. The Northeast Technology and Product Assessment Committee (NTPAC) now partners with 13 states and several laboratories to meet and hash out the pros and cons of the latest innovations in correctional technology. The group, comprised of approximately 45 academicians and practitioners, meets four times each year for two-day sessions. During the first day, the committee listens to half-hour product demonstrations from about eight companies and convenes to discuss the merits of what they have just seen. Any member who has first-hand knowledge of the product on display will speak to his or her experiences, and that information will impact the group's final evaluation of a product. Fox offered his own services to attendees, encouraging them to call him if they are considering a certain product for their facility. He will speak candidly on the technology and share what he has heard about the product from practitioners who have implemented it in their facilities.

"There aren't any programs at all nationally that duplicate what we are doing here," Fox said, which factored into his decision to make the committee's Web site public and provide PowerPoint presentations on each product. For the first two years, MDOC funded the initiative, but since then, funding has been provided by the National Institute of Justice (NIJ). NTPAC can petition NIJ to expand the committee, and Fox told attendees that he is willing to fly anyone interested in becoming part of the committee--and who has a direct role within his or her agency relative to technology--to a meeting. "I want to share this information with people," Fox said, explaining that the technology runs the gamut from "low-tech puncture-resistant gloves for correctional officers to high-tech biometric and digital surveillance systems." The second day of the quarterly meeting is filled with presentations from government officials representing agencies like the Department of Defense and the Department of Homeland Security on products they are developing that may have a direct application to corrections. Fox said that many people are wary of products produced for the military because they believe the technology to be too costly and out of corrections' reach. But he encouraged participants to keep an open mind, reminding them that at one point technologies like radars and digital videos seemed radical. "Everything has its time. Everything has the ability to be introduced into corrections if the moment is right, if the political moment is right, if the money is right," Fox said.

BOP's Evaluation Process. Mahan explained how he and his agency's Office of Security Technology go about evaluating products that companies market to the BOP. Mahan and members of his office also seek out technologies from the private sector and other government agencies, combing trade magazines and attending conferences in search of products that they believe can be adopted for use in corrections. "I'm there waving the flag for corrections, saying 'hey that's good stuff, let's see if we can get it unclassified, harden it a little for corrections and start using it;' that's part of what we do," Mahan explained. By the time a technology gets to Mahan, the engineering aspects should be all worked out and the product should be ready for Mahan to evaluate the "internal" issues--How will this fit into my organization?" For Mahan, this evaluation encompasses several areas. He asks himself:

* Socially, is this acceptable? Products can be too violent--Mahan has seen some technology that can permanently blind inmates.

* What is the political climate like? What is the current administration pushing for, both locally and nationally?

* What are the legal issues? Are the codes up to date? If there are laws prohibiting a certain technology, how can we change those laws?

* Are there some issues the medical community can help clear up for us?

* Is the product financially viable? Can we afford to train enough people to use the product?

After this first informal evaluation, tests on the product become more formal--and more rigorous. They consist of an office evaluation, a field evaluation, a test of standards and a pilot run. Mahan refers to that initial evaluation as a "gut check. ... Is this smoke and mirrors?" And, Mahan asserts, nine times out of 10 it is, and a product does not make it past this first assessment. If it does pass, then Mahan brings some other divisions within BOP headquarters down to evaluate the product, and ask the company some questions--which is nice, Mahan explained, because it does not cost the agency any extra money. Next is the field evaluation, for which Mahan finds a warden in the field who is excited about the new technology and willing to give it a try at his or her facility. This trial run usually lasts 30 or 60 days and provides Mahan with some very honest feedback on how staff and inmates responded to the new technology in the field. This is a crucial step, Mahan explained, because it is hard to assess a product's durability in the office. "I've had some $100,000 technologies that don't last two days [in a facility]. ... They look great, have a wow factor to them, but a day into the evaluation, they're broken." Mahan also consults with a number of different factions during the evaluation process, including different departments within the BOP, such as human resources, medical, legal and facilities.

Mahan's technology office has a specific form staff fill out for each company and product they evaluate. It includes basic information about the product and a picture, and it asks several specific questions about the product that the evaluator answers numerically. It's all designed to be quantifiable for easy comparison, Mahan said. "If three things look the same and act the same, which one has the highest score?" Everything is documented for easy referencing; if someone has an inquiry on a product that was tested two years ago, Mahan can pull up the evaluation and answer specific questions about the product. And like Fox, Mahan encouraged attendees to call him with any specific questions they have. "I've been doing technology for the federal prisons for 20 years," Mahan said. "I've got a lot of solutions I'm looking for problems for."

Up-and-Coming Technologies. Some of the cutting-edge products that Mahan and Fox told attendees to look for in coming years include:

* Cells wired with computer-like kiosks that give inmates IT capabilities such as TV, video visitation, e-mail, electronic scheduling and access to the law library;

* Precision detection to locate cell phones;

* RFID (radio frequency identification) to track inmates--and possibly staff;

* Remote cell sensors that can detect an inmate's heart rate and respiration;

* Biometrics that use eye and fingerprint scans to identify staff;

* Ground radar that creates virtual fences to extend perimeter fences;

* Robotics; and

* Video analytics.

In closing, Fox again stressed the importance of developing a system to evaluate products in every agency. "It doesn't have to be as elaborate as the Federal Bureau of Prison's system, but there should be some type of process and policy in your agency." Networking is essential, as is culling information from agencies with these testing systems in place, which include New York state, California and Texas, Mahan said. "Talk to other people; get associated with some committees. ... Get a few people who know the technology and get involved with them. It's a two-way street--we want to learn from your experiences too."

--Lia Gormsen

Women Take on Corrections

In the workshop, "Women Professionals in Corrections: A Growing Asset," three speakers stressed the important role that women play in today's correctional work force. Moderator and speaker Carl Nink, executive director of MTC Institute, began by stating that there are more women than men in the U.S. He noted that the number of women in the overall work force is expected to grow by 10.9 percent, compared with 9.1 percent for men through 2014. And first-line corrections supervisory staff is expected to increase by 13 percent by 2016. In addition, managerial positions are projected to increase by 9.4 percent during the next eight years.

Nink pointed out that this is a great opportunity for those who are prepared, and one way to prepare is by becoming more educated. According to the National Center for Educational Statistics, Nink said, between 2004-2005 and 2016- 2017, the number of people receiving associate degrees is expected to increase 9 percent--2 percent for men and 14 percent for women. During that same period, the number of people receiving bachelor's degrees is projected to increase 26 percent--16 percent for men and 33 percent for women. The number of people receiving master's degrees is expected to increase 35 percent--24 percent for men and 43 percent for women.

Due to the increase in inmate population, there will be a need for more correctional employees. This will create more opportunities for women to enter the field. "The growth in the correctional industry will grow faster than average during the next several years," Nink said. He noted that according to the Bureau of Labor Statistics, working women increased from 35.7 percent in 1960 to 60.2 percent in 2000. The number of men in the work force declined during that time period from 80.4 percent to 74.7 percent in 2000. "The employment of correctional officers is expected to grow 16 percent between 2006 and 2016," Nink said, adding, "The percentage of women working in adult correctional facilities has increased significantly during the past eight years, as has the percentage of women working in correctional security and as wardens or superintendents."

Nink went on to give a brief summary of some research on gender-specific training and emphasized the need for such training. He noted that research in the U.S. has shown that "women were perceived by male inmates 'as equally or more capable of dealing with higher-custody offenders,' and inmates were more likely to discuss medical and educational concerns with female officers." Research from the U.K. found that women have a calming influence on prison operations. "Gender-specific training is very important to the success of women," Nink said. "And research has shown that women in the work force are good for the atmosphere."

Being prepared for promotion is essential for women in corrections, Nink said. This includes:

* Selecting one or more mentors (networking);

* Having a plan that provides experience and knowledge;

* Pursuing continuing education and training;

* Volunteering for the "tough" assignments;

* Seeking out agency work group assignments;

* Treating others with professionalism and respect;

* Making intentions for promotion known to supervisors; and

* Keeping supervisors abreast of accomplishments, expanded work skills and knowledge.

In summary, Nink noted that participation in corrections by women is growing and gender-specific training is helping them grow professionally and personally. "Women are performing well in the corrections environment," Nink said. "Women represent a growing, educated and capable talent pool."

Gender, Leadership and Policy. Kimberly Greer, Ph.D., associate professor in the Department of Sociology and Corrections at Minnesota State University, then shared with attendees some of the background and results from research that she conducted on gender, leadership and correctional policy. Greer wanted to find out whether gender influenced leadership styles and, if so, in what ways. She also wanted to know if women in leadership positions impact changes in correctional policy.

During her study, Greer interviewed about 25 female correctional leaders to find out how they got to where they are in their careers. Overwhelmingly, she found that the women faced barriers when trying to break into the corrections field. These obstacles included hostile reception, the "good old boy" network, and the feeling that women had to work twice as hard as men to be recognized as simply doing their jobs. She pointed out that often women are evaluated on their performance, while men are evaluated on their potential.

Greer recalled the experience of one responder who said, "I was asked whether I was practicing birth control. One of the interviewers asked, 'Well, you're Catholic, aren't you? Am I going to have to worry about maternity leave?'" Greer noted that similar themes emerged. "It was tough to break into this field," she said. "Many of these women were pioneers."

While interviewing female correctional leaders, Greer met some women who were involved in the Association for Women Executives in Corrections. AWEC gave her the opportunity to mail out a questionnaire to its members, enabling her to gather even more information. "I got some really rich data," Greer said. The primary leadership styles that were reported included"

* Participatory  33
* Directive      15
* Democratic     11
* Negotiator      7
* Authoritarian   5

"Overall, more of the leaders used a participatory and collaborative style," Greer said. "Women use collaboration." Another point she touched on was the connection between women leaders and the millennial generation. Millennials value team work, flexibility, work-life balance, leadership along with autonomy and diversity. The attributes women bring to the corrections profession include participatory, democratic leadership styles; a focus on solutions and problem solving; a willingness to include many perspectives in the decision-making process; an understanding of the struggle for work-life balance; and the power of equal relationships.

Developing and Retaining Women. Darla Elliott, warden of the Arizona State Prison--Kingman, then challenged the audience to come up with ways to help develop women in the field. "How do we encourage them and get them to stay in the profession?" she asked. "How can we mentor and nurture them?"

Understanding the culture and making it acceptable for everyone is essential, Elliott stressed. "Culture needs to change so women don't feel like they are on the outside looking in," she said. Audience members added to this discussion with many agreeing that culture starts at the top with the director, secretary, CEO, etc. Attendees also examined how to develop and support mentorship programs within an agency or facility. Despite all the progress that has been made, Elliott said, challenges do remain. And everyone--male and female--is needed to meet these challenges. Finally, Elliott noted that leadership is essential at every level. "The key is leadership."

--Susan L. Clayton