Addressing those same issues, 46 correctional systems responded to this month's survey on elderly inmates that on Dec. 31, 2000, there were 30,098 inmates classified as "elderly" in their facilities, which represented 8 percent of the total prison population in Florida and a low of 1 percent or less in Connecticut, the District of Columbia and Maryland. "Elderly" was defined as age 60 or older by 74 percent of the respondents. Of the elderly, 6,816 inmates are serving life sentences and 175 are on death row (in those states with the death penalty). The numbers of inmates identified as chronically or terminally, ill have not been tracked or are unknown by 22 states, but range from fewer than 1 percent in Alaska and Maine to 80 percent or more in Rhode Island and Washington.
Separate housing for elderly inmates is maintained by 16 of the 46 reporting jurisdictions. Ohio reserves one small prison for males over 50 and Tennessee operates a geriatric unit at a boot camp for those who are healthy. Regardless of age, all California inmates are housed according to their security program classifications and health care needs; some facilities, however, may choose to have elderly inmates in specific housing units. Numerous options are included in the systems as age-specific accommodations, such as having all necessary services under one roof (dining, medication dispensing, etc.). An assisted-living unit is maintained by Connecticut. Ramps, handrails, elevated toilets, single cells, lower bunks on main-floor tiers and wheelchair accessibility are indicated.
For the chronically or terminally ill, infirmary care, hospitals, hospice and special needs units are primarily in use. In Oregon, care is provided in dormitory infirmary living quarters by trained inmate assistants and Rhode Island uses a community acute care or long-term care hospital, if needed. The hospice care and special care units in Colorado are licensed. Thirteen systems are presently 100 percent ADA-compliant (Americans With Disabilities Act). Plans are in place for becoming compliant by most of the remaining states, with lack of funding the primary reason for noncompliance. As money becomes available and at any time replacement items are necessary, they are replaced in Alabama with ADA-approved equipment and Alaska has hired an ADA coordinator to implement plans under consideration.
Health Care Provisions
Nine systems do not include age-specific provisions in their medical treatment. Annual physicals and flu vaccines are indicated in a number of states. Nebraska offers a boarding/nursing home-type living arrangement, chronic care clinics and referrals to outside sources when appropriate. Oklahoma considers some of its elderly population open to exploitation or victimization by others and places them in single cells. Washington operates with a 24-hour nursing staff, with full-service infirmaries on-site. Inmates there may request medical visits on a daily basis, if needed, and Iowa is planning for a new facility specifically for its chronically ill patients. Most special diets for health care purposes -- therapeutic, diabetic, high-fiber, low-salt, low-fat, low cholesterol, cardiac, liquid, pureed, etc. -- are available at the institutions, based on need as determined by medical staff.
Mental health needs often are treated in separate housing units, as in Arizona, Colorado, Delaware, the district, Indiana, Maryland, Missouri, Nevada, Ohio, Virginia, West Virginia and Wyoming. Four systems provide medication upon release for only seven days. Texas provides 10 days of medication; 18 states provide 14 days and 16 others provide 30 days of medication. Pennsylvania provides medication for 60 days to those released to a community corrections center. Time frames apply in six states ranging from-seven to, l4 days in South Carolina, 10 to 11 days in-West Virginia, seven to 30 days in Rhode Island, and up to 60 days in Colorado. Indiana increases its availability from seven to 30 days for anti-tuberculosis medication and New York increases from 14 to 30 days for AIDS-related drugs. Prescriptions are not provided in 30 of the reporting systems. Illinois allows one refill of current medication, while Indiana provides a prescription only if an appointment with an outside physician cannot be made quickly.
General Program Participation
Age-specific special management techniques are not incorporated in the operation of 19 systems and participation in general programs is open to elderly inmates in all reporting systems with the exception of the district. Special programs for the elderly have been incorporated in a number of states, including horticulture in California, victim awareness and family development in Florida, modified exercise and education in Ohio, and dealing with the aging process in Wisconsin. Forty-four systems allow elderly inmates to participate in prison industry programs and most of those do not place any restrictions on workers. South Carolina requires that workers have a high school diploma or be in pursuit of one. The same guidelines as prison industries hold true for participation in work release programs in 39 systems, although Indiana indicates that its releasees must not have medical problems or chronic conditions requiring frequent treatment.
Early release options are offered in 41 of the systems in a variety of ways. Inmates must not be physically able to repeat their crimes in Alaska, inmates have the right to apply to the governor for executive clemency in Illinois and Washington, inmates must be in need of skilled nursing home care in Missouri and, if terminally ill, inmates in Ohio may be released or furloughed in South Carolina. The Texas Council on Offenders with Mental Impairments (TCOMI) administers that state's early release program with legislation excluding offenders sentenced for aggravated convictions. Prerelease planning for elderly inmates' needs is not in effect in four systems. Six months is noted more often as the duration of its course prior to release. New York begins its release program at the completion of reception, and planning for release may begin up to 18 months in advance in Connecticut. Halfway houses, community release centers and work release facilities are used by Missouri and New Jersey, while Oklahoma and South Carolina are considering pilot reintegration plans.
Of those systems that actively pursue formal outreach services coordination, Pennsylvania provides extensive services through the S.T.E.P. (Services to Elderly Prisoners) program, as does Arizona through the Family Assistance Program. Kansas coordinates its efforts through the Kansas Department of Aging and, again, TCOMI-contract agencies in Texas are required to develop community resources for special needs offenders. In Washington, the Offender Accountability Act mandates formal partnerships with comprehensive community services. Ten states do not offer assistance with housing needs for released elderly inmates. California assists those needing placement in a medical facility or for special housing, and the elderly are referred to community agencies in their counties of residence in New York. Maryland offers referrals for assisted living, adult foster care and nursing homes, including help with accompanying applications for entitlements, medical assistance, etc. It appears that the areas of concern noted in Nadel's article, "Mainstreaming and Special Units, Environmental Considerations, Work Programs and Activities, and Multidisciplinary Approach," have indeed been considered in the ensuing years.
For information on monthly surveys featured in this or past issues of Corrections Compendium, please contact Cece Hill, CEGA Services Inc., P.O. Box 81826, Lincoln, NE 68501 - 1826; (402) 464-0602.