Forum Explores Issues Related To The Aging Prisoner

More than 80 people attended Visions of Justice IX, The Aging Prisoner, to explore policies and laws pertaining to the management and care of Delaware’s aging prison population. The forum, which took place May 8 at Clayton Hall on the University of Delaware Campus in Newark, featured Jonathan Turley, Maurice Shapiro Professor of Public Interest Law at George Washington University School of Law and executive director of the Project for Older Prisoners.

Also on the program was the Delaware panel, which included the Hon. Richard S. Gebelein, chief deputy Attorney General; Carl Danburg, commissioner, Delaware Department of Correction; and, Ina Li, M.D., associate director of Geriatric, Family, and Community Medicine at Wilmington Hospital, Christiana Care Health System.

In his presentation, Dr. Turley said, “We can make rational, bipartisan choices about how to better manage the criminal justice system, but there has been a disconnect between what is best to do and what is chosen to do.” He elaborated on that by explaining that our prisons are in an acute problem state, pointing out that we are warehousing prisoners and experiencing a recidivism rate that is far too high.

“It shouldn’t be a surprise, he said, “especially since there is a move against parole boards and pardons systems. The California prison system, for example, is a bloody nightmare, with a 70 to 90 percent recidivism rate.”

Pertaining to older prisoners, he said that we cannot ignore special needs among prisoners, or the costs go through the roof. According Danburg, in our nation it costs $32,000 a year per prisoner; older prisoners cost between $60,000 and $70,000 a year.

Turley said that prison populations reflect the demographic changes in society; therefore, we see more elderly there, but they are graying at a faster rate than the general population. Prisoners tend to be 10 to 15 years older than their chronological age.

A Complex History of Irrational Choices

According to Turley, in the1960’s and 1970’s, we made some progress. We used to be the world leader in correctional philosophy and science. “Today, Europe sees our policies as stupid. We are not applying rational choices to our corrections problems,” he said.

Turley acknowledged that the Bureau of Prisons is trying to achieve standardization in prisons and uses a correctional philosophy and science to guide its decisions. The Bureau sees it as a science in that how we house prisoners is important; setting out to achieve something to reduce recidivism is important; equal treatment of all people is needed; mainstreaming communities within the system is the way to go.

Age and Recidivism

The irony, he said, is this: “We know what fuels recidivism. We have data that gives us accurate projections.” For example, age is a significant factor. It is the most reliable predictor of recidivism. For males, age 30 is the dividing line. After this age, male offenders are less likely to recidivate. Age should not be used as a single marker for release, but should be considered as individuals are evaluated for success outside the prison. Along with age, he said, we need to consider whether each individual is a habitual offender, if his crime was violent or a property crime, if he is drug dependent or has health problems. “Most important,” said Turley, “we need to find out if there is a place where, upon release, he can find a soft landing.”

The reality is this, he said. “…we push out high recidivists and protect low recidivists (like older prisoners) by keeping them in prison. It makes no sense.”

Older prisoners tend to stay away from the rest of the population, as they fear younger prisoners. The older prisoners fill the hospital beds in the corrections system. Suicide is higher among them. There are fatalities from victimization of older prisoners.

The Program for Older Prisoners

The Program for Older Prisoners (POPS), which takes a risk-based approach to dealing with the burgeoning older prisoner population, is established through law schools. POPS students at George Washington University Law School are trained to identify and evaluate low-risk prisoners within the system, providing a path forward for the supervised release of low-risk, high-cost prisoners. It also looks to help establish geriatric units for high-risk, older prisoners. Such a system can lower costs, improve care for inmates, and reduce crime by making room for more dangerous, younger prisoners.

Turley said, “Political will is needed to effect needed changes; so far, we have lacked it. We have information and know what works to reduce recidivism, as evidenced, in part, by POPS’ zero percent recidivism rate. Politicians don’t sign on, though, as then they can blame others for high recidivism rates. Here’s the bottom line: creating more victims is the cost of doing business for politicians, who are afraid to try such programs, afraid to put their name on the line, and fear being seen as not being tough on crime.”

Delaware Panel Responds

Dr. Li provided more insight into health issues related to our aging population and the older prison population. She pointed out that from 1990-2001, those over 50 tripled in Delaware, and by 2050, one out of five people in our country will be over 65.

“This is causing a health crisis,” she said, “as we don’t have geriatricians prepared to take care of the aging population, and medical costs continue to rise. In prisons, caring for aging prisoners costs three times more than caring for younger prisoners.” She explained that the cost goes up exponentially because older prisoners are subject to high blood pressure, stroke, and cancers, and screenings are needed.

“In prisons, 51 percent of older prisoners said their health was good to excellent before going in prison. Five years later, 46 percent said it was poor,” she said.

Li also pointed out that, in prison, the biological vs. chronological age is very different among prisoners; in fact, there can be up to a 15-year difference, so a 60-year-old may physically be more like 75. Depression is underreported. Dementia in prison is a problem that needs to be managed as well.

Danburg provided an overview of the current prison population in Delaware. “We have 25,000 in and out of the system’s 7,200 beds each year. There are 7,200 people in the system on average in a year, with 3,800 in for one year or more. The average age is 45, but the physical age is much older, by about 10 to 15 years.

Danburg stated that the younger population (those under 55 years of age) is underrepresented, and the number of those that are older is rising significantly. From 1992 to 2001, the percentage of older prisoners in the prison population increased from 5.7 percent 7.9 percent. The trend is expected to continue, so while there are 157 over 60 years of age in prison today, over the next 5 years it will double.

Danburg pointed out the irony of the situation. He said that the average number of convictions before someone is actually imprisoned is eight. So the DOC gets these people when they are older (over 30), exactly the time when data shows that the likelihood to recidivate drops dramatically.

Elderly prisoners are invisible and easier to manage, he said. They are vulnerable to abuse and tend to stick together. Physical accommodations are needed for them in the prison system, and we are not able to do that in our diverse system, with three men’s prisons and one women’s prison.

Danburg agreed that we need specific programs for older prisoners, but that the system sees this as counterintuitive, since older prisoners require less of an effort to keep discipline and order than younger prisoners.

He added that funds are “disproportionately spread to older inmates in Delaware.” Nationally, it costs $32,000 to incarcerate one person a year, up from $27,000 in 1991. The cost spent per elderly prisoner is much higher: $60,000 to $70,000 a year. He said that the average age of prisoners who die of medicalrelated deaths in custody is 45.

He concluded by saying that Delaware has to make choices about olderinmates . Ideas offered by Jim Wel sh, medical director for DOC, include set t ing aside a housing unit carved out for the older population, tailoring benefits/ restrictions to their health care, and providing incentives for prisoners to participate in their own health care.

Judge Gebelein addressed the audience last, providing an overview of a release mechanism “experiment” undertaken in 2002. The effort’s goal was to reduce the expansion of level V space by reducing the prison population in a controlled way. Representatives from the Delaware Sentencing Accountability Commission, Department of Correction, Department of Justice, Superior Court, and Delaware Board of Parole began by reviewing 730 files of offenders who had served at least 50 percent of their sentences and who had been sentenced under mandatory minimum drug laws that had been modified.

Of the 730, 147 were recommended to the parole board and 98 were released, of which 10 returned to level V custody within the study period (10.2 percent). Thirty-three were over 40 years of age at the time of release; only one of those (3 percent) returned to level V.

Data made clear that it might be a good idea to look at the sentences of those over 40 every year or every other year to determine release potential. Gebelein said, “Risk analysis is better now, so we can predict future criminal conduct more accurately.”

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