State weighs costs of aging prison population
SALEM — Oregon inmates are getting older, and lawmakers are trying to prepare for the extra care they may require.
Last year, legislative budget-writers asked the Corrections Department to study how much it would cost the state to renovate an old prison in Salem to house elderly inmates. Corrections officials returned to lawmakers last week to present their initial findings.
State Sen. Jackie Winters, R-Salem, the co-chair of a budget subcommittee on public safety, was one of the lawmakers who asked for the study. Winters, a leading voice on criminal justice issues in the Legislature, said in an interview that she was curious how Oregon was using a vacant penitentiary in the state capital.
She foresees a need for the state to accommodate aging prisoners, who will require more intensive medical care. "For me, it was like, you've got to start planning," Winters said. "You can't wait until D-Day."
The share of senior prisoners has grown in recent years. According to the Oregon Corrections Department, in 2018, people 50 and older made up 21 percent of the inmate population. That compares to 12 percent in 2004.
"This issue has been on our radar for decades," said Jennifer Black, a department spokeswoman.
The trend is happening across the country. The number of state prisoners 55 and older leapt 280 percent between 1999 and 2016, according to the Pew Charitable Trusts. At that time, Oregon had one of the highest shares of elderly people among its inmates, Pew found.
The corrections department told lawmakers last week that it would cost $32 million to renovate the Oregon State Penitentiary minimum annex in Salem, and about $11 million per year to operate it as a geriatric facility.
The penitentiary stopped housing inmates at that complex in 2010 to save money. These days, SWAT teams and other corrections employees use the building for training, Corrections Department Director Colette Peters told lawmakers during a budget hearing last week.
The prison, which opened its doors as Oregon's first women's prison in 1965, would need a lot of work to safely house older inmates with mobility limitations and serious health conditions, Peters said. "When we constructed all of our facilities across the state, they were built for a healthy population," Peters said. "I don't think we anticipated that we would have such a rapidly growing elderly population, even when we built this facility in 1965."
According to corrections department data, 4,191 of the state's 19,660 inmates in 2018 were 50 or older. Elderly inmates are the fastest-growing segment of the state's prison population, Peters said.
The total number of Oregon prisoners is expected to decline by about 4 percent in the next 10 years due to state sentencing reforms, according to the state's Office of Economic Analysis.
But at this point, the state's Criminal Justice Commission doesn't have any specific projections on how much the aging population could grow in the future.
To convert the minimum-security prison to a geriatric prison would require new medical equipment, cell and office furnishings and upgrades to comply with state and local codes and federal accessibility laws, Peters said. "Most furnishings and equipment have been actually pillaged," Peters said. "Anything we could take and use elsewhere, we have."
The department has not taken a position on the concept.
The corrections department has infirmary care in five of its 14 prisons, but most are east of the Cascades and further from hospitals, a spokeswoman said.
"This means that we struggle to find room in the west side infirmary beds for patients who are recovering from surgery, discharged from the hospital, or who have chronic illness," Black said in an email. "Conversely, we have more infirmary beds on the east side of the state in rural areas where medical resources are scarce."
State Rep. Tawna Sanchez, D-Portland, asked if the effort could reduce the amount of overtime that correctional officers spend guarding prisoners who have to be taken to medical facilities far from the prisons where they are housed.
"That to me is a huge factor," Sanchez said. "If we could eliminate the amount of time an officer has to do that medical transport, how many officers are needed for medical transport, that time alone I think, may be a better trade-off for … the cost."
So-called "hospital watches" are the primary driver of overtime for the state's corrections officers, Peters said.
Filling up prisons
The agency asked for 80 new employees to drive down overtime costs in the next two-year budget. Gov. Kate Brown recommended 12.
Peters said that the agency already manages the elderly population efficiently. "We manage that population so well in our current facilities, from a cost perspective, that it's going to cost more every time we have that conversation," Peters said.
The Deer Ridge Correctional Institution in Madras "was designed and built with the aging population in mind," Black said.
Peters said the geriatric-specific facility could cost twice as much per prisoner than a proposed prison in Junction City was estimated to cost in 2009. That planned prison, which lawmakers staved off the need for by reducing sentences for certain crimes, was expected to be specifically for prisoners with special needs, such as older prisoners and prisoners with disabilities.
One reason that elderly inmates are of particular concern is because the state must pay their health care costs. The federal government doesn't allow state inmates to go on Medicaid or Medicare unless the inmate is out of prison and hospitalized for more than 24 hours, and in that case the federal government does provide some matching funds depending on the type of care, Peters said.
That means the cost for inmate medical care comes out of the state's general fund.
Sen. Dennis Linthicum, R-Klamath Falls, asked how high the need for geriatric beds was now and in the future.
Although the corrections department was asked to focus its feasibility study on inmates 75 and older, inmates younger than that could likely use geriatric care too, Peters said. Many inmates are less healthy than the general population of the same age.
"Absolutely, we could fill them up on day one with individuals that would benefit from that infirmary-level care at a geriatric facility, no doubt," Peters said.
State administrative rules say that the Parole Board can consider reductions in prison terms when an inmate is "is suffering from a severe medical condition or is elderly and is permanently incapacitated and is unable to move from place to place without the assistance of another."
However, if an inmate is serving time for a crime committed after June 12, 1997, and their sentencing order says they are not eligible for any form of early release, the board can't grant an early release due to a medical condition.
The corrections department is working on a deeper dive into the prison system's aging population. They're looking at medical classifications and, regardless of age, which inmates are the most expensive to care for.
Reporter Claire Withycombe: email@example.com or 971-304-4148. Withycombe is a reporter for the East Oregonian working for the Oregon Capital Bureau, a collaboration of EO Media Group, Pamplin Media Group, and Salem Reporter.