The Aging Inmate Population: Southern States Outlook

The Council of State Governments
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Southern Legislative Conference
The Aging Inmate Population

Southern States Outlook
By Jeremy L. Williams, Policy Analyst
DECEMBER 2006
Todays inmates are older, sicker, and staying longer behind bars than ever before.
U.S. Department of Justice
Introduction
n recent years, the largest and fastest growing

number of incarcerated inmates over the age of 50
in United States prisons has continued to shape
the demographic of prison systems throughout
the country. The perpetual explosion of elderly
persons in the general American population, and the
repercussions of the tough-on-crime laws during
the 1980s and 1990s, have led to a current increase of
approximately 675,000 arrests of elderly persons every
year in the United States.1 Experts assert that this is
not attributable to an elderly crime wave, but rather to
several factors that will continue to put more elderly
people behind bars and continue to keep these persons
behind bars longer.
According to the Criminal Justice Institute, in
1992 inmates over the age of 50 made up 5.7 percent
of the total inmate population. Only a decade later
that percentage had increased to 8.6 percent,
which amounted to almost 121,000 elderly
inmates in prison, more than double the
number in 1992.2 Elderly inmates are now
the fastest growing cohort of the inmate population in most states throughout the country.3
Specifically, across the 16 Southern Legislative Conference (SLC) states Alabama,
Arkansas, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, Missouri,
North Carolina, Oklahoma, South Carolina,
Tennessee, Texas, Virginia, and West Virginia
this growth rate has escalated by an average
of 145 percent since 1997, prompting state
corrections systems to address the ramifications of this upsurge.
the term connoting different age groups depending

on the state the statistics, along with general uses of
the term elderly, in this report are based on inmates
who are 50 years of age or older. Six of the 16 SLC
states distinguish an inmate as elderly if he or she
is 50 years of age or older, but nine others define the
term using the ages 55, 60, or 65 years of age, 65 being
the traditional demarcation for characterizing elderly
persons in society at large. The reason many states,
and a large portion of experts, use the adjusted age of
50 to define an elderly inmate is due to the existence of
several factors that typically lower the life expectancy
and, correspondingly, the point at which old age is
reached of persons in prison. One of these factors is
the basic stress of prison life, which includes anxiety
associated with a change in environment; isolation and
often ostracism from family and friends; the prospect of
living a large portion or ones life in confinement; and
Figure 1
Characterization of
Elderly Inmates by State
Although states have various definitions of elderly with regard to inmates
S o u t h e r n
L e g i s l a t i v e
C o n f e r e n c e
Alabama Arkansas Florida Georgia Louisiana Kentucky Maryland Mississippi Missouri

North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia
The Aging Prison Population: Southern States Outlook
the threat of victimization, which disproportionately

affects older inmates.
Other factors that contribute to an accelerated
aging of inmates include lifestyle choices that are
common among prisoners, both before and after incarceration. These include drug and alcohol abuse; risky
sexual behavior; lack of preventive healthcare; and
other causes that also can be associated with poverty
and lack of education. In fact, the combination of
these patterns is unique to this group4 and can be
used to forecast patterns of physical deterioration for
elderly inmates. Just as the facultative age 65, which
indicates entrance into old age for the average person
outside of prison, has been adopted by habit,5 age 50
is an equally arbitrary margin between middle and old
age for inmates. However, this boundary is meant to
classify aging patterns in inmates that are particular to
this cohort. In other words, although not an absolute
or rigid boundary, the chronological age 50 is a helpful
indicator of the physical age of inmates, just as the
chronological age 65 indicates a similar physical state
for persons outside of prison.
Figure 1
This 15-year gap may seem excessive, but experts

contend that it conveys a useful comparison between
elderly persons in prison and those not in prison. In
fact, the distinction between the health of someone
entering prison and the rest of society is so pronounced
that differences often have been noted between those
being admitted into prison and those spending time in
local jails. Sheriff Daron Hall of Davidson County,
Tennessee, which includes Nashville, says of the
difference between jail and prison inmate intakes,
[T]he emotional and physical health of those admitted
into jail, in most cases, are extremely different from
those being transferred to prison.6 Likewise, there
are epidemiological considerations because of the
overall severely lessened health of the average elderly
inmate, which is coupled with the dangers created by
confining large numbers of people to restrained living
quarters. Due to the environment produced by these
confines, institutionalization drastically increases the
probability that infectious, communicable diseases will
spread. Although not all chronically and terminally
ill inmates are elderly, there is a distinct overlap that
Elderly and Non-elderly Inmates

in SLC States
most correctional healthcare programs acknowledge

as significant.7
The SLC began closely examining this issue

during the 1990s. From information gathered from
state corrections department through 1997, the SLC
published a report, The Aging Inmate Population, on
the topic in 1998, noting that many states have found
that the increase in the geriatric inmate population has
been far greater than anticipated.8 As an update to the
1998 report, this SLC Regional Resource explores the
increase of the elderly prison population in Southern
states and the nuances of this development, focusing

particularly on changes since 1997. It examines policies and procedures employed by each state, as well
as facilities and programs that are geared toward
accommodating this growing population. Also, this
report addresses the concerns of corrections officials
regarding the future of the elderly inmate population
within their states. Information was gathered through
polling corrections departments in the 16 SLC member
states. In addition, information was amassed from
existing research projects and studies.
The Increasing Elderly Inmate Population
The Graying of America
he aging of the general American public is

a dynamic that has had the most obvious
and ubiquitous effect on the elderly inmate
population. Persons over the age of 65 are
the most rapidly increasing age group in the United
States. This largely is due to the ability of people
to live much longer than preceding generations. In
fact, according to Dr. Ronald Aday, director of Aging
Studies at Middle Tennessee State University, about
20 percent of all human beings in the world who have
ever lived to be 65 years of age or older currently are
alive.9 Moreover, there are no indications of this rapid
development slowing. By 2030, it is projected that
approximately 80 million people living in the United
States will be 65 years of age or older, making up as
much as 20 percent of the population.10
influencing the graying of America. Another factor

is that more people in general are living longer lives.
The U.S. Department of Health and Human Services
Administration on Aging estimated that those 65 years
of age and older numbered 36.3 million in 2004, an
increase of more than 9 percent since the mid-1990s.
Also, by way of example, the Administration on Aging
projects that the over-85 population in the United States
will reach about 9 million by 2030.12 Correspondingly,
these trends are reflected in the growing percentage
of elderly persons in prison, which has been steadily
increasing since the early 1980s and, particularly,
over the last decade. The older the general population
becomes, the older the prison populations will become
as well.
Although this expeditious increase in the age of

the general population has been noticeable in recent
years, and although it was not until recently that
the effects of this dynamic became importunate and
alarming, the gradual increase has been documented
through the course of the last century. According to
the U.S. Census Bureau, in 1900, only one in every
25 people in the United States was over the age of 65.
By 2000, that number had reached one in every eight.
The aging of the baby boomer population (anyone
born between the years 1946 and 1964) has contributed
greatly to this dynamic. In 2005, there were approximately 78 million baby boomers alive in the United
States, with approximately 7,900 people turning 60
years of age every day.11
here has been concern regarding the aging of

Americas prisoners since the early 1980s.
Therefore, this trend has been anticipated,
although remedies for it are varied and often
conjectural. One of the most obvious reasons for the
aging of the inmate population, apart from the aging
of the general population, is tougher sentencing laws
passed by states during the late 1980s and early 1990s.
This time period is characterized by the war on drugs, a
time when great attention was paid to escalating crime
rates in almost all states. Two- and three-strikes laws,
along with truth-in-sentencing laws, became popular
during this period in an effort to dissuade criminal
behavior. The swell of incidences of heinous crimes
committed against people, such as murder and rape, led
to the advent of this type legislation in many states. The
strand of such laws culminated with the federal Violent
Crime Control and Law Enforcement Act of 1994, the
countrys most comprehensive crime bill ever passed.
While the baby boomers reaching retirement age

will continue to augment the elderly population in the
United States, this is not the only contributing factor
Tough-on-Crime Laws
Due largely to these stricter sentencing laws, more

inmates are remaining in prison until they are older, and
more inmates are dying in prison. For instance, at the
state penitentiary in Angola, Louisiana, 97 percent of
the inmates die in prison. In Texas, more than 100
inmates a year die in prison, each death costing the state
approximately $1,500. Nationwide, the U.S. Justice
Department has estimated that, in 2002, almost 4,000
inmates died in prison from all causes.14 Most of these
inmates are elderly; meaning conversations regarding
the number of inmates dying in prison must involve
the prospect of alternative programs for early parole or
special release as alternatives to these inmates spending
the end of their lives in prison.
Another version of truth-in-sentencing laws that
significantly impacts the increasing likelihood that
inmates will spend more time in prison is the abolition
of parole for individuals who commit certain crimes.
More young persons are receiving sentences of life
without parole, which will continue to contribute to
the already escalating prison population as a whole,
and to the number of inmates who will grow old in
prison. Equally disconcerting is the fact that elderly
persons are committing more serious crimes. The
reasons for this are unclear, but experts speculate that
causes can range from an increasing neglect in society
for elderly persons in general, to other social and
psychological factors that often affect criminology.
It is clear, however, that elderly persons commit
offenses for different reasons than younger ones. This
rise in serious crimes by the elderly is contrary to the
stereotype that elderly individuals always are frail and
defenseless, and almost always the victim of misdeed.
However, while the elderly population is not exempt
from participation in serious criminal behavior, that
is not to say that there is or has been, in recent years,
a significant elderly crime wave. Statistics show that
elderly persons are becoming less likely to commit
crimes in general. Unfortunately, the crimes they do
commit are becoming much more serious.
Many states have eliminated parole programs

for prisoners who have committed ruthless crimes,
while other states have abolished parole programs
altogether.15 For example, Georgia enacted a law in
1995 that mandates a prisoner serve a minimum of
10 years for the first offense from the list of seven of
the most egregious crimes, dubbed the seven deadly
sins. Furthermore, under a two-strikes amendment to
this law, a second conviction of a deadly sin yields a
mandatory life sentence. In addition, the constitutional
amendment that established this law abolished parole
for those convicted of a crime covered under the deadly
sins categories. This legislation soon made Georgia
fourth in the nation for the amount of time served in
prison for most violent offenses.16 What has resulted
from these laws are a greater number of people being
proscribed to, and fewer people being discharged from,
state prisons. The dramatic effects tough-on-crime
legislation has had on the length of time a prisoner is
incarcerated continue to be felt. Truth-in-sentencing
laws, for instance, have added an average of 15 months
to prison sentences for violent crimes, nationwide, and
the prisoners becoming elderly in prison due to such
laws are beginning to add up.
Various organizations have attempted to address
potential solutions for problems associated with aging
inmate populations by evaluating the pros and cons
of these more stringent sentencing laws. The Coalition for Federal Sentencing Reform, for instance, has
worked to encourage federal legislation that would
permit managed release for elderly inmates who have
not committed violent or sex-based crimes. Such
organizations encourage states to reevaluate guidelines
for mandatory sentences as a means of reducing the
number of elderly inmates who are entering prison,
as well as the number of inmates who will grow old
in prison.
Now many states are attempting to combat problems associated with tough-on-crime legislation that
has produced prison overcrowding and longer prison
sentences for criminals. California, as an example,
which initiated the tough on crime movement in
1994 by passing its three strikes, youre out law,
has considered amending this legislation in order to
prohibit judges from sentencing offenders to life in
prison for their third offense unless the offense is a
violent or other serious crime. California, whose state
jails are built to accommodate a total of 100,000 prisoners, has a growing 170,000-inmate prison population. In addition, in 2005, approximately 60 percent
of Californias inmates who were sentenced for their
third offense were sentenced for nonviolent or nonserious crimes. Correspondingly, it costs the state
approximately $31,000 a year to house a non-elderly
prisoner.

While the goal of this legislation was to stifle

criminal behavior, particularly violent and drug-related
crime, it has led to an influx of prisoners incarcerated
in state and federal prisons. Most of the prisoners
sentenced under these laws spend large portions of their
lives, if not their entire lives, behind bars. At mid-year
2005, the U.S. Department of Justice calculated that
prisons and jails throughout the country incarcerated
2,186,230 persons. Two-thirds of these, or 1,438,701
inmates, were incarcerated in state and federal jails (the
remainder housed in local jails or in release programs).
From 1995 to 2005, incarceration rates have risen an
average of 14 percent, from 379 to 433 prisoners for
every 100,000 U.S. residents.13
Challenges
The Condition of Elderly Inmates
any elderly inmates have numerous

chronic diseases requiring extensive
care and treatment that can become
very expensive for state corrections
departments. A major component of this problem is
the sheer number of mentally and developmentally ill
inmates in prison. Currently, there are more mentally
ill individuals in correctional facilities than in mental
hospitals and institutions throughout the United States,
amounting to more than 200,000 inmates with severe
mental illnesses being housed in state prisons or jails.17
Reflecting on the link between mental illness and crime,
Robert Hofacre, nursing director of the Ohio Department of Youth Services, has stated, The increase of
mentally ill offenders within correctional systems is
directly proportionate to the deinstitutionalization of
the mentally ill in public psychiatric hospitals.18 It
is not uncommon for elderly inmates to suffer from a
variety of mental illnesses, ranging from various forms
of depression and anxiety disorders, to ailments that are
more specific to this age group, such as Alzheimers
disease. Moreover, prison systems were not originally
designed to address the needs of such a large and
diverse population of chronically ill inmates.
Since women typically need more medical
services throughout their lifetime than men, it follows
that the average elderly woman prisoner will utilize
more medical services than their male counterparts. In
fact, elderly female inmates use more medical services
than any other prison cohort.19 Therefore, states have
begun to give considerable attention to programs that
specifically address concerns regarding the medical
needs of elderly female prisoners. Although there
are far more men incarcerated in state prisons than
there are women, the aging female population in state

prisons will bring with it a continued need for better

housing and medical services, as well as the need for
more medical staff, in order to meet the needs of this
population.
Likewise, African American men are more likely
than other male inmate groups to spend large portions
of their lives in prison. Therefore, elderly African
American men will continue to be disproportionately
represented in the elderly prison population. Overall,
Southern states have greater percentages of African
American inmates male and female than other
regions of the country. As an example, 52 percent
of the 5,600 elderly inmates incarcerated in Georgia
are African American.20 By 2005, approximately
12 percent of all black males in their late 20s were
in prison or jail, compared to less than 2 percent of
whites in this same age group. This makes African
American males in this group five to seven times more
likely to be incarcerated.21 The overall percentage of
elderly African American prisoners is much lower than
the percentage of young African American prisoners;
however, these statistics that reflect higher incarceration rates for young African Americans, involving
serious crimes, predict that an incommensurate number
of African American men likely will spend their later
years behind bars.
There are three types of elderly inmates: first-time
offenders, recidivists and long-term servers. First-time
offenders are elderly criminals who are incarcerated
for the first time. Approximately 45 percent of elderly
inmates now in prison are first-time offenders. Recidivists are habitual offenders, in prison for a second or
more time. Long-term servers are elderly prisoners
who were not elderly when they entered prison, but
have matured to an elderly age within prison. There
H o u s i n g : C o sts, Overcrowding,
a n d V i c t i m i z a tion
he cost of housing the average prisoner in the

South continues to rise. According to Adult
Correctional Systems, an annual comparative date report submitted to the Fiscal
Affairs and Government Operations Committee of the
SLC, prison spending in Southern states has increased
by more than 51 percent over the last decade. The
average cost for housing an inmate for one year in
the South is approximately $18,864, with some states
spending more than $30,000 per inmate.23 While
increasing medical costs for elderly inmates were the
most frequently mentioned major problem by state
corrections departments, the cost of housing healthy
inmates is exorbitant as well. The National Council
on Crime and Delinquency estimates that it costs more
than $1 million to house an inmate for 30 years, which
is the average span of a life sentence, and more than
$2 million to house an inmate for 50 years.24 These
astronomical expenditures are estimates calculated by
basic housing costs and do not include expenses for
medical treatment for that inmate.
In order to address problems associated with
overcrowding, as well as the cost of housing, many
states are examining the benefits of alternative housing
for elderly inmates, either by maintaining separate
prisons for these inmates, or by having partitioned
prison wings or units in which to sequester them. One
of the benefits to this is reduced costs associated with
consolidated staff for inmates in these areas. Since the
elderly inmate population has distinct medical needs,
training for staff in these prisons or facilities can be
more focused, just as training for staff in other prisons
or prison units can be tailored to best accommodate the
needs of their populations. Also, the facilities themselves can be customized to meet the needs of these
inmates. Just as the infrastructure of maximum-security prisons is modified to minimize the potential for the
most dangerous inmates to escape, prisons for elderly
inmates would be designed to best accommodate the
prisoners there. For instance, facility alternatives can
be prisons that are restricted to only elderly prisoners.
Therefore, other prisons that do not house inmates with
severe mobility restrictions could forego providing
wheelchair ramps, handicap bathroom stalls, and the

like, for their prison populations. Such modifications
could drastically restrict and reduce costs for state
corrections departments.
The level of care provided in these prisons or
prison units for the various needs of the elderly inmate
population can be tiered as well. While many elderly
inmates require nursing-home caliber care, many do
not. There are other elderly inmates who do not require
a nursing-home environment, but would benefit from
a more protected location that can better meet their
needs. The extensiveness to which elderly inmates
need adaptive services, more so than almost any other
single prison group, makes the rationality behind separate facilities that much more plausible. In general,
studies have shown that most elderly inmates react well
to congregate living communities. 25
Housing elderly inmates in separate facilities also
would address another problem associated with this
prison population: the view that conflates the physical
problems associated with old age with the justice of
punishment in prison. Many states are attempting to
reform the perspective that any suffering or distress
experienced by an inmate is duly deserved because
of wrongs that the prisoner committed. Educating
communities in general is important, but training staff
who interact with these inmates on a daily basis is
even more imperative to ensure that inmates receive
respectful supervision. As noted, consolidating staff to
one prison, or one area of a prison, would make goals
such as these much more attainable.26
Housing issues also are relevant to the persistent
problem of victimization of elderly inmates by younger
inmates. Elderly inmates often become targets of
prison violence and abuse due to their physical frailty
and lack of ability to defend themselves. Although
many states in which elderly prisoners are housed in the
general population reported that victimization is not a
problem in their prisons, such occurrences are particularly debilitating to elderly inmates when they do occur,
raising humanitarian concerns in many correctional
systems. Again, this problem can be addressed, if not
completely remedied, through separate housing for
frail, elderly inmates another reason states are investigating the benefits of this option.
Parole and Recidivism Issues
verall, elderly inmates have lower recidivism rates than younger inmates. The 16
SLC states reported varying recidivism
rates for elderly inmates. Little research
has been conducted to examine the reasons for these
varying rates, but what information is available is
of great relevance to existing and prospective parole

are significant differences between these three groups.

For instance, both recidivists and long-term servers
are more institutionalized than first-time offenders,
and long-term servers are more institutionalized than
recidivists. First-time offenders are less likely to adapt
to prison life and typically are in greater threat of
victimization, a problem addressed later in this report.
Recidivists generally have chronic behavioral patterns
and have more complicated behavioral patterns than
first-time offenders and often long-term servers.22
programs. Part of the difficulty in gauging the potential

for retrogression into criminal behavior, specifically
for this age group, is that the causes for recidivism
cover a variety of psychological and social reasons.
There are trends being evaluated that may begin to help
decipher more definitive, potential causes, and many of
these trends will prove helpful to states in structuring
parole programs for elderly parolees. For instance,
it is known that often elderly inmates released from
prison commit crimes in order to intentionally return to
prison, out of a social need to return to a safe, familiar
environment, rather than a tumultuous, unfamiliar one.
Another known cause of increased recidivism rates
for elderly inmates is lack of belonging or purpose in
society. Inmates reluctant to become involved in civic
activities, such as religious organizations, volunteer
programs, or work programs, are more likely to return
to criminal behavior. The lack of social responsibility
makes the paroled or released inmate less connected to
society and, therefore, more likely to act disobediently
toward the rules of that society.
Such behavior should be addressed by parole
programs to curb greater potential for recidivism and
re-incarceration. These causes can be evaluated and
dissected, and the results used to construct more effective parole programs. Recidivism also can be affected
by patterns of behavior that cannot be so easily linked
to a succinct origin or basis. Repeat offenders, for
instance, often continue in their patterns of behavior.
Elderly first-time offenders of nonviolent crimes do
not always commit further crimes when released but,
for varying reasons, sometimes they do. In order
to address increased rates of recidivism, states must

implement programs that provide an individualized
approach that will increase the chances for an inmate
to rejoin society in a positive manner.
There are organizations that are attempting to
address parole problems associated with elderly inmate
parole and special-release programs. The Project for
Older Prisoners (POPS) is an organization that seeks to
address prison overcrowding, in general, and the needs
of elderly and disadvantaged inmates, specifically, since
its inception in 1989. Developed by Jonathan Turley
at the George Washington University School of Law,
the program actively campaigns for the early release of
elderly inmates with serious or life-threatening health
conditions, and low-security-risk prisoners who have
the means of working and supporting themselves in
society. For high-risk elderly prisoners who have little
or no possibility of being released, POPS advocates the
availability of acceptable nursing-home care within
the prison. POPS was initiated in response to a case
in Louisiana involving an elderly man convicted of
a minor felony, but sentenced to a 37-year term due
to state tough-on-crime laws. Since then, POPS has
orchestrated the release of 500 elderly inmates.27 In
a critique of the general environment of most current
state prisonS, as well as the inadequacy of many prison
programs for elderly inmates, Jonathan Turley, head
of POPS, has stated, Prisons make perfectly lousy
nursing homes and, as a result, prisons do things that
are not just inadequate but prohibitively expensive.28
Southern State Profiles
n order to collect information regarding elderly

prisoners in the South, surveys were sent to corrections departments in all 16 SLC member states. 29
Participants responded to questions concerning
five major areas of investigation regarding their states
elderly prison population: general statistics, specific
criminal statistics, policies, facilities, and concerns.
There was an additional section provided for any
information each department considered relevant and
important to a characterization of their states strategy

regarding elderly inmates. Reponses were received
from all 16 states. This information was coupled with
information gleaned from general research. Unless
explicitly stated otherwise, the following state sections
reflect the survey responses submitted by each state
corrections department. The 1997 data in each state
table was taken from The Aging Inmate Population
SLC Special Series Report by Todd Edwards.
Table 1 How Southern States Compare

1997
Total Inmates
State
in Institutions
Alabama
21,761
Arkansas
10,221
Florida
63,763
Georgia
36,972
Kentucky
12,910
Louisiana
26,779
Maryland
22,109
Mississippi
14,032
Missouri
22,025
North Carolina
31,764
Oklahoma
20,316
South Carolina
20,604
Tennessee
18,795
Texas
132,394
Virginia
28,408
West Virginia
2,755
Total/Total %
485,608
Elderly
Inmates
1,223
563
3,985
2,082
936
1,356
869
730
1,189
1,451
1,430
901
1,116
7,923
1,411
235
27,400
2006
% of
Elderly
Inmates
5.62%
5.51%
6.25%
5.63%
7.25%
5.06%
3.93%
5.20%
5.40%
4.57%
7.04%
4.37%
5.94%
5.98%
4.97%
8.53%
5.64%
Total Inmates
in Institutions
28,050
13,494
86,559
51,484
19,925
39,039
22,607
20,891
30,997
36,663
24,146
23,657
27,964
151,852
30,704
5,390
613,422
Elderly
Inmates
3,588
1,271
9,168
5,658
2,216
4,060
1,947
1,916
3,512
3,769
2,651
1,761
2,741
16,622
3,134
641
64,655
% of
Elderly
Inmates
12.79%
9.42%
10.59%
10.99%
11.12%
10.40%
8.61%
9.17%
11.33%
10.28%
10.98%
7.44%
9.80%
10.95%
10.21%
11.89%
10.54%
1997-2006
% Increase % Increase
of Inmates in
Elderly
Institutions
Inmates
28.90%
193.38%
32.02%
125.75%
35.75%
130.06%
39.25%
171.76%
54.34%
136.75%
45.78%
199.41%
2.25%
124.05%
48.88%
162.47%
40.74%
195.37%
15.42%
159.75%
18.85%
85.38%
14.82%
95.45%
48.78%
145.61%
14.70%
109.79%
8.08%
122.11%
95.64%
172.77%
26.32%
135.97%
*Note: Includes all inmates under the states corrections department, which would comprise all those in prison, jails, and
in parole or other community-release programs, such as nursing homes or half-way houses.
Source: The 1997 statistics were taken from the SLC Special Series Report The Aging Inmate Population. The 2006
statistics were received from surveying the corrections department in each state.
Methodology
Alabama
General Statistics
1997
2006
% Increase: 1997-2006
Crime Statistics
Convicted of Violent Crime

Convicted of Sex-based Crime
Rate of Recidivism
Total Inmates
21,761
Elderly Inmates
1,223
% of Elderly Inmates
5.62%
28,050
28.90%
3,588
193.38%
12.79%
Total Inmates
14,846
3,234
Elderly Inmates
2,301
732
15.50%
22.63%
28.8%
NA
Policies:
The Department of Corrections
considers inmates 65 years of age and older to be
elderly. Upon admission into a facility, inmates receive
a medical screening and are evaluated annually or
biannually, depending on their medical condition
upon arrival. There are no furlough or medical-release
programs for elderly inmates at this time.
Facilities: The Department of Corrections
maintains an 80-bed prison for elderly and infirm
inmates at the Hamilton Aged and Infirmed Center
(HAIC) in Hamilton, a facility purchased from the
Alabama Mental Health Department in 1981. Although
this prison does not exclusively house elderly inmates,
it is designed to meet the needs of older inmates with
more serious medical and physical needs. The facility
comprises five acres of housing units and can accommodate minimum- and medium-security inmates.
Security and medical policies are coordinated at HAIC
in order to provide adequate safety along with ample
medical care to the individuals housed there.
10
Challenges: According to Adult Correctional

Systems, Alabama is at 199 percent capacity for their
overall prison population, the most severe of the inmate
housing crises in the 16 SLC states.30 The Department
of Corrections has experienced a 193 percent increase
in elderly inmates in its prisons since 1997, one of the
most drastic increases among the 16 SLC states. Rising
medical costs are of grave concern to the Department of
Corrections. Lack of proper and prompt identification
of chronic illness before admission to prison greatly
contributes to this problem. Also, readily accessible
medical care for the elderly inside prison currently is
in the process of being optimized, particularly with
regard to diseases associated with this group, such as
Alzheimers and other forms of dementia.
Arkansas
Total Inmates
Elderly Inmates
1997
2006
563
1,271
125.75%
5.51%
9.42%
% Increase: 1997-2006
10,221
13,494
32.02%
Crime Statistics
Total Inmates
Elderly Inmates
5,825
2,250
51.4%
1,250
429
8.0%
21.46%
19.07%

Rate of Recidivism
Policies: The Department of Corrections has a

variety of programs that prompt prisons to screen for
inmates who are mentally and/or physically disabled,
chronically or terminally ill, or have other special
medical needs. Since the Department of Corrections
does not have an established definition of elderly, the
community standard of equal to or greater than 65 years
of age has been adopted as a standard for classifying
geriatric inmates. Likewise, the Department does not
use any cohort based on age as a standard for healthcare policy. However, such policies are designed to
accommodate many of the needs that elderly inmates
often have. The Department of Corrections has specialrelease programs designed to accommodate elderly
inmates who have been diagnosed with a terminal
illness or a permanent physical or mental disability.
accommodates the needs of elderly inmates through the
availability of several separate living areas specifically
designed for the needs of infirm and elderly inmates.
The Diagnostic Unit and the Jefferson County Jail and
Correctional Facility, both in Pine Bluff, house many
of the elderly inmates in the state. These two facilities
can accommodate 120 inmates who have medical and
mental health needs, many of whom are elderly. One
prison, the McPherson Unit in Newport, houses elderly
female inmates. This facility provides services for

four female inmates with physical needs and 11 female
inmates with mental health needs. Increasing the
number and quality of special needs beds, for both men
and women, is an important part of the Department of
Corrections 2007 legislative agenda, with the prospect
of gaining funding for a maximum 800-bed special
needs facility to be constructed during 2008-09.
Challenges: With the second highest percentage
of elderly violent crime offenders among the 16 SLC
states, efforts to curb this trend have been undertaken
by the Department of Corrections as well as the
General Assembly and other government bodies. The
Department of Corrections maintains that increased
operational and budgetary support is necessary in order
to adequately accommodate the increasing population of elderly inmates in state prisons. As in many
other states, longer sentences have contributed to the
ever-increasing demand for special accommodations
similar to those found in skilled level or nursing home
environments, which are very expensive to maintain
and operate. The construction of the highly anticipated
special needs facility, which has been an operational
need and a topic of discussion since the early 1990s,
would alleviate many of these difficulties associated
with accommodating elderly inmates.
11
General Statistics
Florida
General Statistics
Total Inmates
Elderly Inmates
1997
2006
63,763
86,559
35.75%
3,985
9,168
130.06%
6.25%
10.59%
Crime Statistics
Total Inmates
44,053
Elderly Inmates
6,022
13.67%
% Increase: 1997-2006

Rate of Recidivism
9,630
NA
Policies:
elderly. Every newly committed inmate arriving at
a Florida prison receives complete health appraisals
by a clinical associate, an advanced registered nurse
practitioner, or physician. These evaluations, carried
out within 21 working days of a prisoners arrival, are
reported and documented. General medical plans for
inmates are not predicated upon age, but are based on
the individual inmates needs, although factors such as
age, gender, and medical history are considered in the
evaluation. Although the Department of Corrections
does have a medical furlough program, like the medical
plan, age is not a determining factor in qualifying for
the program.
maintains six facilities designed to house elderly
inmates. River Junction Work Camp in Chattahoochee
is designed as a male inmate, elder care facility. It
accommodates approximately 400 elderly inmates who
do not have housing restrictions, such as convictions of
sex-related crimes or who suffer from advanced disease
that requires more extensive medical care. Union
Correctional Institution in Raiford is a maximumsecurity prison that houses elderly male inmates who
require higher level security arrangements and who
have more austere housing restrictions. Zephyrhills
Correctional Institution in Zephyrhills has approximately 75 beds for elderly male inmates who have
12
2,139
NA
22.21%
significant mental health needs or who have physical

disabilities that can be addressed by institution staff.
The Reception and Medical Center in Lake Butler
can accommodate approximately 100 elderly inmates
with complex medical issues and who require longterm medical care. Lowell Correctional Institution in
Ocala houses approximately 15 elder female inmates.
Finally, the South Florida Reception Center in Doral
houses approximately 600 elderly inmates who have
general needs. Most facilities in the state are capable of
housing mobility-impaired inmates, regardless of age.
These facilities have produced the opportunity for more
specialized care and, among other accomplishments,
have reduced the levels of victimization for inmates.
Also, in other facilities throughout the state, specialized
training is conducted for both healthcare and security
staff regarding the needs of specific inmates.
Challenges: The Department of Corrections has
indicated that rising medical costs have become a major
issue for elderly inmate healthcare. The increased
number of aging inmates in Florida has dramatically
intensified this problem. Paradoxically, advancements
in technology and medical treatment regimens have
increased the level of care for older inmates, but have
contributed to the problems associated with increased
costs. As a result, prisons are forced to rely on community healthcare services in order to obtain the requisite
level of services. Shortages in nursing and other
specialized staff also are a major concern.
Georgia
Total Inmates
Elderly Inmates
1997
2006
2,082
5,658
171.76%
5.63%
10.99%
% Increase: 1997-2006
36,972
51,484
39.25%
Crime Statistics
Total Inmates
Elderly Inmates
22,538
7,137
37.0%
2,476
1,471
NA
10.99%
20.61%

Rate of Recidivism*
*Statistics are based on repeat offenses within a three-year period.

Policies:
elderly. All elderly inmates housed by the Department
are given a physical examination at the time of intake.
Mirroring the medical testing recommendations that
are followed in regular prisons, post-intake examinations for elderly inmates include more frequent colonoscopies, prostate-specific antigen tests, and other tests
which help to identify diseases that are more prevalent
in older persons. These examinations are performed
through a medical reprieve from the Board of Pardons
and Paroles. Special needs are addressed based on
specific diagnoses. Meals for inmates are designed by
a nutritionist, and special diets are available for inmates
with conditions such as diabetes or other ailments that
are adversely affected by diet. Also, there are specific
exercise curricula for inmates over the age of 50,
such as a wellness walk program. The Department of
Corrections is continuing to evaluate the benefits of

early-release programs which have saved the state a
great deal of money in housing costs.
Facilities: Although separate facilities specifically for elderly inmates are not maintained, prisoners with particular medical needs, such as mobility
restrictions, can be transferred to facilities that can
adequately accommodate them. The Department of
Corrections maintains several such facilities. Mens
State Prison and Bostick State Prison, both in Hardwick; Johnson State Prison in Wrightsville; Metro State
Prison in Atlanta; and Augusta State Medical Prison in
Grovetown all contain physical adaptations, such as
wheelchair ramps and specialized staff, that are able to
meet the needs of the population.
Challenges: None indicated in survey response.
13
General Statistics
Kentucky
General Statistics
Total Inmates
Elderly Inmates
1997
2006
936
2,216
136.75%
7.25%
11.12%
% Increase: 1997-2006
12,910
19,925
54.34%
Crime Statistics
Total Inmates
Elderly Inmates
6,911
2,590
17.0%
906
610
11.3%
13.11%
23.55%

Rate of Recidivism
Policies:
elderly. All elderly inmates entering prison must be
screened immediately and have an applicable healthcare plan constructed within 48 hours of entry. All
inmates are assessed for general medical and mental
health concerns, and an individual health plan is established for each inmate, including treatment proposals
for chronic and intermittent diseases. All major
correctional facilities have on staff several physicians;
psychiatrists and psychologists; nurse practitioners and
full-time nursing staff; as well as support staff, such
as dental hygienists, physical therapists, and dialysis
staff. The Department of Corrections requires that all
elderly inmates receive an annual health examination.
The Department employs an early medical parole,
which must be recommended by a physician, based on
a prognosis that the inmate has less than a year to live or
is unable to live without significant medical assistance,
such as reliance on a life-support system. Another
consideration for early medical parole consideration
for elderly inmates is severely limited mobility due
to paralysis or other conditions that often result from
stroke or other trauma. Currently, there is a policy
under review that allows furlough for catastrophic
medical issues or the existence of other medical conditions that are not necessarily fatal in nature but cannot
be adequately treated within prison facilities. All these
considerations are influenced by the inmates likely
threat to society.
Facilities: Various facilities that can accommodate elderly inmates are available. Most major
facilities have provisions that address the needs of
inmates over the age of 50, with special training for
medical and security staff for interaction with and
understanding the needs of an aging inmate population.
Staff is made cognizant, for instance, of the potential
for victimization. Also, the safety of elderly inmates
is better secured by facilities that separate inmates
from the rest of the prison population, thus allowing
a more homogeneous approach for staff working
14
in these areas. Specifically, the State Reformatory

in LaGrange, which houses the majority of inmates
with medical or mental health concerns and has a bed
capacity of 1,996, allows staff to focus attention toward
the needs of elderly inmates in a way that would not
otherwise be feasible without this consolidation. In
addition, the prison maintains a nursing care facility
for inmates with special and debilitating medical
conditions that warrant continuous supervised care.
This division accommodates approximately 58 inmates
with intensive-care caliber conditions. Also, the reformatory has 90 beds designated for inmates who have
moderate special medical needs, and 150 beds for those
with strictly mental health concerns.
Challenges: Like most states, Kentucky has
concerns regarding the rapidly escalating costs of
housing elderly inmates. For instance, the cost for
housing these inmates at the State Reformatory, $70 per
day, exceeds the housing cost for an inmate at the states
maximum-security prison, which is approximately
$65 per day. Increased cost for professional medical
care for all inmates, regardless of age, is severely
exacerbated by the increasing elderly inmate population and will only continue to worsen. The rising cost
of healthcare is partly attributable to the rising cost of
pharmaceuticals. The State Reformatory, for instance,
has a $200,000-a-month pharmaceutical bill. Also,
the availability of medical and mental healthcare staff
has become problematic for the Department of Corrections. Maintaining an adequate variety of medical
and mental health professionals who are equipped to
address a multiplicity of diseases and disorders is a
challenge for any healthcare facility, but has become
even more challenging in the prison setting. Further,
the growing percentage of sex-based crimes being
committed by elderly persons is a dynamic that must be
addressed from a policy perspective. The percentage of
elderly criminals convicted of sex-based offenses has
now reached more than 23 percent, the second highest
among the 16 SLC states.
Louisiana
Total Inmates
Elderly Inmates
1997
2006
1,356
4,060
199.41%
5.06%
10.40%
% Increase: 1997-2006
26,779
39,039
45.78%
Crime Statistics
Total Inmates
Elderly Inmates
14,517
4,050
47.90%
2,257
816
1.5%
15.55%
20.15%

Rate of Recidivism*
*Statistics are based on repeat offenses within a five-year period.

Policies: The Department of Corrections
elderly. Initially, all elderly inmates entering Louisiana
prisons are screened for physical and mental disabilities. After admission, routine annual examinations
are carried out for elderly inmates in order to address
conditions specific to this age group. The Department
of Public Safety and Corrections has a program that
allows for medical parole or medical furlough for
terminally ill inmates. Also, medical parole is available
for inmates who have permanent incapacities and are
not a likely threat to society. Eligibility is contingent
upon the severity of the inmates illness or condition.
Many of the states policies have been revised in
recent years to include updates recommended by the
Centers for Disease Control and Prevention, American
Correction Associations performance-based medical
standards, and the Health Insurance Portability and
Accountability Act Guidelines.
These changes
include: encouraging a heightened awareness by staff
of victimization of elderly inmates, increased sensitivity to confidentiality standards, and general quality
of care improvement by staff.
Facilities: Although age alone does not determine housing assignments anywhere in the system,
most frail elderly inmates are housed at one of four
institutions. The Elayn Hunt Correctional Center in
St. Gabriel provides for geriatric inmates who require
specialized housing and care. It maintains a 28-bed
general infirmary, medical dormitory, and 98-bed
mental health unit. The Martin L. Forcht, Jr., Clinical
Treatment Unit of the David Wade Correctional
Center, in Homer, can accommodate approximately
338 inmates who need special attention due to age or
physical impairment. Also, a 50-bed skilled nursing
unit has been completed at this facility and awaits
budget funding in order to begin operations. The State
Penitentiary in Angola maintains a 34-bed medical
dormitory in the R. E. Barrow, Jr., Treatment Center for
geriatric inmates who have significant medical needs
or are too frail to be in the general population. The
Treatment Center contains a 64-bed physical disability
dormitory for inmates. It also offers a certified hospice

program for up to six inmates. Prisoners in this
program are allowed to have two visitors for two-hour
intervals daily. The Correctional Institute for Women
in St. Gabriel contains an 8-bed ward for female
inmates with especially acute medical needs. This
facility also accommodates approximately 43 women
who are unable to live in the general prison population
due to significant medical or mental health disabilities.
It houses inmates with severely limited mobility in a
centrally located dormitory, bringing them closer to
medical care, food services, and program activities. All
institutions under the Department of Public Safety and
Corrections satisfy the Americans with Disabilities Act
standards for inmates with mobility impairments.
Challenges: Generally, many of Louisianas
problems involving elderly inmates stem from its
high overall incarceration rate. Almost 1 percent of
Louisianas entire population is in prison, the highest
incarceration rate in the nation. The percentage of
elderly inmates has grown almost 200 percent since
1997, more than any other of the 16 SLC states. Rising
medical costs have become a severe problem for the
state, particularly due to the rising cost of services,
supplies, and prescriptions. The increasing number of
inmates requiring these services continues to strain the
system as well. Louisiana has experienced particular
difficulties in the wake of Hurricanes Katrina and Rita.
For instance, the entire medical infrastructure of the
states charity hospital system, upon which services
for state and pre-trial inmates heavily relied, was negatively impacted and portions must be rebuilt. Additionally, the Department of Public Safety and Corrections
lost access to the Medical Center of Louisiana in New
Orleans, one of four main referral hospitals in the state
for inmates. With decreased hospital-based beds and
services, there are longer waiting periods at hospitals
that are attempting to accommodate larger numbers
of incarcerated persons, and longer hospitalization
periods for inmates due to treatment delays associated
with hospital staff and resource shortages. The state
also has experienced problems that are present in the
15
General Statistics
rest of the nations general aging inmate population,

such as increased rates of depression, senile dementia,
substance abuse, and other sicknesses prevalent in the
elderly population. Also, stigma related to mental
health issues often creates reluctance among inmates to
request or accept treatment. This is a major factor that
16
has stagnated the otherwise expeditious and affective

medical care for elderly inmates. Overall quality of
care has been affected by budget cuts for the Department of Corrections. However, negative impacts due
to budgetary restrictions have been offset in part by
enhanced training.
Maryland
% Increase: 1997-2006
Elderly Inmates
869
1,947
124.05%
3.93%
8.61%
Crime Statistics
Total Inmates
Elderly Inmates
11,034
2,104
49.70%
1,294
480
NA
11.73%
22.81%

Rate of Recidivism
Policies: The Department of Public Safety and

Correctional Services considers an elderly inmate to
be someone 60 years of age or older. Screenings are
conducted for all incoming elderly inmates, testing
for overall physical and visual and hearing disabilities
in order to establish a level of functionality for each
inmate. This information is used in classifying inmates
for housing assignments, which is stratified based on
the level of care needed to maintain the physical and
mental health of the inmates. After admission, elderly
inmates are provided physical examinations annually,
with specific monitoring when medically necessary
and appropriate. Inmates who are terminally ill or who
have other serious medical problems who could be
better served in the community are eligible for medical
parole. Comprehensive policies regarding the treat-
ment of hepatitis C inmates recently have been developed in order to more adequately identify and treat this
population among the elderly in prisons.
Facilities: As mentioned, most state prisons have
segregated housing units, which are designed to better
accommodate elderly inmates, making facility staff
and the environment more congruous for the group.
Adjustments in services range from modification of
lunch lines for physically disabled inmates to more
readily available medical services. Also, various locations throughout the state have hospice or palliative
care facilities in prison infirmaries for inmates who
have terminal illnesses but are unable to be released
into the community.
Challenges: None indicated in survey response.
17
1997
2006
Total Inmates
22,109
22,607
2.25%
General Statistics
Mississippi
General Statistics
Total Inmates
Elderly Inmates
1997
2006
730
1,916
162.47%
5.20%
9.17%
% Increase: 1997-2006
14,032
20,891
48.88%
Crime Statistics
Total Inmates
Elderly Inmates
6,948
1,903
32.76%
684
359
NA
9.84%
18.86%

Rate of Recidivism
Policies:
considers an elderly inmate to be one over the age of
65. All elderly inmates are given physical examinations during their initial days of entry into the prison
system. Inmates are separated based on different
levels of physical and mental capacity, with frailer
inmates routed to chronic care units. The Department
of Corrections does not provide any medical-release
furlough programs for older inmates at this time.
Facilities: Although Mississippi prisons do not
have facilities specifically for elderly inmates, they
do have special units for inmates who have degenerative diseases. These facilities have readily available
18
nursing staff and special care accommodations that can

address the needs of these inmates.
Challenges: According to Adult Correctional
Systems, over the last decade Mississippi has had a
growth rate of 118 percent for inmates housed in state
facilities, the highest among the 16 SLC states.31 The
increased number of elderly inmates and, correspondingly, the increased medical costs for these inmates,
has strained the medical budgets for state prisons. The
Department of Corrections anticipates that these costs
will only continue to escalate.
Missouri
General Statistics
% Increase: 1997-2006
Crime Statistics

Rate of Recidivism*
Elderly Inmates
1,189
3,512
40.74%
195.37%
Total Inmates
14,176
4,593
38.0%
Elderly Inmates
2,022
962
18.0%
5.40%
11.33%
14.26%
20.94%
*Statistics are based on repeat offenses within a two-year period.

Policies:
elderly. The Department of Corrections screens all
elderly inmates within seven days of admission into
the prison system. These evaluations focus on ensuring
that serious physical and mental health needs, including
developmental disabilities and alcohol or drug addiction, are properly identified and corresponding treatments are authorized. Elderly inmates are reexamined
annually once they are admitted. Although most of the
Department of Corrections general policies regarding
the health and wellbeing of elderly inmates are covered
under the same policies that apply to younger inmates,
there are specific policies that acknowledge the unique
needs of elderly inmates. For instance, the Department of Corrections has a specific policy that mandates
ample communication between facility administration,
health services staff, and clinicians regarding the health
needs of all inmates, but expressly remarks upon the
distinctive health requirements for the elderly inmate
cohort. This ensures that elderly inmates receive
proper treatment in regard to clothing, healthcare
needs, mobility, and bathroom assistance. Medical
parole is granted to elderly inmates who are in need
of long-term, specialized nursing or extensive palliative care. Medical parole excludes capital punishment
offenders and others who are considered a further threat

to society.
maintains an elderly unit in a medium-security facility,
Moberly Correctional Center, in Moberly, designed
specifically for elderly inmates who are ambulatory.
The unit entails two floors and accommodates 22
single-bed cells, all of which are currently full. The
purpose of the unit is to give as much individualized
care to these inmates as possible. Additionally, the
Department of Corrections has 11 different prison
facilities designed to accommodate inmates with
physical disabilities.
Challenges: The Department of Corrections
is attempting to give more attention to the specific
difficulties experienced by elderly inmates related to
the aging process. With the second fastest-growing
elderly inmate population among the 16 SLC states,
a growth of more than 195 percent since 1997, and
the third largest overall percentage of inmates that are
elderly, the Department of Corrections is evaluating
policies that address this population shift. Given these
statistics, problems associated with this cohort will
only continue to worsen if they are not addressed.
19
1997
2006
Total Inmates
22,025
30,997
North Carolina
General Statistics
Total Inmates
Elderly Inmates
1997
2006
1,451
3,769
159.75%
4.57%
10.28%
% Increase: 1997-2006
31,764
36,663
15.42%
Crime Statistics
Total Inmates
Elderly Inmates
17,949
4,392
NA
2,223
843
NA
12.39%
19.19%

Rate of Recidivism
Policies:
elderly. The elderly inmate population in North Carolina has increased faster than any other inmate age group
in the state over the past five years. In July of 2005, the
director of prisons initiated a study, the Aging Inmate
Population Study, on the aging inmates in the state.
In May of 2006, the Department of Corrections Division of Prisons issued their findings from this study.
The report is a descriptive commentary that provides
information regarding the status of the aging inmate
population. It primarily explores the characteristics
of this population, as well as the challenges facing
the Department of Corrections in providing sufficient
services for elderly inmates.
Facilities: Although there are no prisons in
North Carolina designated exclusively for the elderly
inmate population, many prisons have geriatric, skilled
medical and mental health units. Three prisons in
the state with units designed specifically for elderly
inmates are McCain Correction Hospital in Raeford;
Randolph Correctional Center in Asheboro; and Pender
Correctional Institution in Burgaw. McCain has both
acute care and skilled nursing care beds, and offers
20
laboratory, x-ray, respiratory therapy and pharmacy

services. The medical staff totals more than 135 healthcare professionals, including four full-time physicians.
There are 222 beds dedicated to the disabled, elderly
and others with physical and mental needs. Randolph is
a minimum-security prison that houses 135 adult males
with no serious medical needs. This includes 57 elderly
inmates. Pender is a medium-security prison housing
764 inmates; 138 of those are elderly. Like Randolph,
inmates at Pender must not require significant daily
medical attention.
Challenges: Accelerated medical and mental
health issues and costs have caused serious problems
for the Department of Corrections. The cost of housing
elderly inmates is almost four times that of younger
inmates. The 2006 Aging Inmate Population Study
found that in fiscal year 2004-2005, the cost of housing
an elderly inmate was approximately $7,159, as
compared to an average of $1,919 for inmates younger
than 50. The study also found that the myriad of needs
associated with elderly inmates, such as required
mobility assistance or special diets, makes maintaining
proper housing facilities for these inmates much more
difficult.32
Oklahoma
Total Inmates
Elderly Inmates
1997
2006
1,430
2,651
85.38%
7.04%
10.98%
% Increase: 1997-2006
20,316
24,146
18.85%
Crime Statistics
Total Inmates
Elderly Inmates
10,064
2,747
27.95%
1,471
584
16.74%
14.62%
21.26%

Rate of Recidivism*
*Statistics are based on a four-year period and represent fiscal year 2002.
Policies: While not explicitly stated in the
policies of the Department of Corrections, elderly
inmates generally are considered those at or above the
age of 55. All inmates ages 50 to 64 have physical
examinations every one to three years, depending on
their overall health, and all inmates ages 65 and older
typically have annual physical examinations. There
are medical parole programs for elderly inmates and,
in order for inmates to qualify for these programs, a
recommendation must be made by a facility physician.
Acceptance of parole is based on the inmates diagnosis, disciplinary record, amount of time remaining
to serve, employment history, a verifiable offer of
residence, acquiescence of the inmate, and the severity
of his or her crime. There are a variety of crimes that
exclude prisoners from medical parole consideration.
Offenders who are not eligible for medical parole
are those who have not served at least 85 percent
of a sentence for truth-in-sentencing crimes, those
who have been sentenced to life without parole, and
prisoners who have been sentenced to death. There
are specific qualifications for offenders who have
committed the most severe crimes such as assault with
a deadly weapon. Such inmates must be terminally ill
with a life expectancy of one year or less, and whose
medical condition has rendered them no longer a threat
to society. A secure nursing home must be available
in order for these inmates to be released. Likewise,
qualifications for lesser crimes mirror the severity of
the crime (i.e., there are less stringent qualifications
for criminals who have committed less serious, and
less dangerous, crimes). Recommendations must be
approved by the chief medical officer, director of the
Department of Corrections, Pardon and Parole Board,
and the governors office.
Facilities: In August, 2005, the Department of
Corrections initiated the Health Assessment for Inmate
Transfers, a program that provides guidelines for evaluating an inmates general physical and mental health for
appropriate programs and facility placement. Inmates
are routed based on medical acuity, mental health classi-
fication level, and physical activity score. For instance,

if an inmate is diagnosed as having a severe physical
impairment, that inmate will be sent to the facility that
can best accommodate that inmates mobility needs.
Oklahoma has 14 different prisons that can adequately
house inmates with physical disabilities.
Challenges: Escalating healthcare costs for
elderly inmates are becoming increasingly worrisome.
Increased utilization of medication is one reason for
this. The number of prescriptions for inmates under
the age of 55 averages 3.9 per inmate, compared to
5.4 per inmate for those over the age of 55. Specialty
care and hospitalization costs average $4,911.43 per
inmate for those under the age of 55 and $6,230.98 for
those over the age of 55. Housing also presents challenges for the Department of Corrections. Although
Oklahoma has the lowest rate of increase of the elderly
prison population among the 16 SLC states, it has
experienced an 85 percent increase since 1997. Eleven
percent of the entire prison population in Oklahoma
is elderly. Currently, there are 85 vision-impaired
inmates; 95 hearing-impaired inmates; 283 inmates on
walkers, canes or crutches; and 159 inmates in wheel
chairs in prison. It is approximated that 32 percent of
all elderly male inmates, and 72 percent of all female
inmates, have a history of or current symptomology of
serious mental disability. All of these inmates require
special facilities and staff, increasing the already
escalating costs associated with overcrowding. The
Department of Corrections cited parole problems as a
major concern, particularly in regard to three things:
employment, housing, and medical needs. The Department of Corrections noted that these three areas are
inextricably connected. By way of example, an elderly
prisoner who has trouble gaining employment likely
will have difficulty finding housing and affording the
variety of medical needs that elderly parolees typically
have. Consequently, if a parolee is ill because of lack
of medication, then he or she will be unable to work,
and therefore unable to afford housing.
21
General Statistics
South Carolina
General Statistics
Total Inmates
Elderly Inmates
1997
2006
901
1,761
95.45%
4.37%
7.44%
% Increase: 1997-2006
20,604
23,657
14.82%
Crime Statistics
Total Inmates
Elderly Inmates
11,387
3,294
32.00%
1,129
447
16.50%
9.91%
13.57%

Rate of Recidivism*
*Statistics are based on repeat offenses within a three-year period.

Policies: The Department of Corrections classifies an elderly inmate as one over the age of 55. This
number was adopted by a classification system used to
characterize elderly inmates for housing purposes, but
it no longer is used. The Department of Corrections
does employ medical release furloughs for terminally
ill elderly inmates. In order to be considered the parolee
must have a diagnosis of one year or less to live, with
two physicians concurring on the gravity of the illness.
Additionally, there must be a physician to provide care
outside the prison, as well as some demonstration by
the inmate of planned financial support. The likely
threat the prisoner poses on society also is considered.
In addition, the Department of Corrections adjusts
work duties for inmates based on age and maintains a
retirement policy, by which inmates are allowed to
stop working when they reach age 65.
Facilities: Various prisons have facilities that
can accommodate inmates with physical or mental
disabilities. Such prisons provide mobility assistance and healthcare centers with medical staff. The
Department of Corrections initiated in 1970 one of
the first programs to accommodate elderly inmates
22
by providing separate facilities for them. In 1983,

the program moved to a former tuberculosis hospital
in State Park, establishing the State Park Correctional
Center. The facility provides 24-hour nursing care for
inmates.
Challenges: Rising healthcare costs continue
to strain the healthcare budget for the Department of
Corrections, which already constitutes a large portion
of the agency budget. Specific conditions that ail
elderly inmates, such as menopause-related needs
in female inmates, were cited by the Department as
posing particular difficulties. Improved understanding
of the aging process and the needs of elderly inmates,
such as attention to safety issues, was noted as an
area of concern for the Department of Corrections.
Currently, there are no such programs to address
the impact the aging inmate population will have on
prisons. Problems associated with available housing
for elderly inmates have arisen due to the variety of
individual needs, such as special healthcare provisions,
and will continue to pose difficulties for the Department of Corrections budget and planning.
Tennessee
Total Inmates
Elderly Inmates
1997
2006
1,116
2,741
145.61%
5.94%
9.80%
% Increase: 1997-2006
18,795
27,964
48.78%
Crime Statistics
Total Inmates
Elderly Inmates
13,638
3,131
42.00%
1,722
NA
24.00%
12.63%
NA

Rate of Recidivism
Policies: Under the Department of Correction,

inmates over the age of 55 are considered to be elderly.
The Department of Correction employs a medical
furlough program, which is a time-limited or indeterminate release from institutional custody into supervised
probation or parole, for inmates in imminent peril of
death or inmates who no longer are able to care for
themselves in a prison environment as a result of severe
physical or mental disability. Medical furloughs must
be approved by the warden of the respective prison
and the Department of Correction commissioner, and
are contingent on a notarized report from an attending
physician. The Department of Correction has a policy
that defines the levels of care that are appropriate for
disabled inmates. For instance, the transfer of inmates
from one facility to another requires that inmates who
are physically disabled, seriously mentally and/or
physically ill, or developmentally disabled can be
accommodated in a new housing unit. They are
reviewed by a clinician who estimates whether or not
the receiving institution can provide the appropriate
level of care to the inmate. Furthermore, any restrictions regarding daily activities, such as those applying
to workload or diet, are indicated by the physician and
conveyed to staff at the receiving institution.
Facilities: All Tennessee prisons have chronic
care clinics for addressing the special medical needs
of all inmates, regardless of age. Several prisons do
contain segregated geriatric facilities, and two prisons
maintain programs that specifically address the needs

of inmates who are over the age of 55. Wayne County
Boot Camp in Clifton maintains a geriatric program
for healthy, self-sufficient elderly male inmates. The
DeBerry Special Needs Facility focuses on assisting
especially fragile elderly inmates who require assistance with daily activities and supports a sheltered
living unit for particularly vulnerable elderly inmates.
Additionally, most facilities are designed to accommodate inmates with mobility restrictions and other
general needs of elderly prisoners.
Challenges: In 2005, a task force was formed
to study the special needs populations in Tennessee
prisons, and currently is evaluating the prospect of
creating a geriatric facility. In the past, age alone has
not been a sufficient criterion for maintaining a separate
prison, but as the elderly inmate population in the state
increases, the creation of such a facility may be more
viable than before. Rising medical costs in general
have been enough to have serious budgetary impacts.
The distinct rise in medical costs for elderly prisoners
and the ability to consolidate services for them may be
great enough to warrant separate geriatric prisons in
the future. Also, the sheer number of elderly inmates
entering, remaining, and returning to the prison system
is especially acute in Tennessee. There is a 24 percent
recidivism rate among elderly inmates, meaning that
one-fourth of all elderly inmates who are paroled or
complete their sentences return to prison during their
lifetime.
23
General Statistics
Texas
General Statistics
1997
2006
% Increase: 1997-2006
Crime Statistics
Convicted of Violent Crime*

Convicted of Sex-based Crime*
Rate of Recidivism**
Total Inmates
132,394
151,852
Elderly Inmates
7,923
16,622
14.70%
109.79%
Total Inmates
74,257
24,841
28.30%
Elderly Inmates
8,667
4,936
20.20%
5.98%
10.95%
11.67%
19.87%
*Offense is based on inmates offense that incarcerates the offender for the longest period of time.
**Statistics are based on repeat offenses within a three-year period.
Policies: According to the Department of Criminal Justice, an elderly inmate is classified as one over
the age of 55. The Department of Criminal Justice has a
policy that screens incoming elderly inmates for physical and mental disabilities, and places such prisoners
in appropriate facilities. There is a screening for elderly
inmates being transferred from one facility to another
in order to ensure that the receiving facility can accommodate these prisoners. Elderly inmates work duties
may be adjusted based on age as well. The Department of Criminal Justices Rehabilitation and Re-entry
Division recently began working to develop specific
programs for elderly inmates who will be returning to
society. Elderly inmates are eligible for early parole
under the Medically Recommended Intensive Supervision (MRIS) program if the offender is diagnosed with
a terminal disease; requires long-term care for a degenerative disease; is severely physically handicapped
and cannot be sufficiently accommodated by prison
facilities; is diagnosed with a severe mental illness; or
is mentally retarded. Such inmates are supervised by a
Special Needs Offender Program of the Parole Division
upon release. Since 1997, several changes have been
made to the MRIS program. For instance, the program
now excludes all sex offenders and offenders sentenced
to death. The provision to include the terminally ill
and those who require long-term care was enacted in
2003. Also in 2003, a requirement that offenders be
placed in a skilled nursing facility upon release was
repealed, allowing for expanded placement options
in the community for prisoners. The Department of
Criminal Justice mandates the availability of special
recreational services for some geriatric prisoners, such
as outdoor walking, horseshoes, arts and crafts, and
various table games.
Facilities: The Department of Criminal Justice
provides two types of geriatric housing facilities for
inmates. Type I Geriatric Facilities, which are located
in eight different state prisons, provide accommodations for offenders who are 60 years of age or older and
24
who have specific difficulties regarding daily activities.

These are segregated areas of the prison that allow
geriatric prisoners to have longer periods of time to
dress, eat, move from place to place, and shower. They
also have special accessibility accommodations for pill
and food lines. Inmates in these facilities are grouped
with inmates who have similar medical conditions,
in order to consolidate focus for staff and to provide
an environmental semblance for inmates. The state
also has a second type of geriatric housing unit, Type
II Geriatric Facilities, which characterize outpatient
sheltered housing facilities. Currently, there is only
one such facility in the state, the Estelle Unit in Huntsville, which maintains 60 beds for male inmates. It is
located next to the Estelle Regional Medical Facility
for accessibility to clinical staff. This unit provides
access to multiple special medical services, such as
physical, occupational, and respiratory therapy; special
wheelchair accommodations; temperature-adjusted
environments; dialysis; and services for inmates with
hearing and vision impairments.
Challenges: Healthcare costs for elderly inmates
are 3.5 to 4 times more than those of the average prisoner. The estimated healthcare costs for non-elderly
inmates was approximately $7.46 per offender per day
in FY 2005, compared to $26.11 per offender per day
for elderly inmates. Although elderly inmates represent
only 5.4 percent of the inmate population, they account
for more than 25 percent of hospitalization costs for the
Department of Criminal Justice. This discrepancy is
anticipated to increase as the cost of healthcare and the
number of elderly inmates continues to increase. There
are more than 16,000 elderly inmates in Texas, making
up almost 11 percent of the entire prison population in
the state, and totaling more than the total inmates in
both Arkansas and West Virginia. General resources
for elderly inmates, including staff and housing accommodations, will continue to escalate in cost, as well
as training expenses for staff regarding the needs of
elderly inmates. Parole problems for elderly inmates
accept offenders, thus hindering early-release program

goals. The problem of inadequate prison space in Texas
will continue to worsen as the elderly inmate population continues to increase.
25
have been associated with housing facilities, such as

half-way houses, that are inadequate to accommodate
the health needs of elderly inmates. Without medical
health coverage, many nursing homes are unwilling to
Virginia
General Statistics
Total Inmates
Elderly Inmates
1997
2006
1,411
3,134
122.11%
4.97%
10.21%
% Increase: 1997-2006
28,408
30,704
8.08%
Crime Statistics
Total Inmates
Elderly Inmates
18,004
3,536
29.00%
2,162
807
24.00%
12.01%
22.82%

Rate of Recidivism
Policies:
elderly. The Department requires a medical examination for all elderly prisoners upon admission into state
prisons. The nutritional needs of elderly inmates are
documented and forwarded to the appropriate staff
at the time of this examination. The Department of
Corrections offers a medical-release program for
elderly inmates, whereby prisoners are allowed to
petition the states Parole Board for furlough on the
grounds that he or she has been diagnosed with a
terminal or severely debilitating illness. Decisions
regarding release are based largely on the prisoners
age and the amount of the prisoners sentence that has
been served. Also, eligibility for release is based on the
severity of the crime for which the prisoner is incarcerated. In 2001, the Department of Corrections organized
a task force to study issues involving the needs of geriatric prisoners. Recommendations regarding housing,
medical care, and staffing for elderly inmates have been
made by the task force to the director of the Department
of Corrections regarding their findings.
26
Facilities: The Deerfield Correctional Center in

Capron is the states only facility designed specifically
for elderly inmates. It is a one-story dormitory that
houses 497 of the states elderly prisoners. In January
2007, the Center will be expanded to a 1,100-bed
facility, making it possible to lodge over one-third of
the states elderly inmate population in a central location. Other prisons in the state are able to accommodate
elderly inmates on a smaller scale.
Challenges: As the elderly inmate population in
the state continues to increase, rising medical costs will
continue to be a formidable burden for the Department
of Corrections. Another major problem is release planning. Difficulties associated with the prisoners ability
to secure or maintain a job in society is one example
of the many barriers that inhibit the elderly inmates
capacity for adapting once he or she is released into
the community. Also, high recidivism rates for elderly
inmates in the state raise questions regarding the
likelihood for released or paroled inmates to return to
prison. Virginia has a reported 24 percent recidivism
rate for elderly inmates, one of the highest in the 16
SLC states.
West Virginia
8.53%
% Increase: 1997-2006
5,390
95.64%
Elderly Inmates
235
Crime Statistics
Total Inmates
Elderly Inmates
1997
2006
Convicted of Violent Crime*

Convicted of Sex-based Crime*
Rate of Recidivism
641
172.77%
11.89%
2,147
489
22.78%
881
268
30.42%
11%
NA
*Offense is based on inmates offense that incarcerates the offender for the longest period of time.
Policies: The Division of Corrections considers
the age of an elderly inmate to be 65, the highest characterization among states. All elderly inmates have
annual or bi-annual physical examinations, depending
on the individual health level of the inmate and includes
annual dental and eye examinations. There also is close
monitoring of inmates with chronic conditions through
monthly checkups. Medical diets can be arranged at
most facilities and are coordinated according to the
health needs of elderly inmates. There are no specialrelease programs for elderly inmates at this time;
however, inmates can be moved from prison grounds
to off-site hospitals for observation or specialized care
if necessary.
Facilities: Although inmates are not segregated
by age, they are assigned to housing facilities based on
their health needs. This is to say that, if elderly inmates
have specific health concerns, they can be routed to a
facility that can accommodate these needs.
Challenges: Rising medical costs for elderly

prisoners have become a significant burden in the state.
It is a policy of the Division of Corrections that inmates
receive necessary medical treatment, regardless of
cost; therefore, healthcare for inmates can become
quite extensive. Currently, the Division is researching
the possibility of assisted living units and hospice
programs to house terminally or severely ill inmates.
According to the Division of Corrections, the problem
of employment of elderly inmates who have completed
their sentence or have been paroled is a concern
regarding the ability of elderly inmates to re-acclimate
themselves to society. Often, such inmates have difficulty accessing federal medical coverage unless they
have some type of disability. Lack of medical care
only exacerbates already dismal living circumstances
for elderly inmates, and prison space continues to be
a problem as the elderly inmate population continues
to increase. Also, the large percentage of violent and
sex-based crimes committed by elderly persons has
raised concerns in the state. Almost 23 percent of all
inmates convicted of violent crimes, and more than 30
percent of all inmates convicted of sex-based crimes,
are elderly the highest percentage in both categories
27
Total Inmates
2,755
General Statistics
Summary
he average percentage of elderly inmates in

the SLC states was 10.44 percent slightly
higher than the national average, which
is approximately 9 percent. Alabama had
the highest percentage with 12.79 percent of its
inmate population at 50 years of age or older. Just
as the general elderly inmate populations in state
prisons are increasing, so is the elderly percentage of
inmates convicted of violent and sex-based offenses.
According the Federal Bureau of Investigation, nationwide, there are almost 40,000 arrests of persons over
the age of 50 for violent and sex-based crimes every
year, amounting to almost 6 percent of all persons in
this age bracket who are arrested.33 The 16 SLC states
reported a remarkably higher percentage of elderly
inmates convicted of these type offenses. All but one
of the reporting SLC sates indicated that at least 25
percent of their elderly inmates were convicted of
violent or sex-based crimes South Carolina being the
exception. West Virginia had the highest rate, reporting
53 percent of its elderly prison population serving time
for violent or sex-based crimes. Overall, the 16 SLC
states averaged 34 percent.34
Since these crimes typically carry longer prison
sentences than other crimes, such as crimes against
property, it is important for states to evaluate what
percentage of total inmates are serving sentences for
violent and sex-based crimes. This cohort likely will
comprise the population that will grow old in prison.
According to a 2004 U.S. Department of Justice report,
there were just under 625,000 persons in state prisons
across the nation serving time for violent and sex-based
offenses as of 2002 (the latest available data). At that
28
time, this was slightly more than one-half the entire

prison population. Also, of the 14 states with the highest
incarceration rates, 10 were in the South.35Although it
is speculated that this national percentage may have
slightly increased since 2002, on average the 16 SLC
states exceeded this percentage, with 58 percent of their
total prison population incarcerated for violent or sexbased crimes. According to the SLC survey, Virginia
reported that more than 70 percent of the states prison
population is incarcerated for these crimes, the highest
It should be noted that, overall, Southern states
incarcerate more people than other regions of the
country. It is possible that higher percentages of violent
and sex-based crime convictions may simply reflect a
greater percentage of overall convictions in the South.
Regardless of the causes, these statistics reflect the
greater number of inmates in Southern states who will
be serving longer sentences, and be more likely to serve
the remainder of their lives in prison. It is anticipated
that this high percentage of overall inmates incarcerated for violent and sex-based crimes will continue to
contribute to the number of elderly inmates that reside
in state prisons in the South.
When examining the inmates currently classified
as elderly, it is obvious that length of prison sentence
has been a major factor in the number of prisoners who
spend the remainder of their lives in prison. All SLC
reporting states indicated that at least 30 percent of
their elderly inmate populations are serving sentences
that are at least 20 years in duration, including life
sentences. Six states indicated numbers that were above
The most obvious concern associated with aging

inmate populations, and the one most frequently
mentioned by state corrections departments in this
survey, is the cost of healthcare for this population.
In Estelle v. Gamble (1976), the U.S. Supreme Court
mandated that a prisons control over an inmates body
demands that the prison provide adequate medical care
for that inmate, care that reflects the services that would
otherwise be available in the community. Failure to
provide such a level of care, according to the Court,
violates the Eighth Amendments prohibition of cruel
and unusual punishment. As the level of care in
society increases, so should that provided by prisons.
The cost of maintaining this ever-increasing level of
medical attention can become very daunting and very
expensive for state corrections departments. Ironically, with increased care comes increased duration
of treatment for inmates, i.e. the better the treatment
the inmate receives the longer that inmate will live,
and the longer the prison system will have to care for
him or her. As preventive care improves, the lives of
inmates will lengthen, increasing both the number of
elderly inmates living in prison as well as the length
of time the elderly inmate will live in prison. This
phenomenon alone deserves attention by those who

are investigating the most fiscally prudent means of
housing elderly inmates while maintaining sufficient
care and supervision for prisoners, as well as retaining
ample prison security.
Striving for a better environment for prisoners
often becomes difficult because of common stereotypes, such as that prisoners, particularly elderly ones,
are of little or no value to society. Prisons are viewed
as places of punishment, and so notions of rehabilitation for elderly prisoners often are overlooked or
disregarded. Typically, prisons are designed to house
young, aggressive offenders. This trend yields prisons
systems that are ill-equipped to meet the needs of frail,
sickly inmates, elderly or otherwise. Moreover, prisons
are designed to produce an environment of castigation rather than one of comfort. There seems to be a
concerted effort among Southern states corrections
departments to address this perception by bolstering
staff education and training with regard to the needs
of the elderly and the place of the prisoner in society.
Many states have initiated programs for medical as well
as security staff that will encourage a rehabilitative,
rather than a punitive, approach to care for the elderly
in state prisons.
According to the Americans with Disabilities
Act of 1990, all prisoners with disabilities must have
access to the same services that other prisoners have.36
Since disabilities are more prevalent among older
inmates, the increase in the number of these prisoners
has increased the demands on prison environments.
Therefore, many Southern state prison systems are
Table 2 SLC Ranking

Ranking
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Total Inmates
Texas (151,852)
Florida (86,559)
Georgia (51,484)
Louisiana (39,039)
North Carolina (36,663)
Missouri (30,997)
Virginia (30,704)
Alabama (28,050)
Tennessee (27,964)
Oklahoma (24,146)
South Carolina (23,657)
Maryland (22,607)
Mississippi (20,891)
Kentucky (19,925)
Arkansas (13,494)
West Virginia (5,390)
% Increase of Total
Inmates 1997-2006
West Virginia (95.64%)
Kentucky (54.34%)
Mississippi (48.88%)
Tennessee (48.78%)
Louisiana (45.78%)
Missouri (40.74%)
Georgia (39.25%)
Florida (35.75%)
Arkansas (32.02%)
Alabama (28.90%)
Oklahoma (18.85%)
North Carolina (15.42%)
South Carolina (14.82%)
Texas (14.70%)
Virginia (8.08%)
Maryland (2.25%)
% Elderly Inmates
Alabama (12.79%)
Missouri (11.33%)
Kentucky (11.12%)
Georgia (10.99%)
Oklahoma (10.98%)
Texas (10.95%)
Florida (10.59%)
Louisiana (10.40%)
Virginia (10.21%)
Tennessee (9.80%)
Arkansas (9.42%)
Mississippi (9.17%)
Maryland (8.61%)
29
% Increase of Elderly
Inmates 1997-2006
Louisiana (199.41%)
Missouri (195.37%)
Alabama (193.38%)
Georgia (171.76%)
Mississippi (162.47%)
Tennessee (145.61%)
Kentucky (136.75%)
Florida (130.06%)
Arkansas (125.75%)
Maryland (124.05%)
Virginia (122.11%)
Texas (109.79%)
Oklahoma (85.38%)
50 percent of their elderly inmate population. These

were: Alabama, Arkansas, Oklahoma, South Carolina,
Texas, and Virginia. While this trend emphasizes the
extended longevity of prison sentences, and the rising
number of inmates that will serve such sentences, this
trend parallels the rising number of inmates who will
require medical treatment, as well as special housing
and other accommodations which must be provided by
the state prison system.
examining alternatives to general housing for elderly

inmates. These alternative-housing projects often
involve early release and furlough programs, or the
consolidation of the elderly inmate housing into one or
two main facilities within the state prison system.
Many Southern states that do not have freestanding prisons exclusively for elderly inmates have
developed separate quarters in which elderly inmates
may be separated from the rest of the prison population.
These facilities often will include hospice services
for terminally ill elderly inmates. Although there
are arguments against segregating elderly inmates
from the rest of the prison population, there are many
advantages Southern states have begun to examine.
These type facilities have proven to drastically reduce
costs for states and allow elderly prisoners to be in
an environment with prisoners that are their own age.
This reduces the possibility that elderly inmates will
become victims of younger, more aggressive inmates
by restricting or eliminating close proximity to these
younger inmates. They make it easier for specialized
staff to be consolidated at a central location. Also, such
facilities eliminate or reduce the costs associated with
off-site medical care, which often requires security
personnel to leave the prison in order to accompany
the patient, straining the availability of on-site security staff. Beyond ensuring the safety and wellness
of elderly inmates who have been separated, housing
these prisoners in separate facilities creates more space
in areas such as high-security prisons or quarters that
house more violent prisoners requiring special attention by guards and other staff.
Although many states separate inmates according
to their medical needs, the survey found it often is
the case that an elderly inmate remains in the general
population until he or she develops some ailment that
requires transfer to another facility or facility divi-
30
sion. In other words, while elderly inmates often are

separated from the general population, these inmates
are divided based on frailness or disability, as opposed
to age. Since the entire elderly inmate population will
not qualify for such categorization, and since many
non-elderly inmates will meet these qualifications,
this does not necessarily yield a system where elderly
inmates are housed together. All of the SLC states
polled separate inmates based on physical and mental
condition. However, only six of these states have
either prisons or prison units designed exclusively for
geriatric prisoners. Since inmates in these other states
are separated due to medical reasons, rather than by age
alone, many healthy, elderly inmates are left within the
general prison population. The Southern states are not
alone in their lack of specialized prison units for elderly
inmates. In a 2002 nationwide report by the Criminal
Justice Institute, it was noted that only 15 states in the
country had special housing areas for elderly inmates,
and about half of these were available only for elderly
inmates with special medical conditions.37
A similar disparity is found in the basic way that
state corrections departments classify elderly inmates.
The age of categorization ranges from 50 to 65. Four
states Arkansas, Alabama, Mississippi, and West
Virginia consider elderly inmates to be ones over the
age of 65. Maryland alone accepts 60 as the distinguishing age. Oklahoma, South Carolina, Tennessee,
and Texas consider 55 to be the age of elderly inmates.
Seven of the SLC states Florida, Georgia, Kentucky,
Louisiana, Missouri, North Carolina, and Virginia
have adopted the adjusted age of 50 for characterizing
elderly inmates.
Recommendations
Compose general policies that recognize the aging

trends in America, trends that are being reflected in
the inmate population.
Consider lowering the age threshold for characterizing inmates as elderly as a basis for formulating
accurate and realistic policies as an archetype for
matching the health patterns of these inmates (applicable to states with higher chronological age
thresholds).
Consider the advantages of partitioning inmates
into separate facilities or units based on age. Separate housing facilities and units for elderly inmates
assist in reducing victimization; allow for the consolidation of specialized staff, therefore reducing
healthcare costs; and provide a more appropriate
environment for elderly inmates as an age group.
Consider reforms that would curb the number of

prisoners incarcerated for committing non-serious crimes from being sentenced to lengthy prison
terms.
Evaluate parole and probation programs, ensuring that they accommodate the specific needs of
elderly inmates regarding access to medical care,
affordable housing, and employment opportunities. Availability to these greatly affects recidivism
rates.
Evaluate existing laws and sentencing guidelines
resulting in long-term incarceration and disproportionately long sentences for older or elderly criminals.
The dynamic of aging prison populations is one
that is evident in all 16 Southern states, yet it is one that
requires diligent, innovative efforts by state corrections
departments and lawmakers to advance their prison
systems in ways that effectively and sensibly address
the needs of elderly inmates. Although Southern states
will continue to grapple with many of the difficulties
associated with elderly and perpetually aging inmate
populations, corrections departments should continually work to assess what programs and policies best
serve these inmates and, correspondingly, the societies
to which they belong.
31
here are several trends that many states have

recognized as helpful practices regarding
how corrections systems address the needs
of elderly inmates. These are summarized
as follows:
Appendix Survey Questionnaire

Southern Office
P.O. Box 98129
Atlanta, GA 30359
1946 Clairmont Road
Decatur, Georgia 30033
404/633-1866
Fax 404/633-4896
www.slcatlanta.org
Speaker Glenn Richardson

Georgia
Chair
Representative Julia C. Howard

North Carolina
Chair Elect
Senator Jeff Wentworth

Texas
Vice Chair
Senator Noble Ellington
Louisiana
Chair, Agriculture & Rural Development
Committee
Senator Mark Norris
Tennessee
Chair, Economic Development,
Transportation & Cultural Affairs
Committee
Senator Gerald Theunissen
Louisiana
Chair, Education Committee
Representative Ron Peters
Oklahoma
Chair, Energy & Environment
Committee
Senator Jack Hill
Georgia
Chair, Fiscal Affairs & Government
Operations Committee
Representative George Flaggs, Jr.
Mississippi
Chair, Human Services & Public Safety
Committee
Colleen Cousineau
Executive Director
Kenneth Fern, Jr
Deputy Director
Name:
Title:
Agency Name:
State:
Address:
Phone #:
Email:
1. General Statistics
a) What does your state consider the age of an elderly inmate to be?
b) What is the total number of inmates currently incarcerated under
your department?
c) What is the total number of inmates over the age of 50?
d) What is the total number of inmates over the age of 50 that are lifers?
e) What is the total number of inmates over the age of 50 that are
natural lifers?
f) What is the total number of inmates over the age of 50 with
sentences of 20 years or more?
2. Crime Statistics
a) How many total inmates are serving time for violent crimes?
b) How many inmates over the age of 50 are serving time for violent
crimes?
c) How many total inmates are serving time for sex-based crimes?
d) How many inmates over the age of 50 are serving time for sex-based
crimes?
e) What is the overall recidivism rate for inmates in your department?
f) What is the recidivism rate for inmates over the age of 50 in your
department?
g) How many inmates over the age of 50 are repeat offenders?
3. Policies
a) What policies does your department have regarding screening
inmates for special medical needs?
b) What general medial plans, if any, does your department have
regarding inmates over the age of 50 once they are admitted into a
prison (nutrition, exercise, frequent diagnostic testing, etc.)?
c) Is there a special medical release furlough program(s) for inmates
over the age of 50, or other inmates? If so, what are the directives of
that program(s)?
d) What, if any, general policy changes has your department
implemented since 1997?
e ustohu t h
s esrevr ivni gn tgh et hs o
Alabama Arkansas Florida Georgia Kentucky Louisiana Maryland Mississippi Missouri North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia
32
Thank you for returning your completed survey by May 5, 2006.

Jeremy Williams
The Southern Legislative Conference
Policy Analyst
P.O. Box 98129
jlwilliams@csg.org (Email)
Atlanta, GA 30359

404/633-1866 (Phone)

404/633-4896 (Fax)

www.slcatlanta.org
33
4. Facilities
a) Do any special geriatric facilities exist in your department for accommodating
the needs of inmates over the age of 50?
1. If yes, please describe the facility and the number of inmates or
beds involved.
2. If no, have such facilities been proposed but failed to win
legislative, gubernatorial, departmental or public approval?
b) Do any programs within standard prisons exist in your department for
accommodating the needs of inmates over the age of 50?
1. If yes, please describe the unit, wing, floor, or division and the
number of inmates or beds involved?
2. If no, have such programs been proposed but failed to win
legislative, gubernatorial, departmental or public approval?
c) What other, if any, programs exist for segregating inmates over the age of 50
from the rest of the prison population?
5. Concerns
Please respond to the difficulties, if any, associated with the following issues, and
what role those difficulties play in the overall operation of your department:
a) Rising medical costs for prisoners over the age of 50.
b) Readily accessible medical care for prisoners over the age of 50.
c) Depression and/or other mental problems of prisoners over the age of 50.
d) Staffing and staff preparedness for prisoners over the age of 50.
e) Victimization of prisoners over the age of 50 from younger inmates.
f) Parole problems associated with prisoners over the age of 50.
g) Prison space and prisoners over the age of 50.
h) Facilities accessible for the mobility-impaired prisoner over the age of 50.
6. Other
Please provide any other information you consider relevant and important in
examining the responsibilities associated with elderly inmates in your system.
Survey Respondents and Report

Contributors by State
Alabama
Brian Corbett
Public Information Manager
Department of Corrections
301 South Ripley Street
Montgomery, AL 36130
Arkansas
John Byus III

Administrator of Medical
Services
P.O. Box 8707
Pine Bluff, AR 71611-8707
Florida
David Ensley
Chief of Bureau of Research &
Data Analysis
2601 Blair Stone Road
Tallahassee, FL 32399-2500
Georgia
Nancy Phillips
2 Martin Luther King, Jr.
Drive, SE, 952-East
Atlanta, GA 30334
Kentucky
Charles E. Williams
Director of Operations and
Programs
P.O. Box 2400
Frankfort, KY 40602-2400
Louisiana
Jean Wall
Executive Management Officer
Department of Public Safety &
Corrections
504 Mayflower Street
Baton Rouge, LA 70802
Maryland
Dorothy Strawsburg
Director of Social Work
Department of Public Safety &
Correctional Services
6776 Reisterstown Road, Suite
210
Baltimore, MD 21215
Mississippi
Bill Greenleaf
Branch Director
723 North President Street
Jackson, MS 39202
Tennessee
Cile Crowder
Department Policy and Survey
Manager
Department of Correction
320 6th Avenue, N
Nashville, TN 37243
Texas
David Standlee
Manager II of Executive
Support
Department of Criminal Justice
P.O. Box 99
Huntsville, TX 77342-0099
Missouri
Virginia
North Carolina
West Virginia
Nancy Roberts
Research Analyst
2729 Plaza Drive
Jefferson City, Missouri 65102
Richard Burkart
Policy Development Analyst
Department of Correction
4221 MSC, 2020 Yonkers
Road
Raleigh, NC 27699-4221
Oklahoma
Christopher Hyde
Data Management Coordinator
3400 Martin Luther King
Avenue
Oklahoma City, OK 731114298
South Carolina
John Ward
Director of Division of
Resource and Information
Management
P.O. Box 71787
Columbia, SC 29221-1787
34
Scott Richeson
Statewide Program Director
P.O. Box 26963
Richmond, VA 23261
Jared C. Bauer
Research Analyst
Division of Corrections
112 California Avenue, Bldg 4
Charleston, WV 25305
Endnotes and References

Crime in the United States, 2005, (Federal Bureau of
Investigation, U.S. Department of Justice, 2005).
This report measures the number of arrests each year,
not the number of incarcerations.
Camille Graham Camp, The Corrections Yearbook, 2002,

(Middleton, CT: Criminal Justice Institute, 2002), p.
32.
B. Jayne Anno, Camelia Graham, James E. Lawrence,

Ronald Shansky, eds., Correctional Healthcare:
Addressing the Needs of Elderly, Chronically Ill, and
Terminally Ill Inmates, (Washington, DC: National
Institute of Corrections, U.S. Department of Justice,
2004) p. 29.
Rear Admiral Newton E. Kendic, M.D., Correctional

Health Care Today, Corrections Today, July, 2006,
(Alexandria, VA: American Correctional Association,
2006).
18
Robert Hofacre, The Correctional Health Care Debate,

Corrections Today, October, 2003, (American
Correctional Association, October, 2003).
19
Aday, p.174.
20
Georgia Department of Corrections, Active Offender

Population Statistics, (2006).
21
Harrison, p. 10.
22
Anno, p. 10.
23
Kristy F. Gary, Adult Correctional Systems, (Atlanta: The

Southern Legislative Conference of The Council of
State Governments, 2006), p. 15.
24
Alexandra Pelosi, Age of Innocence: A Glut of Geriatric

Jailbirds, The New Republic, (May, 1997), p. 15.
25
Anno, p. 33, 50-51.
26
Anno, p. 48.
27
George Washington University, POPS Program Gives

a Second Chance. http://www.gwu.edu/~ccommit/
law.htm.
28
Scott Angus, ed., Number of Older Inmates in Sate

Prisons Tripled in Last Decade, The Janesville
Gazette, August 9, 2006, (Janesville, Wisconsin: Bliss
Communications, Inc, 2006).
This point of demarcation at which old age is reached is

based largely on social legislation of the late 19th and
early 20th centuries.
Daron Hall, Jails vs. Prisons, Corrections Today,

February, 2006, (American Correctional Association,
February, 2006).
Anno, p. viii.
29
Todd Edwards, The Aging Inmate Population: SLC

Special Series Report, (Atlanta: The Southern
Legislative Conference of The Council of State
Governments, 1998), p. 5.
See Appendix A.
30
Gary, p. 11.
31
Gary, p. 4.
32
Charlotte A. Price, Aging Inmate Population Study,

(Raleigh: North Carolina Department of Correction,
2006), p. 2.
33
Since this report measures number of arrests, rather than

the number of persons incarcerated for these offenses,
the percentage of incarcerations for these crimes may
be less than the percentage of those arrested.
34
This statistic does not distinguish between criminals

that were elderly when the crime was committed
and inmates that committed the crime as a younger
age, but grew old in prison. Since criminals who
commit violent and sex-based crimes are, based on
most state laws, the least likely inmates to be paroled
the statistic is meant to reflect the growing inmate
population that is least likely to be paroled, rather
than a trend that would disproportionately associate
violent and sex-based crime with the elderly.
35
U.S. Department of Justice, Bureau of Justice Statistics

Bulletin: Prisoners in 2004, (Washington, DC: U.S.
Department of Justice, 2004).
36
The Americans with Disabilities Act of 1990,

(Washington, DC: Employment Standards
Administration, U.S. Department of Labor, 1990).
37
Camp, p. 74.
Ronald H. Aday, Aging Prisoners: Crisis in American

Corrections, (Westport, Connecticut: Praeger
Publishers, 2003), p. 2.
10
Federal Interagency Forum on Aging-Related Statistics,

Older Americans 2004: Key Indicators of Well-Being,
(Washington, DC: U.S. Government Printing Office,
November 2004), p. 2.
11
U.S. Census Bureau, Oldest Baby Boomers Turn 60!,

Facts for Features, (January, 2006).
12
U.S. Administration on Aging, A Statistical Profile of

Older Americans Aged 65+ (Washington, DC: U.S.
Department of Health and Human Services, 2006).
13
Paige M. Harrison and Allen J. Beck, Prison and

Jail Inmates at Midyear 2005, Bureau of Justice
Statistics Bulletin, (Washington, DC: U.S.
Department of Justice, 2006), pp. 1, 4.
14
Christopher J. Mumola, Suicide and Homicide in State

Prisons and Local Jails, Bureau of Justice Statistics
Bulletin, (Washington, DC: U.S. Department of
Justice, August, 2005), p. 1.
15
Aday, pp. 10-11.
16
U.S. Bureau of Justice Statistics, Truth in Sentencing in

State Prisons, (1999), p. 1.
17
Aday, p. 22.
35
The Aging Inmate Population

Southern States Outlook
or a number of years the Human Services

and Public Safety Committee of the Southern
Legislative Conference (SLC), currently
chaired by Representative George Flaggs, Jr.,
Mississippi, has been examining Southern states policies regarding aging inmates. This Regional Resource
investigates the continued trends concerning the Souths
prison population and resumes the analysis initiated by
the 1998 SLC Special Series Report, The Aging Inmate
Population, conducted by Todd Edwards.
The Committee extends a special thanks to the

corrections officials in the South and other participants
who contributed information for this report.
This report was prepared by Jeremy L. Williams,
Policy Analyst for the Southern Legislative Conference
of The Council of State Governments, under the chairmanship of Speaker Glenn Richardson, Georgia.


of The Council of State Governments
P.O. Box 98129
Atlanta, GA 30359
www.slcatlanta.org
Colleen Cousineau, Executive Director

The Aging Inmate Population: Southern States Outlook

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The Council of State Governments

Sharing capitol ideas

Southern Legislative Conference

The Aging Inmate Population

n recent years, the largest and fastest growing

the term connoting different age groups depending

Although states have various definitions of elderly with regard to inmates

Alabama Arkansas Florida Georgia Louisiana Kentucky Maryland Mississippi Missouri

The Aging Prison Population: Southern States Outlook

the threat of victimization, which disproportionately

This 15-year gap may seem excessive, but experts

Elderly and Non-elderly Inmates

most correctional healthcare programs acknowledge

The Aging Prison Population: Southern States Outlook

The SLC began closely examining this issue

states and the nuances of this development, focusing

The Aging Prison Population: Southern States Outlook

The Increasing Elderly Inmate Population

The Graying of America

he aging of the general American public is

influencing the graying of America. Another factor

Although this expeditious increase in the age of

here has been concern regarding the aging of

While the baby boomers reaching retirement age

Due largely to these stricter sentencing laws, more

Many states have eliminated parole programs

The Aging Prison Population: Southern States Outlook

While the goal of this legislation was to stifle

The Aging Prison Population: Southern States Outlook

The Condition of Elderly Inmates

any elderly inmates have numerous

prisons will bring with it a continued need for better

he cost of housing the average prisoner in the

wheelchair ramps, handicap bathroom stalls, and the

Parole and Recidivism Issues

The Aging Prison Population: Southern States Outlook

are significant differences between these three groups.

The Aging Prison Population: Southern States Outlook

programs. Part of the difficulty in gauging the potential

to address increased rates of recidivism, states must

Southern State Profiles

n order to collect information regarding elderly

important to a characterization of their states strategy

Table 1 How Southern States Compare

The Aging Prison Population: Southern States Outlook

The Aging Prison Population: Southern States Outlook

Convicted of Violent Crime

Challenges: According to Adult Correctional

Convicted of Violent Crime

Policies: The Department of Corrections has a

female inmates. This facility provides services for

The Aging Prison Population: Southern States Outlook

The Aging Prison Population: Southern States Outlook

Convicted of Violent Crime

significant mental health needs or who have physical

Convicted of Violent Crime

*Statistics are based on repeat offenses within a three-year period.

Corrections is continuing to evaluate the benefits of

The Aging Prison Population: Southern States Outlook

The Aging Prison Population: Southern States Outlook

Convicted of Violent Crime

in these areas. Specifically, the State Reformatory

Convicted of Violent Crime

*Statistics are based on repeat offenses within a five-year period.