Aging-inmate issues not unique to state system

Most states are having even more difficulty than Nevada with controlling inmate medical costs, according to a national study by Pew Research Center — MacArthur Foundation.

According to the study, which was released Tuesday, per-inmate health care spending rose an average of 32 percent nationwide between 2001 and 2008. That cost actually decreased 16 percent in Nevada.

Nevada’s costs, however, are projected to rise over the coming years as the inmate population ages. Prison medical officials say just 5.8 percent of the inmate population — those over 55 — consumes nearly 20 percent of the medical budget. But they say the number of geriatric inmates will continue to grow in Nevada.

Nationwide, the population of inmates 55 and older doubled between 2001 and 2008, the most recent year data was available, according to the Pew study. There are now some 121,800 prisoners 55 and older nationwide, it states.

What drives that increase is the tough-on-crime sentencing laws that states began passing 30 years ago. Between 1984 and 2008, the study says, the number of state and federal prisoners serving life sentences more than quadrupled, with nearly one-third of them serving life without possible parole.

Elderly inmates are more susceptible to chronic medical conditions. The study adds that those in prison “typically experience the effects of age sooner than people outside prison.” Reasons include substance abuse, lack of preventative care and the violent lives many have led.

A key example in the report is that, while just 1 percent of the U.S. population has Hepatitis C, an estimated 17-plus percent of the nation’s prisoners have the disease.

The report says many states are trying new approaches to cut prison medical costs. Specifically, it says the expansion of Medicaid eligibility in the Affordable Care Act will enable prison systems to qualify many more prisoners for coverage — effectively leveraging federal money to pay half or more of their hospital bills. The new rules cover those under 65 if their income is less than 138 percent of the federal poverty level.

“Virtually all inmates are below that threshold, making them eligible for Medicaid under the new rules,” the report states, adding that initially, the federal government will reimburse 100 percent of covered services for those individuals.

Ohio, it says, estimated it will save $273 million over the next eight years and Michigan $250 million over 10 years.

The Nevada Legislature in 2013 passed legislation enabling the prison system to seek Medicaid reimbursement for hospital services to inmates.

The Pew report says more and more states also are looking at changing their laws to allow geriatric releases from prison, which only 15 states had as of 2009. But some 39 states had medical parole for terminal or debilitating conditions. Louisiana went so far as to designate nonviolent inmates age 60 and up as low risk for parole.

The report says those changes are clear indications that states are beginning to reverse those tough sentencing and parole laws for nonviolent and feeble inmates they feel can be released without danger to the public.