Texas Officials Search for Health Care Options for Aging Prison Population

Back in August, this blog discussed a relatively new trend of prison closures in Texas. After decades of tough-on-crime rhetoric and tougher prison sentences, the cost of running a prison has risen steeply. One reason is because lengthy sentences have resulted in many prisoners reaching senior citizen status, requiring the health care that comes with it.

According to Human Rights Watch, “between 2007 and 2010, the number of state and federal prisoners age 65 or older increased by 63 percent while the overall population of prisoners grew only 0.7 percent in the same period.” In Texas, although senior inmates make up only seven percent of the total prison population (approximately 160,000 inmates), they account for one third of the health care costs.

Now Texas officials are scrambling to find ways of providing low-cost health care. It used to be that the University of Texas and Texas Tech treated inmates, but that system may not be in place much longer, given that last year, their bill for service was $400 million. Just recently, the Texas prison board made a deal worth $46 million with Huntsville Memorial Hospital for the hospital staff to serve inmates who are incarcerated nearby. This type of deal might be extended to other regional medical facilities. Texas also has set up geriatric wards in each prison for inmates 60 years and older.

Otherwise, the Texas solution to stemming the costs of old age is to not have so many inmates reach old age. That is, to find alternatives to putting people in prison. This includes putting more money into rehabilitation programs for drug use and other crimes. Yet the effects of that approach won’t be felt for many years. Meanwhile, inmates are getting older faster than non-inmate senior citizens of the same age. They have physical and mental health issues that pose a challenge to any medical staff.

How did the prison population reach this point? Again, much of it has to do with the tough-on-crime attitude that was prevalent for far too long, since at least the 1970s. It can be seen in the Federal Sentencing Guidelines, which were established in 1984 and have been adopted in many states. They were meant to produce “fairness” in sentencing, but have often had arbitrary, overly harsh results of their own. The most infamous example was the sentencing disparity between crack cocaine and powder cocaine, which persisted until 2010. Although the Sentencing Guidelines are meant to be advisory, they continue to carry great weight with federal judges.

Tough-on-crime public officials wanted those who committed certain crimes to be locked away — for a long time, where they could never hurt anyone again. They forgot that even when you are charged with a crime, you still have certain basic rights. You have the right to have a competent criminal defense attorney defend you. And if you are sentenced to a term in prison, you still have the right to be treated like a human being. Prison inmates have the right to receive proper food and medical care until the end of their sentence. Maybe tough-on-crime advocates thought that inmates with life sentences would eventually dissolve into dust balls? In any event, it is encouraging that Texas officials are beginning to turn away from this trend… even if the reason has more to do with the budget than with a change in conscience.