Monday, May 4, 2015

Aging popluation takes toll on U.S. prisons

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Aging popluation takes toll on U.S. prisons

  • By Sari Horwitz, Washington Post
Saturday, May 2, 2015 9:47pm
INSIDE COLEMAN PRISON — Twenty-one years into his nearly 50-year sentence, the graying man steps inside his stark cell in the largest federal prison complex in America. He wears special medical boots because of a foot condition that makes walking feel as if he's "stepping on a needle." He has undergone tests for a suspected heart condition and sometimes experiences vertigo.

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"I get dizzy sometimes when I'm walking," says the 63-year-old inmate, Bruce Harrison. "One time, I just couldn't get up."
In 1994, Harrison and other members of the motorcycle group he belonged to were caught up in a drug sting by undercover federal agents, who asked them to move huge volumes of cocaine and marijuana. After taking the job, making several runs and each collecting $1,000, Harrison and the others were arrested and later convicted. When their sentences were handed down, however, jurors objected.
"I am sincerely disheartened by the fact that these defendants, who participated in the staged off-loads and transports . . . are looking at life in prison or decades at best," said one of several who wrote letters to the judge and prosecutor.
In recent years, federal sentencing guidelines have been revised, resulting in less severe prison terms for low-level drug offenders. But Harrison, a decorated Vietnam War veteran, remains one of tens of thousands of inmates who were convicted in the "war on drugs" of the 1980s and 1990s and who are still behind bars.
Harsh sentencing policies, including mandatory minimums, continue to have lasting consequences for inmates and the nation's prison system. Today, prisoners 50 and older represent the fastest-growing population in crowded federal correctional facilities, their ranks having swelled by 25 percent to nearly 31,000 from 2009 to 2013.
Some prisons have needed to set up geriatric wards, while others have effectively been turned into convalescent homes.
The aging of the prison population is driving health-care costs being borne by American taxpayers. The Bureau of Prisons saw health-care expenses for inmates increase 55 percent from 2006 to 2013, when it spent more than $1 billion. That figure is nearly equal to the entire budget of the U.S. Marshals Service or the Bureau of Alcohol, Tobacco, Firearms and Explosives, according to the Justice Department's inspector general, who is conducting a review of the impact of the aging inmate population on prison activities, housing and costs.
"Our federal prisons are starting to resemble nursing homes surrounded with razor wire," said Julie Stewart, president and founder of Families Against Mandatory Minimums. "It makes no sense fiscally, or from the perspective of human compassion, to incarcerate men and women who pose no threat to public safety and have long since paid for their crime. We need to repeal the absurd mandatory minimum sentences that keep them there."
The Obama administration is trying to overhaul the criminal justice system by allowing prisoners who meet certain criteria to be released early through clemency and urging prosecutors to reserve the most severe drug charges for serious, high-level offenders.
At the same time, the U.S. Sentencing Commission, an independent agency, has made tens of thousands of incarcerated drug offenders eligible for reduced sentences.
But until more elderly prisoners are discharged — either through compassionate release programs or the clemency initiative started by then-attorney general Eric Holder last year — the government will be forced to spend more to serve the population. Among other expenditures, that means hiring additional nurses and redesigning prisons — installing showers that can be used by the elderly, for instance, or ensuring that entry ways are wheelchair-accessible.
"Prisons simply are not physically designed to accommodate the infirmities that come with age," said Jamie Fellner, a senior adviser at Human Rights Watch and an author of a report titled "Old Behind Bars."
"There are countless ways that the aging inmates, some with dementia, bump up against the prison culture," she said. "It is difficult to climb to the upper bunk, walk up stairs, wait outside for pills, take showers in facilities without bars and even hear the commands to stand up for count or sit down when you're told."
For years, state prisons followed the federal government's lead in enacting harsh sentencing laws. In 2010, there were some 246,000 prisoners age 50 and older in state and federal prisons combined, with nearly 90 percent of them held in state custody, the American Civil Liberties Union said in a report titled "At America's Expense: The Mass Incarceration of the Elderly."
On both the state and federal level, the spiraling costs are eating into funds that could be used to curtail violent crime, drug cartels, public corruption, financial fraud and human trafficking. The costs — as well as officials' concerns about racial disparities in sentencing — are also driving efforts to reduce the federal prison population.
For now, however, prison officials say there is little they can do about the costs.
Edmond Ross, a spokesman for the Bureau of Prisons, said: "We have to provide a certain level of medical care for whoever comes to us."
• • •
Except for the loud clang of heavy steel security doors that close behind a visitor, the Butner Federal Medical Center in North Carolina feels nothing like the prisons portrayed on television and in movies.
Elderly inmates dressed in khaki prison uniforms are not locked up during the day, but instead congregate with each other in their wheelchairs, wait for treatment in clinics and walk, sometimes with canes or walkers, through their living quarters.
Signs hang from the ceiling, directing prisoners to various units: "Urgent Care," "Mental Health," "Surgery," "Ambulatory Care, "Oncology."
"This facility mirrors a hospital more than a prison," said Kenneth McKoy, acting executive assistant to the warden at Butner, a prison about 20 minutes northeast of Durham. "We provide long-term care."
The facility is the largest medical complex in the Bureau of Prisons, which has 121 prisons, including six that have medical centers. With more than 900 inmates in need of medical care, Butner even provides hospice-like care for dying inmates.
In his "cell" on a recent day, Michael Hodge lay in a hospital-like bed where he spent his days mostly staring at the television. A prison official had just helped him get out of his wheelchair. A prison employee delivered his meals. He could hardly keep his eyes open.
In 2000, Hodge was convicted on charges of distribution and possession of marijuana and possessing a gun, and was sentenced to 20 years. When a Washington Post reporter visited Hodge in mid-April, he was dying of liver cancer. He died April 18, prison officials said.
"Tell my wife I love her," said Hodge, who said he was in great pain.
Many prisoners at Butner are as sick as Hodge was, McCoy says.
"Why are we keeping someone behind bars who is bedridden and needs assistance to get out of bed and feed and clothe himself?" asked Fellner, of Human Rights Watch. "What do we gain from keeping people behind bars at an enormous cost when they no longer pose any danger to the public if they were released?"
Hodge submitted at least four requests for compassionate release over the past few years, but none were approved by officials, according to his ex-wife Kim Hodge, whom he still referred to as his wife.
"The man is 51 and dying," Kim Hodge said in an interview last month. "He never killed nobody, he's not a child molester, he's not a bad person. Now he's going to die in there."
Taxpayers are increasingly picking up the tab for inmates who received lengthy mandatory sentences for drug offenses and have since aged and developed conditions that require around-the-clock medical care.
The average cost of housing federal inmates nearly doubles for aging prisoners. While the cost of a prisoner in the general population is $27,549 a year, the price tag associated with an older inmate who needs more medical care, including expensive prescription drugs and treatments, is $58,956, Justice Department officials say.
At Federal Medical Center Devens, a prison near Boston, 115 aging inmates with kidney failure receive treatment inside a dialysis unit.
"Renal failure is driving our costs up," said Ted Eichel, the health-services administrator for Devens. "It costs $4 million to run this unit, not counting medications, which is half our budget." Devens also employs 60 nurses, along with social workers, dietitians, psychologists, dentists and physical therapists. They look like medical workers, except for the cluster of prison keys they're carrying.
Down the hallway, inmates in wheelchairs line up to receive their daily pills and insulin shots.
Although the prison houses about 1,000 low- to high-security inmates, they are not handcuffed or shackled, except when being transferred outside the facility. A golf cart has been redesigned into a mini-ambulance.
At prisons such as Devens, younger inmates are sometimes enlisted as "companion aides," helping older inmates get out of bed, wheeling them down the halls to medical appointments and helping them take care of themselves.
"The population here is getting older and sicker," said Michael Renshaw, a Devens clinical nurse and corrections officer who noted the differences between working as a nurse there and "on the outside."
"Inmates get very good care here," Renshaw said. "But on the outside, maybe you would give a patient a hug or he would hug you. Here, you have to be able to maintain your borders. It's a prison."
As with all prisons, fights occasionally break out. At Devens, it's sometimes between patients who are in wheelchairs or, in at least one case, between an inmate who climbed out of his wheelchair and onto another prisoner's bed to assault him.
John Thompson, a patient-care technician who works with Devens's dialysis patients, said he knows a number of people who "want no part of" providing medical care to prisoners.
"But I just feel like they're good people," Thompson said. "And they're doing their time. Some guys have an attitude, but I tell them, if you show me respect, I'll show you respect."
Jesse Owens, a dialysis patient serving about 12 years for cocaine charges, said he's grateful for the care. "They're keeping us alive," he said.
• • •
Harrison's crammed cell at the Federal Correctional Complex Coleman in Florida near Orlando is devoid of the clutter of life on the outside. The space he shares with another inmate has only a sink, a toilet, a bunk bed with cots, a steel cabinet, two plastic gray chairs, a desk and a bulletin board with a postcard of a Florida waterspout.
From a tiny window, he can see Spanish moss draped over trees in the distance.
Forty-five years ago, Harrison served with the Marines in Vietnam. A machine gunner, he was shot twice and was awarded two Purple Hearts. When he came back, he felt as though he had nowhere to turn. He later joined a motorcycle group known as the Outlaws.
Harrison was approached by an undercover agent who was part of a law enforcement team trying to bring down the group, which had been suspected of illegal activity. He and fellow members of the club were offered a kilogram of cocaine to offload and transport drugs. He declined, saying none of them wanted to be paid in drugs.
"I didn't want drugs, because I really wouldn't have known what to do with them," Harrison said in an interview. "We didn't sell them."
But Harrison and the others took the job because the agents offered cash, and they needed the money. Over a period of several months, they would move what they believed to be real drugs — more than 1,400 kilos of cocaine and about 3,200 pounds of marijuana.
Harrison carried a gun for protection during two of the offloads. He didn't use it, but after authorities arrested him and fellow members of his group, he was charged with possessing a firearm while committing a drug offense.
His 1995 trial in Tampa lasted four months. His attorney at the time argued that "this was a government operation from beginning to end. . . . Everything was orchestrated by the government. . . . He was not a leader. The only leaders in this case, the only organizers in this case was the United States government."
The jury, nonetheless, found Harrison and the others guilty of transporting the drugs.
Harrison was sentenced to roughly 24 years for possessing cocaine and marijuana with the intent to distribute. The conviction on the firearms charge carried a 25-year penalty, meaning he is effectively serving a life sentence.
"There's no doubt that that's a harsh penalty," said U.S. District Judge Susan Bucklew during the sentencing hearing. "But that's what the statute says, and I don't think I have any alternative but to do that."
"I don't have a whole lot of discretion here," she said at another point.
"If I would have been given the right to not only judge the facts in this case, but also the law and the actions taken by the government, the prosecutor, local and federal law enforcement officers connected in this case would be in jail and not the defendants," juror Patrick McNeil wrote.
Six jurors signed a letter requesting a new trial be ordered, saying that if they had been told by the court that they could have found that the government had entrapped the defendants, they would have found them not guilty.
"Bruce Harrison had never been involved in unloading drugs," said his current attorney, Tom Dawson. "He didn't arrange for any of these drugs. The government did."
Andrea Strong, a childhood friend of Harrison, said he doesn't claim to have been a saint.
"But, in a compassionate world, this man would not be less than halfway through a sentence for a drug offense that happened 20 years ago," Strong said. "He would've done his time, paid his debt to society, and be released to his network of supportive family and friends."
Along with tens of thousands of other inmates around the country, Harrison is applying for clemency under the Obama administration's program to release drug offenders who have been in prison for at least 10 years and whose cases meet certain criteria.
"If I got out, I'd go back home and be with my three grandkids and help them out," Harrison said.
• • •
Another aging inmate at Coleman, 58-year-old Luis Anthony Rivera of Miami, has also applied for clemency. He was convicted of conspiracy to import cocaine and has so far served 30 years.
When he was sentenced in 1985, it marked his first criminal offense.
While in Coleman's maximum-security penitentiary, Rivera began painting with oil and watercolors, trying to re-create the world outside bars. When he was moved to the medium-security prison on the same grounds he wasn't allowed to bring his art supplies, and he can't afford to buy new ones.
But the move brought a new joy. He saw a tree for the first time in 10 years.
"It was amazing to see a tree," said Rivera, a former pilot who was in the National Guard and the Army and now spends his days working in the prison commissary stocking shelves and filling orders.
"I understand the system of putting people in prison. It works. No doubt," Rivera said. "But how much time you put them in for makes a determination. For the first five years, you suffer. You really do. They keep everything away from you — food, all your basics. So you long for them, watching a commercial on TV, seeing a product that you can't touch or have."
"But after then, you start to get hardened," Rivera said, his voice cracking.
If he does not receive clemency, how much time does he have to serve before getting out?
His lips quivered and his eyes filled with tears.
"I'm not," Rivera said. "I have life, plus 140 years."
Washington Post staff writer Julie Tate in Washington contributed to this report.
Aging popluation takes toll on U.S. prisons 05/02/15 [Last modified: Saturday, May 2, 2015 9:47pm] 
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