GROWING OLD BEHIND BARS
Release programs for sick, elderly prisoners could save millions, but states rarely use them
Across the country, early-release provisions for elderly and infirm prisoners are billed as a way to address problems such as prison overcrowding, skyrocketing budgets and civil rights lawsuits.
But throughout the USA, they are used so infrequently that they aren’t having much impact.
That’s because thousands of elderly prisoners nationwide — many of whom pose little or no risk of committing new crimes — aren’t allowed to apply.
While these programs are presented as money savers, in 2015 a majority of states granted release to fewer than four applicants each. Within states that have a compassionate-release program and track the numbers, 3,030 people applied, and only 216 were granted release.
For example, in Wisconsin, a program that allows elderly and severely ill prisoners to be released early from prison could save state taxpayers millions of dollars a year. But hundreds of the state’s elderly prisoners — many of whom prison officials acknowledge pose little or no risk of committing new crimes — aren’t allowed to apply.
More than 1,200 people age 60 and older were serving time in Wisconsin prisons as of Dec. 31, 2016, the most recent count available. By one estimate, the average cost to incarcerate each of them is $70,000 a year — for an annual total of $84 million. Last year, just six inmates were freed under the program.
Among those who didn’t qualify were a blind quadriplegic and a 65-year-old breast cancer survivor who uses a breathing machine and needs a wheelchair to make it from her cell to the prison visiting room.
“We’ve taken health out of criminal justice policy to such a degree that the policies that have been developed do not have the geriatric and palliative care knowledge they need to make sense,” said Brie Williams, a physician and professor of medicine at the University of California-San Francisco.
Of 47 states with processes to free such prisoners early or court rulings requiring them to do so, just three — Utah, Texas and Louisiana — released more than a dozen people in 2015, according to a survey by the Milwaukee Journal Sentinel, part of the USA TODAY NETWORK.
A quirk in the law
On its face, Wisconsin has one of the most comprehensive compassionate release laws in the country.
To qualify, a prisoner must be at least 65 with five years served, or 60 with 10 years served. Prisoners with chronic health conditions also may apply regardless of age or time served if two doctors certify the illnesses can’t be properly treated in prison.
People convicted of some of the most serious felonies are not eligible.
From Aug. 2, 2011, through the end of June 2017, 25 people were released under the program, according to the corrections department. Only one was approved because of advanced age alone; the others had health conditions.
A key reason is this: The law governing compassionate release says only people whose crimes were committed on or after Dec. 31, 1999, making them subject to truth in sentencing, are eligible. More than 25% of the state’s elderly prisoners serving long sentences — as well as some younger people with serious health problems — were locked up before that.
That means some of the oldest and sickest prisoners can’t apply.
A quadriplegic behind bars
As a result, people such as Paul Echols stay in prison. Echols was rendered a quadriplegic and left legally blind after a gunbattle with police in
1994. One of his bullets shattered an officer’s arm, ending his career.
Echols’ first court appearance occurred in his hospital room. By then, about five months after the crime, his medical care had already cost the state
$200,000.
He was convicted of three felonies and sentenced to 37 years in prison.
Echols could not raise his arms and spent his days flat on his back listening to audio books, said his father, Paul Gordon. If his headphones slipped, Echols couldn’t adjust them on his own.
Echols was denied parole six times. Every time, the board concluded that his release “would involve an unreasonable risk to the public,” according to parole commission records.
He died in prison last year.
Few receive parole
In theory, parole is the mechanism for people such as Echols to get out of prison before the end of their sentences.
In practice, the number of Wisconsin inmates released on parole has decreased dramatically in recent years.
Corrections officials explain the trend by saying most people now in prison are subject to truth in sentencing. As a result, only about 15% of prisoners are eligible for parole.
In 2016, the most recent year available, just 185 people were approved for parole. Of those, 12 were 60 or older.
The parole board is not required to consider factors such as advanced age, lack of mobility or illness. Instead, commissioners must conclude that someone has served “sufficient time for punishment” and that setting him or her free would not pose an unreasonable “risk to the public,” among other things.
Parole board chair Daniel Gabler declined to be interviewed about how commissioners weigh those factors.
In general, parole boards tend to fo- cus on the crime and often do not have adequate information about an inmate’s medical condition, said Rebecca Silber, formerly a program manager at the non-profit Vera Institute for Justice.
“A parole board may get a disciplinary record that doesn’t have any context with respect to the person’s medical condition and to what extent the diagnosis may be affecting their behavior,” Silber said.
A drug offense
Contrary to a Gabler assertion during his confirmation hearing that prisoners still serving time under the parole system are “killers and rapists,” a spotcheck of parole-eligible inmates ages 60 and older found convictions for a variety of crimes, including drug dealing and robbery.
One of them is Nancy Ezell.
In 1998, Ezell pleaded guilty to eight felonies for repeatedly selling cocaine to police informants and undercover officers, as well as trying to buy purportedly stolen goods from one of them. None of the charges included violent behavior. Her record also did not include violent crimes.
At the time, the “war on drugs” was in full swing, resulting in long prison sentences for even non-violent drug offenders.
Ezell, then 47, was sentenced to 65 years under the parole system, in which inmates become eligible for release after serving a quarter of their sentences.
Ezell, who turns 66 this month, uses a wheelchair and a breathing machine. She takes about 30 pills a day to control more than a dozen health conditions, according to her medical records. Two years ago, she was diagnosed with breast cancer. She became eligible for parole in 2014. She has not been disruptive and has completed every program recommended, according to parole commission records.
Yet she has been denied release repeatedly.
The reasons?
She has not served enough time for punishment, in the parole board’s view.
And they believe her release would pose an unreasonable risk to the public.
Little risk of offending again
Elderly inmates are substantially less likely than younger ones to break the law again upon release, according to numerous studies.
One of them, by the U.S. Sentencing Commission, found that just 6.8% of men age 60 and older returned to prison within eight years, compared with 40% for men under 30.
“Some patients who are dying are dangerous. These laws are not designed for those individuals,” Williams said of the sick and elderly incarcerated.
But the vast majority, she said, are not.
On the flip side, life in prison poses unique safety hazards for aging prisoners, according to Williams, director of the criminal justice and health program at the University of California-San Francisco.
Age-related conditions such as incontinence that would be embarrassing and inconvenient on the outside could become unsafe for someone locked down with a cellmate, she said. Prisoners with dementia may wander into the wrong cell, or they may break the rules because they don’t know any better.
It is often difficult or impossible for prison medical staff to fulfill the constitutional requirement of providing the same standard of care as in the community, Williams said. As a result, inmates must leave prison for medical care at clinics or hospitals.
The cost of that care has increased over time.
While the National Institute of Corrections estimates the amount is double for prisoners age 50 and older, other studies have concluded the cost is between three and nine times as much. And it mounts with age.
It’s up to society as a whole to decide whether keeping sick and elderly prisoners locked up is worth the cost, Williams said.
“It’s a very expensive resource, and we have to decide who it should be used for,” she said. “Do we want to use this resource for someone who is so demented they don’t know their name? For someone who can barely breathe and is dragging around an oxygen tank? It’s a question we have to ask ourselves.”