LINCOLN, Neb. — New medical screening procedures and in-house programs are being implemented in Nebraska penitentiaries as the number of inmates age 50 and older increases. The demand for new operations programs comes from the justice system’s heightened strive to crack down on crime. This, according to experts, has caused the significant increase in older inmates over the years.
Five percent of Nebraska’s prisoners were 50 or older in 1983, with that number jumping to 14 percent in 2012. As this number rises, so does the total cost of inmate healthcare.
Studies show that older inmates show signs of age and sickness approximately 10 years sooner than people of the same age who are not behind bars. Chief Operating Officer of Health Services for Nebraska’s Department of Correctional Services Steve Urosevich says that this advanced aging is due to the inmates’ high rate of medical issues prior to incarceration. Eighty percent of the inmates have a history of substance abuse, 30 percent have mental illness, many have significant dental problems, and there is a high prevalence of HIV/AIDS. Many of these problems stem from inmates not taking advantage of medical care in their communities because of their various lifestyles.
The higher demand for healthcare in prisons in conjunction with the spiked costs has spurred Nebraska’s Department of Correctional Services to implement several new programs, including a medical screening program for older inmates, new facilities for chemotherapy and kidney dialysis and an inmate porter program providing paid incentives for the inmates to help each other.
The screening program, designed at the University of Nebraska at Omaha, determines whether inmates age 45 and older can perform basic functions such as eating, performing hygiene and getting to and from the cafeteria without assistance. “What we’re trying to determine,” Urosevich said, “is if we can complete that evaluation when they get to the housing unit, then we can make accommodations for them…There are different things we can do to accommodate their needs once we identify what their issues are.”
The Nebraska State Penitentiary has also implemented in-house facilities for chemotherapy and dialysis. These new resources have already proven their worth—the chemotherapy program has saved the Penitentiary $115 thousand per year for the last four years and the dialysis program has saved $130 thousand per year for the last two years, according to Urosevich.
Another new program is geared toward individuals with chronic illnesses such as diabetes and hypertension. This six-week course was developed at Stanford and taught by nurses with the Department of Health and Human Services in Nebraska. When discussing the program, Urosevich said, “the results were somewhat amazing. Blood pressure came down. One individual—in six weeks—lost 35 pounds. It’s changed [inmates’] outlook on how they want to age in prison and how they want to now take care of themselves.”
Perhaps the most remarkable new healthcare program is one involving inmates working to help each other. This program, known as the inmate porter program, has been in the system for about 12-18 months. It was implemented for financial reasons—the penitentiary hires inmates to help with healthcare needs while reducing its dependence on external hires.
The program involves an intensive application process. Applicants go through a security screening to identify recent misconduct and the reasons for their incarceration, a psychological interview, and an interview with a panel of security and medical personnel. If hired, inmates are paid $2.38 per hour—an excellent rate, according to Urosevich.
This program is a way for inmates to gain a kind of redemption for their prior mistakes and create meaning out of their time in prison. When commenting on the interview process, Urosevich said, “At the first interview, absolutely the first interview we had, I remember asking the question of the individual, ‘Why do you want to do this?’ He was serving a life sentence without the possibility of parole. And he said, ‘I’m gonna die in here. I want to have a program like this available so when I need it, it’s there.’”