HONOLULU (AP) — Hawaii’s prisons are grappling with rising health care costs brought on by an aging population of inmates.
About 13 percent of all Hawaii inmates are 55 and older. At the state’s largest prison, the Halawa Correctional Facility on Oahu, nearly one in six inmates is over the age of 55. About 5 percent of the facility’s more than 1,000 inmates are disabled because of age, mobility and cognitive issues.
“People think of inmates as 20-year-olds, but there’s a lot of people in here that are over 55,” said Dr. Mike Hegmann, state Department of Public Safety medical director. “You can really think of the whole prison like a nursing home.”
The department says age-related medical costs and a growing inmate population are driving up its $24 million health care budget for correctional facilities. A 2014 study from the Pew Charitable Trusts estimated Hawaii’s per inmate spending on health care rose 8 percent from 2007 to 2011, largely because of aging inmates’ greater health needs.
Specialized care for inmates, such as dialysis, can get expensive because of the added costs for security and transportation, Hegmann said.
“If they were on the outside, Medicare and Medicaid would pay for the dialysis,” he said. “Since they are in here, we pay for the dialysis.”
The state prison system has six doctors, six psychiatrists and three nurse practitioners. Prisoners also help their fellow inmates in need.
Sione Tilini, 29, an inmate aide serving the second year of a 10-year sentence for negligent homicide, helps older inmates with basic needs. He said some have dementia.
“Sometimes they don’t know who I am,” Tilini said. “I see them every day, but sometimes they forget who I am or what I’m doing there.”
Attorney Eric Seitz said he is concerned that inmates with serious health issues are being kept behind bars. “It’s not cost effective to keep people in prison. It’s punitive, and it’s absurd,” he said.
But retired attorney Bob Merce, who is on the state’s prison task force, said the issue is not an easy problem to solve.
“We don’t have a place to put people who are debilitated and have been in prison because there is nobody in our society that wants them,” Merce said. “Private nursing homes won’t accept them, and we don’t have any state facilities set up to accept them.”
At Halawa Correctional Facility, inmates in wheelchairs and older inmates are typically kept together. Ill inmates who need constant care are kept in the infirmary, which has 12 beds dedicated for those with short- and long-term health issues.
Hegmann acknowledged concerns about keeping inmates with serious medical conditions behind bars.
“We want to take care of our patients,” he said. “We probably, better than anyone, recognize that they probably are not a danger to society.”
