Missouri's aging inmate population straining state budget

Thursday, January 27, 2011 | 12:44 a.m. CST; updated 6:05 p.m. CST, Thursday, January 27, 2011
Jack Lindsey has been in prison in Missouri for 27 years, serving a sentence for shooting a policeman in 1978.

JEFFERSON CITY — Jack Lindsey, 63, is a convicted cop killer. He's also a decorated Vietnam veteran, an avid gardener and a model inmate.

Next month, he will complete his 27th year behind bars.


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Lindsey underwent back surgery six years ago. Doctors say that soon he’ll need another. In the meantime, he gets epidural steroid injections for the pain every four months.

Barring any drastic sentencing reforms, Lindsey and a growing number of older inmates like him will live the rest of their lives in Missouri prisons. And Missouri taxpayers will foot the bill for any additional medical procedures or treatments they need.

The number of older inmates in Missouri's prisons has nearly tripled over the past decade and stands at about 4,700 today. That portion of the population is growing faster than others. Prisoners older than 50 represented just 6 percent of Missouri state inmates in 1998; that figure had shot up to 15 percent by 2009.

The trend is "expected to keep spiraling upward," said Missouri Department of Corrections official Deloise Williams, assistant division director of rehabilitative services. The cost of caring for them will strain an already strapped state budget.

Some of the state’s top officials — including Missouri Supreme Court Judge Michael Wolff — question whether the situation adds up to good public policy.

"We seem to be racking up some extraordinary costs for reasons that are not particularly rational," Wolff said in a recent telephone interview. "Some of these men are fairly disabled and probably not able to engage in criminal activity even if they are inclined to."

On Jan. 1, the state's first geriatric wing, or "enhanced care unit," opened at the Jefferson City Correctional Center to help cope with the financial and logistical burden that comes with the aging population. Designed as a miniature nursing home within a prison, the 36-bed unit will be a place where old convicts in wheelchairs, strapped to oxygen tanks or struggling with dementia will be segregated from the general population, where many are vulnerable to abuse.

Officials are training younger inmates to assist older inmates with daily activities, such as moving them from their beds to wheelchairs, or on and off the toilet.

To prepare the unit, prison staff began installing “helping handles” and benches in the unit’s showers, removing top bunks from the beds and placing them on the floors and adding electrical outlets to cells in order to minimize tripping hazards.

After the six-month pilot project, officials plan to open similar units in five more state prisons.

But the new geriatric wards will stave off more costly measures only for so long. Soon, the state will need to construct a separate, fully functioning hospital for this population, complete with a dementia unit, a dialysis lab and other facilities and services for the aging.

According to a 2009 internal corrections department report obtained by the Missourian, "Funding for a specialized correctional facility is a serious challenge, but the real need for a specialized correctional facility needs to be considered; if not now, then in the future."

Corrections officials hesitated to give a cost estimate for the proposed geriatric prison, but a 780-bed unit for the aging and infirm built in Arkansas last year cost that state $60 million in construction costs alone.

Cost of incarceration

The Missouri Department of Corrections doesn't keep track of exactly how much it spends on older versus younger inmates, but the report by the Aging Offender Management Team asserts that it "would be more cost effective to expend taxpayer dollars in a Department of Corrections medical system rather than in a more expensive public facility."

But outside studies paint a different picture. According to the Pew Center on the States, the average annual cost of caring for elderly inmates in a correctional setting is about $70,000 — two to three times that of their younger counterparts. Alternatively, community nursing home placement costs taxpayers about $57,000 a year, much of which comes from Medicaid and Medicare, according to the Federal Interagency Forum on Aging-Related Statistics. Other community-based options such as electronic monitoring reap even greater savings, costing only about $3,600 a year.

There are several reasons it costs more to care for older inmates. Obviously, people on both sides of the razor wire require more medical attention as they age. However, those needs often are exacerbated within a prison setting. Medical and corrections officials say that due to a variety of factors — including backgrounds that often include drug and alcohol abuse, high-stress lifestyles and a chronic lack of proper medical care — prisoners tend to age more quickly than people on the outside.

This is one reason most state corrections agencies classify inmates as "geriatric" at age 50 or 55, the common age when inmates' health begins deteriorating.

A shortage of infirmary beds adds to the fiscal strain. Chronically ill inmates and those suffering from dementia or Alzheimer's disease are assigned to the infirmary, where nurses can keep a close eye on them.

There are only 211 prison infirmary beds available throughout the state. When they are filled, inmates who become ill must be strip-searched, shackled and sent to public hospitals. They are escorted at all times by one to three corrections officers. In 2008, Missouri prisoners made about 12,500 such trips, racking up additional transportation and overtime bills.

All told, the corrections department paid officers $5.5 million in overtime last year. Officials hope the new geriatric units will reduce some of this burden and allow more medical care inside prisons.

Truth and consequences

The growth in the state's aging and overall prison population has been driven not by an uptick in crime but by state sentencing policies, including:

  • The 1979 capital murder statute, which required convicted murderers to serve 50 years before being eligible for release.
  • The 1984 first-degree murder statute, which removed parole eligibility altogether.
  • The 1994 Truth in Sentencing Act, which required certain offenders to serve greater percentages of their sentences before being eligible for parole. This act also imposed heftier mandatory minimums for more crimes across the board.

As a result of these and other "tough on crime" statutes, the state's prison population has grown six-fold since 1979. Meanwhile, the elderly inmate population has grown disproportionately, from 4 percent of Missouri’s prison population in 1990 to 15 percent in June 2010.

Judge Wolff said that when the laws were written, few if any legislators pondered their financial repercussions.

"I'd challenge you to find one," Wolff said, adding that legislators often tout their "tough on crime" credentials during an election year, when a harsher stance toward crime and punishment is invariably seen as a political advantage.

"But I don't think the public is really all that keen on spending hundreds of millions of dollars on running nursing homes in prison for old — dare I say — harmless guys," he said.

Not that making convicted killers pay for their crimes isn't a "legitimate consideration," Wolff said. "But if ‘just dessert’ becomes extraordinarily costly and doesn't provide any benefit to public safety then is it worth it? I mean, just dessert isn't free. It might be the cost that we have to pay, but it is certainly an issue we have to think about."

Second-degree murder is the most common offense for which long-termers growing old behind bars are serving time. Among newly admitted older inmates, a population that also is growing, the No. 1 offense is possession of a controlled substance.

Wolff heads the Missouri Sentencing Advisory Commission, an independent body that monitors the effects of the state sentencing structure and recommends evidence-based reforms. So far, none of the commission's recommendations have become law.

"The legislature does policy, and they have to figure it out," Wolff said. "They have to decide how much money they want to spend on prisons and how much they want to spend on schools."

In recent years, at least one bill that could have reduced long-term prison sentences was introduced in the General Assembly. That bill, which would have required the Board of Probation and Parole to periodically review the cases of offenders serving life without parole, was sponsored by state Rep. Mike Talboy, D-Kansas City, in 2008. It never made it out of committee.

Jack Lindsey wrote up a bill himself in an effort to open an avenue for lifers to petition for parole after serving 30 years of their sentences. He sent his bill to various state legislators but said no one has expressed interest.

Lower recidivism risk for older inmates

Lindsey said he is deeply remorseful for what he did in 1978, when he shot and killed St. Louis County deputy Terry Thomas O'Connell. O’Connell, who was a newlywed with two stepchildren at the time, had pulled Lindsey over for a traffic violation. Lindsey said he was high on LSD, was already facing drug charges and panicked.

"I didn't even know this officer,” Lindsey said. “It was just wrong place, wrong time. There aren't many days that go by when I don't think about it. But you can't change things no matter how much you'd like to."

Nonetheless, Lindsey said he thinks he and others like him deserve a second chance. "Contrary to what the public believes, there are guys in here who made a bad decision in life, but they're not all bad people.”

His brother, John Lindsey, a union representative, said Jack Lindsey was suffering from severe post-traumatic stress disorder at the time of the murder and was using and selling drugs as a coping mechanism. The combination of these factors, he said, is what led to the crime.

"He's told me things between brothers, and I know he's clear in his conscience," he said. "That's not who he is."

If his brother were released today, John Lindsey said, he'd have his choice of family members to stay with and would have help finding a job.

"Believe me, he's got a lot of people who love him, and he would be just fine," he said. "We would do about anything to get him home before my parents pass away."

Across the country, older inmates pose a much lower risk of recidivism than their younger counterparts. According to Missouri Department of Corrections data, people released from prison at age 20 or younger have a recidivism rate of 23 percent for new crimes after two years. For those older than 70, only 3.5 percent commit new crimes.

But there remains the question of whether someone who took a life ever deserves to have his or hers back. Those close to victims of violent crime are often among the first to oppose any possibility of early release, regardless of perceived threat or cost to the state.

The family of deputy O'Connell could not be located for this story, but Sgt. Kevin Ahlbrand, president of the Missouri Fraternal Order of Police, said the organization would oppose parole for Lindsey or any other person involved in the death of a police officer.

"We believe in truth in sentencing," he said.

For now, Lindsey focuses his energy on things like his gardening projects. A year or so ago, he started harvesting seeds to send to homes for at-risk veterans as part of the state's restorative justice program. He now teaches younger inmates how to do the same so that they can expand the program.

He said he'd also like to send seeds to senior centers on the outside and to facilities for juvenile offenders so they can start gardening projects like the one he’s helped nurture at the Jefferson City penitentiary. He said he thinks it would be good therapy for the kids and it might give some of them the chance to turn their lives around.

Still, Lindsey likely will end up in a prison geriatric ward one day, and perhaps eventually in the yet-to-be-built specialized facility for aging inmates. He said he tries not to think about that.

"I try to keep myself busy,” he said. “That way you don't sit around and dwell on, ‘I’m never going home. Oh, God, what am I going to do?' You try to keep yourself focused on positive things."

The reporting for this story was supported in part by a grant from the Soros Justice Fellowships program of the Open Society Institute.

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James Fairchild January 27, 2011 | 11:40 a.m.

"Judge Wolff said that when the laws were written, few if any legislators pondered their financial repercussions".

Really. No one calculated that incarceration for 20 years would be double that of a 10-year sentence...ignoring inflation?

Over-zealous legislators forced the judicial system into this problem. Now they want to dump prisoners into the public situation to avoid paying medical expenses. And where do they expect them to go, get a job, access medical care...(e.g. simply slip back into society)?

It may cost 70K to provide a prisoner with medical care in the conventional system. That is expensive. However, two things are clear: 1) the legislature created this problem, and 2) the legislature must fix the problem. You cannot send these prisoners into a private nursing facility. In addition, you cannot dump them into the streets.

The state needs to construct alternative medical care facilities with lower security costs for these prisoners.

They also need to re-evaluate the statutes as the article states for crimes such as drug possession and non-violent crimes.

The real problem here is we have many legislators ran for office to rubber stamp decisions without any real thought on consequences. And they think puppy mills are complicated issues.

(Report Comment)
Paul Allaire January 28, 2011 | 11:23 a.m.

Maybe they might try not holding people for multiple months for failure to appear for a traffic ticket or for failure to pay fines on time and such. I have no sympathy for the state.

(Report Comment)
Teresa Woolery October 21, 2011 | 6:49 a.m.

My husband was sentence to 6 years on a Class C felony for a nonviolent crime. The judge ordered a SAR report it was reccomended a max sentence of 3 years. This was judge Rolf in Lexington, Mo. My husband for several months passed there UA tests and hair folicle tests. He was innocent and it was proved. Judge Rolf threw away the eveidence because he said he didnt like my husbands attitude when he didnt have an attitude. Then judge Rolf sentenced him to 6 years because he didnt like him. You tell me what kind of honest judge would do that. Judge Rolf is not an honest judge as he said in one of his statements to the media. Do we really wnat this kind of judge in the system. Come to find out after the sentencing our attorney Kelly Rose was also a judge in Lexington, Mo. This was not told to us prior to hiring her. My husband was railroaded by these to judges. No one really has any rites these days. This is the reason our prisons are overpopulated. My husband and I were married June 3, 2011 he was sentenced to prison July 6, 2011. We cant even have a life together because of this neglegeance of these Missouri Judges being dishonest. My husband has a rite to his freedom. He is innocent

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