October 30, 2013

Maine curbing per-prisoner health care costs

A study also shows huge increases elsewhere, including a 300 percent rise in New Hampshire.

By David Hench dhench@pressherald.com
Staff Writer

The Maine Department of Corrections had the highest per-prisoner health care costs in the nation in 2001 but was able to reduce costs significantly in the following seven years, according to a Pew Charitable Trust study released Tuesday.

Interactive map: Inmate health care expenses by state
Click below to compare how much money states spend on inmate health care.

Maine was one of only a handful of states that saw its per-prisoner health care costs go down in the 2001-2008 study period. The state’s annualized spending per prisoner dropped 13 percent over that time, from $7,762 to $6,740, the study said.

Meanwhile, some other states saw huge increases, including New Hampshire, where the per-prisoner costs rose 300 percent to $9,055, according to the study.

The costs of health care generally and the overall costs of corrections have both been increasing rapidly in recent years across the country, the study’s authors said. One of the significant drivers is the cost of mandated health care.

Key factors in prison health care spending are the high rates of mental health and substance abuse among inmates, a generally low quality of health among the people who are sentenced to prison, and an aging prison population.

The Pew study examined changes in correctional health care spending over the eight years and analyzed what some states did to effectively control those costs.

The cost-saving measures include compassionate release, which is a furlough for elderly prisoners with serious health problems, so their health care costs can be covered by other programs, such as Medicaid.

Another strategy is enrollment of prisoners in Medicaid whenever care is to be provided outside the prison. Federal rules prohibit Medicaid from covering medical services inside prisons or jails.

Some states, including California, saw their overall spending on prison health care surge over the study period.

Maine’s overall state prison spending for health care increased 6 percent, from $12.9 million in 2001 to $13.8 million in 2008. Meanwhile, the number of state prisoners climbed by 30 percent, from 1,735 in 2001 to 2,257 in 2008.

State officials said they could not vouch for the validity of the Pew figures, which were taken from U.S. Bureau of Justice Statistics reports. Scott Fish, spokesman for the Department of Corrections, said the state currently spends $18.8 million annually on health care for 2,194 prisoners. Those numbers average out to $8,204 per prisoner.

A spokesman for the Pew Charitable Trust said it is likely that the federal government included different spending categories than the state’s current figures.

Maine has experienced the aging of its prison population, which adds to health care costs.

Last year, Maine had 169 prisoners older than 55 – 8 percent of the total of 2,022 state prisoners at the time. Ninety-six inmates were older than 60, double the number in 2005.

Steve Lewicki, coordinator for the Maine Prisoner Advocacy Coalition, said prison advocates support an expansion of compassionate release, which has historically been underutilized, and see possibilities in improved health care by better utilizing Medicaid.

Lewicki said that under the prison system’s new health care provider, Correct Care Solutions, complaints have gone down and the quality of care has increased.

“That said, there still remains problems with health care services in Maine prisons,” he said.

Lewicki said the aging prison population reflects the demographics in the “free world” – where Maine has the oldest population in the country – as well as mandatory sentencing as part of a “get tough on crime” approach.

The result is an older and sicker prison population.

Lewicki said prisons should look at strategies for keeping prisoners healthy. He said he was told once that one in three prisoners at the Maine State Prison had some type of diabetes. The state should focus on health changes like improved diet that would reduce such chronic conditions, he said.

(Continued on page 2)

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