CARSON CITY, Nev. (AP) — One of the things lawmakers didn't see coming in the mid-1990s, when they passed the "truth in sentencing" legislation, was the long-term impact on prison costs and population.
Truth in sentencing translates to longer, harder sentences for a wide variety of crimes. That means a larger overall prison population in the state and a progressively older inmate population.
And that means growing medical costs, given that the majority of inmates didn't live the healthiest of lifestyles before they were incarcerated.
Charles Schardin, medical administrator for the Department of Corrections, said that at this point, just 5.8 percent of the 13,000 inmates in Nevada's prison system are 60 and older. But they consume 20 percent of the medical budget.
For fiscal year 2013, the average annual medical cost per inmate younger than 60 was $739. The average cost for those between 60 and 69 years old was $3,399.
As of last count, there were 759 inmates older than 60 in the system, most of them in their 60s. But there were 14 in their 80s and, until recently, one inmate in his 90s.
That is changing, Schardin said.
"The population projections will be flat the next 10 years, but because of the sentencing structure, the average age of the population will continue to creep up," he told the Nevada Appeal (http://bit.ly/1gL1GWr).
Not only will they be older, they bring with them more medical problems than the average person on the outside.
"We get inmates coming in that have chronic conditions that have not been treated," Schardin said. "This population tends to be older than their age."
Those conditions include high blood pressure, diabetes, heart problems and other serious issues, he said.
Not only that, there are logistics problems for the state's wardens, who must keep older inmates safe in a population that includes a large number of young and potentially violent prisoners.
Former Director of Corrections Howard Skolnik saw the problem coming five years ago, warning lawmakers they would have to help the system deal with growing numbers of seniors in prison. Skolnik said his best solution was to turn the women's prison in North Las Vegas into a geriatric prison. He pointed out that it's all on one level — there are no stairs — and about the right size to handle that population. Lawmakers didn't go for the idea.
The department's answer, at this point, is True Grit, a program that manager Mary Harrison calls "a comprehensive, structured living program for geriatric prisoners."
She said True Grit has expanded dramatically in recent years.
"There are now about 170 in the program and a waiting list of about 50 from all over the state, including Ely (Nevada's maximum-security prison)," she said.
True Grit is in one unit at Northern Nevada Correctional Center in Carson City.
One reason the program is at NNCC is that's where the system's regional medical facility is.
"We do a lot of medical runs," said Warden Isidro Baca.
If those inmates were in other prisons, they would have to be taken to outside hospitals in cases of emergency.
"That's part of the reason this population is here," he said.
The men in True Grit live together with other inmates 55 and older. They are segregated from the younger and more violent prisoners and are in mandatory work and counseling programs.
Even when they go into the yard, they are exposed to inmates who are at the same security and risk levels they are, Baca said.
"There is a younger population we keep here," he said. "They're not exposed to each other."
He said that for the most part, NNCC has an older population than Nevada's other institutions.
"The younger, more violent, we send those guys to other yards," he said.
Harrison said True Grit has a strong positive effect on older inmates' lives. They're with their peers, working, exercising and, many of them, preparing for life on the outside. Their programs range from psychological, drug and alcohol counseling to crocheting, music classes, creative writing, choir and programs from the Veterans Administration including for Post-Traumatic Stress Disorder.
"We're getting them so they're not lying in their beds; they're not on antidepressants," she said. "They're recovering."
Harrison said there is a surprisingly large contingent of veterans — mostly Vietnam War veterans — in the program.
She said those in True Grit also are improving their chances of getting parole.
"Before, a lot of them were not getting paroled because they weren't in programs and weren't taking responsibility for their offense," Harrison said.
Now some are getting paroled, and they're also more prepared for life outside.
Some, however, have life sentences and will not get out.
"But even if they're not ever getting out, they're taking care of themselves," she said.
Schardin said inmates getting healthier mentally and physically is also relieving stress on his hospital.
"Before the program, a lot of these guys were housed in the regional medical facility, taking up infirmary beds," Schardin said.
There have been a number of attempts to loosen the rules imposed under truth in sentencing.
During this year's legislative session, there was a proposal to allow inmates with some more serious felonies to accumulate good-time credits and speed their eligibility for parole if they were in for a nonviolent crime. That legislation did not pass.
Information from: Nevada Appeal, http://www.nevadaappeal.com