Hawaii's correctional facilities grapple with a 'silver tsunami' - Hawaii News Now - KGMB and KHNL

Hawaii's correctional facilities grapple with a 'silver tsunami'

An imate at the Halawa prison guides an empty wheelchair toward the hospital's medical facility. (Image: Hawaii News Now) An imate at the Halawa prison guides an empty wheelchair toward the hospital's medical facility. (Image: Hawaii News Now)
Hawaii News Now's Mahealani Richardson talks to inmate Sione Tilini, an aide who assists elderly prisoners. (Image: Hawaii News Now) Hawaii News Now's Mahealani Richardson talks to inmate Sione Tilini, an aide who assists elderly prisoners. (Image: Hawaii News Now)
HALAWA (HawaiiNewsNow) -

The state's population is aging, including behind bars.

Nearly 1 in 6 inmates at Halawa Correctional Facility, the state's largest prison, are over 55. Some 13 percent of all Hawaii inmates are 55 and up.

And a full 5 percent of the more than 1,000 inmates at the facility are disabled due to age, mobility or 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 situation is contributing to rising health care costs for Hawaii prisons, already grappling with overcrowding and backlogged repairs, and to growing questions about how corrections officials should handle inmates as they encounter age-related chronic diseases, from diabetes to dementia.

And, officials note, inmates "age faster" than the general population. The rule of thumb: Add 10 years to the life of someone behind bars.

The state Department of Public Safety says age-related medical costs — and a growing inmate population — are already driving up its $24 million health care budget for prisons and jails.

And the situation isn't new.

A 2014 study estimated Hawaii's per inmate spending on health care rose 8 percent from 2007 to 2011, thanks in large part to aging inmates' greater health needs.

Hegmann noted that specialized care for inmates, such as dialysis, is all the more difficult (and expensive) because of the added costs of security and transportation.

“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."

At Halawa Correctional Facility, inmates in wheelchairs and older inmates are typically kept together.

It's safer that way, Hegmann explains.

And those too sick to be without constant care are kept in the infirmary, whose 12 beds are for those with short- and long-term issues.

“If a person is really disabled physically or mentally, they would be housed in our infirmary,” he said. 

The state prison system has six doctors, six psychiatrists and three nurse practitioners.

But it also uses those behind bars to help disabled inmates with personal care.

Sione Tilini, 29, is an inmate aide from the Big Island. He's serving the second year of a 10-year sentence for negligent homicide, and 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's 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’s on the state’s prison task force, said it's 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," he said. "Private nursing homes won’t accept them and we don’t have any state facilities set up to accept them."

There is a process for compassionate release of an inmate who is no longer a danger, but that can take years.

Kat Brady, coordinator for the Community Alliance on Prisons, said no one's arguing that people shouldn't be incarcerated.

"But 'how long' is the question," Brady said. "And why would we incarcerate someone who is unable to do mischief in the community because they are so ill?"

Hegmann doesn't disagree.

“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."

Hegmann said Hawaii has one of the most progressive medical release processes in the country — at least on paper.

And he said he doesn't see the people he treats as inmates. He sees them at patients.

“You are helping people that may have not been helped before,” he said.

Copyright 2017 Hawaii News Now. All rights reserved. 

Powered by Frankly