Almost 500 people incarcerated in New Jersey are age 65 or older. Some have diabetes, heart disease, COPD, cancer, kidney failure, among other medical problems, as well as a host of mental health issues. Dozens die in prison each year.

Studies show that prison can age an individual by as much as 15 years, so advocates and national studies look at those age 50 and older when they discuss aging inmates. Last year, two in 10 people in New Jersey prisons were at least 50 years old, for a total of 2,600. That’s almost double the proportion of a decade earlier.

The New Jersey State Parole Board does not appear to take age into consideration when deciding whether to release inmates. A review by NJ Spotlight News of inmates 65 and older found dozens likely denied parole at least once. Many have been denied parole multiple times, that analysis showed. One 70-year-old inmate convicted of murder who has been incarcerated for nearly half a century has been turned down 11 times.

Advocates and experts say prisons were not designed for elderly inmates and are not equipped to handle their special needs. Yet the war on drugs, mandatory minimum sentences and a parole system that does not tend to release people convicted of violent crimes — even when the data suggests they are unlikely to reoffend — is forcing correctional facilities to keep inmates longer and try to meet the needs of seniors behind bars.

They don’t always do it well, advocates say.

“The treatment is inappropriate … “It’s awful.” said Bonnie Kerness, head of the American Friends Service Committee’s Prison Watch Project who was recently named to the board of trustees of the Edna Mahan Women’s Correctional Facility.

What inmates have said

She said she heard from one man who is paraplegic yet was denied access to a wheelchair to enable him to take a shower. Another man has a feeding tube, yet a staff member pulled the tube out and began to feed him orally, which landed him in hospital. A man who needs kidney dialysis has been inappropriately cuffed, first in metal cuffs that hurt him because of swelling in his limbs and then in soft cuffs that are fastened too tightly when he is taken to hospital two or three times a week.

A woman in her late 60s serving time at the Edna Mahan Correctional Facility for Women has had several health issues, including diabetes. She has only recently begun feeling better after months of trouble with doctor visits and medication. The woman, whose name NJ Spotlight News is withholding because she fears potential retribution, said the prison infirmary lacks proper heat, sheets, blankets, pillows and toilet paper and that staff “give wrong medications all the time.”

Advocates, including former inmates, agree.

“It’s hard to get to the hospital; if it’s not an emergency, you’re not going,” said Ali Mays, who is 70 and spent 30 years incarcerated in several New Jersey prisons before being released in 2019 on completion of his sentence. He had cancer while incarcerated. “If you really need to get to the hospital, it takes a long time for them to get you out to the hospital. They could leave you in your room for hours. And if somebody’s not strong enough to make it, then they’ll die. I have seen many, many people die in prison.”

He described seeing a man who had a stroke die while a corrections officer tried to help him as hospital staff “who were supposed to help him” stood by.

“That’s pretty traumatic for the people who are experiencing it and watching it,” he said. “It could be you.”

Liz Velez, a spokeswoman for the state Department of Corrections, said deaths occur in prison as they do in the community, mostly from chronic medical illnesses. She said 62 people died in custody in 2009, 44 in 2019 and 82 in 2020, including about 50 deaths of inmates who contracted COVID-19. The average age at death increased from 52.9 in 2009 to 60 in 2020, Velez added.

Rutgers ‘provides chronic care clinics’

The department pays Rutgers University Correctional Healthcare to provide both medical and psychiatric care to all inmates and offer hospitalization when the prison infirmary cannot provide the specialized care needed.

“RUCHC provides chronic care clinics to address these conditions, regardless of age, to lessen the impact of these illnesses over time,” Velez said. The most common causes of death include hypertension, coronary artery disease and elevated lipids, asthma, COPD and diabetes. Other conditions include hepatitis, HIV/AIDS, cancer, neuropsychiatric diseases and kidney disease requiring dialysis. “All of these are addressed through chronic care clinics in NJ DOC.”

“The Health of America’s Aging Prison Population,” published in March 2018, listed a host of conditions common to older inmates. They include diabetes mellitus, cardiovascular conditions and liver disease. Mental health issues were common, particularly anxiety, fear of death or a desire for death or suicide and depression. Vision, learning and hearing impairments were also relatively common, as were difficulties with mobility or performing such routine daily activities as bathing, dressing and feeding oneself.

“Older incarcerated individuals require a different level of care than do younger incarcerated individuals, because of increased comorbidity burden and physical and cognitive disabilities,” the study’s authors wrote. Their findings also said that older adults were the fastest-growing demographic in prisons because of the imposition of longer sentences and a reduction of parole or early release because of strict “tough on crime” laws.

The study found that “efforts to prevent disability are generally nonexistent” and prison staff are often reluctant to give the incarcerated such assistive devices as walkers or canes “because they may be used or perceived as a weapon.”

Older and sicker

Several federal laws require prisons to meet the needs of ill and disabled inmates, said Alexander Shalom, an ACLU-NJ attorney, but the older and sicker the prison population becomes, the harder it is for officials to provide good care.

“Most certainly they are not prepared to deal with lots of people with lots of challenges, it’s not something that’s in their wheelhouse,” Shalom said. “As the percentage of people who are ill or infirm goes up, the ability of officials to deal with them grows more challenging.”

But while the number of people incarcerated in New Jersey prisons has plummeted, the amount the state spends on corrections has not dropped proportionately. That’s in part because older prisoners require more expensive care.

It costs roughly $1 million to keep an individual imprisoned for life, with “expenses increasing precipitously after middle-age” because of increased health costs, a group of Black criminal justice and law enforcement organizations said in court papers. They were arguing on behalf of 85-year-old Sundiata Acoli who was convicted of killing a state trooper in 1973 in a high-profile case and since denied parole four times.


Credit: (The Sundiata Acoli Freedom Coalition)
Sundiata Acoli was convicted of killing a state trooper in 1973. He has been denied parole four times.

A report by the Sentencing Project on life imprisonment found a total of 1,715 people were serving life sentences or terms long enough to be essentially life in prison given their ages in 2020. Roughly eight in 10 were minorities and they represented 9% of the prison population at the time. But that percentage is likely higher now given the large number of inmates released by the state. Under emergency COVID-19-related orders that began in late 2020, the state has reduced the prison population by more than 5,000.

Higher costs

According to ”The Health of America’s Aging Prison Population,” higher disability rates for older inmates “contribute to overall health care costs estimated at 3-9 times greater than that of younger inmates.” Increased spending for better care “may be difficult to justify in prison budgets,” it states, noting there are savings to taxpayers when these older individuals are released from custody.

In their book “Aging Behind Prison Walls: Studies in Trauma and Resilience,” authors Tina Maschi and Keith Morgen report that some $16 billion, or about 20% of the $77 billion that states and the federal government spend on correctional facilities, pays for health care costs for older incarcerated individuals.

A fiscal note from the nonpartisan Office of Legislative Services on a bill (A-1059) said it could not estimate the amount spent on health care for older inmates in New Jersey. The total amount budgeted in the 2020 fiscal year was almost $167 million. As much as $30 million of that may be attributed to about 480 individuals age 60 and older.

“It is not possible to precisely quantify these costs due to a lack of data, but research suggests that healthcare costs of inmates 65 years and older would be two to three times that of the younger population,” the legislative analysis said.

Proposal for ‘geriatric parole’

The bill, which would provide “geriatric parole” for some inmates age 60 and older, would save an indeterminate amount in housing and health care that would no longer need to be provided, the analysis said. But there would be an unknown increase in costs to the parole board for hearing requests for parole and supervision of those released.

Assemblyman Gary Schaer (D-Passaic) said he is sponsoring the bill as “a way we are showing compassion” to older people who are incarcerated and unlikely to reoffend.

“People who have done wrong should be incarcerated, but it reaches a point where their incarceration does not serve anyone anymore,” he said. “At a certain point in someone’s life, no matter what their criminal background, they are no longer in a physical state to commit a crime again.”

Schaer’s bill would create a system of geriatric parole for those 65 and older who have served at least a third of their sentence and for those 60 and older who have served at least half of their sentence. The parole request would still have to be approved by the parole board. The measure would exclude those who have committed more serious or violent offenses, including murder, kidnapping, terrorism, sexual assault and racketeering.

“If they committed a crime of that level, there was tremendous harm and damage to another person. They still present that danger to the community,” Schaer said in explaining why some would be excluded from geriatric parole.

The measure passed the Assembly 60-12 in July 2020, four months after the outbreak of COVID-19 in New Jersey with about 50 prisoners having died of the disease. But it never got a hearing in the Senate. Schaer, who first introduced the bill in 2019, said COVID-19 “motivates me more to see this bill be passed.”

Advocates complain that these kinds of releases, as well as typical parole, automatically bar certain offenders regardless of their age or likelihood of reoffending because of crimes they committed when they were much younger.

Less likely to reoffend

Data shows that the older the individual, the less likely he is to reoffend. A brief filed by the American Friends Service Committee in the Acoli case cites a number of studies, including the state corrections department’s own data, to drive home this point.

For each additional year when an older an inmate is released “the odds that the person engages in future criminal behavior decreases by over 7%, independent of other factors such as prior criminal history and offense of conviction,” the brief states. “The criminological evidence does not support a finding that the seriousness of the offense suggests a likelihood of recidivism that would support the denial of parole.”

The corrections department’s 2015 recidivism report, the most recent available, states, “Inmates who were released after serving a sentence for a violent offense had the lowest rates of rearrest and reconviction. Inmates who served a sentence for a weapons offense had the lowest rates of reincarceration.”

Analysis of parole data

NJ Spotlight News reviewed information from the state Parole Board on some of the oldest and longest-serving inmates. That showed several had been denied parole more than twice. Besides the inmate who is imprisoned almost 50 years and denied parole 11 times, NJ Spotlight News found several other instances of elderly inmates denied release after several decades in prison. For example, a 75-year-old imprisoned for murder since 1978 has been denied three times. On the first denial the board set his next eligibility date for 22 years in the future; on the second denial, 20 years and on the most recent denial, 10 ½ years.

According to the Parole Board’s 2021 annual report, the board approved supervised release in about half the cases it heard. The report does not specify the types of crimes committed by those approved or denied parole.

But a report by the Office of the Public Defender Parole Project, issued last September, was critical of the parole process for repeatedly denying release to some individuals.

“The discretion bestowed by the Board unto itself … has arguably transformed the parole eligibility process into resentencing,” states the Parole Project’s revised report. “Occasionally the Board will repeatedly deny parole release and impose FETs (future eligibility terms) that exceed the length of prison-time contemplated by the sentencing judge.”

Tony Ciavolella, a spokesman for the Parole Board, said the board acts properly.

“All New Jersey State Parole Board decisions are made in accordance with relevant New Jersey statutes and Administrative Code provisions,” he said.

Republican lawmakers push back

There’s been pushback from Republican lawmakers over other state actions to show compassion to inmates, even those convicted of less serious offenses.

Earlier last month the state released 260 people early under a 2020 law that provides credits to those convicted of nonviolent offenses who are incarcerated during a public health emergency. Meant to stem the spread of COVID-19 and deaths inside prisons, the program has led to the early release of more than 5,400 inmates near the end of their sentences. An executive order Gov. Phil Murphy issued earlier in the pandemic led to some 420 vulnerable inmates being placed on temporary emergency medical home confinement to protect them from COVID-19. Despite being in the age category at greatest risk from severe injury or death due to the disease, senior prisoners comprised only about 1% — 58 individuals — of those released early under the initial COVID-19-related releases, according to state data.

“The virus is running out of steam. There is hardly any risk to keeping these criminals behind bars where they belong,” said Sen. Joe Pennacchio (R-Morris) as the state released additional people earlier this month. “There is absolutely no need to let even one more prisoner out of jail early.”

‘They might be safer in prison.’

Maschi, co-author of “Aging Behind Prison Walls” and a professor at the Fordham University Graduate School of Social Service, said public officials and policymakers don’t “want to go near” releasing people who have committed violent crimes because people are “traumatized” either because they have experience with violence or see it on the news.

“We’ve got the long-term sentences of the 70s and 80s, when we got stricter, more punitive and mass incarceration unduly impacted all the people going into prison,” said Maschi, who interviewed hundreds of older inmates in prisons in New Jersey. “So now we have the stockpiles in prison and we don’t know what to do and corrections is not prepared to deal with it. They don’t want them in there either. It’s the public and the attitudes about it … The glitch comes with the violent offenders, right, where they’re not covered. Now, if we only look at the offense, committed violence, what it does is instill fear in people.”

Prisons ‘built for a younger population’

Similarly, prisons are ill-equipped to handle the mental health and addiction challenges of older adults, said Keith Morgen, Maschi’s co-author, who is an associate professor of psychology at Centenary University in Hackettstown. He said prisons are “built for a younger population and the older population, depending upon their age and their co-occurring medical, psychological, addictive issues, may find themselves in a system where the supports aren’t really there for them … There are unique components of older adulthood that do lead to differences in symptom expression and at times, perhaps, the care being offered to individuals isn’t the best care because it’s not necessarily built for the unique needs of the older adult.”

On the other hand, Maschi said, there’s no guarantee that elderly individuals released from prison will get the medical care that they need — nursing homes, in some cases — outside.

“They might be safer in prison,” she added.

Not everyone agrees.

A number of current and former inmates said that people who need medication for diabetes, blood pressure, heart disease or other illnesses can’t always take it on their schedule because staffers do not always give medicines at the proper time.

“You have to argue for it. You have to fight for it,” said Ali, the former inmate.

Other times, medication is not administered properly, said Lydia Thornton, who spent four years at the Edna Mahan Women’s Correctional Facility and now advocates for the incarcerated. She said one man was recently released from Cooper Medical Center after having been hospitalized because he had been given too much anti-seizure medication.

“The level of medicine in his system was so high they had not seen levels like that before,” she said.

Few are given compassionate release

For those seriously ill who might benefit from receiving care outside a prison, New Jersey no longer has a medical release law with the parole board as a gatekeeper. It was replaced by a year-old compassionate release program that put courts in control over releases. The New Jersey Criminal Sentencing and Disposition Commission recommended the change, saying the state’s former medical release program was “rarely used” because it was too difficult for seriously ill individuals to navigate. Unlike medical release, compassionate release is available to those convicted of murder and other serious crimes. So far, only one person has been given compassionate release.

At least twice, judges have refused to grant releases.

‘Turning our prisons into nursing homes is bad public policy.’

An appellate panel last summer agreed with a lower court ruling to deny compassionate release to F.E.D., 72 and suffering from heart failure, because it disagreed with certificates issued by two doctors — as the law requires — proclaiming him to be permanently incapacitated. The state Supreme Court has agreed to hear an appeal of that decision.

Earlier this month, Superior Court Judge Ronald Wigler, sitting in Essex County, ruled that while 53-year-old Al-Damany Kamau, convicted of killing a police officer 29 years ago, is permanently incapacitated, the law still gave him the right to deny release and he chose to do so because Kamau deserves “zero compassion.” Kamau’s public defenders are working on an appeal.

Shalom of the ACLU called these denials “troubling” and said it was clear the Legislature changed the law to enable a greater number of releases in part because “turning our prisons into nursing homes is bad public policy.” He said that when people are dying or incapacitated and incapable of re-offending, the original crime a person committed should not factor into the decision to release him and lawmakers recognized that by allowing those convicted of murder and other violent crimes to be eligible for compassionate release.

The Acoli case

That question is key to another appeal, this one awaiting a ruling by the Supreme Court. The ACLU is one of several organizations that filed briefs and argued in favor of parole for Acoli, described by advocates as in the early stages of dementia and denied parole for the fourth time in 2017 despite being a model prisoner for decades. Most concerning in this case, Shalom said, is that the statute in effect when Acoli and JoAnne Chesimard shot two troopers after a traffic stop on the New Jersey Turnpike required that an inmate be released on parole when he became eligible unless “a preponderance of the evidence” showed a “substantial likelihood” that he would reoffend.

Thornton, who co-chairs New Jersey Prison Justice Watch, said it is the public perception of the correctional system that makes it harder for people to win release.

“The point of the Department of Corrections is not to correct, it is to penalize people for what they’ve done, in the eyes of much of the public,” she said. “Some people say anyone who uses a gun should never get out of prison.”

— Katie Crist contributed to this story.

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