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W.Va. spends more on prisoner health

Prison populations around the country are growing, requiring states to spend more on inmate health care each year.

West Virginia saw a 38 percent increase in prisoner health care spending between 2001 and 2008, going from $15.7 million to $21.7 million, according to a new report from the Pew Charitable Trusts.

That's much better than other states. New Hampshire saw a 379 percent increase in inmate health care spending, going from $5.4 million in 2001 to $25.8 million in 2008.

California topped the list of inmate health care costs in both 2001 and 2008, spending $981 million and $1.98 billion, respectively.

West Virginia's prison health spending ranked 36th out of the 44 states included in the Pew study.

Researchers identified three main reasons for the nationwide increase in prison health care costs: growing prison populations, aging prisoners and the overall rise in health care costs.

Having more inmates behind bars naturally leads to an increase in inmates with health care needs, which increases costs. But the nation's aging prison population also is causing significant problems for prison administrators.

Researchers found that from 2001 to 2008, the number of prisoners 55 or older increased 94 percent, from 40,200 to 77,300.

Meanwhile, the number of prisoners younger than 55 grew by 12 percent, from 1.3 million to 1.46 million, researchers found.

"Like older Americans outside prison, older inmates are more likely to have physical and mental illnesses," Maria Schiff, director of the Pew Charitable Trusts' state health care spending project, told reporters in a teleconference this week.

Schiff said the health challenges of aging prisoners is leading to some states to increase training requirements for prison staff, increase more medical services and even build special housing facilities. Some states are even looking to build prison nursing homes for its oldest and sickest inmates.

West Virginia Corrections Commissioner Jim Rubenstein said the trend is a little less drastic in the Mountain State, but still is occurring.

About 12 percent of West Virginia 6,800 prisoners are 55 or older. Ten years ago, only about 7 percent of the state prison population was that old.

Rubenstein attributed West Virginia's increased prison health care costs to an overall jump in the number of people in state prisons, however, not just aging inmates.

In 2001, there were 4,106 people in state prisons. By 2008, 6,097 people were in Division of Corrections custody.

Rubenstein said the prison system likely will request more money for medical services in next year's budget because of the 388-bed facility it plans to open in Salem.

"Ours has been more of a direct correlation of the growth and the additional beds," he said.

The Pew Report also found West Virginia's per-inmate health spending decreased by 4 percent between 2001 and 2008.

The state spent $4,439 per inmate in 2008, down from $4,623 in 2001.

Rubenstein said several different factors likely contributed to that drop.

He said the state worked with its prison health care contractor, Wexford Health Services, to find ways to control costs.

That included limiting trips to hospitals when prisoners' health issues could be addressed at prison infirmaries and providing some services -- dental work, optical services, and even medical tests like x-rays and electrocardiogram tests -- behind the prison walls.

Rubenstein said the prison system also has instituted a chronic disease management program.

"With proper management of chronic diseases, less complications occur," he said.

He said a 2007 law allowing the Division of Corrections to pay the same amount as Medicaid for health services also has saved money for the prison system.

The Pew Report also detailed ways states could save money on prisoner health care while still ensuring quality care and protecting public safety.

Schiff said Texas prisons have increased their use of "telehealth," Internet video chats between prisoners and primary care physicians and specialists. That saved the state about $780 million between 1994 and 2008.

Other states are enrolling prisoners in Medicaid, although the benefits of this plan are limited.

Medicaid does not cover health services delivered in prison, but can cover prisoners' costs at nursing homes or hospitals where they are admitted for more than 24 hours. This allows states to receive federal reimbursements for inmates' health care.

Schiff said some states are looking at special parole provisions for chronically ill or very old prisoners. California released 47 inmates on medical parole between 2010 and 2012, saving the state $20 million.

West Virginia law also allows for severely sick individuals to be paroled, although Rubenstein said the provision is rarely used.

Schiff said there is no easy fix to the health care spending costs facing U.S. prisons.

"There is no one size fits all solution to state's prison health care challenges," she said, urging lawmakers around the country to examine which options will work best in their states.

Contact writer Zack Harold at 304-348-7939 or Follow him at



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