RD240 - Assisted Living Facilities for Geriatric Inmates


Executive Summary:
In accordance with the 2008 Appropriations Act, Item 387-B the Department of Corrections and the Virginia Parole Board have analyzed the comparative costs and benefits of state operation compared to contracting for privately operated assisted living or nursing facilities for geriatric offenders. The report first reviewed how to define the “geriatric” inmate. Second, the geriatric release mechanisms for older inmates were explored. Finally, the comparative costs and benefits of state operation compared to private operation of geriatric facilities were considered.

Geriatric release application in Virginia is limited to offenders who have not been convicted of Class 1 felonies and either (1) are at least 60 years old and have served at least 10 years of their sentence, or (2) are at least 65 years old and have served at least 5 years of their sentence. The Parole Board reviews all geriatric release applications. However, relatively few apply. Truth-in-Sentencing offenders who are not normally parole eligible, have to petition the Parole Board to be considered for geriatric release. Since there will be increasing numbers of such offenders eligible in the future, an automatic review of these cases might result in more geriatric releases. The nature of the offenses committed by geriatric inmates and concerns for public safety are the most common reasons stated by the Parole Board for not releasing those that apply for geriatric release. Even if released, reentry for these offenders is difficult. Without families or nursing facilities willing to take these offenders due to their offenses, placement in the community is a problem. It is recommended that legislation to form a joint committee to study the issue of reentry for geriatric offenders be enacted.

A comparative cost assessment of Richmond area private nursing homes versus Deerfield Correctional Center, as the Department’s representative example of a geriatric/special needs facility, revealed that the Department is the least cost care provider. In general, health care costs for geriatric inmates are higher than for the younger inmate. This is true whether provided in the Department or in the Community; the main difference being the source of revenue used to support such care. In the Department, general funds are used and in the community, the federal tax dollars that support Medicare and Medicaid would be used. The average 2006 nursing home costs of $56,940 to $66,430, do not include hospital care, and is twice the per capita cost of housing an inmate at Deerfield ($25,395), which does include hospital care. Contracting for privately operated assisted living or nursing facilities for lower risk geriatric offenders is difficult. There are limited public facilities for geriatrics in the community. Many of these for profit facilities have long waiting lists and many do not accept offenders. Since the Parole Board is not likely to release many offenders on geriatric release because of the nature of their offense, and many geriatric offenders have no family or outside support to go home to, it is more likely that the Department is and will be the place of last resort for many geriatric inmates.

The Department is able to provide diagnostic and disease prevention/care less expensively than the private sector and therefore has recommended to the General Assembly a statewide correctional medical center. The Department is providing geriatric inmates with the services needed in a much more cost effective manner than private nursing home care would cost, even if it could be secured.