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Private Prison Operators Enter Medical Care Market

As criminals receive longer sentences and serve a greater portion of them under threestrikes, truth-in-sentencing and mandatory minimum laws, the number of elderly prisoners with health problems has increased accordingly. Some consider this trend to be the result of a misplaced emphasis on incarceration as a solution to crime. Others view it as a profit-making opportunity. Several companies have opened a niche market of building and operating for-profit prisons specially designed to house aged and medically infirm prisoners.

In September, 1998, Alabama-based Just Care, Inc. opened the Columbia Care Center in South Carolina. Advertising the facility as "an alternative resource for medically dependent inmates," the company hopes to attract state, county and federal prisoners to fill the center's 326 beds. Six months after it opened, however, this private medical prison housed just two incarcerated patients.

The Columbia Care Center, a renovated state mental hospital, offers sub-acute, skilled, intermediate and hospice care for the ill and disabled prisoner, according to Just Care's promotional literature, and claims savings of 20-50% through reduced overhead and flat-rate (e.g. "managed care") fees. Although the center provides extensive medical services, Just Care notes that "security comes first" at the facility, which is surrounded by an electronically monitored 15foot fence topped with razor wire.

Just Care isn't the only player in the private medical prison market. Corrections National Corp. of San Antonio, Texas, plans to open a 700-bed facility in Clearfield County, Pennsylvania, within a year that will offer nursing, geriatric and hospice care for prisoners. And the behemoth ($3.2 billion) Corrections Corp. of America has operated the Correctional Treatment Facility, a Washington, D.C., prison for addicted and mentally ill prisoners, since 1997.

Corrections National Corp. and Just Care plan to expand their operations, counting on steadily increasing numbers of elderly prisoners who tend to have more health problems. According to the Criminal Justice Institute, the two companies may be correct; the percentage of the prison population age 50 and up grew from 4.9% in 1990 to 6.8% in 1997. The number of elderly prisoners is expected to reach 225,000 by the year 2005.

Moreover, prisoners of all ages are more prone to debilitating illnesses due to histories of substance abuse, poverty and poor health care and hygiene. "It's mostly because of their abusive lifestyle," says Tish Smyer, a professor at the South Dakota State University College of Nursing who is conducting a study on medical care for elderly prisoners. "These are high-risk people. Lots of hepatitis C, cardiac problems, diabetes, all the normal chronic ailments except for more drug abuse and sexually transmitted diseases."

The greater the increase in elderly, ill and disabled prisoners, the greater the profit potential for private medical prison operators. Norm Cox, founder and president of Corrections National Corp., hopes to open four 500- to 1,000-bed secure health care facilities in the next five years. Just Care plans to open fifteen such facilities over the same period.

Ken Faiver, a corrections consultant in Lansing, Michigan, acknowledges the existence of a market for privately- operated medical prisons but cautions that doesn't guarantee success.

"There's a need out there, no question about it," says Faiver. "But you could lose your shirt if you go out and find there's not much acceptance of your product. Need is one thing, but will it be politically acceptable?"

Sources: The Philadelphia Inquirer; Just Care, Inc. promotional brochure.

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