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FL's Aging Prisoner Problem, Florida Tax Watch, 2014

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September 9, 2014
Dear Fellow Taxpayer,
Florida’s prison population is among the largest in the United States, and disproportionately
large, given the state’s population. Furthermore, estimates show that the population will
continue to grow much faster than other similar states in the foreseeable future. As the
state’s prison population rises, it will be accompanied by ballooning costs, especially health
care costs, that are already overwhelming the Florida Department of Corrections (DOC), and
creating crippling costs for taxpayers.
Previous Florida TaxWatch research has produced constructive policy recommendations
that would safely reduce the prison population. These policies have been shown to
be effective at reducing costs in other states without jeopardizing public safety, and, if
implemented by the Legislature and Governor, would help address many of the issues
facing Florida’s taxpayers.
However, the sheer number of inmates is not the only concern. As prisoners age, they put
a severe strain on the state budget, largely due to the high costs of providing health care
to long-term, elderly, and infirmed inmates. Florida’s current criminal justice policies tie the
hands of the DOC and keep the taxpayers of Florida financially responsible for housing and
caring for infirmed inmates incarcerated after they are no longer a threat to public safety.
Once again, other states and the federal government have faced similar issues and forged
policy solutions. The path they have laid can be followed to benefit Florida taxpayers.
Florida TaxWatch has examined options for the DOC to reduce the costs of the existing
system and providing increased security for our communities by reducing crime and
recidivism rates, all without harming public safety. Past recommendations have included
examining sentencing reform, vocational, educational and liftestyle training, and reentry
and reintegration programs. To solve the current health care spending concern, this Florida
TaxWatch report analyzes this cost driver and provides recommendations to reduce the
elderly prisoner population, saving taxpayers’ hard-earned money without compromising
the safety of Florida communities.

Dominic M. Calabro
President & CEO


Florida passed very tough crime laws in the 1990s. Drug wars,
tourist murders, and the shooting deaths of law enforcement
officers spurred legislators to adopt strict sanctions for crime
which removed parole; required 85 percent sentence
completion; added mandatory minimum sentences for drugs
and violent crimes; lengthened sentences for habitual
offenders; imposed 10/20/Life punishments for gun crimes;
and added involuntary civil commitment for convicted sex
predators. Life felonies, which previously included parole
review hearings, now carry life without parole (LWOP)
sentences. This development is particularly important in
Florida, one of three states where a jury of six, instead of 12,
can sentence a convicted felon to Life Without Parole (LWOP).1
These strict criminal justice policies had immediate and longterm consequences on corrections issues in Florida. The
general prison population shot up dramatically, the length of
sentences increased, and the number of prisoners with LWOP
sentences rose to the highest in America. Elderly prisoners, no
longer paroled when advancing age renders them a low risk,
remain in prison cells.
These changes have brought to the forefront urgent issues
that must be addressed for Florida’s taxpayers. As the average
age of the prison population rises and the number of elderly
prisoners multiplies, the cost of lenthy sentences and prisoner
healthcare needs threaten a substantial rise in Florida’s
Corrections budget; however, there are options for reform that
may help keep costs from overwhelming taxpayers.

1 Florida law permits a jury of six to impose a LWOP sentence. Connecticut and Utah
are the only other states to allow six-member juries to sentence to LWOP. See, “Bill
Would Double Jury Size for Life Felonies,” The Florida Bar News, April 4, 2014. See also,
Senate Bill 98 “Bill Analysis and Fiscal Impact Statement,” February 11, 2014.



Florida’s Prison Population
Defined in Florida Statutes as those prisoners within the Florida Department of Corrections
(FDOC) system over the age of 50, the elderly prisoner count increases every year, by an
average of greater than 1,000 prisoners. The tables to the right show that between 2000
and 2014, the elderly prison population grew from 5,605 to 21,002, at an average increase
of 9.9 percent per year, a

Historical Florida Prison Population
Including Specific Age Groups2

rate more than three times
higher than the general prison


Prison Pop



Total 50+






Furthermore, the chart shows






that while the overall prison


























102,000 prisoners, the elderly






prison population has grown



























population growth in Florida
has steadied out during the
last 5 years at about 100,000–

by more than one third (38
percent) in the same time
frame, and has yet to find a


As of June 2014, the data show
that Florida has 5,694 prisoners











* Data from 2014 taken from June 10, 2014 estimates.

at least 60 years of age, 1,091 prisoners at least 70 years old, 130 octogenarians, and 10
nonagenarians.3 Among the octogenarians, 40 percent were sentenced to terms of years
as opposed to life without parole, and 19 have release dates in the next 3 years. Florida
also has two prisoners aged 92, who rank at the top of the oldest prisoners in the US.4
Further evidence of the graying of Florida’s prisons is demonstrated by analysis of the
average age of prisoners (chart, next page). From 1996 to 2013, the median and mean
ages have both increased significantly, and the mean age has increased more than the
median age, indicating a shift to an increasingly older population.
2 Corrections Offender Network: Offender Information Search, Florida Department of Corrections, June 10, 2014.
3 Ibid.
4 Drayton Curry, 92, Nation’s Oldest Federal Prisoner: Obama AWOL on Clemency Request,” The Village Voice, Sep 2011.



Average and Median Age
of Florida Prisoners

To gain a full grasp of the prison population


Average Age








Going back to 2000, Florida’s total population was just




under 16 million, while New York’s was just under 19







million.5 Both had equivalent prison populations of







Fourteen years later, Florida and New York have







nearly identical total populations, but Florida’s













Florida, all of which is directly attributable to different




philosophies on criminal justice.8










Florida leads the country with almost 8,000 prisoners




sentenced to Life Without Parole (LWOP),9 and no

Source 2009-2013: “Agency Statistics:
Inmate Population - Current Inmate Age”,
Florida Department of Corrections, June 30th
estimates, 2009-2013.
Source 1996-2008: “Annual Report: Inmate
Population on June 30th - Current Inmate Age”,
Florida Department of Corrections, 1996-2008.

explosion in Florida from a population and prison
count, a comparison to New York is appropriate.

about 70,000.6

prison population is 102,467, while New York’s
prison population is 54,600;7 and there are 9,200
elderly prisoners in New York compared to 20,680 in

A 2012 study by The Sentencing Project reported that

other state is close.
By comparison, Texas had 538, and New York only
246. By June 2013 the number of prisoners in Florida
with death or life sentences stood at 12,667. As would
be expected, the increase in life sentences and terms
of years is keeping prisoners behind bars into their
senior years, leading to the substantial increase in
elderly prisoners shown above.

It is not just the increased life sentences which are driving prison populations up. As a result
of Florida’s tough-on-crime laws, the length of prison sentences in Florida has increased
more than any other state.10
5 Population Distribution and Change:2000 to 2010. U.S. Census Bureau 2010 and Census 2000.
6 State of Recidivism: The Revolving Door of America’s Prisons, Pew Center on the States, April 2011.
7 New York State Department of Corrections and Community Supervision Announces prison Reforms That Will save Taxpayers
more than $30M Following Decline in Crime rate and Inmate Population,” July 26, 2013.
8 “If the Risk is Low, Let them Go”: Efforts to Resolve the Growing Numbers of Aging Behind Bars, Truthout January 19, 2014.
9 “Life Goes On: The Historic Rise in Life Sentences in America,” The Sentencing Project 2013.
10 Time Served: The High Cost, Low Return of Longer Prison Terms, PEW Study June 2012.


Average prison time served in Florida has grown by 166 percent, meaning that a typical
felon now serves 22 months longer than they would have served two decades earlier. The
Sentencing Project study stated that Florida “sticks out like a sore thumb” and has done
little to “rein in their sentencing and corrections costs.”
For context purposes, the elderly prison population nationwide constitutes 16 percent of
the 2.5 million prisoners in the US. In Florida, that percentage has now reached over 20
percent, which makes Florida the state with the greatest percentage of elderly prisoners in
the nation. Prison in Florida is no longer simply a detention facility for young people, it is
largely becoming a repository for elderly prisoners serving extended sentences.

Healthcare Costs Threaten State Budget
The fiscal consequences of a rapidly aging prison population pose an ominous threat to
Florida taxpayers. Not only will it costs hundreds of millions of dollars per year to pay for
medical costs of prisoners who pose little threat to public safety, but it will also distract
from the corrections mission, divert needed resources, and reduce public safety.
FDOC provides the following comments in their 2012 Annual Report regarding the elderly
prison population and projected health care costs:
“Although Florida does not track health care costs by age, utilization data shows
that elderly inmates account for a disproportionate share of hospital services. In FY
2011-2012, elderly inmates accounted for 46.6% of all episodes of care and 49% of
all hospital days…The dramatic increase in the elderly population, and the related
cost of care for this population, presents one of the biggest challenges for FDOC
over the next 15-20 years.”
The potential fiscal consequences of providing health care to a large elderly prison
population are staggering. The National Institute of Corrections estimates that states
spend on average $70,000 per year to incarcerate someone age 50 or older, nearly three
times what it costs to house a younger prisoner, largely because of the difference in healthcare costs.11 Other studies are in accord, including a 2012 comprehensive analysis by the
American Civil Liberties Union, which concluded the annual average cost to house a
prisoner is $34,135, but rises to $68,270 if the prisoner is age 50 and older.12

11 “State Initiatives to Address Aging Prisoners”, Kevin McCarthy and Carrie Rose, Office of Legislative Research (OLR), March
4, 2013.
12 “At America’s Expense: The Mass Incarceration of the Elderly” ACLU 2012


These studies point out that arthritis, diabetes, hepatitis C, cancer, hypertension, ulcer
disease, AIDS, dementia, Alzheimer’s disease, and prostate problems are common chronic
ailments among elderly prisoners. The treatment and medicines for these illnesses are very
expensive, and the bill goes directly to Florida taxpayers. Florida prisons, built to insulate
law-abiding citizens from dangerous and aggressive felons, are being transformed into
intensive care units and hospices.
The federal government, which also has a significant elderly prison population, recognizes
the gravity of the situation, as demonstrated by this excerpt from a Department of Justice
Inspector General (DOJ IG) Report:
“While the Department has taken initial steps to address its reduced budget, the
Department must also have in place an innovative and transparent strategic vision
for how to fulfill its mission in the long term without requiring additional resources.
Nowhere is this problem more pressing than in the federal prison system, where the
Department faces the challenge of addressing the increasing cost of housing a
continually growing and aging population of federal inmates and detainees.”13
The report from the DOJ IG went on to proclaim that “we are on an unsustainable path,” and
also found that, like Florida, the Federal Bureau of Prisons does not track the costs related to
the care for aging and sick inmates.
Extrapolating the cost of elderly health care from published FDOC information is possible.
FDOC reports that elderly patients accounted for 49 percent of all hospital days in 2012.
Assuming hospitalization days are representative of overall prison health care costs, the
elderly prison population was responsible for approximately half of the $408 million
prisoner healthcare costs in 2012, which averages to $11,000 per year solely for the health
care of elderly prisoners. The remaining 82,209 prison population is under the age of 50,
and their health care costs average approximately $2,500 per prisoner.
This rough analysis indicates that elderly prisoners cost four times as much as non-elderly
prisoners. Furthermore, this estimate is very likely a conservative one, as a “hospital day” for
an elderly patient likely requires more doctor and nurse supervision, more drugs, more
physical therapy, and more tests than younger prisoners.
These estimates are congruent with medical costs estimates from prison studies conducted
around the country, and from medical experts regarding prison healthcare costs for the
13 “Cost Savings and Efficiencies at the Department of Justice”, Statement of Michael E. Horowitz, Office of the Inspector
General, United States Department of Justice, April 10, 2013.


elderly (see text box, right). These experts report
elderly prisoners create cost multipliers of 2-8 times
that of prisoners below 50 years of age.
Other studies suggest the costs to imprison elderly
felons are even higher. The American Civil Liberties
Union released a detailed report in 2012 which

elderly prison costs were $5,372
than 50 years of age, a 6 times cost

estimate of $66,294; and a high estimate of

A Virginia study in 2012 found
compared to $795 for those less

offered a low estimate of $28,362; a middle

Examples of Annual Elderly
Prisoner Health Care Costs
in Other States


A Louisiana report found that the

A 2008 Georgia study found that

Angola Prison houses a group of elderly prisoners

care for those 65 and older costs

with annual medical costs exceeding $100,000 per
inmate.15 This led the Warden of Angola, Burl Cain,

$8,565 compared to $961 for

to say: “When I came here and saw the elderly

those under 65.2

population, I said why are they here? Our name is

A 2010 Texas study reported

Corrections to correct deviant behavior, but there’s
nothing to correct in these guys; they’re harmless.”


health care costs of $4,853 per
elderly prisoner, and $795 for

A recent study from the Michigan Department of

younger prisoners.3

Corrections reported a 65 year old prisoner with

A 2010 Michigan study found

$316,420 in medical bills in 2013.


According to this

report, the top 10 prisoners with the highest health
care costs averaged more than $220,000 per
prisoner for health care or mental health care
treatment. There is no reason to believe these types
of high-cost elderly patients are not present in every
state prison system, and even more pronounced in
Florida because of its substantial elderly population.
FDOC’s annual reports contain additional
information about corrections budgets and prisoner
health care costs. The table on the next page shows
the overall FDOC budget, with specific line item for

elderly care was $11,000 annually,
and more than 4 times that of an
offender in their twenties.4
1 Virginia Department of Corrections, “Older
Inmate Population: Managing Geriatric Issues”
October 2011.
2 “Government Explores Early Release for More
Aging Prisoners,” LA Times November 12, 2013.
3 “Elderly inmates are putting a burden on
Texas taxpayers,” Houston Chronicle, May 16,
4 “Michigan’s Prison Health care: Costs in
Context,” Michigan Senate Fiscal Agency,
November 2010.

healthcare costs, since 2000.
14 “At America’s Expense: The Mass Incarceration of the Elderly,” American Civil Liberties Union Report 2012.
15 “Aging Prisoners Costs Put Systems in Nationwide in a Bind,” USA Today, July 11,2013.
16 “At America’s Expense: The Mass Incarceration of the Elderly,” American Civil Liberties Union Report 2012.
17 “Michigan gets serious about high cost of prisons,” The Center for Michigan, April 15, 2014.


The FDOC budget has grown by $560 million (35 percent) from 2000-2012. Health care
costs have grown by $176 million, or 76 percent, in that same period. Health care costs are
growing at more than twice the rate of overall corrections spending.
How much will FDOC budgets rise to meet the necessary costs to incarcerate elderly
prisoners? That will depend specifically on two variables, both of which are also escalating.
The first factor is the increasing cost of health care and mental health treatments for the
types of ailments most common to aging prisoners. Medical costs for treating hepatitis C
alone could swamp FDOC budgets, as a new treatment for the disease is projected to cost
upwards of $100,000 per patient (see case study on next page). Additionally, mental health
treatment is a particular problem in Florida, where it is estimated that minimum care for
one mentally ill prisoner costs more than $60,000.18
A second factor determining health care costs will
be the longevity of prisoners. Life expectancy in
the U.S., now 81 for women and 76 for men, has
steadily increased over time.19

Corrections Budget in Florida
vs. Heathcare Costs

DOC Budget

Healthcare Costs


$1.58 b

$232 m


$1.63 b

$246 m

legislative and judicial leaders will have to answer


$1.62 b

$257 m

these controversial questions, but an imposing


$1.68 b

$280 m


$1.79 b

$307 m


$1.88 b

$315 m


$2.06 b

$340 m


$2.13 b

$373 m

state prison care cannot show “deliberate


$2.29 b

$424 m

indifference to serious medical needs” of


$2.24 b

$394 m


$2.30 b

$414 m


$2.39 b

$409 m


$2.14 b

$408 m


$2.07 b

$295 m

Must Florida provide expensive medical, mental
and drug treatments to prisoners? Executive,

hurdle will be the 8th amendment ban on cruel
and unusual punishments, which the U.S.
Supreme Court has interpreted to mean that

prisoners.20 The Illinois precedent will speak loud,
and it is hard to imagine state and federal courts
permitting a state to withhold from an afflicted
prisoner a treatment capable of curing a lifethreatening disease.

Source: Florida Department of Corrections. Annual
Reports: Agency Statistics: Budget, 2000-2013.

18 “From Prisons to Hospitals-and Back: The Criminalization of the Mental Illness,” Prison policy initiative
19 US Life Expectancy Map 2013, National Geographic.
20 Estelle v. Gamble, 429 U.S. 97, 104 (1976).


A new antiviral drug treatment for hepatitis C, known as Sovaldi, was approved in early
2014 for the treatment of this life-threatening, blood-borne infection common in
prisons because it can be passed by needles used for drug injections, tattoos and
body-piercing.1 The number of prisoners in Florida with hepatitis C is not reported, but
national estimates indicate anywhere from 16–41 percent of prisoners carry this
disease, and 12–35 percent are chronically infected.2 Sovaldi is very expensive,
approximately $1,000 per pill, and it takes months of treatment with the cost ranging
from $65,000 to $170,000.3 Sovaldi has a cure rate in some clinical studies of 95
percent, which is significantly higher than all other available treatments for hepatitis C.
Prior to 2014, state prison systems had not prescribed this medicine for prisoners. This
is beginning to change. The Federal Bureau of Prisons began making Sovaldi available
in February 2014,4 and New York has begun using Sovaldi for prisoners with the most
serious cases. Washington and Wisconsin are also beginning to use Solvaldi, and
California is revising its prison health care policies to incorporate the use of the new
Illinois corrections officials estimate the treatment will cost $61,000-$122,000 per
prisoner, and they have as many as 3,750 prisoners who will need the drug. Cost
estimates are $61 million in the first year. Illinois is facing great budget challenges,
aggravated by these new corrections costs. A temporary tax has been requested, and if
not granted, reports are as many as 15,500 inmates would be released to offset the cost
of corrections.5 The total prison population in Illinois is 49,154, or approximately half
that of Florida.6
If Florida makes these drugs available to those afflicted with hepatitis C, health care
costs will explode. Using the Illinois estimates leads to a cost of $122 million to treat
hepatitis C in Florida prisons, and if higher national estimates are applied, there could
be as many as 7,000 prisoners in Florida suffering from chronic hepatitis C, and needing
the new costly treatments.
Such estimates lead to treatment costs in the $1 billion range. That is more than double
the entire FDOC budget for prison health care.
1 “State approves prison hepatitis C drug, likely to cost millions,” Herald-Review, April 22, 2014.
2 “Correctional Facilities and Viral Hepatitis,” Centers for Disease Control and Prevention, April 22, 2014.
3 “Should Prisoners Get Expensive Hepatitis C Drugs?,” The Pew Charitable Trusts, March 26, 2014.
4 “New Hepatitis Drugs Vex Prisons,” Wall Street Journal, April 24, 2014.
5 “Illinois prisons to use costly hepatitis C drug,” The Kansas City Star, April 18, 2014.
6 “Illinois Corrections numbers show record prison population,” Journal Star, Sep 18, 2012.

Setting the Sovaldi issue aside, the final years of incarceration are the most expensive to
taxpayers, so at more than $11,000 per year per prisoner, the addition of 2,500 elderly
prisoners per year will add $30 million per year in health care costs. If the national average of
$68,270 per year estimate is used, the annual cost to Florida taxpayers to incarcerate 20,750
elderly prisoners is $1.5 billion, or almost three-fourths of the current FDOC budget. These
numbers become astronomical, and unsustainable, if new medical treatments and mental
health requirements are added to cost spreadsheets.

Projections for Florida
As the statistics demonstrate, the elderly prison population has gone up every year since 2000
by an average of more than 1,000 prisoners per year, and exhibits a growth rate significantly
exceeding that of the general prison population. The Florida Criminal Justice Estimating
Conference (CJEC), which uses relevant real-time criminal justice data such as arrests, felony
filings, and convictions to assess future prison population growth, projected in early 2014 that
the total prison population in Florida in 2018 will be 104,960.21 This constitutes minor
prisoner increases over the next four years, and shows the rapid growth from the last decade
has now steadied. CJEC does not estimate the elderly prison population subset within the
total prison population projection, nor does the FDOC, but estimates can be extrapolated
from existing data.
The variables below can be used to estimate where the elderly prison population will be at
the end of FY2014-15:
•	 Current prisoners aging up to 50: The 35-49 age group presently housed in Florida
prisons consists of 36,048 prisoners. Within this group, 4,452 prisoners are 48-49
years old. A quick survey of the first 200 names in the 48-49 age group reveals 23
percent have release dates in 2014 and 2015. Assuming this sample is representative,
one fourth will be released in the next 20 months, leaving approximately 3,200 current
prisoners who will remain imprisoned and join the elderly prisoner category by the
end of 2015.
•	 New elderly prisoner admissions in 2014-2015: The FDOC annual report shows there
were 3,349 elderly admissions in 2012; 3,452 in 2011; and 3,448 in 2010. A fair
expectation from these statistics is about 3,400 elderly prisoner admissions per year in
2014 and 2015. Conservatively, this will add more than 6,000 new elderly prisoners by
the end of 2015.
21 Criminal Justice Estimating Conference: Held November 20, 2013.


•	 Elderly prisoner releases. A quick survey of the first 200 names in the 50+ category
shows 26 percent will be released in 2014-2015. Again assuming this sample is
representative, approximately 5,100 elderly prisoners will leave the prison system
by the end of FY2014-15.
•	 Summing up: The 20,750 elderly prison population in Florida today will gain
approximately 6,000 new admissions by the end of 2015, age up about 3,200
prisoners, and release 5,100 prisoners. That equals a net gain of 4,100 elderly
prisoners by the end of FY2014-15, or an increase of 200 elderly prisoners per
The addition of 4,100 elderly prisoners to the current population of 20,750 will take Florida
to 24,850 elderly prisoners by the end of 2015. Assuming no interim policy changes to
manage the elderly prison population, the number will further climb to 30,000 by 2018.
Comparing this to national average predictions from the Wall Street Journal, which reports
that “at current rates a third of all prisoners will be 50 or older by 2030,”22 Florida will
achieve this dubious distinction 10 years ahead of the rest of the nation.

The dilemma of expanding elderly prison populations and their high healthcare costs is
not unique to Florida, but it is a relatively recent problem. Parole and compassionate
release programs existed in Florida prior to 1995. That all changed, however, when Florida
enacted a new law which removed parole, substituting in its place of a system requiring
prisoners serve 85 percent of the sentence imposed. Life sentences from that point on
were “for the rest of their natural lives, unless granted pardon or clemency.”23 All flexibility
in Florida corrections has been removed, and there are no exceptions.
Federal, state and foreign jurisdictions are enacting early release programs for prisoners
based on age, offense, medical condition, time served and public safety assessments.
These initiatives, known by such terms as “geriatric parole,” “compassionate release,”
“elderly parole,” “medically recommended Intensive supervision,” and “humanitarian
release” have become the most common way for states to avoid enormous health care
costs for aging prisoners by releasing aging and ailing prisoners who pose no risk to the
public. Some advocates of early release programs also point to the compassionate aspects
of releasing terminally ill and physically disabled prisoners in their last stage of life.
22 “Care for Aging Inmates Puts Strain on Prisons,” Wall street Journal, January 27, 2012.
23 Florida Statutes 944.275


The policy rationale for releasing nonviolent elderly prisoners is clear. Elderly prisoners
cost the most to incarcerate, but pose the least danger to public safety. The potential
savings available are substantial, as a 1 percent reduction in Florida’s prison population
gained through early release of elderly prisoners could result in annual savings of $67
million. A five percent reduction would save more than $300 million.
One method for reducing prison sentences for the elderly is through executive clemency
powers. Although this administrative prerogative is generally used sparingly by the
President and Governors to prevent injustice or correct errors, it can be accessed to reduce
sentences. President Obama recently announced his willingness to use his clemency
authority to focus on federal felons serving long terms for drug offenses.
Under the revised clemency program, eligible prisoners would be those who have served at
least 10 years, with no significant criminal history, that are non-violent low level offenders
not associated with gangs, and with a good conduct record in prison.24 The clemency office
will be beefed up to allow quick review and action on those prisoners who meet the
guidelines adopted. It is estimated that this could result in the release of thousands of
non-violent drug offenders, and save hundreds of millions of dollars.25
The administrative requirements surrounding President Obama’s decision to use his
clemency power to reduce certain federal drug sentences does serve to remind state
governors that while they could institute similar guidelines and reduce the sentences of
specific classes of prisoners, like those very old or terminally ill, it remains highly unlikely.
States do not have the legal assets of the Department of Justice to review large numbers of
clemency requests, and clemency cannot become a de facto parole board in a state that
has abolished parole.26 However, clemency could be used for unique cases of very old and
ailing prisoners, to show them compassion, and save costs, at the end stages of life.
Assuming clemency is, at best, a limited option for the early release of aging and ailing
prisoners, can Florida create a broad elderly prisoner release program under existing state
law to review and grant meritorious requests for release prior to 85 percent sentence
completion? In order to be consistent with state law, the elderly release program would
24 “DOJ announces clemency overhaul, allows release for some after 10 years,” Fox News, April 23, 2014.
25 “President Obama Could grant Clemency to Thousands of Non-Violent drug Offenders,” Think Progress, April 21, 2014.
26 The only current avenue to reduce a sentence in Florida is through executive pardon and clemency. The Clemency
Board does not typically grant nor revoke parole or probation, but there are examples of this power being used to reduce a


have to be specially tailored so that it does not offend the “end, terminate or expire”
statutory language of mandating 85 percent completions.
The federal government provides an ideal road map on how to proceed, because the
United States Federal Sentencing Guidelines enacted in 1987 also discontinued parole.27
Like Florida, federal prisoners serve 85 percent of their sentences. The sentencing regime
in the federal criminal justice system is very similar to Florida with one exception: the
federal government has a Compassionate Release/Reduction in Sentence program which
permits a prisoner to request early release in special circumstances which include
advanced age, terminal medical conditions, other extreme and chronic physical limitations,
and family hardships.28
A request for Compassionate Release goes to the Federal Bureau of Prisons (BOP), and if
supported, the request is submitted it to a federal court, given unfettered discretion to
approve the request.
In 2013, the BOP sought to reinvigorate the program with new guidelines for
Compassionate Release/Reduction in Sentence, based on the detailed criticisms and
recommendations from the DOJ IG.
These guidelines now permit Compassionate Release/Reduction in Sentence for the
•	 Prisoners with terminal medical conditions, defined as life expectancy of 18 months
or less;
•	 Prisoners with a debilitative medical condition, which is an incurable progressive
illness or injury which renders the prisoner confined to a hospital bed or unable to
care for themselves;
•	 Prisoners 70 or older who have served 30 years of their sentence;
•	 Prisoners 65 or older who have served 10 years, or 75 percent of their sentence;
•	 Prisoners 65 and older who have served 50 percent of their sentence and suffer
from a deteriorating mental or physical health condition which diminishes the
prisoners ability to function.

27 Compassionate Release/Reduction in Sentence: Procedures for Implementation of 18 U.S.C. 3582 and 4205
28 The Federal Bureau of Prisons Compassionate Release Program, U.S. Department of Justice Office of the Inspector
General, April 2013


What should be the criteria for an elderly prisoner release program in Florida? The federal
program outlined previously is a good place to start, but variables commonly included in
state plans center on the following:
•	 Age. This is the factor with the widest range of options. The age selected
determines how large the eligible pool will be, and also determines how much risk
will be accepted. Research studies and criminologists have consistently found that
age is one of the most significant predictors of criminology. Ninety percent of those
convicted of felons are under 50 at the time of admission to prison, and only 1.8
percent are 60 or older.29
States have chosen to consider prisoners for early release as young as 45 in
Louisiana; progressing to 55 (Alabama); 60 (Virginia, Wisconsin, Oklahoma); 65
(Colorado, Washington DC, Maryland, North Carolina, New Mexico); and 70 in the
federal system.30
Recidivism rates for elderly prisoners shed further light on age selection. FDOC did
a 7-year study on recidivism by age groups using statistics from 2003-2010,31 and
found that the lowest recidivism rates occur among those aged 65 and older. The
50 to 64 year group also falls well below the average recidivism rates.
Age profiles for prison admissions report similar age group distinctions. FDOC
reports the 50-59 year group amounted to 8.6 percent of those admitted in 2012,
8.2 percent in 2011, and 7.8 percent in 2010. The number of prisoners aged 60 and
over admitted to prison constituted 1.8 percent in 2012, 1.7 percent in 2011, and 1.5
percent in 2010.
•	 Medical Condition. The health criteria for early release consideration should be
dependent on medical opinions regarding terminal illness, the progressive state of
disease, treatment costs, chronic pain levels, and difficulty of care. Obviously, the
graver the illness, the more cost to the taxpayer, and less danger to the public.
Illness and physical disability can serve to incapacitate as readily as incarceration.

29 FDOC Annual Report 2012, page 31.
30 Federal: “Early Release for Federal Inmates: Fact Sheet”, Nathan James, Congressional Research Service, February 3, 2014.
All other cited states: “It’s About Time: Aging Prisoners, Increasing Costs, and Geriatric Release”, Tina Chiu, Vera Institute of
Justice, April 2010.
31 2011 Florida Prison Recidivism Report: Releases from 2003-2010. April 2012, Bureau of Research and Data Analysis.



•	 Offense Committed. Some classes of crimes should be excluded from consideration
for early release in the interest of public safety. Those who commit murder, sexual
predators and rapists, offenses against children, and all other capital felonies should
not be considered for early release in the interest of public safety.
•	 Time served. The amount of time served by the elderly prisoner should also be a
consideration. Some states use a percentage ranging from 33–75 percent; others
require 10–30 years.
•	 Risk Assessment. Risk assessment is a very important consideration in all prison
release programs. Age-based recidivism rates are instructive, but a prisoner’s
individual factors are equally germane. The specific facts of the offense committed,
as well as the prisoner’s record while incarcerated, family and community support,
restitution, and all other relevant facts should be considered.
•	 Type of Decision-Making Forum. The state of Florida has a Parole Commission,
designed to ensure public safety through the post prison release process. The
Commission is comprised of three Commissioners who are appointed to six year
terms by the Governor, and confirmed by the Senate. Currently, the role of the
Parole Commission is diminishing as prisoners sentences under the old philosophy
disappear from the system.



The rising cost of health care for elderly prisoners is a national dilemma, creating
budgetary headaches for the federal government and most states. Nowhere is this
looming crisis more acute than in Florida. Florida’s elderly prisoner population is now over
20,000, and on its way to 30,000 by 2018. By 2020, one out of every three prisoners in
Florida will be elderly. This rate will be double the 16 percent national average, and impose
huge and unsustainable fiscal burdens on Florida taxpayers.
Florida TaxWatch recommends that Florida implement the following measures designed to
identify, assess, and manage the exploding aging prison population in Florida:
Report the Current Cost of Elderly Prison Health Care
Florida TaxWatch recommends that Florida collect and report the health care costs of the
elderly prison population. Understanding the current costs for elderly heath care, the
average cost per year to incarcerate an elderly prisoner, and the highest cost prisoners, are
vital to the analysis and understanding of correction costs. Additionally, cost figures
identifying current costs are necessary, so that cost projections can be determined and
Report the Projected Growth of the Elderly Prison Population in Florida
The data is available for the state to project the growth in elderly prison populations.
FDOC reports elderly statistics for the overall prison population, and the age groups of new
prison admissions each year. The FDOC offender database also permits searches of those
currently incarcerated by age. This provides sufficient data to project elderly prison
population growth.
The state can use these projections, as it does to estimate future prison population totals,
and make annual prison population projections for elderly prisoners. While prior year
statistics show an elderly prison population which has grown from 5,605 in 2000, to 20,750
in 2014, the important information for decision-makers is if/when this growth will stop.
Consider clemency option for unique cases of elderly and ailing prisoners
Some cases cannot wait for FDOC and legislators to implement an early release program
for elderly and infirm prisoners in Florida. As an example, there are currently 27 prisoners
over 80 years of age who have been incarcerated for decades, and have release dates in
the next 5 years. Three of these prisoners are in their nineties. They are feeble and
harmless to the general public. There are also prisoners with life-threatening diseases in
the end stages of life.


These prisoners should be considered for release, and clemency is the only way this can be
done in adequate time to allow a more compassionate death outside of prison walls.
Implement an Elderly Prisoner Release Program
The Florida Legislature should reexamine the fundamental purposes and goals of prison
and sentencing, which are to punish, incapacitate, deter future crimes, and rehabilitate.
Prisons are not intended to be senior citizen retirement communities or hospice centers
for prisoners with terminal diseases. Old age, life-threatening medical conditions, loss of
physical mobility, and degradation of sensory and memory recall can incapacitate as surely
and effectively as prison cells, watchtowers, and barbed wire.
In order to stop runaway spending on health care for elderly prisoners, a program should
be created in Florida to review aging and ill prisoners for release to community medical
clinics and hospices. The program can be modeled on the federal Compassionate Release/
Reduction in Sentence program, and other geriatric release programs implemented by
sister states. Criteria would likely be based on age, offense, medical status, prison record,
public safety assessment and humanitarian factors, but should not be automatic based on
any of those factors.
The recommendations made by the U.S. DOJ IG report after thorough review of the federal
Compassionate Release/Reduction in Sentence program in 2013 are germane and should
be carefully analyzed. The DOJ IG report found the process so encumbered with review
layers, and the criteria for eligibility so tightly structured and interpreted, that the program
was mired in red tape and ineffective.
Florida should look to this program as a model, and borrow the best practices from state
programs discussed in this study, when creating appropriate criteria for elderly prisoner
early release.

Dan McCarthy is a Miami native and a graduate of the United States Naval Academy. He
also has a law degree from Duke University and an LLM from George Washington.
Before joining TaxWatch, Dan spent three decades as a naval officer where he served
as a legal advisor to the Secretary of the Navy and was in command of all Naval trial
offices in the Southeast and Caribbean. He has also worked at the law firm of Holland
& Knight, served as the Director for Military and Veterans Affairs for the City of
Jacksonville, was the Chief Assistant State Attorney for the 4th Circuit, and was a Director
at Wounded Warrior Project.


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Dominic M. Calabro 	
Robert Weissert, Esq. 	
Kurt Wenner 		
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All Florida TaxWatch research done under the direction of Dominic M. Calabro, President, CEO, Publisher & Editor.

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