KANSAS CITY, Mo. - The number of older Americans serving prison sentences is on the rise, and those facilities weren't originally designed to accommodate an aging population.
Linda Redford is director of the Central Plains Geriatric Education Center at the University of Kansas.
She says Missouri is one state that has gotten ahead of the curve, by setting up enhanced-care units in some of the larger prisons and in some cases, people in prison are learning health-care skills by helping take care of each other.
She says that can benefit the older people, and the younger ones as well.
"I've often heard them say it's a way to pay back for what they've done, for whatever crime they've committed, that they feel now that they're finally able to give back," says Redford. "And in some cases, they know they're probably going to be aging and dying in prison, and they want someone there to care for them."
Redford points out that people in prison age faster than those on the outside, partly because of the lifestyles they led before they were arrested, which often included substance abuse and poverty.
She says most prisons aren't equipped to deal with so many people with cardiac disease, diabetes, dementia and other chronic conditions.
Although some states have an early-release program for elderly prisoners, Redford says that isn't the perfect answer because they often don't have anywhere else to go.
"Partly, we're in this mess because we emptied out all of our state hospitals for the mentally ill, and guess where they ended up," says Redford. "They ended up in our homeless shelters, dead, or in our prisons."
The aging of the prison population costs a lot. The federal Bureau of Prisons saw health-care expenses increase 55 percent from 2006 to 2013, when it spent more than $1 billion.
Every state is having to deal with increases in its older prison population, and Redford says Missouri deserves credit for what's been done so far.
"Missouri has probably moved as quickly as I've seen a state move, in terms of setting up the units within their prisons," says Redford. "But that isn't easy, because you have to retrofit a prison that was never meant for old people."
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South Dakota is creating an Office of Indigent Legal Services after House Bill 1057 passed the Legislature with nearly unanimous support this month.
The U.S. Constitution gives all people accused of a crime the right to a lawyer. South Dakota is one of only two states where counties, not the state, have been responsible for providing public defenders for those who cannot afford to pay.
Neil Fulton, dean of the Knudson School of Law at the University of South Dakota and co-chair of the Indigent Legal Services Task Force, said costs added up for counties, and noted there are added challenges for people in rural counties seeking attorneys.
"The biggest challenge is just availability," Fulton observed. "And the geographic reach from where the lawyer is to where the client is."
Fulton predicted the bill will improve the quality of public defense. He hopes to see the new state office taking cases by the end of this year, following the creation of a Commission on Indigent Legal Services and hiring and training attorneys.
It is still undecided how the program will be funded long-term. Indigent defendants are expected to pay back the costs of their legal services.
Samantha Chapman, advocacy manager for the American Civil Liberties Union of South Dakota, urged changes to the practice.
"We hope that there'll be future policy reform bills changing the way that the state is recouping the costs from those indigent defendants, many of which will never be able to pay off their debt," Chapman stressed.
The changes to the system are projected to cost the state $1.4 million annually, and save counties more than $1.5 million.
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A man from Dothan, Alabama, serving a life sentence for selling drugs received a presidential pardon, which sparked discussions about long sentences for marijuana-related offenses.
As President Joe Biden granted forgiveness to Earlie Deacon Barber, advocates for changing the current drug laws emphasized the need for broader reforms for marijuana-related charges.
Paul Armentano, deputy director of the advocacy group NORML, highlighted the significance of presidential pardons in the overall debate.
"It's an acknowledgment from the most powerful person in the land that we have moved on from these offenses," Armentano asserted. "We're forgiving these people for these offenses, and that this record should not be holding them back from future opportunities."
Barber's life sentence is set to expire April 20. Armentano pointed out a pardon still does not eliminate the challenges faced by people with criminal records in getting jobs and housing. Multiple states have changed their cannabis possession laws and state courts have expunged or sealed the records in more than 2 million marijuana-related cases.
Randall Woodfin, mayor of Birmingham, has pardoned more than 23,000 people with charges dating back to 1990. And he has appealed for stronger federal protections, such as changing the legal classification of cannabis to allow for greater access or fewer restrictions on its use.
Armentano agreed more could be done at the federal level to address the stigma and challenges.
"Because it's Congress that enacted marijuana prohibition, and at the end of the day, it needs to be Congress that has to enact policy to end marijuana prohibition at the federal level," Armentano urged.
He noted NORML advocate Chris Goldstein, a pardon recipient, recently discussed federal cannabis policies with Vice President Kamala Harris.
At present, 24 states allow nonmedical adult use of cannabis, but they are still at odds with federal law, which considers marijuana use illegal.
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Women are treated much differently than men by the criminal justice system, according to a new report detailing how and why mass incarceration is harmful to women in the U.S.
The report said nationwide, more than 190,000 women are behind bars, with the vast majority serving time in local jails.
Mike Wessler, communications director for the Prison Policy Initiative, said it includes about 29,000 women in Mississippi. He argued the system is particularly harsh toward women. One major challenge is receiving sufficient medical care.
"Women are frequently overdosed behind bars; they may have consumed drugs or alcohol at high level before they came to jail," Wessler noted. "And when they're there, the jails don't have the capacity to treat them. So, they often overdose or they detox without any assistance, and it costs them their lives."
Wessler pointed out about 82% of women who are entangled in the legal system are on probation or parole. The other 18% are in jail or prison. The Magnolia State has one of the higher incarceration rates, with more than 1,000 people per 100,000 residents behind bars.
Wessler emphasized around 58% of women who are incarcerated have minor children. Their families often cannot afford cash bail, which is one reason they are trapped in the legal system. Worse yet, he added, the women are typically the primary caregivers for their kids, which may cause their parental rights to be at risk.
"If you can't afford that, you're going to sit in jail until trial, and that can be months and months at a time, in which time you're likely to lose your job, lose your housing, lose custody of your children," Wessler outlined. "Women who are incarcerated don't make enough money to often pay that bail. The average bail in this country is about one year's salary for an incarcerated woman."
The report also echoed concerns about the stark racial disparities in locking people up. It said in Mississippi, white people are incarcerated at a rate of 386 per 100,000 residents. For Black people, the rate is 960.
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