Beleaguered Budget: Aging Population, Mental Health Issues Plague Oklahoma Department of Corrections

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Oklahoma currently incarcerates 673 per 100,000 people; state spends less than $1,500 per inmate per year for health care.

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  • Southwest Ledger photo by M. Scott Carter         Clint Castleberry, center, Director of Health Services for the Department of Corrections, speaks to the Legislature’s Health Care Working Group Wednesday, Aug. 21.
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OKLAHOMA CITY – Oklahoma’s Department of Corrections spent about $43.5 million on health care for more than 30,000 inmates during the 2018 fiscal year, a corrections official told lawmakers Wednesday.

Speaking at the second meeting of a legislative working group charged with examining Medicaid expansion, Clint Castleberry, director of Health Services for DOC said that figure doesn’t include the cost spent on private prisons or payroll.

With more than 30,000 inmates in state custody – Oklahoma currently incarcerates 673 per 100,000 people, according to U.S. News and World Report – that figure means the state spends less than $1,500 per inmate per year for health care. Additionally, DOC officials said Oklahoma has only 49 infirmary beds for inmates.

For years, state lawmakers have struggled to fund Oklahoma’s beleaguered corrections system. With an incarceration rate more than twice the national average, the cost of health care for inmates – required under the Eighth Amendment of the U.S. Constitution – continues to climb. Wednesday, Castleberry told lawmakers the corrections department paid about $2 million of the $9 million due for Medicaid reimbursement. Some of that cost is due to an aging prison population.

“Certainly, there is some age issues,” Castleberry said. “When you are talking about an incarcerated population, take the chronological age of someone and add 20 years’ worth of health conditions to that.” A portion of those problems, Castleberry said, are due to lifestyle choices and to lack of health care prior to incarceration.

“Our population is aging now,” he said. “There are more of those individuals who are over the age of 50 now than there were 10 years ago.” The issues surrounding Medicaid expansion in Oklahoma come at the same time as lawmakers wrestle with criminal justice reform issues. Since the early days of the then-Governor Mary Fallin’s administration, lawmakers from both parties have debated the pros and cons of expanding Medicaid in Oklahoma.

 

FALLIN’S DECISION

During her tenure as governor, Fallin justified her decision not to expand Medicaid saying she was worried the state would be left with huge debts if the federal government pulled back its support. However, over the past two years, the debate has grown.

 

SUPPORTERS OF MEDICAID EXPANSION

Earlier this year, Oklahomans Decide Healthcare, a group of supporters of Medicaid expansion, drafted an initiative petition which would add health coverage for Oklahomans who earn up to 133% of the poverty level. That petition, challenged by the Oklahoma Council for Public Affairs, was okayed by the Oklahoma Supreme Court.

Supporters now have 90 days to gather 178,000 signatures to put the proposal on the ballot. In addition to issues surrounding inmate health care, Wednesday’s meeting also emphasized the need for better mental health care for prisoners. Janna Morgan, Chief Mental Health Officer for DOC, said about 64% of the state’s prison population – more than 16,000 inmates – have a history of or are currently be- ing treated for some form of mental illness.

“That’s a pretty high number,” Morgan said. She said about 23% were currently receiving some type of psychotropic mental health medication. Morgan said prison officials evaluate inmates for various types of treatment and also look to see if they qualify for Medicaid disability. Inmates who have been approved for disability and who are discharged can notify the Social Security Administration, she said, and get their benefits reinstated.

“That way they (the inmate) doesn’t have to go through the whole process again of reapplication and reevaluation,” she said. Members of the Health Care Working Group will meet again next Wednesday at the state Capitol building.