Pennsylvania’s prison population may be shrinking, but its costs aren’t.

One reason, according to Corrections Secretary John Wetzel, is a growing number of elderly inmates.

In a hearing before the Senate Appropriations Committee Thursday, Wetzel said the state’s aging prison population “100 percent has to do” with his department’s rising medical costs. He said Pennsylvania needs to create a medical parole program to allow sick and aging people to spend their final days outside of prison.

The vast majority — $2 billion — of DOC’s $2.7 billion budget goes toward personnel costs, Wetzel said. This year, they’re asking for a $15 million increase for medical funds to treat elderly patients and rising rates of Hepatitis C.

Pennsylvania’s elderly prison population has increased from 6 percent of its general prison population in 1996 to 22 percent today, Wetzel said.

Wetzel said different agencies define elderly inmates as those who are at least 50 or 55 years old. But as Sen. Lisa Baker, R-Luzerne, pointed out, incarceration accelerates aging-related health complications.

Elderly inmates are more likely than members of the general population to suffer from “cardiac disease, high blood pressure, hepatitis C, diabetes, and other chronic diseases,” according to a Pew Stateline article.

Since federal law prohibits incarcerated persons from receiving Medicaid coverage, the DOC shoulders their healthcare and prescription costs. Eighty-four percent of Pennsylvania’s elderly prisoners take medication, compared to 26 percent in the non-elderly population, Wetzel said.

In all, the annual cost of incarcerating people 55 or older can be two to three times higher compared to a non-elderly inmate, according to the National Institute of Corrections.

Pennsylvania does have a Compassionate Release program, but it only results in about three releases per year, Wetzel said. An inmate qualifies for compassionate release if a doctor certifies that he or she has just six months to live.

Relaxing the qualifications for compassionate release could allow more sick and elderly people to leave the corrections system as parolees, Wetzel said.

“Pennsylvania doesn’t have good medical parole program,” Wetzel said today. “There’s a real need for it here.”

In addition to medical parole, Wetzel said that Pennsylvania could also create secure, state-run residential nursing homes for paroled people.

They could be modeled after a program in Connecticut, he said, which allows paroled prisoners who are not deemed public safety risks to receive nursing home care.

Since the nursing home residents are parolees, and not inmates, their medical costs are partially covered by Medicare. The Connecticut facility was the first of its kind in the country to receive a certification from the Center for Medicare and Medicaid Services that qualified it for federal nursing home funding.

A bipartisan group of Pennsylvania lawmakers kicked off 2019 by calling for parole and probation reform, but their package of bills does not include any provisions for medical parole.

According to Wetzel, that’s not a problem.

He said any medical parole program that Pennsylvania passes should be developed in a separate bill, so that it doesn’t take support away from the parole and probation proposals currently before the General Assembly.