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JOANNE FARYON (Host): Hello everyone.

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Welcome to this Envision[br]special, "Life in Prison."

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About one in five of all inmates in[br]California are serving life sentences.

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Combined, they could potentially cost[br]taxpayers in this state $140 billion

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over the course of their sentences.

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Lifers are getting more expensive because[br]they're aging in prison and rarely paroled.

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It's all adding up to record[br]health care costs for inmates.

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Tonight, we explore the cost of[br]California's tough on crime legislation.

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It's lead to so much overcrowding in state[br]prisons the federal courts have stepped in.

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You'll meet some lifers -[br]men who were sent to prison

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when Lyndon B. Johnson was[br]president and they're still there.

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This is not a report on whether they[br]should be paroled - it is an examination

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of how much it costs to lock[br]people up and rarely let them out.

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Especially when locking them up means[br]you're responsible for their healthcare.

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At first glance this could[br]look like a nursing home.

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The wheelchairs and walkers[br]have a way of fooling you.

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This is the California Medical[br]Facility, one of California's 33 prisons.

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CMF operates the largest prison hospital.

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It is where many of the states old,[br]sick and dying inmates will end up.

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And these days, those old and sick[br]inmates are growing in number.

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California faces a problem that touches[br]nearly every aspect of society -

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from our economy to our safety to our[br]health - one that forces us to take sides

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between punishment and redemption.

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We have too many men and women in our prisons.

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The statistics say so and so[br]did a federal court in 2002.

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There are 170,000 inmates in[br]prisons that were built for 100,000.

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One in five serving life sentences.

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TERRY CAMPBELL (Inmate):[br]My name is Terry Campbell.

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I'm in prison for murder, first-degree[br]murder, and I've been in prison for 44 years.

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GLENDA VIRGIL (Inmate): "My name is Glenda[br]Virgil, and I'm serving a 15 to life sentence.

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I've been here 23 years.

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FARYON: And how old are you?

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VIRGIL: And I'm 63 years old.

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RICHARD LAURENZANO (Inmate): Being 62 in[br]prison is a struggle, it's a struggle.

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First of all the reflection of losing 27[br]years of your life but you get sicker.

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FARYON: Richard Lauranzano[br]represents the fastest growing segment

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of the inmate population: men over 50.

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He's also among the most expensive.

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He's been sick and has been treated at[br]hospitals outside the prison system.

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LAURENZANO: I had cancer[br]about four years ago, stage 4.

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The prison system saved my life.

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They sent me to outside hospitals they never[br]hesitated FARYON: Glenda Virgil has had surgery.

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VIRGIL: I've had major back surgery.

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I was in the hospital with two guards[br]24 hours a day for 11 days FARYON:

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Terry Campbell has had seven operations.

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CAMPBELL: My back.

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My shoulders because I broke bones[br]in both my back and shoulders.

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My hand, twice.

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CLARK KELSO: We're dealing with a corrections[br]population that is aging in prison.

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. FARYON: Clark Kelso is in charge of[br]health care in California's prisons.

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KELSO: So we've seen explosion in cardiovascular[br]problems, an explosion in diabetes,

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we have the results of hep c, there was[br]sort of an explosion of it in the 80;

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s we're seeing the results of that now.

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We have a lot of inmates who[br]have very serious liver disease

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because of an abuse of drugs and alcohol.

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But they're all at the age now where you have[br]those issues plus other chronic conditions

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which simply require a different type of care"[br]FARYON: A federal judge made Kelso a receiver

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and put him in charge when a court ruled[br]inmates did not have access to health care

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and mental health services because[br]California's prisons were so over crowded.

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The court ruled lack of health care[br]was cruel and unusual punishment

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and violated inmates' constitutional rights.

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A panel of federal judges has since[br]ordered California to come up with a plan

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to reduce its prison population[br]by 40,000 inmates.

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Both decisions forced the state to confront its[br]overcrowding problem and challenged the public

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to contemplate the health care[br]debate in a whole new way.

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If we as a country can't decide whether[br]health care is a right for all free citizens -

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why is it so easily determined as[br]a right for convicted criminals?

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It's a question Clark Kelso[br]has been asked many times.

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KELSO: The technical legal answer[br]is there's a huge difference

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between government's responsibility[br]to you a citizen, a free citizen,

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and government's responsibility to[br]someone that government is incarcerating.

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Once you have incarcerated someone,[br]government has a constitutional obligation

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under the 8th amendment to[br]provide certain levels of acre

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and that what the state has to do.

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FARYON: Since the receivership[br]assumed control of health care

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in prisons three years ago spending on medical[br]treatment for inmates has almost doubled -

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from just over one billion dollars a[br]year to nearly two billion dollars.

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And that budget will increase if the[br]state is to continue providing health care

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to its growing geriatric population.

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One independent report projects[br]the number of men

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in California prisons over[br]age 60 will triple by 2018.

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KELSO: The state of California and the people[br]of California have made consistent judgments

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that certain types of crimes or certain[br]patterns of criminal conduct need to be punished

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with life in prison and that's a judgment that[br]has to be respected from my perspective is

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that needs to realize those[br]decisions come with a cost

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that you can't have a prison population 16[br]or 20 per cent of which in a maybe a decade

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or to are going to be 55 and older,[br]you can't do that unless you're willing

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to devote a very substantial portion of[br]the general fund to their health care

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because those aging prisoners are going

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to have health care needs that[br]are very expensive to meet.

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FARYON: There are about 35,000[br]lifers in California prisons.

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Using government statistics, KPBS[br]calculated how much money the state pays

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to imprison inmates for a life sentence.

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If Inmate X is incarcerated at age 37,[br]he costs taxpayers about $49,000 a year.

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But as he ages, his health[br]care expenses will increase.

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At age 55, he could cost[br]the state $150,000 a year.

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If he lives until he's 77, he[br]will cost California taxpayers

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as much $4 million to keep[br]him in prison for life.

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FARYON: So, when you were first convicted[br]and sent to prison did you expect to still be

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in prison when you were sixty-five?

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CAMPBELL: No, not at all.

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No, I believed the hype that if you change[br]while you're in prison and prove to us

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that you're capable of functioning in society[br]by doing the programs that we provide,

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showing us that you've rehabilitated[br]and the CDC staff supports

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that effort, then you will be paroled.

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FARYON: Lifers rarely get parole.

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In 2008, the most recent[br]year statistics are available

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for the full 12months, 7,303[br]lifers were up for parole.

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The board granted 294.

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But the governor has the right to reverse[br]those decisions or send them back for review.

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In 2008 Governor Arnold Schwarzenegger[br]denied 81 lifers parole

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and sent more than 30 cases back for review.

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Fewer than 60 inmates were released.

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The year before even fewer were[br]paroled and in 2006, fewer still.

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MANSON MURDERS NEWS CLIP:[br]In a scene...found dead.

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FARYON: To understand why Californians[br]developed this tough on crime mantra,

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you have to go back to the[br]days of Charles Manson.

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At the time homicide rates were on the rise -

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nearly doubling from the mid[br]sixties to the late 70's.

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HARRIET SALARNO: Because the high crime,

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murder was on the rampage and[br]people were getting furious.

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FARYON: Harriet Salarno was raising a[br]family in San Francisco at the time.

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She and her husband owned an electronics store.

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They kept a gun because stores like[br]theirs were often the target of robberies.

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It was the gun her daughter's[br]killer would use in 1979.

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SALARNO: And he shot her and[br]murdered her execution style.

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And he went up to his dorm didn't call any help[br]or anything watched her try to call and she died

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and finally another student[br]found her and it was too late.

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FARYON: When Salarno learned her[br]daughter's killer was up for parole

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after just serving 10 years,[br]she began a life-long campaign

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for tougher sentencing laws[br]and stricter parole policies.

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Her victims rights group raises enough money[br]to employ a full time lobbyist in Sacramento.

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SALARNO: Public safety is in our constitution

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and it's the priority and[br]it must be served first.

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We will back right there lobbying as heavy

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as we can every morning we will have a new case[br]we will be able to discuss with a legislator

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because somebody was murdered it will be[br]on the morning news as it is every morning.

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And that's their obligation.

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Their obligation as legislators is to do this.

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FARYON: Dozens of changes to sentencing laws[br]in the last few decades have all contributed

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to California's highest rate[br]of lifers in prison.

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Two of the most significant, are[br]determinate sentencing in 1977,

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which imposed minimum sentences,[br]and three strikes in 1994,

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which allowed repeat offenders[br]to be sentenced to life.

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LINDA: My sentence is 15 to life.

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FARYON: And you've been here how long?

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LINDA: I'm in my 24th year.

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FARYON: And Glenda?

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VIRGIL: Fifteen to life, plus[br]two for a gun allocation.

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And I've been here for 23 years.

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FARYON: And Marylinn?

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MARYLINN: Mine is 15 to life for[br]second-degree murder and I've been down 25.

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FARYON: At the California Institution for[br]Women in Corona California, a group of inmates,

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all convicted murderers, all women, talk[br]about what its like to grow old in prison.

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LINDA: The change is for me my health.

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My health has declined and the getting[br]around that I don't have anymore.

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I didn't think that I'd ever grow old.

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That my hips wouldn't work, that I couldn't[br]get down or get up anymore, or my legs.

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MARYLINN: And never in my life did I[br]think I'd be sitting in prison and going,

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wow I'm 70 years old and I don't[br]even have a retirement plan.

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I don't have to go to work[br]everyday because that's the program.

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That's what you have to do.

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Or that I would have lost my whole[br]family behind these circumstances.

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That I would no longer have[br]a family to reach out to.

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FARYON: The women are part of a[br]group called the Golden Girls,

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inmates over 55 who are granted[br]special privileges

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like a double mattress on their metal cots.

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And they're first in line during meals.

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But this is still prison.

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And there are rules.

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Like getting down on the[br]floor when an alarm sounds.

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This happened while we were there.

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59-year-old Linda can barely[br]make it down or back up again.

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DR. JOSEPH BICK: Prisons[br]weren't built to make it easy

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for mobility-impaired people to get around.

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Prisons were built to safely[br]incarcerate individuals whoa re sent away

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and keep them from escaping.

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So we're trying to deal with things how do[br]you accommodate activities of daily living

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of somebody who's in their 60s, 70s, and 80s.

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Simple things like getting their[br]clothes on, going to the bathroom,

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ambulating down the hallway to the dining halls.

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Having enough time to eat.

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Having more than 15 minutes to consume a meal.

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FARYON: Dr. Joseph Bick has been[br]working as a prison doctor for 20 years.

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He tends to patients at CMF's[br]hospital and the prison hospice,

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where he's held the hand of many dying inmates.

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DR. JOSEPH BICK: I'm not privy to inmates'[br]commitment offenses as a clinician,

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it's something I'm not particularly[br]interested in knowing.

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In fact I endeavour to not[br]know because I think my job is

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to provide the best quality[br]of health care I can.

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But I'm human too and I don't want[br]to run the risk of being influenced

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by knowledge of someone's commitment offense.

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FARYON: We met two inmates in the[br]prison hospice on the day of our visit.

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Angelo Chavez has end-stage liver disease.

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ANGELO CHAVEZ: I was hoping they[br]would give me a compassionate release

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and that's what I'm waiting for, to[br]see if I can go home to my family.

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FARYON: Chavez is a three striker[br]and serving a life sentence.

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His convictions include drug[br]possession, robbery and manslaughter.

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CHAVEZ: I would love to go home and[br]die out there, than to die here.

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FARYON: We also met Brian Long.

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He has cancer and is expected[br]to live another three months.

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In 1993, Long was convicted of having[br]sex with a minor and served six years.

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In 2003 he was sentenced to 11 years for[br]a second sexual offense against a child.

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In California, inmates can be[br]released for compassionate reasons

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if they have less than six months to live.

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Last year there were 57 requests.

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Three were granted by the courts.

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DR. JOSEPH BICK: People have[br]very strong opinions on all sides

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of this discussion you certainly have people[br]who have been victims or their family members

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of some very heinous crimes from some[br]of the people who live in this facility.

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And they strongly feel that it doesn't matter[br]how old somebody gets or how sick they get

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or what they're likelihood of[br]reoffending is they should spend the rest

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of their life in prison.

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FARYON: But Dr. Bick says we[br]can't deny them health care.

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Not only is it the law, it is[br]also a matter of public health.

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DR. JOSEPH BICK: With so many people[br]incarcerated we choose as a society

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to incarcerate people that come to us[br]with such an incredible burden of disease,

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HIV and hepatitis and tuberculosis[br]and mental illness

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and substance abuse whoa re someday[br]going to go home, to me the tragedy is

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to somehow ignore them an[br]put them off there and assume

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because they're incarcerated they[br]don't matter or they're not going

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to somehow impact upon the[br]general health at time of release.

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FARYON: And how do you see your life[br]playing out then here as you age?

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CAMPBELL: I'll just grow[br]old and eventually I'll die.

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I don't see it as - you know I'm well adapted.

0:18:48.770,0:18:50.770
Institutionalized, if you will.

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So I don't see a problem just existing.

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Eventually I wont be able to function[br]anymore and eventually I'll end

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up in a hospital and eventually I'll die.

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But in the meantime it's going to cost the[br]state an awful lot of money to take care of me.

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FARYON: Terry Campbell was convicted in[br]1966 of murder during an armed robbery.

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He has two other convictions from 1968[br]and 1973, both while incarcerated.

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He told KPBS he was mixed up[br]with prison gang violence.

0:19:25.330,0:19:32.440
Since that time Campbell has[br]earned two college degrees FARYON:

0:19:32.440,0:19:37.170
What's your biggest fear[br]about growing old in prison?

0:19:43.800,0:19:51.920
CAMPBELL: I don't know if it's a fear, but my[br]biggest concern about growing old in prison is

0:19:51.920,0:19:56.950
that I went through all the trouble - on a[br]personal level I went through all the trouble

0:19:56.950,0:20:12.090
to change, to become a different[br]person and now I don't know

0:20:12.090,0:20:16.540
for what reason other than[br]personal satisfaction.

0:20:16.540,0:20:18.640
I can't give anything back.

0:20:18.640,0:20:21.350
VIRGIL: And being alone.

0:20:22.480,0:20:33.670
Dying alone where there isn't anyone[br]who cares about you or knows you.

0:20:33.670,0:20:39.610
FARYON: Glenda Virgil was convicted of[br]second-degree murder in 1987 for shooting

0:20:39.610,0:20:41.870
and killing the man with[br]whom she had been involved.

0:20:41.870,0:20:45.130
She told KPBS she had been a battered woman.

0:20:45.130,0:20:47.060
LAURANZANO: They didn't give you life without,

0:20:47.060,0:20:51.410
they didn't give you the death penalty[br]they gave you 25 to life or 15 to life

0:20:51.410,0:20:54.100
that means you get out at some point.

0:20:54.100,0:20:58.420
And if you do everything they say you should[br]get out and be a functioning member of society.

0:20:58.420,0:21:02.240
FARYON: Richard Lauranzano[br]was convicted of seven counts

0:21:02.240,0:21:10.650
of sexual assault with children[br]under 14 in 1984.

0:21:10.650,0:21:15.470
While in prison he was also[br]convicted of murder in connection.

0:21:15.470,0:21:26.020
He is serving a 50-year sentence[br]but is eligible for parole in 2013.

0:21:26.020,0:21:33.820
Lauranzano's cancer is in[br]remission, but he has heart trouble

0:21:33.820,0:21:39.520
and is consulting with experts about surgery.

0:21:39.520,0:21:43.990
GOVERNOR: 30 years ago 10%[br]of the general fund went

0:21:43.990,0:21:48.730
to higher education and only 3% went to prisons.

0:21:48.730,0:21:56.710
Today almost 11% goes to prisons and[br]only 7.5% goes to higher education.

0:21:56.710,0:22:06.000
Spending 45% more on prisons than universities[br]is no way to proceed into the future.

0:22:06.000,0:22:14.100
FARYON: But it will be a difficult ship to turn[br]given California's 30-year history of support

0:22:14.100,0:22:22.950
for longer prison sentences and this[br]administration's record of denying parole.

0:22:22.950,0:22:31.370
Plans to build a new billion-dollar prison[br]to house old inmates who need chronic care

0:22:31.370,0:22:35.140
and inmates who need mental[br]health services are now underway.

0:22:35.140,0:22:37.470
There isn't room for them anywhere else.

0:22:37.470,0:22:41.920
Clark Kelso is also looking at ways to[br]get his outside hospital costs down.

0:22:41.920,0:22:49.360
Last year the state spent 500 million dollars[br]on those visits - about 1,000 very sick

0:22:49.360,0:22:52.730
and dying inmates accounted[br]for most of that cost.

0:22:52.730,0:22:55.700
KELSO: There are solutions[br]I think the legislature

0:22:55.700,0:23:00.790
and the people need o become more comfortable[br]with such as medical parole or other types

0:23:00.790,0:23:05.140
of programs that will get these[br]unhealthy inmates these again inmates

0:23:05.140,0:23:10.810
who don't pose very much threat to the public[br]in terms of recidivism very good numbers there,

0:23:10.810,0:23:16.130
we have to come to a better[br]public understanding in California

0:23:16.130,0:23:19.440
with how to take care of those inmates.

0:23:19.440,0:23:26.000
FARYON: Kelso has been in talks with[br]officials, including the governor's office,

0:23:26.000,0:23:30.160
about releasing some inmates to[br]privately run secure nursing homes.

0:23:30.160,0:23:34.330
According to government statistics,[br]people over 55 have less

0:23:34.330,0:23:38.940
than a four per cent recidivism rate which[br]means they are the least likely of all inmates

0:23:38.940,0:23:41.660
to commit another offense and return to prison.

0:23:41.660,0:23:48.690
And once released from state run[br]prisons, it's likely they'd be eligible

0:23:48.690,0:23:51.140
for federal health care subsidies.

0:23:51.140,0:23:53.900
KELSO: One way or another health care needs

0:23:53.900,0:23:57.360
of these people are going[br]to be paid for by somebody.

0:23:57.360,0:24:01.670
FARYON: Should a life sentence[br]mean a life sentence in California?

0:24:01.670,0:24:04.320
If they're not rehabilitated absolutely.

0:24:04.320,0:24:08.970
HARRIET: What are you going to[br]do with them if you let them out?

0:24:08.970,0:24:11.870
Where are they going to go?

0:24:11.870,0:24:14.380
What are you going to do with them?

0:24:14.380,0:24:18.080
You're going to say they're not going to[br]commit a crime if they can't get a job

0:24:18.080,0:24:27.380
and you're talking maybe 65 they need to[br]make some income and they cant get a job

0:24:27.380,0:24:32.860
and they have no place to live what[br]are they going to do they're going

0:24:32.860,0:24:36.200
to rob somebody's home, where[br]are they going to get the money.

0:24:36.200,0:24:42.610
You just don't open the door[br]here's your $200 go get the bus.

0:24:42.610,0:24:45.340
FARYON: Do you ever think you will get out?

0:24:45.340,0:24:47.370
CAMPBELL: No.

0:24:47.370,0:24:47.970
No I don't.

0:24:47.970,0:24:59.080
That saying about it doesn't really matter where[br]you are, but it always matters who you are?

0:24:59.080,0:25:00.000
You know, that applies.

0:25:00.000,0:25:11.460
That applies to a lot of us that are in prison[br]because there are a lot of lifers who came

0:25:11.460,0:25:20.660
to prison, who didn't get into[br]trouble like I got into trouble

0:25:20.660,0:25:28.180
when I came to prison, who are still here.

0:25:28.180,0:25:37.040
And they're sitting around[br]wondering, well what do I have to do?

0:25:37.040,0:25:42.470
What do I have to do to get out of prison?

0:25:42.470,0:25:48.930
How do I prove myself and[br]who do I prove myself to?

0:25:48.930,0:25:53.270
And there's no answer.

0:25:53.270,0:26:16.180
FARYON: You can learn more about this issue[br]by going to our website, kpbs.org/prisons.

0:26:16.180,0:26:25.280
And you can also leave a comment.

0:26:25.280,0:26:30.330
We'd love to hear from you.

0:26:30.330,0:26:45.120
For KPBS, I'm Joanne Faryon,[br]thanks for watching.