Lansing Faced with increases in health costs, the population of older inmates and the number of prisons in Kansas, the bill for treating inmates is ballooning.
The elderly men visit quietly, taking advantage of the December sunshine that has snuck over the razor wire and rock-wall perimeter.
Rudolph Steele, 65, sits astride the cane he needs to make the 30-foot walk from his bed.
Frank Wilkins, 72, takes a drag off a cigarette, drawing smoke into what's left of his lungs. Doctors removed part of one lung a little more than a year ago after Wilkins was diagnosed with cancer.
After the men leave the concrete and chain-link courtyard here at the Lansing Correctional Facility infirmary, there will be more treatments, more medication, more observation and perhaps more surgeries for their various ailments.
And the state's costs for treating inmates will inch upward again, adding to a 55 percent increase since 1990.
Lansing and state corrections officials say an increase in the number of inmates spending their so-called golden years behind bars is partly behind the rise in health-care spending.
"The average age has risen only a couple of years," said Bill Miskell, spokesman for the Kansas Department of Corrections. "But what we're seeing is an increase in older inmates and an increase in younger inmates, which balance each other out."
According to figures compiled by Miskell, spending for medical and mental health-care services rose from $10,626,324 in 1990 to an authorized limit of $16,480,610 for fiscal year '94.
Over the same period, the number of inmates has gone up only 7 percent, from an average daily population of 5,703 in 1990 to 6,109 this year.
Where's the money going? Miskell and Roger Werholtz, deputy secretary of corrections, said a principal factor was a prison building boom that started in the 1980s and added El Dorado, Ellsworth, Norton and Stockton to the corrections department's budget. In addition, new facilities were built at existing prisons in Larned and Hutchinson.
"El Dorado, for instance, opened in 1991," Miskell said. "Norton started coming on line in '87. Ellsworth came on line in '88, and was fully operational a couple of years later. So we've seen these places really get fully operation in the last three or four years, from '89 to '92."
With new prisons came new health-care facilities, more doctors and nurses, more equipment and higher medical bills for the state. In 1990, the state spent an average of $1,863 per inmate for health care.
That figure has shot to a projected $2,698 -- a 44 percent increase -- for fiscal year 1994. Werholtz said that in comparison, the state pays $2,500 to $2,700 per year in health-care premiums for each state employee.
Part of the overall increase lies in the rising cost of health care in general. Prisons walls don't shut out the bills or the illnesses that afflict people on the outside.
"Prisons operate just like a city," said Tabor Medill, administrative assistant to the warden at Lansing. "You have a mayor, we have a warden. You have judges, we have our disciplinary council. The same holds for medical issues. You've got cancer, we've got cancer. You've got AIDS, we've got AIDS."
Our health care is expensive, prison health care is expensive. That's true whether it's chemotherapy for cancer patients, medication for AIDS patients or less intensive treatments, such as dialysis, which can cost up to $1,500 per week per inmate.
"At one point, we were sending five inmates to KU (the Kansas University Medical Center) three times a week for treatment," said Gay Savino, charge nurse at the Lansing infirmary.
That's $7,500 for one week of treatment for less than four-tenths of 1 percent of one prison's population.
And the patients have kept coming, drawn from an unusually unhealthy population pool.
Mark Boyd, administrator of the Lansing infirmary, said many inmates have neglected their health or abused their bodies through smoking, drinking and using drugs. Some come in with gunshot wounds, broken bones and other traumatic injuries from fights or accidents.
Steele and Wilkins brought a host of medical problems with them from beyond the walls. Steele, a diabetic who was a frequent cocaine user, suffers heart problems. He's serving a 36-year-to-life sentence for possessing cocaine with the intent to sell.
Before he was sentenced, Steele underwent bypass surgery, and he continues to receive medication for his heart.
Wilkins' smoking is a main culprit behind his lung cancer. Before he was sentenced on a sex-related crime last year, he said, he didn't know he was sick. He never went to a doctor for checkups, he said, preferring instead to go to a Wichita Veterans' Administration hospital when something was bothering him.
"I didn't have any health problems, not that I could notice," he said. "My chest hurt once in a while."
Although Steele and Wilkins are ancient by prison standards -- Wilkins is the fourth-oldest inmate at Lansing; Steele the 14th -- they're far from a dying breed.
Medill said prison officials had seen an increase in the number of sexual molestation cases, many of which involve older men. And because of stiffer sentences being meted out for some crimes, he expects to see more inmates 60 and older in coming years.
"An example is the Hard 40 sentence," he said, referring to a 40-year minimum murder term that went into effect in July 1992.
Steele and Wilkins are leaving their outdoor chairs now, heading back to their beds. Wilkins says he will be eligible for parole in May, and Steele is hoping an appeal being argued in his case will win his freedom.
But for now, there will be more treatments, more medication, more observation. Because neither man wants to die here.
"Oh, I'll get out of here," Steele said. "I have no fear."