Management of Aging Offenders

By Elizabeth Franklin-Best, Esq., and Christopher Zoukis, JD, MBA

Program Statement 5241.01 at a glance

Field	Value
Program Statement	5241.01, Management of Aging Offenders
Subject	How the Bureau of Prisons identifies, tracks, houses, screens and accommodates people aged 50 and older
Effective / current edition date	April 14, 2022 (PDF header: “NUMBER: 5241.01 / DATE: April 14, 2022”), signed by Director M.D. Carvajal
Change notice	None. There is no change notice to 5241.01
Supersedes / rescinds	Nothing. The header block carries no “Program Statement Rescinded” line — 5241.01 was issued as a new statement, not a reissue of an earlier one
Governing statute	The PS names no statute as its own authority. Its REFERENCES block lists the Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq.; the Architectural Barriers Act, 42 U.S.C. § 4151 et seq.; and the First Step Act of 2018
Governing regulation (28 C.F.R.)	The PS’s REFERENCES block cites 28 C.F.R. § 39.170 and 28 C.F.R. parts 39 and 500. Part 39 is DOJ’s disability-nondiscrimination rule; part 500 is the Bureau’s general definitions. There is no 28 C.F.R. part devoted to aging prisoners
Related BP forms	BP-A0148, Inmate Request to Staff (the “cop-out”), named at PS 5241.01 § 9 as the way to request an accommodation
Official PDF	PS 5241.01, Management of Aging Offenders (Apr. 14, 2022)

Checked against the BOP policy set · 2026-09-06.

Program Statement 5241.01 tells Bureau of Prisons staff how to identify people who are aging in federal prison, what accommodations to give them, and how often to reassess their health and their release planning. It is the document behind a lower bunk, a first-floor cell, an inmate companion, a walker, and the annual review that asks whether someone should be considered for a Reduction in Sentence.

This page explains what the policy says and reproduces its age categories word for word. If your question is instead whether a court can shorten an elderly person’s sentence — the standard, the filing, the record a judge wants to see — that belongs on our compassionate release for elderly inmates page, and this page does not duplicate it. For how medical care is actually delivered day to day, see Patient Care (PS 6031.06); for how someone gets moved to a medical facility, see medical designations and care levels.

The rule itself: BOP’s four age categories and what each one triggers

The heart of PS 5241.01 is its definitions section. The Bureau does not use one cut-off for “old.” It uses four overlapping categories, each of which switches on a different set of obligations for staff. Everything in the table below is reproduced verbatim from the Program Statement’s own DEFINITIONS section.

The age categories, verbatim

Category	Definition as printed in PS 5241.01
Accelerated Aging (age 50-64 years)	“This cohort of offenders aged 50-64 years typically have multiple comorbid medical and mental health problems due to risk factors such as long-standing variable access to health care, prolonged exposure to psycho-social and environmental health deterrents, and detrimental health behaviors, and may be enrolled in multiple chronic care clinics.”
Aging Offender	“Offender exhibiting measurable physiological, functional or cognitive changes related to accelerated aging, generally an individual whose chronological age is 50 years or older.”
Elderly Inmate	“Inmate whose chronological age is 65 years or older.”
Frail Elderly/Elderly Offenders	“Frail elderly/elderly offenders have the highest risk and prevalence of age-related health problems. Frail elderly offenders are 65 years or older and meet two or more of the following criteria” (the three criteria are set out below).

Source: PS 5241.01 at pp. 1–2.

The three frail-elderly criteria — two or more must be met

A person 65 or older is “frail elderly” under the policy only if at least two of these three are true:

1. “have one or more permanent medical conditions that result in end organ damage as part of the natural history of the disease, and for which conventional treatment will not substantially arrest, reverse or control/mitigate the end organ damage despite optimal medical management”;
2. “require human assistance (staff or inmate) on a daily basis to perform activities of daily living and/or instrumental activities of daily living (see the Definitions section above) despite the regular use of assistive devices as observed and documented in the health record”; and/or
3. “require frequent human assistance (by staff or inmate more than once a week) to be reoriented to person, place, or time related to early stages of cognitive dysfunction as observed and documented in the health record.”

Source: PS 5241.01 at pp. 2–3.

The policy also defines the two clinical terms that criterion 2 turns on. “Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)” are “[a]n inmate’s abilities to perform actions that involve the management of basic bodily functions (ADL) or activities that permit independent living (IADL),” and the PS gives the example that “an inmate with an impairment to an ADL may have difficulty eating; an inmate with an impairment to an IADL may be able to physically eat, but could not plan the meal” (PS 5241.01 at p. 2). That distinction matters, because “requires daily human assistance with ADLs or IADLs” is one of the two boxes that has to be checked before the Bureau’s own policy calls someone frail elderly.

What each birthday actually triggers

Age / status	What the Program Statement directs staff to do	Where it says so
50th birthday	“Inmates become eligible for aging specific programming and services upon their 50th birthday. At that time, they are eligible to address their needs though age appropriate FSA interventions.” Needs are reassessed “every six months.”	PS 5241.01 § 6 at p. 5
50 and older	Health Services staff “will perform a baseline Preventive Health assessment and an annual Preventive Health record review for aging offenders 50 years of age and older.”	PS 5241.01 § 7 at p. 6
Within 6 months of the 60th birthday	“All offenders who are within 6 months of their 60th birthday must be considered under the Elderly Offender Program and the appropriate referral made to the Residential Reentry Management Branch as described in the First Step Act of 2018 and policy.”	PS 5241.01 § 10 at p. 8
65 and older (elderly)	Staff “[r]eview the suitability of assigned age specific accommodations and determine whether other accommodations are warranted” and “[e]valuate annually for Reduction in Sentence (RIS) eligibility.”	PS 5241.01 § 7 at p. 6
65 and older, frail elderly	The same two steps, plus: “Assign to an Aging Offender Interdisciplinary Care Team.”	PS 5241.01 § 7 at p. 6
Any age, all institutions	“A minimum of one program focused on aging issues will be provided per quarter and documented in SENTRY or other appropriate databases.”	PS 5241.01 § 6 at p. 5
Any age, all institutions	“Conduct, at a minimum, an annual inspection of the institution grounds and buildings to identify infrastructure problems that would impede offenders aging in place from accessing programs and services.”	PS 5241.01 § 3 at p. 4
Facilities with 5% or more elderly and aging offenders	Will “consider establishing an Aging Offender Interdisciplinary Care Team.”	PS 5241.01 § 3 at p. 4

Source: PS 5241.01 at pp. 4–8.

The accommodations the policy names

Two lists matter here. The first is the policy’s definition of an “Age Specific Accommodation”: “Consideration for the management of aging offenders which may include the need for longer time to travel across the compound, the possibility of placement in a housing unit near Health Services or the dining hall, the need for an inmate companion, housing at the bottom level of a facility, and/or a bed assignment closer to restroom facilities” (PS 5241.01 at p. 2).

The second is the operative list in § 9: “Accommodations may include, but are not limited to, accessibility of all relevant areas of the compound, assistive devices or technologies, specialized approaches to learning, interpreters, and additional time to complete tasks, modified materials (e.g. large print), enhanced reentry planning, and inmate companions” (PS 5241.01 at p. 8).

Read the two together and the Bureau’s own catalog of age accommodations is:

• extra time to move across the compound, and additional time to complete tasks;
• a housing unit near Health Services or the dining hall;
• a bottom-tier (ground-floor) cell and a lower bunk;
• a bed assignment closer to restrooms;
• a wheelchair-accessible cell;
• an inmate companion to help with activities of daily living;
• assistive devices and technology — the policy names “wheelchairs, canes, hearing aids, glasses, text magnifiers, large print books/signs, and assistive devices” (PS 5241.01 § 3 at p. 4);
• modified materials such as large print, specialized approaches to learning, and interpreters;
• enhanced reentry planning.

Two limits sit right next to that list, and both are in the policy itself. First: “The accommodation(s) provided does not have to be the accommodation requested by the aging offender” (PS 5241.01 at p. 7). Second: “In deciding whether to grant an accommodation, institutions may consider whether the program or activity would be fundamentally altered, or whether it would result in undue financial or administrative burden. Before denying a request for accommodation on this basis, the appropriate legal office will be consulted” (PS 5241.01 at p. 8). So a denial on burden grounds is supposed to pass through a lawyer before it reaches the person who asked.

How a request is made and who decides it

Staff can act on their own — “Staff members may unilaterally provide accommodations to aging offenders without a formal inmate request.” A person can also ask: “Inmates also may request an accommodation or a modification to accommodations already provided by making a BP-A0148, Inmate Request to Staff” (PS 5241.01 § 9 at p. 7). For complicated cases the decision goes to a committee the policy names and staffs:

“For particularly complex cases, accommodations are determined by a team (known as a local Aging Offender Committee), comprised of a Psychologist, Medical Provider, Supervisor of Recreation, Unit Manager, Reentry Affairs Coordinator, and Captain. This team is led by the Associate Warden, Programs, whose responsibility is to serve as the local coordinator on aging offenders.”

Source: PS 5241.01 at p. 7.

Finally, and this is the sentence families most often need: “Information about accommodations authorized for a particular inmate is documented by the department approving them, and a notification is sent to the unit team to include in the inmate central file” (PS 5241.01 at p. 8). An approved accommodation is supposed to leave a paper trail in the central file. If it did not, that absence is itself the thing to raise.

What the aging offender policy means for you

If you are the person inside: requesting an accommodation

The document that starts everything is the BP-A0148 Inmate Request to Staff — the cop-out. PS 5241.01 § 9 names it by number as the way to ask for an accommodation or to change one you already have. Write it to the department that controls the thing you need: Health Services for a lower-bunk pass, a cane, a walker, hearing aids or a text magnifier; the Unit Team for a cell assignment, a tier change, or a housing move nearer to Food Service or the clinic; Recreation or Education for modified materials or extra time. Keep a copy, keep the staff response, and date everything.

Two dates are worth writing on the wall of your locker. At 50, the policy treats a person as an aging offender for programming purposes and directs that their needs be reassessed every six months. At 65, staff are directed to review your accommodations and to “[e]valuate annually for Reduction in Sentence (RIS) eligibility” — meaning the medical staff at your institution are supposed to ask, once a year, whether your case should be sent up for a compassionate-release recommendation. Nobody has to tell you they did it. Asking in writing whether the annual RIS review was done, and asking for the result, is how you find out.

If you are being told a request is denied because it would be too expensive or too disruptive, note that the policy directs the institution to consult “the appropriate legal office” before denying on that ground.

If you are a family member: supporting an aging relative

You cannot file a request for your loved one. Under 28 C.F.R. § 542.10, “[a]n inmate may not submit a Request or Appeal on behalf of another inmate,” and the administrative remedy system is built around the incarcerated person’s own signature. What you can do is more practical than it sounds.

Get the outside medical records into the institution. PS 5241.01 § 7 directs staff to conduct an intake screening and a comprehensive history and physical for newly admitted aging offenders and to refer people “presenting with physiological, functional, cognitive or sensory problems for additional targeted assessment.” Screening is only as good as the information in front of the clinician, and pre-incarceration records — a cardiology workup, a neurology note, a fall history, a dementia screening — are frequently the difference between a routine screen and a referral.

Then track dates, not feelings. Write down when the cop-out went in, what department it went to, what the answer was, and when. When a call home describes a fall on a stairwell, a missed pill line, or a cellmate helping with dressing, note the date. Those notes become the timeline that a lawyer, a warden, or eventually a judge can actually work with.

If you are counsel: aging offenders

PS 5241.01 gives you four record hooks that most files never develop. First, the frail-elderly definition: it is a three-part clinical test with a “two or more” threshold, and the Bureau’s own health record is where the answer lives. Second, § 7’s directive that frail elderly and elderly offenders be evaluated “annually for Reduction in Sentence (RIS) eligibility” — whether that review happened, and what it concluded, is discoverable through the medical record and through a Privacy Act request. Third, § 9’s requirement that authorized accommodations be documented and forwarded to the unit team for the central file, which makes the central file a place to prove either that an accommodation was granted and not delivered, or that it was never granted at all. Fourth, § 3’s annual physical-plant inspection, with a named inspection team and a required “corrective action plan” for identified deficiencies — an institutional record, not an individual one.

Remember what this document is and is not. A Program Statement is the Bureau’s internal instruction to its own staff; it is not a regulation and it is not a statute. The binding disability rule for a DOJ-conducted program is section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), which provides that no “otherwise qualified individual with a disability … shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under … any program or activity conducted by any Executive agency.” DOJ’s implementing rule is 28 C.F.R. part 39, and its complaint procedure at § 39.170 is explicit that “[b]efore filing a complaint under this section, an inmate of a Federal penal institution must exhaust the Bureau of Prisons Administrative Remedy Procedure as set forth in 28 CFR part 542,” after which complaints “shall be filed within 180 days of the final administrative decision of the Bureau of Prisons.” That is a real, separate, and frequently missed route.

On the constitutional floor: Estelle v. Gamble, 429 U.S. 97 (1976), held that “deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain’ … proscribed by the Eighth Amendment,” and that this is true “whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed.” The same opinion is equally clear about the limit: “a complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner.” Farmer v. Brennan, 511 U.S. 825 (1994), supplies the mental state: an official is not liable “unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.” Verified through the Estelle and Farmer opinions.

What changed with Program Statement 5241.01

PS 5241.01 is unusual among Bureau policies in one respect that matters for anyone comparing editions: it rescinded nothing. The header block on page 1 has no “Program Statement Rescinded” line. Before April 14, 2022, the Bureau had no standalone Program Statement on aging offenders; aging was handled through the disability policy, the Patient Care policy, and clinical guidance. 5241.01 is the first national statement to define an “Aging Offender,” an “Elderly Inmate” and a “Frail Elderly” offender in one place, to name a local Aging Offender Committee, and to require a quarterly aging-focused program at every institution.

What has changed is everything around it. The policy’s own REFERENCES block, frozen as of April 2022, points to editions of other Program Statements that the Bureau has since reissued — several of them in the 2026 mass reissue. It cites “P6031.04 Patient Care (6/3/14)”; the operative edition is now 6031.06, dated June 22, 2026. It cites “P5325.07 Release Preparation Program (8/15/19)”; the operative edition is now 5325.09, dated June 22, 2026. It cites “P5100.08 Security Designation and Custody Classification Manual (9/4/19)”; that manual now carries a May 6, 2026 change notice. It cites “P5322.13 Inmate Classification and Program Review (5/16/14),” a number the Bureau has since replaced with 5321.09, Unit Management and Inmate Program Review. And it cites “P5310.16 Treatment and Care of Inmates with Mental Illness (5/1/14),” now carrying a February 18, 2025 change notice. None of that invalidates 5241.01. It does mean that when a staff member tells you “policy says X, see the Patient Care PS,” the edition they are quoting from inside 5241.01 may be two reissues out of date.

The bigger movement is statutory, and it runs the other way. Section 10 of the Program Statement directs that everyone within six months of turning 60 “must be considered under the Elderly Offender Program … as described in the First Step Act of 2018 and policy.” That program is the home-detention pilot at 34 U.S.C. § 60541(g). The First Step Act rewrote it in December 2018 — dropping the age from 65 to 60 and the served-time fraction from three-quarters to two-thirds. But the current codified text of § 60541(g)(3) still reads that the pilot “shall be carried out during fiscal years 2019 through 2023,” and § 60541(h) still authorizes appropriations “for each of fiscal years 2019 through 2023.” As of this page’s currency date, the United States Code has not been amended to extend those fiscal years. Whether and how the Bureau continues to operate an Elderly Offender Program after the authorized window is a question for the Bureau, and it is one worth asking in writing rather than assuming. See the LAW-WATCH note at the foot of this page.

Where people get stuck when an accommodation is not delivered

The accommodation is approved but never delivered

This is the most common failure, and the policy anticipates it: an authorized accommodation is supposed to be “documented by the department approving them,” with “a notification … sent to the unit team to include in the inmate central file” (PS 5241.01 at p. 8). So there are two different problems wearing the same face — never approved, or approved and not implemented — and they have different fixes.

Start with a BP-A0148 cop-out to the approving department asking, specifically, whether the accommodation was authorized and on what date. If the answer is that it was, and the lower bunk still has not appeared, that is an implementation failure and it goes into the Administrative Remedy Program: informal resolution first, then a BP-9 within 20 calendar days of the event, then a BP-10 within 20 days of the Warden’s signed response and a BP-11 within 30 days of the Regional Director’s. If no response arrives inside the response window, 28 C.F.R. § 542.18 lets you “consider the absence of a response to be a denial at that level” and move up — do not sit and wait.

The annual Reduction in Sentence review nobody can confirm happened

Section 7 directs Health Services staff to “[e]valuate annually for Reduction in Sentence (RIS) eligibility” for both elderly and frail elderly offenders. There is no form, no notice to the person, and no docket. The practical route is a cop-out to the Clinical Director or Health Services Administrator asking whether the annual RIS evaluation was completed for the current year and what the outcome was, followed — if the answer is silence or a non-answer — by a BP-9. Whether a Reduction in Sentence is ultimately recommended is discretionary with the Bureau, and no policy entitles anyone to a favorable result; what the policy does describe is a yearly evaluation, and whether it happened is a fact you can pin down. If it did not, that gap belongs in any later filing. See Compassionate Release / Reduction in Sentence (PS 5050.51).

The compound itself is the barrier

An accommodation can be granted and still be useless if the walk to Health Services is 400 yards over broken pavement. Section 8 requires wardens to ensure “the environment (building, compound) is accessible and inspected annually,” with the inspection covering “adequate lighting; functional heating and cooling systems; level and unimpeded passageways/walkways; accessibility to programming areas, cells, bathrooms, showers, and hand railings,” and it requires that “[a] corrective action plan will be created and implemented for any identified deficiencies.” Section 3 names the inspection team: Health Services, Facilities, Occupational Safety and Health, and Correctional Services. That is an institution-level record. It is a legitimate subject of an administrative remedy, and — once BOP remedies are exhausted — of a disability complaint under 28 C.F.R. § 39.170.

“You are at the wrong prison for this”

Sometimes the accommodation problem is really a designation problem: the institution genuinely does not have the medical resources. Section 5 of the policy is short and important — “Ordinarily, aging offenders are designated via standard procedures … The Office of Medical Designation and Transportation will make medical designation determinations and will consult with the WASPB as needed regarding age specific accommodations at a particular facility.” That is a different process with different decision-makers, and it is covered on our medical designations and care levels page. Age alone does not move anyone; medical care level does. Where the real issue is that a person needs skilled nursing, help with dressing and toileting, or a dementia setting, the argument is a care-level argument, and it is worth a consultation rather than a cop-out written in the dark.

Related BOP policy on aging offenders

Page	What it covers
Compassionate release for elderly inmates	The court-side question: age, health, the § 3582(c)(1)(A) standard, and how a motion is built
Medical care in federal prison	The practical overview of getting seen, getting medication, and disputing a decision
Patient Care (PS 6031.06)	Sick call, intake screening, chronic care clinics, treatment refusal, informed consent
Medical designations and care levels (PS 6270.02)	Care Levels 1–4, OMDT, and how someone is moved to a medical facility
Inmate Copayment Program (PS 6032.01)	The $2.00 fee, what it applies to, and the eight exempt categories
Management of Inmates With Disabilities (PS 5200.06)	The parallel accommodation process 5241.01 cross-references by name
Treatment and Care of Inmates with Mental Illness (PS 5310.16)	Cognitive decline, dementia, and mental health care levels
Compassionate Release / Reduction in Sentence (PS 5050.51)	The Bureau’s own RIS criteria and internal review path
Administrative Remedy Program (PS 1330.18)	BP-8 through BP-11, deadlines, and constructive denial
Inmate Request to Staff (PS 5511.08)	How the BP-A0148 cop-out works
Release Preparation Program (PS 5325.09)	Reentry planning, including the referrals § 10 requires for aging releasees
Home confinement (PS 7320.01)	The placement authority the Elderly Offender Program runs through

Frequently Asked Questions About Aging Offenders in BOP Custody

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Program Statement 5241.01 — full text

What follows is Program Statement 5241.01 exactly as the Bureau of Prisons published it, reproduced in full from the official PDF rather than summarized. Source: bop.gov/policy/progstat/5241_001.pdf.

U.S. Department of Justice Federal Bureau of Prisons

PROGRAM STATEMENT

OPI: RSD/WSP NUMBER: 5241.01 DATE: April 14, 2022

Management of Aging Offenders

/s/ Approved: M.D. Carvajal Director, Federal Bureau of Prisons

1. PURPOSE AND SCOPE

To ensure the Bureau of Prisons (Bureau) properly identifies, tracks, and provides services to aging offenders.

a. Program Objectives. Expected results of this program are:

• Institutions ensure aging offenders have appropriate access to program s, services and age specific accommodations.
• Reentry planning includes referral to age specific accommodation services and appropriate housing.
• Sufficient resources will be allocated to deliver appropriate services to aging offenders.
• Ensure staff are provided training in order to work with aging offenders.

b. Institution Supplement. None required. Should local facilities make any changes outside

changes required in national policy or establish any additional local procedures to implement national policy, the local Union may invoke to negotiate procedures or appropriate arrangements.

2. DEFINITIONS

Accelerated Aging (age 50-64 years). This cohort of offenders aged 50-64 years typically have multiple comorbid medical and mental health problems due to risk factors such as long-standing variable access to health care, prolonged exposure to psycho-social and environmental

health deterrents, and detrimental health behaviors, and may be enrolled in multiple chronic care clinics.

Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs): An inmate’s abilities to perform actions that involve the management of basic bodily functions (ADL) or activities that permit independent living (IADL). For example, an inmate with an impairment to an ADL may have difficulty eating; an inmate with an impairment to an IADL may be able to physically eat, but could not plan the meal.

Aging in Place: An individual living in a residence for as long as they are able as they age. This is the ability to live safely, independently, and comfortably, regardless of age or ability level. Aging in place in prison offers the added benefit of allowing an inmate to remain in an institution near his/her release residence and potential visitors/family.

Aging Offender: Offender exhibiting measurable physiological, functional or cognitive changes related to accelerated aging, generally an individual whose chronological age is 50 years or older.

Age Specific Accommodation: Consideration for the management of aging offenders which may include the need for longer time to travel across the compound, the possibility of placement in a housing unit near Health Services or the dining hall, the need for an inmate companion, housing at the bottom level of a facility, and/or a bed assignment closer to restroom facilities.

Assistive Technology: Adaptive or rehabilitative devices used by inmates with disabilities. Examples include but are not limited to: hearing aids, communication devices, wheelchairs, walkers and text magnifiers.

Elderly Inmate: Inmate whose chronological age is 65 years or older.

Frail Elderly/Elderly Offenders. Frail elderly/elderly offenders have the highest risk and prevalence of age-related health problems. Frail elderly offenders are 65 years or older and meet two or more of the following criteria:

• have one or more permanent medical conditions that result in end organ damage as part of the natural history of the disease, and for which conventional treatment will not substantially arrest, reverse or control/mitigate the end organ damage despite optimal medical management;
• require human assistance (staff or inmate) on a daily basis to perform activities of daily living and/or instrumental activities of daily living (see the Definitions section above) despite the regular use of assistive devices as observed and documented in the health record; and/or
• require frequent human assistance (by staff or inmate more than once a week) to be reoriented to person, place, or time related to early stages of cognitive dysfunction as observed and documented in the health record.

3. AGENCY RESPONSIBILITIES

Aging offenders may have needs that are different from their younger peers. They frequently deal with increased needs related to health care, physical and cognitive accommodations, mobility, sensory deficiencies, dementia, Alzheimer’s disease, maintaining family contact, end of life and palliative care.

• Central Office

a. The Women and Special Populations Branch (WASPB) is responsible for ensuring

consistent establishment of the programs, services, and resource allocations for necessary accommodations for aging offenders. This will be done in accordance with all laws, rules and regulations.

b. The Health Services Division is responsible for establishment and oversight of all

health related clinical care/services and health-related matters.

• Regional Offices

a. Provide oversight to institutions regarding services and other relevant trends related to

managing aging offenders.

• Institutions

a. Considering safety and security, ensure the cell assignments of aging offenders are

consistent with their physical abilities and limitations, e.g., access to lower tier cells, lower bunk passes, and wheelchair accessible cells.

b. When applicable, assign cells, assistance devices, and other supportive services to

allow aging offenders to easily navigate to key areas of the institution (e.g., Health Services, Food Service, Commissary, Education, and Recreation).

c. Offer age-specific programming opportunities in key areas as outlined in the First

Step Act Approved Programs Guide located on the Bureau’s intranet.

d. Ensure recreational and educational activities offered at the institution include

activities appropriate for and of interest to aging offenders.

e. As available, offer aging offenders the opportunity to serve in a mentorship role in

reentry programs.

f. Implement Inmate Companion Programs to assist aging offenders with activities of

daily living, as appropriate.

g. Ensure adequate resources and information are available to meet the wellness needs

of aging offenders (e.g., recreational activities, health fairs, and other resource materials).

h. Ensure the availability of accommodations frequently required for aging offenders

(e.g., wheelchairs, canes, hearing aids, glasses, text magnifiers, large print books/signs, and assistive devices).

i. Conduct, at a minimum, an annual inspection of the institution grounds and buildings

to identify infrastructure problems that would impede offenders aging in place from accessing programs and services despite the provision of accommodations as outlined in Section 8 of this Program Statement. The inspection team will consist of management personnel from the following departments: Health Services, Facilities, Occupational Safety and Health, and Correctional Services. The institution Executive staff may appoint additional members as applicable. This annual inspection will serve as the planning meeting to identify issues when considering proposals for gaining aging accommodation projects.

j. Facilities with 5% or more elderly and aging offenders will consider establishing an

Aging Offender Interdisciplinary Care Team to manage aging offenders as clinically indicated consisting of the Associate Warden with oversight of the Health Services Department, Clinical Director or designee, a Psychologist, Supervisor of Recreation, Unit Manager, Special Populations Coordinator (if the position is filled), and Captain.

k. Convene a local Aging Offender Committee as described in Section 9 of this Program

Statement.

Accommodations for aging offenders for age related or other needs will be made following the guidelines in the Program Statement Management of Inmates With Disabilities and clinical guidance.

4. STAFF TRAINING

Staff will complete the Introduction to Correctional Techniques (ICT) training module on the Management of Aging Offenders. Thereafter, refresher information is provided locally on an annual basis. Training information and topics related to the management of aging offenders is available on the WASPB intranet page. Participation in training will be tracked by the Employee Development Department.

Wardens will ensure staff are provided adequate time to complete trainings during duty hours. Staff will be provided proper relief to complete the training.

5. DESIGNATIONS

Ordinarily, aging offenders are designated via standard procedures specified in the Program Statement Inmate Security Designation and Custody Classification. The Office of Medical Designation and Transportation will make medical designation determinations and will consult with the WASPB as needed regarding age specific accommodations at a particular facility.

6. PROGRAMMING

Inmate programming specific to aging offenders can be found in the First Step Act Approved Programs Guide located on the Reentry Services Division’s (RSD) page of the Bureau’s intranet site. These programs focus on aging related issues such as grandparenting, health and wellness, financial stability and aging-specific reentry needs. Inmates become eligible for aging specific programming and services upon their 50th birthday. At that time, they are eligible to address their needs though age appropriate FSA interventions. These needs are reassessed looking at multiple factors including the aging process every six months as outlined in Program Statement First Step Act Needs Assessment.

All institutions will provide programming for aging offenders. A minimum of one program focused on aging issues will be provided per quarter and documented in SENTRY or other appropriate databases. These programs will be delivered as outlined in the First Step Act Approved Programs Guide.

Aging in place is a best practice and community standard utilized by the Bureau rather than specific units created only for aging offenders.

Institutions with a large aging population are encouraged to utilize inmate companion programs. Companion programs for aging offenders are a collaborative effort between Special Populations Coordinators and Psychology Services, and these departments deliver the program and training in accordance with the most recent protocols on the RSD pages of the Bureau’s intranet site.

As applicable, institutions will collaborate with community-based aging organizations to develop a cadre of volunteers with the expertise in aging issues to provide volunteer services in the institution. The Reentry Affairs Coordinator or Special Populations Coordinator is assigned oversight of this process.

7. MEDICAL CARE

Intake Screening, History and Physical Assessment. Health Services staff will conduct an intake screening and a comprehensive history and physical assessment as specified in the Program Statement Patient Care for all newly admitted aging offenders. Staff performing these initial assessments will refer aging offenders presenting with physiological, functional, cognitive

or sensory problems for additional targeted assessment, intervention, and enrollment in chronic care clinics as clinically appropriate.

Baseline Assessment/Assessment Tools. The purpose of the preventive health assessment of aging offenders 50 years or older is to assess age-related factors, and identify the need for and frequency of preventive health measures. Clinical decisions will include the clinical guidance located on the Health Services Division, Health Management Resources intranet page.

Ongoing Assessment. Health Services staff (e.g. physician, physician assistant, nurse practitioner, or registered nurse) will perform a baseline Preventive Health assessment and an annual Preventive Health record review for aging offenders 50 years of age and older in accordance with the most current Preventive Health Care Clinical Guidance and Patient Care Program Statement. Health Services staff will perform a baseline Preventive Health assessment based on the current Preventive Health Care Clinical Guidance.

Frail elderly offenders require more comprehensive and frequent assessment and monitoring. In addition to the current Preventive Health Care Clinical Guidance, Health Services staff will take the following actions:

• Review the suitability of assigned age specific accommodations and determine whether other accommodations are warranted.
• Assign to an Aging Offender Interdisciplinary Care Team (see institution responsibilities section above).
• Evaluate annually for Reduction in Sentence (RIS) eligibility.

Elderly offenders have a variable profile of current and historical health problems. These offenders may require more comprehensive and frequent assessment and monitoring. However, a segment of elderly offenders will have self-manageable health conditions, independently perform ADLs/IADLs, and need only minor accommodations or assistive devices to maintain independence. Health Services staff will monitor all elderly offenders as follows:

• Review the suitability of assigned age specific accommodations and determine whether other accommodations are warranted.
• Evaluate annually for Reduction in Sentence (RIS) eligibility.

Medical and Mental Health Information. Bureau staff will maintain medical and mental health information regarding aging/elderly offenders in the current electronic recordkeeping system in accordance with Program Statements Health Information Management and Release of Information.

8. INSTITUTION PHYSICAL STRUCTURE

Institutions are accessible and, when needed, accommodate aging offenders with housing assignments near institution services, lower bunks, quarters assignments near restroom facilities, and extra time to move through the institution. To the extent required under the Rehabilitation Act, the Architectural Barriers Act, relevant Federal standards concerning Government buildings (e.g., U.S. Access Board Standards), and Bureau policies including the Program Statements Design and Construction Procedures and Facilities Operations Manual.

Aging offenders are more likely to have physiological and functional problems related to diminished strength, balance, flexibility and sensory impairments. Wardens ensure the environment (building, compound) is accessible and inspected annually. This inspection includes but is not limited to the following: adequate lighting; functional heating and cooling systems; level and unimpeded passageways/walkways; accessibility to programming areas, cells, bathrooms, showers, and hand railings; and any other concerns noted by the team during the inspection. This annual inspection will also serve as the planning meeting to identify and consider proposals for aging accommodation projects. A record of this annual inspection and planning meeting will be maintained. A corrective action plan will be created and implemented for any identified deficiencies.

9. AGING OFFENDER ACCOMMODATIONS AND PROGRAM ACCESS

Staff members may unilaterally provide accommodations to aging offenders without a formal inmate request. Inmates also may request an accommodation or a modification to accommodations already provided by making a BP-A0148, Inmate Request to Staff. As described below, the institution will evaluate the request and make a final determination on the accommodation to be provided. Additional information on this process can be found in the Program Statement Management of Inmates With Disabilities.

Aging offender accommodation needs vary from person to person, and therefore must be individualized. When a determination is made that an inmate’s needs go outside the scope of a single department, departments must work collaboratively to meet the needs of the inmate. For particularly complex cases, accommodations are determined by a team (known as a local Aging Offender Committee), comprised of a Psychologist, Medical Provider, Supervisor of Recreation, Unit Manager, Reentry Affairs Coordinator, and Captain. This team is led by the Associate Warden, Programs, whose responsibility is to serve as the local coordinator on aging offenders. Legal staff are consulted as needed and a Social Worker and Special Population Program Coordinator are members of the team in institutions in which the positions are filled.

The accommodation(s) provided does not have to be the accommodation requested by the aging offender. Appropriate accommodations promote improvement to ADLs and IADLs to the extent

possible. Wardens should request assistance from the WASPB if needed in evaluating accommodation requests.

In deciding whether to grant an accommodation, institutions may consider whether the program or activity would be fundamentally altered, or whether it would result in undue financial or administrative burden. Before denying a request for accommodation on this basis, the appropriate legal office will be consulted. Accommodations may include, but are not limited to, accessibility of all relevant areas of the compound, assistive devices or technologies, specialized approaches to learning, interpreters, and additional time to complete tasks, modified materials (e.g. large print), enhanced reentry planning, and inmate companions. Information about accommodations authorized for a particular inmate is documented by the department approving them, and a notification is sent to the unit team to include in the inmate central file.

10. REENTRY NEEDS

All offenders who are within 6 months of their 60th birthday must be considered under the Elderly Offender Program and the appropriate referral made to the Residential Reentry Management Branch as described in the First Step Act of 2018 and policy.

The Residential Reentry Management Branch must be notified in the referral packet of any releasing inmate with age related concerns (health care, mobility, dementia, etc.). With the exception of immediate releases, unit team notifies the Social Worker, Reentry Affairs Coordinator and Special Populations Coordinator when they are working on release plans for aging inmates releasing directly to the community so they can assist in the reentry transition process.

Institution Social Workers locate resources, specialized services, and direct placements in the community serving aging individuals. In the event that an institution does not have a Social Worker, the Special Populations Coordinator, or Reentry Affairs Coordinator will perform these duties.

REFERENCES

Statutes Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq. Architectural Barriers Act, 42 U.S.C. § 4151 et seq. First Step Act of 2018

Federal Regulations Title 28 CFR, Section 39.170 Title 28 CFR, Sections 39 & 500

Program Statements

P5100.08 Security Designation and Custody Classification Manual (9/4/19)

P5310.16 Treatment and Care of Inmates with Mental Illness (5/1/14)

Additional Resources American Academy of Ophthalmology and International Ophthalmology American Speech Language and Hearing Association American Geriatrics Society National Association for States United for Aging and Disability National Council on the Aging National Institute on Aging

ACA Standards

• Performance-Based Standards and Expected Practices for Adult Correctional Institutions, 5th Edition: 5-ACI-2C-11, 5-ACI-2C-12, 5-ACI-2C-13, 5-ACI-2F-03, 5-ACI-5E-02, 5-ACI-5E- 03, 5-ACI-7B-10
• Performance-Based Standards for Adult Local Detention Facilities, 4th Edition: 4-ALDF-2A- 34, 4-ALDF-6B-02, 4-ALDF-6B-04, 4-ALDF-6B-05, 4-ALDF-6B-06, 4-ALD-6B-07, 4-

ALDF-6B-08.

• Standards for Administration of Correctional Agencies: 2nd Edition: None.

Records Retention Requirements and retention guidance for records and information applicable to this program are available in the Records and Information Disposition Schedule (RIDS) on Sallyport.

Reviewed for legal accuracy by Elizabeth Franklin-Best, Esq., Principal Attorney·September 2026