PORTLAND — Health care costs for Oregon prison inmates have reached about $100 million a year and keep increasing as the state deals with inmates who are getting older and sicker, including one woman with kidney disease who cost the state about $1.1 million last year.

The cost is taking an ever-bigger share of the state prison budget, jumping from 6 percent in the 2003-05 biennium to 15 percent in 2009-11, The Oregonian reported.

With no insurer to help, the state pays for every inmate.

Lawmakers faced with tough choices this legislative session had to cut other state services, including elderly care and treatment for youth addiction.

Inmates are guaranteed decent medical care, thanks to Texas inmate J.W. Gamble, a convicted killer who was hurt in 1973 while unloading cotton bales on a prison detail. He sued prison officials for neglect and pursued his claim to the U.S. Supreme Court.

Justices ruled in 1976 that poor medical care was cruel and unusual punishment forbidden by the Constitution, and that remains the rule.

“There is an obligation to provide medical care for serious medical needs,” said Dr. Don Kern, president of the national Society of Correctional Physicians. “We’re not talking about cosmetic surgery.”

Last month, the U.S. Supreme Court ruled that inadequate medical and mental care in California prisons is intolerable. The court said California, given one chance after another to make fixes, must bring down its prison population until all inmates receive adequate care.

“If we’re out of money, we still have to provide the treatment,” Bill Hoefel, health services administrator of the Oregon Corrections Department, told The Oregonian.

Besides sheer numbers and growing complexity, prison officials face the same pressures as any medical system — escalating prices for tests, drugs and specialized treatments.

“We have no control over who’s coming in or with what,” Hoefel said.

Elderly inmates

Elderly inmates, in particular, are an increasingly costly challenge. Ten years ago, Oregon prisons held 258 inmates 61 and older. Now there are 674.

Corrections officials say they spend $776 a year on a 40-year-old inmate’s health needs. The tab soars to $6,527 for inmates over 70.

Inmates also enter prison older in body than age after years of drug and alcohol abuse, and infrequent health care, Kern and others said. A 50-year-old inmate often has problems typical of a 60-year-old, Kern said.

“I’m just seeing sicker and sicker patients,” said Dr. Michael Puerini, medical director at Oregon State Correctional Institution and the next president of the Society of Correctional Physicians.

Mental health care costs are also a major factor. About seven in 10 of the state’s 14,000 inmates need some type of mental health care in a system never designed to provide it, officials say.

The Corrections Department has added 525 beds for mental health care since 2005 for a total of 900 — more than the Oregon State Hospital, the state’s main psychiatric care facility.

Separate mental health infirmaries have been created within prisons and one “supermax” facility has been turned into a ward for the most severely ill.

But officials still must choose who gets a bed and more focused treatment. Sending troubled inmates back into the general prison population leaves them vulnerable to taunts and attacks. And some mentally ill inmates lose control, harming themselves, other inmates or employees.

“The corrections environment is not good for a person with serious mental health illness,” said Jana Russell, administrator of the Corrections Department’s Behavioral Health Services Division.