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DRAPER - George Putnam and Daniel Lassche lie shackled to easy chairs in a converted laundry room at the state prison as dialysis machines purify their blood.
Putnam isn't too interested in how the machine works.
"I know it saves my life, and that's all I care about," he says as he lies back watching the movie "National Treasure."
It's a picture of the evolving nature of health care at Utah's state prison, where an aging inmate population and a desire to cut down on hospital transports and costs is pushing doctors to provide more specialized, in-house treatment.
The prison began contracting with University Health Care to provide on-site hemodialysis last month for five inmates with kidney failure. Prison officials estimate the machines will save them $75,000 a year in transportation costs, more than covering the $20,000 a year it costs to run the machines on site.
The dialysis patients are among 14 mostly elderly inmates who were moved out of their cells last year and into the Olympus mental health unit to receive around-the-clock treatment for ailments ranging from paraplegia to Parkinson's disease.
The prison houses three inmates with Parkinson's disease, a degenerative disorder of the central nervous system - a number that was unheard of when prison clinical director Richard Gardner started working at the prison 13 years ago.
"We're getting multiples of something that would be rare in the past," Gardner said. "It's the graying of the prison population, just like the graying of the normal population."
The number of inmates older than 55 has nearly doubled in the past decade, according to the Department of Corrections. That's less than 5 percent of the total inmate population. But because it typically costs the prison 16 times as much to care for older inmates than younger ones, Gardner said, they are sapping a greater chunk of the system's resources.
An increasing number of sexual offenders like Putnam and Lassche - who tend to be older than typical inmates - is contributing to the trend, Gardner said.
The increased burden comes as Corrections Director Tom Patterson is pushing to reduce the number of hospital transports, following a deadly escape attempt by an inmate during a hospital visit in June. The cost of transports nearly doubled to $120 per trip after Patterson mandated that two officers accompany all inmates.
Gardner is also working to cut costs through a telemedicine program with University Hospital in which about 10 patients a week speak with doctors at the hospital through a video monitor for initial visits and check-ups for specialties including orthopedics, dermatology and cardiology. He plans to do the same with prenatal care in coming months and is working to persuade doctors to come on board for other specialties, he said.
Corrections pays doctors an extra $25 for telemedicine visits compared with in-person visits, Gardner said, and boosts their fees by 15 percent when they visit the prison.
At Olympus, Lassche has no concern the treatment is different - the same University Health Care nurses work the machines - but misses the ride to Sandy three times a week.
"It's better because you don't have the security requirement [of a shackled transport]," Lassche said. "But I do kind of miss going out."