A study commissioned by state lawmakers found Vermont spent $21 million on health care for inmates last year.
WCAX-TV reports the state spends a high amount on inmates compared to the rest of New England at $1,100 per month per inmate.
Corrections Commissioner Mike Touchette says Vermont lacks an economy of scale because it has to provide all systems required in larger facilities despite having small correctional facilities.
The American Civil Liberties Union says the number of inmates in Vermont over 50 has doubled since 2004, which also increases health care costs.
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Since inmates don't qualify for Medicaid, the cost of health care comes from the state's general fund.
The study recommends the state consider a single, centralized correctional facility and review staff levels.