"The immense costs of incarceration have increasingly framed the conversation around reducing the prison population as a matter of fiscal responsibility and budgetary necessity. This discussion is often centered around reducing the arrest and prosecution of so-called “non-violent drug offenders.” But these issues belie a much more pressing human and economic concern: the aging prison population, whose costs for incarceration and care will soon prove unsustainable if meaningful action is not taken. And though prison is expensive, cost is far from the only justification to move away from our reliance on incarceration, as the continued long-term incarceration of aging citizens has serious moral, ethical, public health, and public safety implications" (p. 1). This paper explains how agencies might go about effectively addressing these issues. Sections following an executive summary address: the threat facing the United States-economic costs, health impact, strain on correctional systems, social costs and public safety, and the roots of the crisis; from the inside out-meeting the needs of the aging within prisons-six innovative programs; the question of parole; the reentry experience-five viable strategies; the work to be done within correctional facilities, release mechanisms, and post-release services; and toward a new paradigm of punishment. "The interconnected complexity of the aging prisoner crisis demands a strategic response that is versatile and multifaceted, and that seeks to address the issue at multiple points of intervention with involvement from all stakeholders. The fields of gerontology, philanthropy, health, and corrections are uniquely positioned and qualified collectively to inform and implement both short- and long-term solutions to this issue. Armed with critical interdisciplinary knowledge and backed by investment from the philanthropic community, such a collaborative partnership possesses unparalleled opportunity to make lasting contributions to the policies and best practices affecting the aging prison population. This joint stakeholder alliance is particularly well-suited to enrich the reentry process, first by identifying those factors that formerly incarcerated elders need to thrive upon their release to the community and subsequently creating resources and pathways for success. Such an approach would not only yield tremendous cost savings, improved public health outcomes, and economic growth, but would also embody a commitment to human rights-including the freedom for our elders to live the remainder of their lives within their communities and to die with grace in the presence of friends and family" (p. 14-15).