During the past decade, the number of elderly and infirm inmates in State prison system has increased tremendously. As the inmate population rises, correctional administrators are encountering new challenges in managing the requirements of older inmates and those with special physical and medical needs which include: (1) management and housing of inmates with special needs; (2) special accommodations for inmates with special needs; (3) cost containment in providing for inmates with special needs; (4) epidemiological considerations; (5) preparing staff to respond to the requirements of special needs inmates; and (6) functional assessment of special needs inmates. Correctional systems must provide special accommodations that meet the medical and security needs of elderly inmates and inmates with chronic and terminal illnesses. A functional assessment is a screening tool that is used to identify behaviors of physical, mental, or emotional disabilities that may cause a patient difficulty in daily life. This assessment lays the groundwork for decisions concerning medical treatment or the most appropriate institutional living environment. A special needs population of inmates includes three prison populations: elderly, chronically ill, and terminally ill. In this report, consideration was given to the functional assessment; specific program, housing, and treatment considerations; and correctional policy considerations for these populations. The report is divided into four main chapters: (1) what is known about elderly, chronically ill, and terminally ill inmates; (2) effective evaluation for identifying the special needs of inmates; (3) program, housing, and treatment considerations; and (4) ethical and policy considerations for the care of elderly and infirm inmates. Appendices A-C