It is noted in this study that the prison population has been affected by changes in sentencing policy resulting in an increase overall in the number of older inmates, including chronically ill and/or disabled persons who require long-term care. The State correctional institutions in Pennsylvania were studied to determine the need for and the current provision of long-term care in Pennsylvania. Phase one of the study contained a written survey to the superintendents and administrators of each State correctional institution (SCI), a conference telephone call with all of the above to explain the survey form; and an interview with the superintendent or administrator, conducted on site with accompanying tours of the facilities, and more interviews by telephone. Phase two of the study obtained more in-depth information about the models and strategies used in providing long-term care in seven SCIs selected for on-site visits. Quantitative findings included responses concerning the number of inmates needing assistance including those needing additional prompting to perform activities of daily living. Models studied include the transfer model, where an inmate is transferred to another SCI; a nursing home model; an in-home care model; a personal care attendant model; an adult day services model; an assisted living facility model; a hospice model; and a continuing care retirement community model. The study concludes with a discussion of issues for policy makers and planners, and recommendations for the future, including among others, additional research be conducted to target the specific long-term needs of female inmates, the impact of AIDS and hepatitis C on long-term care needs, and the impact of the Americans With Disabilities Act on prison operations.