By contract, essentially acting as a capitated HMO, UTMB-Galveston provides medical care for 80% of prisoners in the state, much of it via "telemedicine" where inmates are seen via teleconferencing link by doctors in Galveston. The Texas Tech medical school handles the other 20%. But with Galveston Island devastated and UT's facilities there in tatters, UTMB just announced widespread layoffs, reports the Houston Chronicle:
A day after elected officials claimed they had helped avert a planned layoff of thousands of employees at the University of Texas Medical Branch, the interim chancellor of the UT System said a "significant" portion of workers will lose their jobs.This announcement raises many more questions, especially for the state prison system, than the article answers. How will these layoffs affect UTMB's contract with TDCJ, which already was an underfunded, understaffed hodge podge of services held together by "telemedicine" out of Galveston? Has TDCJ reduced medical services in the wake of Ike, one wonders? And if so, how is that playing out in the field? After all, Ike hit Galveston on Sept. 12, nearly a month ago. (Thank heavens the main pharmacy is located in Huntsville; if it had been destroyed, I'm not sure how the agency would operate.)
The layoffs will come as a direct result of damage inflicted by Hurricane Ike, which cost the academic medical center about $710 million in building damage, ruined equipment, revenue losses, cleanup and evacuation. Insurance will cover about $100 million, said Kenneth Shine, the interim chancellor and executive vice chancellor for health affairs, in a story Thursday in the Austin American-Statesman.
"We recognize there have to be significant reductions in force on the island," Shine said. "It's a very challenging situation."
According to Shine, some of the 85 buildings on campus took on as much as 8 feet of water, and storm damage essentially destroyed the hospital's kitchen, blood bank and radiology department.
In addition, the center's main revenue source, a 500-bed hospital at the campus, is expected to return as a 200-bed hospital for the foreseeable future. With the hospital and other revenue generators out of commission or at reduced capacity, the medical branch will likely operate at a deficit beginning as soon as next month, Shine said.
Prisoners at the hospital in Galveston were evacuated to Tyler, where the UT-Tyler Hospital continues to handle their care. But it's not designed as a prison hospital, nor is it likely equipped to act as the center of UTMB's telemedicine services. The Chronicle reported that the prison hospital "wasn't badly damaged, but many of the required auxiliary services, including a pharmacy, aren't yet available."
Certainly the system must be flexible and I have tremendous sympathy for those in Galveston who've lost their homes and in many cases, now, their livelihood. But the medical school is also the health care system for 106 prison units holding more than 150,000 prisoners (from UTMB's perspective, read: "patients"), about 40 of whom die every month regardless of the weather. (That's more than California even though their prison system is larger.) It's one thing to scale back services for a month or so in response to disaster, but if UTMB lays off most of their staff and their facilities in Galveston are out of commission, is UTMB even capable of fulfilling its TDCJ contract anymore? Quien sabe?
I'll poke around today and see what else I can discover on this topic; check back for updates at the end of this post. And anyone with first-hand knowledge of what's going on inside the prisons with UTMB-delivered healthcare services, please let us know in the comments.
UPDATE (10/10) I put out some feelers and am still waiting to hear back. Most UTMB buildings, though, are currently not open even for employees. Also, in addition to buildings and labs, many computers were damaged and heaven knows how long it will take to sort out their information systems. Certainly it will be a profound test of their backup systems, at the very least.