Which prison health employees getting the axe at UTMB?

Here's a little more detail from a FAQ on UTMB's home page explaining which medical staff at Texas prisons are getting the axe:

• What is the breakdown of the reduction in force by position types? Jobs affected: 133 registered nurses; 56 medical assistants; 47 facility clinical associates; 43 administrative staff; 33 dentists; 19 dental assistants; 15 dental hygienists; 5 human development consultants; 4 vocational nurses; 3 patient care technicians; 2 physicians; 1 optometrist; 1 mid‐level practitioner; and 1 clinical associate. Of the 363 employees affected, 306 are female and 57 are male. The ethnic breakdown is: 240 White; 71 African‐American; 42 Hispanic; 9 Asian; 1 Native American.

• What units/cities will be affected? The reduction in force will affect CMC employees at all 86 outpatient units that UTMB staffs in central, coastal and east Texas. These units are organized into nine geographic regions. Reductions per region follow:

• Galveston, 12
• Beeville, 30
• San Antonio, 28
• Gatesville, 33
• Dallas, 24
• Palestine, 64
• Huntsville, 76
• Houston, 51
• Beaumont, 45
  

Especially noteworthy and potentially problematic are the reduction in the number of R.N.s. UTMB is also eliminating roughly half the dentists they presently employ. "UTMB estimates that the reduction in force will save approximately $22 million over the 14‐month period between July 21, 2010, and Aug. 31, 2011."

Relatedly, see this "white paper" (pdf) from UTMB's Ben Raimer titles "Healthcare in the prison system: A looming fiscal crisis." Major cost drivers for the system identified by Raimer were:

• Aging offenders
• HIV infection
• Serious mental illness
• Hepatitis C virus
• Cardiovascular diseases
• Kidney failure and dialysis
• Asthma
• Diabetes

One particularly astonishing fact bite jumped out at me: "Approximately 19,700 offenders incarcerated in a TDCJ facility in April of 2010 had a diagnosis of HCV infection." That's an enormous number. In addition, "In FY 2009, nearly 9,200 TDCJ offenders in the UTMB-CMC sector were diagnosed with a serious mental illness, compared with only about 5,600 in FY 2004. This increase in the prevalence of serious mental illness among TDCJ offenders has significantly strained the personnel resources of the mental health program."

UTMB was already skirting the borderline regarding provision of acceptable levels of inmate healthcare; these cuts may set the state up for litigation down the line of the type that's driven California's health costs through the roof.