Monday, July 19, 2010

UTMB won't lay off as many prison dentists, but other RIFs stand

UTMB won't be laying off quite as many people in their correctional managed care division as previously reported, restoring dental care to previous levels. (Nurses, especially R.N.s, were the other big category affected.) A reader informed me of the news, which was confirmed when I contacted UTMB's Raul Reyes who declined to respond verbally but later emailed me this written statement:
In response to a projected shortfall of $65M—$105M within UTMB’s Correctional Managed Care budget, a reduction in force within the CMC program will take place as scheduled, Wednesday, July 21. However, working with the TDCJ, UTMB has modified the staff plan so that dental care for offenders can continue at its current level for now, reducing from 363 to 296 the number of individuals affected. In addition, UTMB expects to hire some of the nurses and other medical staff whose positions were eliminated into comparable positions at other sites, which would further decrease the overall impact of the workforce reduction.  The new staffing plan for CMC outpatient units is based on a proven model of community health care delivery that UTMB and TDCJ consider appropriate for the offender patient population as well. This model — which has been designed with anticipated changes related to health care reform in mind — employs a sophisticated electronic medical record system to better manage patient care and outcomes. While UTMB is relieved that the total number of CMC employees affected by the reduction in force is less than anticipated, the university recognizes that this remains a difficult time for everyone involved in the program. Job assistance services are available through the Texas Workforce Commission, and affected employees will continue to receive priority consideration for UTMB and CMC positions for which they qualify. 

17 comments:

Anonymous said...

Statement is gobbledygook written in bureaucratese. Very few positions have been restored. Management solutions appear to be ill-thought out, more of a reactive, fly-by-the-seat-of-the-pants approach. Morale among the rank-and-file employees could not be lower, no one has any confidence in the future. Management is keeping everyone in the dark. Patient care will surely suffer short time. Most surprising is that TDCJ medical management has allegedly "signed off" on all changes. Everyone is waiting for the next shoe to drop.

Poor College Student said...

Surely Brad Livingston, who was a bean counter for Rick Perry before Perry appointed him to TDCJ, can come up with some serious budget cuts.

Anonymous said...

Anyone ever been to Texas Workforce Commission? Your chances are better to get a job if you create a resume, look online for jobs yourself, and apply. It's another "do-nothing but get paid for it anyway" program. (That would be those who work for Tx Workforce who of course will continue to get paid.) I feel sorry for those who are getting laid off, I feel even sorrier for them if they have to go through Tx. Workforce to get a job. I hope the government is planning to provide a whole lot more funds for unemployment. Anyone ever get the feeling that the world is in serious trouble?

Anonymous said...

Anonymous said...
Anyone ever been to Texas Workforce Commission? Your chances are better to get a job if you create a resume, look online for jobs yourself, and apply.
----------------------------------
This is absolutely true. If you have a resume and access to the internet, you have the SAME resources they will use at Texas Workforce.

Anonymous said...

Anonymous said...
Anyone ever been to Texas Workforce Commission? Your chances are better to get a job if you create a resume, look online for jobs yourself, and apply.
----------------------------------
This is absolutely true. If you have a resume and access to the internet, you have the SAME resources they will use at Texas Workforce.

Anonymous said...

Anonymous said...
Anyone ever been to Texas Workforce Commission? Your chances are better to get a job if you create a resume, look online for jobs yourself, and apply.
----------------------------------
This is absolutely true. If you have a resume and access to the internet, you have the SAME resources they will use at Texas Workforce.

Anonymous said...

They hired back all of dental INCLUDING the dental hygienists! Yep, the inmates are guaranteed to get their annual teeth cleaning now! And the RN's, they opened up a whole 30-slots...most will have to relocate. Our most valuable employer and it's like "you're fired, oh wait, you can have your job back if you come here..." And some, the privileged ones, had jobs "Created" for them. The whole RIF sucked but the semi un-RIF just seems unfair and slightly biased, like they're hiring back only who they wanted to. And at Anonymous 8:12pm, YOU ARE SO CORRECT! Oh, and the Texas Workforce Commission is a joke!

Can't type worth a damn! said...

sorry folks, meant to say "employee(s)" not employer. Underappreciated, overworked and under staffed, yes the nurses are definitely our most valuable employees.

Anonymous said...

Wow anonymous 9:44...you are jaded. If you knew anything about how dental ran you would know that the hygienists do a ton more then just give the inmates their annual teeth cleaning...

Anonymous said...

Thank you "Grits" for acting on my comments. I hope also that they are being read by a rather large population. Your latest comment and the response from UTMB deserve comment.

The CMC Dentists are now spared. Actually, Dental HealthCare is as important as blood pressure or blood sugar control. And most Inmates in my experience have the absolute worse dental hygiene ever. I wonder what "Prison Doc" might think about that? I will also state that in my experience that alot of CMC Dentists work harder at not seeing Patients than seeing them. I state this on my personal observations at several Units. There are few Dental Hygienst that are the ones that clean the teeth, Dentist surely do not do that, they mostly just pull teeth. And dentures are few and far between for the Inmates.

The "outpatient model" that was referenced by UTMB/CMC deserves comment. The model was based on the "Electronic Medical Record" (EMR). The EMR allows the Provider to create a note, order meds, order labs, order xrays, write referrals and allow others to view what was done somewhere else in "real time". Certainly the EMR concept is even toted by the Federal Government as a means to decrease the overall cost of HealthCare. However, a Patient still needs to be seen (by a Provider), medicines must be distributed, blood must be drawn, xrays must be shot, etc. Providers are in critical short supply (at least in the District where I am), Lab Technicians and Xray Technicians cover two to three Units (again in this District), and the Pharmacy or "Medicine Distribution System" is very "labor intensive" even with all of its EMR attributes. For example, many years ago the Medical Director, at the time, gave a very elaborate synopsis of how medicines are ordered and tracked in our System. It was stated at the end of her synopsis, "And then a PCA has to give the medicines to the Patient." And there in lies the "weak link", in that there are not enough PCAs to do that, such that Nurses are having to do it (so now the Nurses are not seeing Patients) and the process itself is very labor intensive. I have never been on a Unit that did not have an immense burden just to "pass the pills". The process starts when a Provider orders medicines, then a Pharmacists reviews the prescription, then a Pharmacy Technician packs them in a "card of 30 pills for 30 days", then the medicines are sent by various means to the multiple Units throughout most of Texas from Huntsville, and then the medicines arrive at the Units in multiple "totes" that now must be unpacked, scanned as received, sorted by Patient (as many as 2500 to 3000 Inmates per Unit, though not all Inmates are on medicines, or not all Units are that large, but some Patients may be on up to ten medicines). So Nurses are now unpacking and scanning and passing (or not, how often I hear from Patients that they are not getting their medicines and to see the number of medicines that are returned to the Pharmacy, for what ever reason, and the Pharmacy admits returned medicines as a financial loss problem needing management at the Unit level)the medicines to the Patients standing in long lines two or three times per day. Medicines must also be individually delivered to AdSeg (Inmates locked up 24/7) Patients, which is a physically demanding act for most of the Nurses (due to their own poor health, age, or obesity). So what is the point - it still takes "people power" to make this Prison HealthCare System work not some flippen EMR. This EMR is being toted as that which will allow "Constitutional HealthCare" (again whatever that means) to successfully proceed with CMC's new "outpatient model". The "bottomline" point, CMC Leadership (the Despotist) are at again by the "seat of their pants" probably doing the best that they can (they do have their limitations)!

Anonymous said...

Yes- Dental Hygienists do more than "clean teeth". But so many have no idea about the oral-systemic link. Everything from diabetes, heart disease and low birth weight babies are but of a few of the conditions directly affected by ones oral health.

Anonymous said...

9:44 may be just a little sensitive when it comes to nurses being fired for no logical reason? I personally don't wish for anyone to lose their jobs. However, today I heard through the rumor mill that Woodman State Jail is being forced to send their only two registered nurses to another unit indefinitely. Apparently this will leave only 4-LVN's on the unit. Two of those are assigned elsewhere (CID and Intake) and thus will leave only 2 nurses on the floor...split into two cards. How is this unit going to run?!

Anonymous said...

The point this above comment represents; the personnel to complete the "process and procedures" for the HealthCare delivery as it is defined right now is "artificially complicated and extremely cumbersome" for the "manpower" left behind. It is due to the poor forethought on the part of CMC Senior Leadership.

Another fact: CMC Senior Leadership and TDCJ Health Services have agreed to twelve hours of medical coverage at the Units (very few are excepted). A "Central HUB" exists for after hour medical complaints. The problem is that "they" did not take into consideration that Prisions historically, traditionally and functionally start early (between 2AM and 3 AM, not at 6 AM as it is now). Due to noncompliance with the existing Prison schedule chaotic conditions have been created (eg, worse for the Diabetics that are on Insulin).

Again the point being, poorly planned operations, creating chaotic conditions and the overt Despotism and Nepotism between CMC Senior Leadership and TDCJ Health Services over the last 15 years, continues to define the elusive, "Constitutional HealthCare" Enigma!

Anonymous said...

I work at Woodman and everything said about the RN's is true...what was left out is that one is being forced to work nights. WTH?! Not cool UTMB, not cool!

Anonymous said...

As one of the employees who was RIF on July 21st, I have a few comments on this subject.

There are numerous dentist who try to avoid work and have no compassion for the patients that they do see and there are a few who do a great job.

The major problem with UTMB CMC is it's senior leadership. They lie, cheat and stab each other in the back. It's just a big game to them. They do not care who they lay off as long as they get to keep their jobs. I hope they are out of a job soon. Karma......

Brian said...

UTMB senior leadership as well as mid level managers are looking out for their job, no one else's. They have shown every onwe that they will lie to your face. I have never seen such back stabbing, two faced, out right lying, and ingorance of ethics in my life. It is laughable and if licensing boards knew what was going on, heads would roll...starting from the top on down. The trench workers are heroes.

Anonymous said...

Brian is right on the mark. I wish grits would look in to the corruption of the Senior Leaders at UTMB CMC. They have no regard for anyone other than themselves. They sleep around, drink and party while they claim they traveling on the states dime. Would love for grits to look in to it.