Sunday, May 29, 2011

Texas budget ditches 'smart on crime' approach, reverting to old priorities

From LBB's summary (pdf) of Texas' conference committee report on the budget, here's the quite disappointing short-hand analysis of criminal justice spending from the budget conference committee, amounting to a rollback of diversion priorities funded over the last couple of sessions and a renewal Texas' old habit of prioritizing incarceration over smart-on-crime reforms. From LBB's summary:
$4.9 billion in All Funds ($4.8 billion in General Revenue Funds and General Revenue–Dedicated Funds) is provided for the incarceration of adult offenders in the Texas Department of Criminal Justice which includes housing, security, classification, food and necessities, health care, and treatment services. The bill includes a net decrease of $5.5 million in General Revenue Funds, which includes reductions compared to the 2010–11 biennium of $71.5 million for Correctional Managed Health Care services, $7.8 million for Texas Correctional Industries, $4.8 million for correctional support and other operations, $1.5 million for academic and vocational programs, and $0.5 for treatment services; and increases of $36.8 million for correctional security, $16.1 million for contract prisons, private state jails, and residential parole facilities, $15 million for contracted temporary capacity, and $12.7 million for substance abuse treatment.
An aggregate $5.5 million cut to spending on incarcerating adult offenders is a downright offensively paltry sum at a time when education and Medicaid will experience multi-billion dollar cuts. Faced with a choice between funding schools or prisons, in other words, the Texas Legislature decided it values prisons more. I see no other way to explain the outcome except as an expression of (misplaced) legislative priorities.

The budget continues Texas' longstanding pattern of prioritizing incarceration over community supervision and diversion programming. TDCJ's budget overall was cut $21.9 million, but with just $5.5 million cut from incarceration, that means community supervision got a $16.4 million haircut - less than previously anticipated, but with 80+% of TDCJ funding going to incarceration, 75% of cuts came from the smallest part of TDCJ's budget. Despite the success of much-touted de-incarceration reforms in 2007 and the resultant drop in crime, the Lege refused to further reduce costs by reducing incarceration. Frustrating; even angering.

The only bright spot on that ignominious list is the slight boost in substance abuse programming, but that amount won't be nearly enough to avoid estimated incarceration growth after Texas had successfully staved off new prison spending in recent budgets. There would be no need for the $31.5 million in private/contract prison costs if diversion programs had been expanded. Indeed, programs aimed at reducing incarceration could have mitigated the need for $36.5 million in additional "security" spending. Closing the Central Unit alone should have saved enough to cover that amount, but instead of making plans to incarcerate fewer people, the Lege chose to shift incarceration from public to private facilities with virtually no resultant savings. These priorities amount to an abandonment of the smart-on-crime reform approach for which Texas has recently received national praise.

Meanwhile, the $71.5 million cut to prison healthcare spending comes at a time when UTMB-Galveston was already claiming they couldn't afford to provide prison healthcare under their previous budget. And since we clearly won't be incarcerating fewer people (and since the prison population is aging, with health costs therefore rising), it's hard to imagine this won't result in further erosion of health services despite assertions from officials that previous levels of care were "barely" constitutional.

This budget isn't quite as damaging as cuts in 2003, but it replicates that Legislature's approach of promoting incarceration at the expense of community supervision and diversion programs. Talk is cheap; mass incarceration is not. This session the Legislature talked a good game on being "smart on crime," but looking at the resulting budget decisions, talk is all it was.

54 comments:

Anonymous said...

Hate to break it to you, Grits, but you are one of the very few people in this state who are likely to be angered over the prospect of criminals continuing to be locked up. Protecting our citizenry from threats, both domestic and foreign, is the Number 1 purpose of government. The people of California are about to understand this concept very well, I'm afraid. Good job, Texas Legislature.

Anonymous said...

How many people are in there who are not a threat to society. And how much is the are the prison's making on the familys who send money to help the ones they love. How much will the private prisons be making off of us to. People make mistakes some worse than others,but that doesn't mean we need to keep them locked up forever. Think about how the tax money we pay is going to the prison's. want to keep paying for the ones that aren't a threat, cause I know there are alot of them there.always about money in someones pocket.

Gritsforbreakfast said...

11:06, I've got a granddaughter who is about to enter kindergarten, and will be in public schools beginning in first grade. I bet I'm not the only one similarly situated who's unhappy that they're slashing public ed to the bone without taking even a nibble, in relative terms, out of a bloated corrections budget.

Take a look at the Texas Tribune's polling on the budget, and you'll find more folks favor cutting prisons than primary and secondary education. You may be right that people would favor prison spending in the abstract, but ask them about the tradeoff (either/or), and more Texans support funding education, particularly when you factor in that all the sky-is-falling, crime-will-skyrocket predictions about past de-incarceration efforts never panned out.

Anonymous said...

Several months ago I posted about cutting out elective surgery's and the Gritsforbreakfast doubted that UTMB was doing elective surgery's and I kinda felt like he was calling me a liar. Well now that UTMB is trying to get more money they have canceled approx 4000 clinic appointments this past week and have drastically reduced the operating room schedule of all these so called needed medical procedures. The doctors are telling the offenders that TDCJ is out of money and they are not doing elective surgery's not hear say I seen & heard it with me own eyes & ears. Case Made? Managed Health care and UTMB administrators Heads should be on a stick for all the abuse of the trust of the states money they have wasted on needless surgury's.
This money would be better used for our public schools or for elderly health care. TDCJ,UTMB,CMC are all culpable and should be held accountable for this waste.

Gritsforbreakfast said...

2:53, I didn't call you a liar, I asked you to document the claim and you were unable to. Now you say (anonymously) that you've heard it with your own eyes and ears. Which leaves me still asking for documentation: What procedures are you referring to as "elective"? Are women in Gatesville getting boob and nose jobs - what are you talking about? You characterize it that way but without documentation or a credible source (surely there is one, if it's true), it's hard to know what to make of your assertion. So no, case not made. I'm looking forward, though, to seeing you make it. Why don't you try?

Now, I don't doubt that they're canceling clinic visits, but that doesn't mean in the least that all those were unnecessary. In fact, if clinic visits were reduced as much as you say, it more likely means they're cutting healthcare for those who actually need it.

Anonymous said...

The threats that our citizenry need protected from is our police-state government and the corrupted from top to bottom criminal (in)justice system, Anon 11:06. Add me to the 'few' like Grits that are damned angry that my tax dollars are being spent in criminalizing the populace, while schools don't have the money for text books, etc. When we're all 'criminalized', well then, where will the tax dollars to fund this greedy feeding at the trough hog of a system get it's funding?

Anonymous said...

The "catch and release" approach to prisoners makes sense to me.

David said...

We could always emulate the CJ system in Mexico. Seems to be working well.

Prison Doc said...

All in all a very disappointing session as far as prison issues are concerned. "Smart on Crime" definitely died and not many people care. Too many in Texas seem to agree with Anonymous Commenter 11:06 who praises the idea of locking up everybody forever. It just makes no financial sense to lock up drunks and dopers who could be managed in the community, since there are enough violent criminals to devour the budget all on their own.

Regarding healthcare, there will definitely be changes: its true about cancelling the clinic appointments, got that email this week. Probably a small percentage will be rescheduled, most will not be seen (that's just my guess). Hard decisions will have to be made that will ultimately result in only MEDICALLY NECESSARY treatments being done; treatments and operations that would be nice to have, but are not necessary to maintain life, just won't happen.

There'll be lots of moaning and gnashing of teeth and probably more litigation before this all settles out, which won't be any time soon.

Much remains unknown at this point.

Gritsforbreakfast said...

3:57, Texas has 155K prisoners in TDCJ and released more than 71,000 in 2010. By that measure, "catch and release" is here already, and crime is at its lowest point in decades. I just checked the latest TDCJ statistical report and of releases in 2010, 88% got out after serving less than 10 years. And that's with the Rick Perry, "tuff on crime" approach in full sway at the parole board. Even with this budget, they can't (and won't) keep 'em any longer. Most everybody in prison will get out eventually. The more important factors for public safety are a) were they rehabilitated while inside and b) what happens to them when they get out.

Prison Doc, why don't you settle this issue of whether TDCJ provides "elective surgery"? ¿Es verdad? What non-"medically necessary" procedures are performed now?

Prison Doc said...

The definition of medically necessary is in the mind of the definer. Individuals, courts, insurance companies and governmental entities will all disagree on the definition. I think from a practical standpoint, a medically necessary treatment is one which must be done to preserve life or to correct a condition, which, if uncorrected in a timely fashion, will lead to the death or serious disability of the individual.

For example, in the prison system at this time it is difficult to have a hernia repair approved. This may be reasonable for in the free world many people do not have hernia repairs performed and in most instances--though certainly not all--may live a normal or near normal life. Same thing with back pain, arthritis of various joints, etc.--surgery does not have a great success rate, so surgery is rarely offered but everyone is offered a medical (non-surgical) treatment. Cancer, AIDS, HIV disease--treatment of these conditions is Medically Necessary because without treatment, they get worse and die. Same goes for chronic conditions like diabetes and high blood pressure. Treatment is medically necessary and it is given.

There may be times when medically necessary treatment has not been given, but in my 3+ years in Texas prisons I've not seen one. Hate to make that statement because I don't want to stir up the Gatesville harpies.

Anonymous said...

Grits is definitely not the only one regarding this backward looking Lege and their priorities with utter disgust. We are right back to "lock em up and throw away the key". I hate to believe that given education and mental health cuts Texans believe this is the way to go. Of course there's money to be made in keeping this huge population incarcerated. Back in the good old days when at least people said what they thought instead of lying, it was called slave labor on the plantation. I bet they still sing the old hoe songs today.

Woodsy said...

Anonymous 11:06, you don't listen (read) very well. If you did, you'd note,among other things, that since expanding treatment and other diversionary programs the previous two legislative sessions, the crime rates in all categories of offenses have decreased, despite the economic turmoil. Most importantly, you and I have benefited, in that we have had to pay much less for these programs as opposed to the brick and mortar policies of yesteryear complained about in Scott's original post here. The programs that were cut made our streets safer AND saved us money. Locking property offenders up for 50 years does neither.

Woodsy said...

You cut medical care to the degree, e.g., that impacted wisdom teeth are not being pulled, leading to other teeth being pushed out of the mouth, and any "savings" will be offset by litigation expenses. The case in point is California, who is being required to release people because,among other things, they aren't capable of providing medical care to them all

sunray's wench said...

Better education usually leads to lower crime through raised personal expectations - education is about the only thing TDCJ offers inmates in any way designed to reduce recidivism. But educating those in TDCJ is a way more expensive route than to better educate the youngest members of society in an attempt to stop them entering TDCJ in the first place.

I think it would be sensible to limit medical operations to things sustained while actually inside TDCJ, and to not patch people up who have pre-existing conditions (ie hernias) when they enter TDCJ. But something that happens while you are in the care of the state should be treated by the state.

Gordonsmom said...

The number of non-violent offenders who are currently serving time with TDCJ for revoction of probation on technicals like not having "meaningful employment or having a cell phone" and not for re-offending is only part of the reason for the overcrowded conditions, but as silly as it sounds given todays economic woes, it is happening. When I mentioned this fact to a legislator this secession, I was told that I was mistaken. That such a thing would not happen in a Texas court, that there had to be more to it... I refrained from laughing in his face, but I told him it was too bad the right hand didn't know what the left hand was doing and should I tell my son that the 10 years they want to give him for this was a mistake?

DEWEY said...

"Faced with a choice between funding schools or prisons, in other words, the Texas Legislature decided it values prisons more."
The ledge understands that when you are convicted of a felony, you can't vote them out until you are off parole. (I try to.)
Wouldn't it be cheaper to build a double chain link fence with guard towers every hundred yards around the state borders?
(Sarcasm is one of my better attributes.)

Nurseypooh said...

Carpal tunnel surgery is elective in my opinion. They may not do them after this month but they've been doing them. Repairing a broken/dislocation of a elbow, finger, toe etc. which occured in the free world and had been this way for 3-4 yrs that the offender didn't have repaired is elective.
I agree with prison doc, I'm a prison nurse.
Does anyone have any speculation on whether UTMB will renew their contract with TDCJ, if thats even possible. I've been told UTMB has been ordered by law and the only way they can get out of it is if they are released by leg's. Not sure if thats true. Half our nursing staff was layed off last year, we are working bare bones. What do you think they will cut next?

Gritsforbreakfast said...

Thanks Nurseypooh. FWIW, UTMB cannot choose to get out of the contract unilaterally. They needed permission from the Lege and didn't receive it.

David Sergi said...

The system is clearly going California. I am representing Lee Andrew Taylor who is on death row. He has friends in Europe that want to pay for an operation that he needs. We have had to file a suit seeking an injunction to allow his friends to pay for a medically necessary operation. Now, who disagrees with outside sources paying for inmates medical needs. Why not let inmates that have resources tap into a type of private health insurance or let friends pay for individuals medical procedures ; its perfect free market.

austex1151 said...

I know intimately the details of the guy Dr. Owen Murray(UTMB) calls "the poster boy for wasted tax dollars" - Roddy Pippin. He has cost the system hundreds of thousands of dollars for his difficult care (severe Type 1 diabetes). The outrage is that1) he was a teen, first time , nonviolent offender who stole some cows but was slapped with 4, stacked 2 yr state jail sentences, 2) he was put on probation for 2 yrs, handled his own medical care very well,completed his probation with flying colors per his PO, but was forced by the DA up in Hardeman County to return to prison, and 3) worst of all, he has done his entire time day for day, yet TDCJ refuses to acknowledge even the trial court's calculation of his release date and is working to hold him another 15 months! There go your tax dollars!

txskn54 said...

To Prison Doc and Nurseypooh,
How does someone get REAL healthcare at TDCJ? My brother keeps getting stonewalled by TDCJ and the medical staff for treatment of a growth on the heal of his foot. It wears holes in his shoes, is read and inflamed, causes him constant pain, and after 6 years, he was give a "boot" that does not good. This growth has moved up into his ankle and he was told if they cut it off it would probably break this foot. Serious enough for you? Medically necessary enough for you? He is looking at another 9 years. By then he won't be able to walk. I don't know what prison you work in, but the one he is in offers no medical care. The nurses sit around and eat pizza all day, and you have to call a Senator to get a visit to the doctor. Tell me what he has to do to get some relief. It took 5 years of complaining to just get a lower bunk.

Nurseypooh said...

txskin54
I have some questions for you?
What have they said the growth is?
Has he been sent to Hospital Galveston for it? Xray's etc.
By "access to care" after an offender submits a sick call medical determines either they can be seen by nursing within 48 hours or a Dr. within 7 days this is all non-emergent cases. An offender can request to see a Dr. even if nursing doesn't refer him by requesting it in a sick call. An offender can request a 2nd opinion on his health problem if he doesn't like what the 1st Dr. told him by way of the sick call form. This is all policy as in access to care, and they are very strict about it where I work, we have audits all the time etc. and to be ACA certified we have to maintain and follow all these policies.
I'm sorry your brother is not getting the care he wants or needs. Sometimes if family members complain to TDCJ enough they will and do look into it. Have you approached the Warden in a civil manor concerning this issue?

Barnabus said...

Ok, what are the people of Texas going to do? Cry or get busy fixing the problem? We must stop looking to the people who created the problem to fix it! I'd like to first attack how we reintegrate offenders, that alone will slow down the revolving door and give TDCJ breathing room. There are some excellent models which better deal with reentry, let's try them! I'm in the process of duplicating one as a pilot project as I write. If anyone in Texas is finally ready, give me a call 254-855-6973- I'm the one who has his sleaves rolled up, sweating, not expecting the government to do what we can do for ourselves! But please be ready to take the cotton out of your ears and put it in your mouth!!! "Vision without action is a dream. Action without vision is a waste of time. But vision and action together can change the world." Let's Go Texans!

Anonymous said...

Senate Approves Safe-Teacher Bill

By Mike Ward | Tuesday, May 24, 2011, 02:48 PM

A bill that would require teachers to be alerted when they have students in their class who have been arrested or accused of serious crimes — prompted in part by a high-profile attack in Austin — was approved today by the Texas Senate.

State Rep. Jerry Madden, R-Richardson, the sponsor, said House Bill 1907 was prompted by increasing reports of attacks on teachers statewide.

In 2009, a high-school teacher in Tyler was stabbed to death by a 16- year-old student who had served time in the Texas Youth Commission for serious crimes.

In 2006, a teacher at Austin’s Reagan High School had a registered sex offender student hold a pair of scissors to her neck and threaten to sexually assault her after a school meeting.

Under House Bill 1907, Madden said, teachers and school staff members will have to be notified when students are “arrested, referred, convicted or adjudicated” for serious felony crimes.

The bill applies to both public and private schools, Madden said.

“This is a teacher protection bill,” he said.

Under the current law, school officials can use their discretion on when to notify teachers about a student’s offenses. But under HB 1907, failure to inform the teachers and staff could result in sanctions against school officials.

Madden and Sen. John Whitmire, D-Houston, the Senate sponsor, said the bill was a step forward to better protect teachers, who might not otherwise know which students had been accused of serious crimes.

Two teacher groups applauded the bill.

Paige Williams, with the Texas Classroom Teachers Association, said the bill “will make the school environment safer for students and teachers by enhancing requirements for notification of potentially dangerous students to appropriate school personnel.”

Texas State Teachers Association President Rita Haecker added that the legislation “will go a long way toward assuring that our classrooms are safe environments, not only for our teachers but also for their students.”

Nurseypooh said...

txskn54

Here is the link to UTMB
cmcc website where you can find information on the whole process of getting healthcare in Tx prison.

http://www.cmhcc.state.tx.us/

Anonymous said...

I think the good tax payers in the state of Texas will soon learn what the taxpayers of California will soon learn also. A Federal Take over of the Texas Gulag system is now in order. The Gulag system rips the family members off while some pint size person who is employed there laughs in their faces. I would expect the famnily members will be paying for meals next. What the taxpayers need is protection from the police state that has beem created with the help of the LBB. Yes in Texas locking people up is more important than education because no one has found out how to make money and steal from the tax payers using education. UTMB should be held accountable no doubt and I can assure you at Gatesville units is not doing elected procedures because they will not even treat a sick person. A woman was once written up for making too much noise one night in the dorms right before she died. That same employee still works there but what do you expect when we have War Criminals in charge of that unit.

sunray's wench said...

@Nurseypooh
I absolutely agree with you, but it shouldn't take someone's family members complaining endlessly and making themselves a security threat in the eyes of TDCJ just to get someone looked at if they are in pain with something like a growth that is preventing them from walking properly. If we told you how to do your job at any other time, you would be rightly offended - but here you suggest that this is the course of action that might get a resolution just because it means dealing with TDCJ. There is something wrong with that, I think.

Anonymous said...

Approaching a Warden in a civil manner to get help? That is laughable at best. Wardens do not care about an inmate or a slave getting health care.

Anonymous said...

That is their excuse if you complain enough or try to send information through the mail system your label a security threat to silence you. This is a tried and proven TDCJ and UTMB tatic. Blame the people advocating for humane treatment for people who have lost all their civil and constitutional rights. The Wardens have taken those guaranteed rights away from. I know first hand in TDCJ the Wardens can get away with anything and of course they never lie either.

Nurseypooh said...

Sunray- I agree it shouldn't take family members actions for him to get treatment, but unfortunatley sometimes it does.

All my information comes from my own personal experience at working at several different units, male and female and what happens on my end of the deal.

I do know that when a family member contacts the UTMB person of contact for complaints it does get investigated and attention. When the warden gets a phone call or letter from a offender's family member, they come directly to medical to get answers from our supervisors, where I am it isn't taken lightly.

Sometimes timely care is not received due to not having enough Dr.'s employed there to stay caught up with some chronic care such as paps, chronic clinic for diabetes, high blood pressure, things like that which are required to be seen once yearly.

The system is not perfect very few are. My opinion is just one from my standpoint of my experience on my end of the system.
The suggestion of a civil letter to the warden was to encourage family members to advocate for their loved ones in a way that would be more well recieved. If you approach anyone with hostility, accusation's of neglect, or mentioning things that have nothing to do with the subject at hand that contact is not as well received as one that is more to the point, non-accusatory and leaving out derogatory comments about nurses, doctor's, wardens etc. You don't gain anything in doing that.

I'm sure there are units, wardens, officers, nurses, and doctor's who are what some of the others have mentioned at some point at some time.

I listed the CMC website for anyone who is interested in learning more about the healthcare system and how, what, when , and where offender's and their family members can become more informed.
http://www.cmhcc.state.tx.us/

sunray's wench said...

@ Nurseypooh

I always speak to anyone I encounter within TDCJ as politely as possible. I have to, many have trouble understanding my English accent :)

Hubby's unit seems to work OK, given its size. He spent some time in Hospital Galveston a couple of years ago and wasn't too critical of it. But it would seem that conditions that are not life threatening but give serious discomfort are currently treated as standard by aspirin or ibuprofen, regardless of the actual symptoms.

don3330 said...

Scott, do I understand correctly that we released over 70,000 last year and still have 155,000. So the population grew even though we stepped up pace of releasing inmates. And now with the cuts, the incarceration rate will continue to go up?

Gritsforbreakfast said...

That's right, Don, they come in on the front end slightly faster than they release them on the back. There were around 72,000 new receives in 2010, see here, p. 12-13 of the pdf.

Anonymous said...

What can we say -- Texas politics are serious out of whack with the evidence.

The policy decisions of the Lege simply ignore, for ideological reasons, anything thing that does not match their beliefs. They really do think they have a corner on truth with a capital "T". With that certainty critical thinking is not needed.

Anonymous said...

I wonder how much the "TAXUS" school system pays for a select number of students in the athletic system? Extremely extravagant field houses, equipment, fashionable sports clothing...
Damn shame that schools are charging students for honors english and other necessities for classroom education while athletic budgets, staff, and salaries will continue to cut a fat hog in the ass twice. There are numerous school districts that require elementary children and parents to go out on the streets selling items to pay for copying paper and other classroom needs. Ironically the same school districts have athletes wearing the most expensive clothing and accessories on the market. Yet no high school athlete was ever seen hitting the streets to drum up money for sports? Coaching staff should be subject to same salary scales as teachers. If you could pay teachers what Texas pays coaches, the quality of education would be second to none! POINT BEING... While Education is important and should be a funding priority, it needs a budgetectomy. Make sure the money is being spent prioritizing education where Tax payers expect it to be spent, or prepare to be cut.

Don said...

How does a school district "require" children and parents to go out on the street selling stuff. What if they don't comply? Jail?? Fine?? What?? That's a silly statement.

Anonymous said...

Don... As silly as it sounds you will be very suprised to find this actually occurres and in some places on a frequent basis.

There is no fine, no jail... it's more along the lines of coercion. "If you all don't go sell at least ___$ we won't have money to do A,B,C."

Children are sent home, not with homework but with an envelope with a goal number of items to sell. Everything from cookie dough to lightbulbs and cleaning supplies. My first impression was that this money was for field trips and so on. However it is typically for general supplies and operating, or supplanting money.

The issue is the priority of spending money on athletics above and beyond education. It is hard to be sympathetic to the crying about school budget cuts when there is more than enough athletic funding to cover the budget 10 times over.

Some of these school districts whining about no money to buy textbooks are building multi-million dollar field houses, stadiums, gyms... so on. Meanwhile when a handful of students are needing advanced Math, English or other type courses they are being told "we can't afford it." Or we can't afford a computer lab, or trade skill classes?
FWIW

austex1151 said...

Sorry, Nurseypoo, but my experiences with CMC care has not been positive. Inmates can write I-60's till the cows come home, but TDCJ can simply ignore it and do nothing. And they do just that. Requests to be seen by medical? Ha! Sometimes you can't even get security to pass along the request or an I-60. TDCJ breaks its own rules so often its pathetic. I defy TDCJ to show any significant number of grievances actually won by an inmate. The process is a sham.
Many. many inmates with chronic pain from correctable conditions are simply not treated, but put off with aspirin. And when it comes to complicated medical care? What a joke! The doctor at JIII told a severe type 1 diabetic he was manipulating his wildy out of control sugars by eating toothpaste! I actually sent a request to Colgate on that- and got an astonished reply asking how anyone could even consider that. Another time this inmate was told that since his treatment plan was "correct", if he still had poor control then he "must be doing something" to manipulate it. That is CMC medical care far too often.

Anonymous said...

I have been told by inmates in the Crain Unit aka Gatesville that the officers will throw the I-60's away and I have never heard of any inmate winning a grievance. If they did win one it would be after they served the entire punishment. They will hold a grievance that should be over turned until after the punishment phase has been served. See you are always guilty in their Kangaroo courts. Once again you have a morally weak Warden in charge.

Nurseypooh said...

Sorry about the negative encounters ya'll have had with CMC.

As I said before what I write about is my experience on my end.
I-60's should not be given to a officer, it can be mailed in regular mail or placed in the sick call box both boxes are located thru out the facilities in various locations, dorms, pods, bldg.s outside chow halls etc. I Medical staff UTMB not TDCJ check the boxes and retrieve the I-60's or sick calls daily, if the offender is in seg, transit, (can't leave their cell) they can give these I-60's to the medication nurses, nurses or pysch who make round daily. We then date/stamp them and a RN triages them, does chart reviews, divides them up into piles of provider sick call, nursing sick call, med refills, pysch, medical records, dental, CID etc. and they are given to those departments, entered into the computer and appt.'s set up.

No UTMB does not give Oxycontin, hydrocodone, darvon and other narcotics for chronic pain. Unless it's at HG post surgical etc.

This process does work at some units the way it's suppose to but at others from what I'm hearing it doesn't. I'm sorry for that because i work somewhere where it does for the most part.

Taxpaying free person(AKA anon) said...

Have you ever heard of the HIPP law Grits?
I watch criminals I am not going to become one because you don't want to believe me. After hearing from several posters like nurseypooh and prison doc I feel thats proof enough that UTMB was doing un-needed procedures. I have no problem with fixing a problem that is needed but you as a free taxpayer can't run to the doctor and get the insurance to pay for pre-exsisting problems such as a crooked finger that you hurt 5 years before you got locked up.
Or genital warts because they look alwful and deviated septums from doing to much coke.
Female inmates come in the system and with in a few weeks they will be in Galveston getting an annual mammogram which by the way they have never had before because it would have cost them out of their own pocket. So why not make crime pay while law abiding elderly people have to skip meds and not go to the doctors.

Anonymous said...

Every County Health Department and Planned Parenthooh in the state of Texas will give women free PAP and OB/GYN Exaims so I am not buying this one. Elected procedures I just can not see it from my experience with getting a pass to see medical at a certain unit I know takes an act of Congress.

austex1151 said...

Nurseypoo, I will readily admit that there are good people working within CMC, and that certain prisons follow the rules. But my experience with inmates in 3 different prisons and in general over years of involvement lead me to believe that is the exception. I agree that TDCJ never lets an inmate win a grievance. And those supposed hard deadlines for response? There is no recourse to an inmate when TDCJ breaks its own rules. Just tough. Many inmates must rely on guards to transmit I-60's and medical requests, and find that these requests hit the trash before leaving the unit, sometimes directly in front of the inmate! As for making a request of nurses, the problem is that so many of them barely speak English! CMC seems to have scoured Africa and Asia to find as many nurses as possible, not even requiring they speak English enough to communicate.

No, TDCJ has thrown up these sham procedures to symbolically comply with laws, but they are still shams. Men and women die every day in this evil system for lack of medical care, while Pakistani Doctors and Ghanian nurses look away. (Nothing against either of those countries, just health care providers from there who cannot and/or will not do the job.

Nurseypooh said...

Hmmmm, I've never encountered anyone who couldn't speak English as coworkers during training or at my own facility, not that they don't hire them.

I don't know to much about grievances on the security end, except when one is filed on us it gets investigated by our supervisors.

I worked today and this was my day.

I arrived at 0430, sat in my car and said a little prayer. Went into the unit, got the keys, signed in, had my 1 gallon clear ziploc lunch bag examined to make sure I wasn't bringing any contraband.
Went thru many locked gates and doors. As I passed the chow halls, I opened the padlocks to the sick call boxes and removed them all.
My coworkers and I entered medical dept. and began date/time stamping the sick calls, I gathered paperwork of my list of offenders I had to check on while making rounds, ones who can't come out for meals, rec, walk freely on the unit.
The medication nurses are getting the meds ready to pass. My coworker nurse is getting ready for diabetic clinic.

We count all our instruments, ck the ER jump bag, aed, suction, Ox. tanks, fill out lot's of paperwork pertaining to all these check's on equipment.

I go to the bldg's to make rounds, I tap on each cell door, that are on my list and ask them to turn on their light, identify them and ask them "u doing ok." If not I write it down next to their name.
I was given 3 I-60's
1 was suicidal
2 had medication concerns
5 wouldn't turn on their lights or answer me so I had to ask security to intervene.
6 had questions.
It took me and hour and a half.

I referred the suicidal to pysch
and so on.

I started taking vitals for the offender's who were seeing the Dr.

Got called out to behind the back gate on a emergency for an offender who had a seizure. Took my jump bag, aed, and wheelchair waaaay out there, brought offender back to medical, assessed her, had the Dr. see her, realeased her once she was stabilized.

I saw many, many walk ins for those who didn't want to work today. Only one was legit.

Saw nursing sick call. 10-12

All in all busy good day.

Towards the end of the day, we had a cutter come in, after unwrapping the sock on the wound, I cleaned it and determined the Dr. needed to look at it, we put in 4 stitches and 5 steri-strips,
Saw a few who had injuries that needed treating and documenting (walk in's)

Now it's time to see more sick call and afternoon diabetic clinic.

One of our medication aides who had been out at the bldg's passing medications came to me to report her concern over an offender whom she had passed meds too. We have been treating this offender for a infection. I called security and asked them to bring said offender to medical so I could ck. on them, to make sure offender wasn't declining. Thankfully offender did not have a fever and was ok, doc came out and looked at the infection. Meds are working, and we will continue to monitor.

Then I did a dressing change to offender x who is a insulin dependent diabetic. X got ulcers, sores on x's toes and leg. AS a lot of diabetic's do. 6 months ago it looked bad and I really thought X would loose the leg.
However: X was referred to a wound care specialist in Galveston and a new treatment regimen was started.
We've been doing these treatments twice per day for 6 months, X see's the specialist once monthly on the TV and our Dr. monitors X as well. Today X's wounds are nearly completly healed! Only 1 ulcer which is very small now remains and today I noted it's now completly covered with new healthy skin! Several of us did a little cheer because we've been watching this leg for 6 months. It is a great victory that X's leg has been saved! X and the nurses all learned a lot in this process.

This is a life in one day of a correctional nurse and it was a good but busy day! I work for UTMB at a TDCJ unit.

Anonymous said...

So what unit do you work on? I can tell you there is no human compassion on the Crain Unit because I have had many tell me about a medical aid or nurse down there who belittles and degrades all the women who go on sick call when they get there. She treats them all as fakers or trying to get out of slave labor.

Nurseypooh said...

I do not work at Crain.
I decline to reveal which unit and units I've worked at but I've been in the system 10 yrs and worked at 3 different units.

Anonymous said...

The reason I asked is I know from many years and many inmates The Crain Unit is a dog with fleas in all areas of human compassion and they follow no rules there period. I am glad to hear the system works somewhere and god bless you for what you do. I am glad to hear some one actually does their job in TDCJ but I will go to my grave exposing the abuses I have witness at the Crain unit under the last two wardens and the entire staff.

Nurseypooh said...

I have heard the Crain unit has lots of issues and that it's been very hard to keep medical staff there.

HB 4 just passed, there may be changes on the horizon, not sure if they will be good or bad?

Anonymous said...

The issue's on the Crain Unit is the medical staff that works there does not want to be there and for over ten years now that I have tracked this some medical staff see abuse as sport. The last two Wardens there are both morally weak and no better than war criminals. The entire staff down there play games on how to abuse people. Some of the staff down there are responsible for people's deaths and should be behind those very bars themselves. The only cure for that place is to tear it down and build a womens prison in another part of the state and let Gatesville slowly disappear off the map.

austex1151 said...

I have no info about Crain, other than I hear many, many complaints of the same things. I know at JIII that I-60's are often simply not answered. Or answered, but left pending till the hard deadline is long past, and then it's dead. No inmate recourse. No "exhausting" of the institutional process, so no going to court. I know that if you call the medical section, there is a high probability you'll get a nurse with an accent so heavy that you cannot really understand a word, and she'll get real testy if you ask her to repeat things. I also know that the charting there is almost exclusively formulaic- different date, but virtually the exact words in every single "progress" note or other entry. Was this person actually evaluated, or did the nurse just write the same note day after day after day. I can now identify several nurses by their formulas. lol I know at least one of the foreign doctors is incompetent to deal with complicated cases. He still claims that a severe diabetic "somehow" manipulated his blood sugars by eating his toothpaste- even in the face of a letter from Colgate Palmolive saying it's not possible. And a nurse who still claims that a Diet Coke raises blood sugar levels- despite a letter from Coco Cola Co. debunking that. So what I see is a health system designed around security needs primarily- meals at 4am, lunch at 10am, supper at 3-4pm,leaving 12 hours as a fast; hard to get access often. Sick call requests often trashed. The "grievance process" a sham. And an arrogant culture overall built on the assumption that they answer to no one, that what happens inside those walls is shielded from prying outside eyes.And they will do almost anything to keep outside eyes out. As to approaching a warden "civilly". Ha! If they'll lie to the public, refuse to talk to family,etc, refuse to discipline officers clearly out of line- then how do you think they treat inmates?

Anonymous said...

I whole heartly agree the TDCJ culture is where a warden and staff answers to no one. A family member will never be able to see those trash dumps that hold the slaves. Those Wardens should be over at the HAGUE being tried as war criminals as the ones from the Balkens our country invest millions into prosecuting or at least the last two Wardens and Asst Wardens at the Crain Unit. The officer who wrote the dying woman a case for making too much noise before she died should be under the prison right now instead of a having a higher rank and position to abuse others. No one even blink an eye when this woman died and I bet the case went through also.

PMHNP Job Seeker said...

I'm just wondering if UTMB renewed their contract with TDCJ-ID before I bother looking for a job with them. Any suggestions on this point?

Gritsforbreakfast said...

They renewed it but they also had 9-figure budget cuts that forced them to lay people off.