Tuesday, December 06, 2011

Prison health costs from UTMB deal obliterate claimed TDCJ budget savings

The Texas Department of Criminal Justice and the UT Medical Branch in Galveston last week agreed to a temporary extension of their contract for nine more months, with the state pledging an additional $45 million over that period, reported Mike Ward at the Austin Statesman (Dec. 2):
Senate Criminal Justice Committee Chairman John Whitmire, a Houston Democrat whose committee oversees prison operations, said the $45 million in additional funding will be advanced from the state's next budget, as promised by legislative budget leaders.

Whitmire said he will initiate hearings in January to "look at all alternatives for prison medical care: regional hospitals, UTMB, private companies — all options will be on the table." ...

UTMB "was prepared to walk and they still want out of everything except the care in Galveston," Whitmire said. "That wouldn't solve anything right now, except it might put the system into crisis."
Remarkable: Promising to deliver money in 2012 that won't be budgeted till 2013. Given this year's budget wrangling and the likelihood that the gap between budget and revenue will be even greater in 2013, one wonders if that's a promise legislative leaders can keep?

That $45 million entirely wipes out the paltry $5.5 million in "savings" the Lege claimed to find in TDCJ's budget. As Grits wrote yesterday, the only real way to reduce costs at TDCJ is to change policies to incarcerate fewer people. Slashing medical budgets without reducing the number of patients was always a non-starter, and Texas' spending on prison healthcare per capita is already among the lowest among states. If legislators want to cut prison health costs, they must reduce the number of prisoners, starting with the oldest and sickest among them. Any other approach - regional hospitals, privatization, etc. - amounts to a band aid that fails to address the core malady underlying TDCJ's budget infirmity.


dfisher said...

Trouble brewing between UTMB and Galveston Co. Commissioners Court is spilling out into the public domain.

Today the commissioners are meeting in executive session to sever the inter-local autopsy agreement between Galveston Co. & UTMB. Galveston Co. doesn't have an appointed medical examiner, nor do they have a county medical examiner's office. For decades Galveston Co. has paid UTMB to act as the county ME.

This arraignment is not only illegal, it creates a conflict of interest between UTMB and the TDCJ for prison health care.

One example of this conflict can be seen in the 2007 death of Larry Louis Cox.

Nurseypooh said...

and the saga continues.

Anonymous said...

Nurseypooh, do you work in the prison system? If so, what does your leadership say about the contract for prison healthcare?

Prison Doc said...

I'm predicting that the shotgun wedding will yet see it's Silver Anniversary and maybe a golden one too. The answer is at the Lege: either more money for prisoner health care, or fewer prisoners. Can't treat lots of bad guys with ever-less money, just can't be done.

Anonymous said...

Why doesn't someone ask UTMB/CMC upper management how much of a bonus they just received? The facility staff were given $500.00 dollars and they received thousands of dollars. Just check it out if you don't believe. Amazing since the budget is in the RED. Just ask one of them surely they wouldn't lie.

debunker4u said...

Anonymous, The leadership says "Hang on helps comin...we will cut your staff, but not responsibilities, and continue to maintain the standard of care even though we are taking your help...but we REALLY appreciate you...really..." Licensed staff are risking their licenses every single time they walk in the prison doors. Its the most horrible feeling to be afraid to make a move for fear of being thrown under a bus as a proverbial scapegoat. As long as UTMB leadership consists of high-paid individuals who don't know squat about prison operations, and get paid thousands of dollars in bonuses UTMB will never survive, it will tank. Let me assure you fellow bloggers...the glass ceiling is alive and well in UTMB, and forget about transparency. I have never seen an organization tolerate verbal abuse and sexual harrassment like UTMB. Why do our elected officials in Austin tolerate such behavior? Me thinks we should remember that on election day!!!

Anonymous said...

The union between the prison system and the medical school was a forced union initially in the 90's. It was an attempt to ration care and to have some of the historical esteem that the University had (at that time)fall upon the prison system as it exited the Ruiz case decades. The description of "corporation" was a device and not a true corporation ... it still enjoys the legal support for its many and several suits of the prison staff.

The University staff opposed the diminishing of its esteem of being associated with a different standard of care for that portion of the University. But the melding was continued by Austin pressure.

Those who spoke against the bonus question (no bonus for state employees) did not fare well. And if you can justify state employees having bonuses, should any employee in that fictitious corporation receive a bonus when the product that they produce was so mediocre.

The initial budget in 1993 (and later) was immediately diminished by the corporate staff. And the rationing of care has progressed without relief since then.

And the destruction to the reputation of a fine medical school continues by forced participation in a standard that does not represent the level that any medical school should demonstrate to future physicians (in training).

There is no solution to underfunding other than to increase funding or decrease the amount of work (the number of prisoner patients) for which the University becomes responsibile.

And all of this discussion only serves to support the wisdom of the need for fundamental alteration of the State's attitude about law enforcement. That's the fundamental issue here in the discussion. The present attitudes are not only fiscally wrong but fail to accomplish the task assigned ... correction of criminal behavior. We in Texas have never been successful in dealing with crime in a successful manner ... our only solution is to build more prisons, wasting huge sums of money and large number of lives.

Anonymous said...

I'm with you Prison Doc. Doesn't make financial sense for the state to allow UTMB and Texas Tech to walk away from prison healthcare. If folks think prison healthcare is too expensive right now, just wait till TDCJ execs sign up a regional hospital or go private. Don't believe me, give it whirl!

Anonymous said...

So now the phony baloney Texas cowboy crybabies want the rest of the US---namely Medicare and Medicaid---to pay for their John Wayne swagger? Hey Texas---you wanted them---you got them---and now YOU pay their health costs, not the rest of the US. So the welfare mentality finally comes to TDCJ and UTMB? Maybe you should have voted for Obama! Ha Ha. Nobody asked Texas to levy prison terms that are usually four times what they should have been so TEXAS must ante up and shut up! You gotta pay for that tough guy way of life and don't ask the rest of the US to pay the damage you clowns did to your own people.

Yosemite Jim