Monday, May 07, 2012

Prison healthcare budget falls predictably short

This news should come as no surprise to Grits readers, but Mike Ward reported in Friday's Austin Statesman ("Report: Texas prison health costs higher than thought," May 6) that:
The cost of providing health care to Texas' 154,000 imprisoned criminals during the next two years will likely exceed the amounts allocated in both the Senate- and House-approved versions of the state budget, a new financial analysis shows.

The report on the University of Texas Medical Branch at Galveston's costs appears to validate the university's earlier assertions that it was losing money on providing the care, and it projects that the prison care could cost $930 million over the next two years — far more than either legislative chamber has appropriated so far.
The new figures counter an earlier "report that triggered intense criticism of the medical school and has prompted a lobbying rush by private companies who contend they can do the job for much less." Bottom line, the latest analysis found that:
In recent years, UTMB and Texas Tech have claimed losses totaling more than $60 million for providing the care, requiring supplemental appropriations several times from the Legislature.

The new financial review projects that the losses will continue for UTMB. Texas Tech costs were not examined.

In 2010, the summary shows, UTMB lost as much as $26.8 million — with actual costs listed at $436.1 million, for which the university was paid only $409.3 million.

During the 2012-13 budget period, the report estimates, the costs for UTMB to provide prison health care could range from $879.6 million to as much as $930 million — depending on whether costs for some physicians, interns and residents are included.

Madden acknowledged that the numbers in the report are significant, "if they prove correct, which I think they will."
This should come as no surprise; it was predictable and predicted; Grits calculated when the budget passed that prison healthcare was underfunded by $126.5 million over the biennium, and here we are, facing projections right at that amount. The lesson: It's possible to significantly cut prison health costs, but not without reducing the size of the prison population. They can't just cut on paper; the state must change policies to reduce costs.


John C. Key MD said...
This comment has been removed by the author.
Nurseypooh said...

Nope no surprise. It isn't because they're paying the employees who work for UTMB/CMC a lot we haven't had a raise in 4-5 yrs some of us longer.You can't cut cost until policy is changed if policy dictates the inmates get certain care then they get it. I'm all for treating inmates humanly but there are some things they get I don't agree with some of them play the system and take advantge of it but they are allowed to so you really can't be mad at them. We are still short handed. UTMB has a contract until Aug of 2013.

DeathBreath said...

How ironic, a 26.8 million dollar loss? When UTMB-CMC first contaminated the medical model in 1996, profits soared during this honeymoon period. In fact, Little Leon, the vermin in charge of this train wreck, reportedly pocketed 30 million dollars. Free enterprise! Since then, the self-serving politicians in Austin have been gutting the funding thinking they could save money. What fools!

It doesn't take a rocket scientist to realize this is not a money-making operation.

To this very day, those in Austin are completely ill-informed. You cannot understand the complexity of treating this population from afar. But, rest assured, Pretty Boy Perry & his Christian friends will pray the bad away. Praise Jesus!

Anonymous said...

It would be interesting to see the commissary revenue generated by prisons/jails on a historical 5 year trend. Might be that there is health care money beneath prison/jailhouse?

Prison Doc said...

Anonymous, the commissary profits would amaze you but medical isn't part of that!

I guess I am too new or too dense to know who "Little Leon" is.

I believe Grits' comments above are apropos. The real solution is alternatives to incarceration. I sure get tired of seeing young nonviolent offenders who could be more easily and more effectively managed in some other way. But I have come to think that indeed "all politics is local", and as long as the citizenry wants to lock up and throw away the key on minor drug offenders and 19 year olds who date 15 year olds, well, it's a problem we have to deal with.

Anonymous said...

How does one go about reporting someone who medical ethics violations, who are TDCJ providers to TDCJ? Is it even possible and do they fall under the same ethical standards? Could someone tell me who and if I can report them to the State of Texas Medical License Board? Is this something that requires someone to file a Federal Lawsuit? I had to pay the $100.00 fee this year for a family member and they are being refused treatment. Thanks for any help.

Prison Doc said...

Anonymous 1250, you are most likely to get a response from the TDCJ ombudsman or TDCJ Health Liason office if you want results. If you just want to cause trouble, you can go the lawsuit route or contact the Texas Medical Board.

It is not likely that your family member is being denied medical care; they are probably just not receiving the care that you or the family member desire or would prefer.

Proving true denial of care or an ethical problem is a pretty steep hill to climb.

Anonymous said...

Thanks Prison Doc, but I was told TDCJ clean inmates teeth either once or twice a year. I am not sure about that but once in seven years does not seem right to me after I was charged a medical fee this year and I pay a whole lot of taxes. The medical health laison did not seem too concern about the matter. I am not asking for braces or crowns and caps Hollywood style but a simple teeth cleaning. I am not a lawyer but when one is charged a fee for services and the services are not provided than that is against the law in all 50 states in this country. Now that is how Federal Law suits are filed and why. Would it not be simple to clean their teeth?

Nurseypooh said...

Anon: Your family member must not have passed the "brush test' more or less the inmate has to show that they care enough about their teeth to actually brush them on a regular basis if they fail the test tthey can request again in a couple of months. If that is not the case I would contact he practice manager on her unit.

Anonymous said...

How can you pass a plague test when you get your teeth clean once in seven years. My insurance cleans my teeth every six months and I have plague issues. Will the plague go away in six months. That does not even pass the common sense test of a 1st grader. That is just an excuse to not do your job! I was charged for a service and the service was not provided. I talked to my denist, a real denist who can be sued for not providing ethical services and he told me that was hog wash. Any denist will tell you it is the most important oral hygene for one to have their teeth clean every six months. TDCJ family guide book for families does not state you have to pass a brush teeth, but says dental cleanings are provided. That thought process right there, tells me there is no accountabilitiy but just excuses to deny treatment. This is why people file lawsuits and now after reading this, there is no integrity in the UTMB, TDCJ ethics of treatment. Why call the unit practice manager, they already refuse treatment by not providing a service for which I paid for. The Health Laison sure did not seem concern enough to do the ethical and morally right thing either. I never mention a sex of the inmate anyway. Something sure does not seem right here. TDCJ and UTMB tells the tax payers one thing about medical and dental services and I bet they charge them too, but then turns around and does not provide the actually service. Like I said I am no lawyer here but that equates to fraud against the tax payers and the state of Texas.

Nurseypooh said...

I don't make the rules Anon. just giving you some info that may help you. Believe it or not it does do some good to contact he practice manager, warden, dental manager etc. I don't work in dental but the noisy wheel gets the most attention! If a family or friend of an inmate calls it gets at least looked into. Just remember to always be polite and don't yell, curse or become defensive no matter how frustrated you become that usually shuts down the line of communication. I didn't say "plaque" test i said "brush test" I don' know your loved ones situation just surmising that is what could have happened, dental and medical alike are behind on preventive screenings and treatments if they've had a hard time keeping a dentist, Dr. provider. Just saying not excusing.

Anonymous said...

Good luck with that ,lol apparently medical treatment is off the civil rights list, so is federal disability,complaints are worthless and having them go " check on the kids' almost as wortless as lifting the hood and not checking the oil,
There's not one person going to help you,file complaint,or follow through, ironically my son is on disability,judge said there was no mental disability with. Him (.even with federal paperwork) he was sent to bootcamp ,has a horrible back from car wreck, he calls me supervised telling me he couldn't get out of bed ,another cadet helped him, he was in so much pain, he rested against wall, gaurd comes up , demands he get the f@ck up, son renders telling him his killing him, ( I still wonder what.Dr name.was at juvi that passed his physical) yes this along with mental mentioned in court)
The gaurd goes pushing him around ,he tells story on phone 2 times (me ,dad) well council is listening,he ask for med call,and I asked ,nothing ,sick with viral ontop of this ,making him do drills ( losing points)oh and they call me to tell me he's crashing (depression,bipolar).they want to get him Dr and meds ,) noooo are you serious cause judge.and his council,said he's perfectly fine , (.2 complaints filed in 8.weeks for Dr. Meds in juvi).(.also he.tried to file).got taken out of his hand and in trash ).guess what? I call for his back ,when it flares up he.needs steroids,anti flam , also worried gaurd and drills might have done more damage ) I call and complain, hotline , lol was told I have never before (.surprised no ,figures) and I use a cell for everything ,(call log,date,times,duration ) still no Dr. He's lost weekly points
(.was told he lost them due to his crashing)
Emotionally and back issue ,so he gets punished and longer stay till he gets certain points,
Punished for a disability that was noted several times in court , and now his back. Also noted .that a gaurd felt physical abuse was answer ?
They now want to give him mental help with meds ,(.asked since Feb).I'm thinking hell no!!!!!
They can't get injury checked by a phd, even an illness that he has, throat so sore eating he passes , diahrea over a week, and oh I'm going to trust you with giving him meds for his mental state, ?( I'm wondering if doping him up is shutting him up in there eyes ) , giving him dangerous meds if not carefully monitored , and they couldn't and still haven't dealt with injury ,yet now I'm the bad mom , your preventing his reform ,honey a ride to behavior health got his an assault with deadly weapon ( which is complete bs, there was 4 other people here , never caused trouble in all these yrs, his baby due any day , mom is fighting a health battle ,and he gets shipped 5 hrs away ,hasn't talked or seen gf since Feb ,(.been together 3 yrs, he won't see sons birth ,he can't talk to babies mom , punished for something he didn't even do ,minipulated,lied to , denied his rights ,
Struggling all that ,meds won't take the hurt he feels.inside ,( wouldn't a sane person) cost me $120.00 gas each trip and 5 there 30 visit. 5 hrs home, so the reform ,townsend pdfs of her beliefs, looks good on paper ,but its babbled bs
Family separation, financially draining, he says he hurts so bad but can't miss drill (ordered) he says he won't see son till he's 3 months to a yr old , he doesn't trust a sole ,can you blame him ?
Been locked away since Feb and the 8 weeks in juvi isn't even time served , his federal disability setting him back from points ,and the back that they won't do more then have a nurse look at , (.her eyes must be cat- scan. Ability) you wonder why these kids turn into monsters ?

Anonymous said...

Non violent turn violent to survive there, pulled seclusion to a place that has a program he doesn't need ,drugs and alcohol never his thing ,assaults between inmates ,gaurds just watch, missing contact from family since financially 5 hrs there 30 min visit 5 hrs back and $120.00 worth a gas one trip,emotional stress on whole family. Told after 16 yrs of struggling and accepting his disability ,that he's a lier,minipulitve,and he's just fine ,it was just an excuse ,a faulty physical sent away ,now phone rings non stop saying he has a mental disorder ,crashing ,depressed ,we want permission for meds,
You tell me how bad he is , but why the rush now? Suicidal 3 times ,denied Dr,meds since Feb ,it wasn't important to you then ,just like his injury now ,or his illness but I'm to trust you ,not even a doctor there ,a licenced council( med and). Dr stops by told every other week by one and once a week by another ,5 hrs away ,I think he's been through enough, I'm the bad mom? Or am I the mom that has valid reason and fear? Medicine won't solve his legitimate feeling ,times up go home ,with all you have learned kiddo , parents pick up pieces and rebuild if its not to late ,trained for that revolving door , he says my son won't know me ,breaks my heart especially when only people that know the truth is us,
Don't call and complain for medical or abuse ,it only gets worse on the ones inside ,civil rights are long gone ,

Anonymous said...

Yes mame ,if a child has insurance,fed or state its not effective while in states costudy, parents get billed ,as you know that's expensive with no insurance ,if they had that kind of money there children wouldn't be on Medicaid, to beat it theres a time frame its to be Payed in ,
State,tax payers,federal all in one boat, considering federal also give a chunk for certain programs ,plus some children are on federals books . People are unaware of what's really going on ,there told one thing and until they hear the real deal( which won't happen until its big like Houston) or they have been pulled into it ,hard lesson learn ,

Anonymous said...

If you want improvement then put children in programs that are suited for them ,a child mental health ,you can't bootcamp them ,push ups,fear,seperation from loved ones,seperation anxiety, force won't change the chemical imbalance ,mental can't be reformed ,but it can be managed with proper meds,Dr,and positive guidance,and that doesn't mean drug and alcohol meetings and reform ,its not the same ,you have ability to recover from them ,and quit ,you can't quit mental illness. Bring back the individuals needs instead of uniforming them all one class, ignoring important details such as one above is only creating more damage ,go in one disorder come out with three disorders, treat cases based on evidence, as a name not a number ,help the real issue ,don't toss them in what has the best refund for you ,but better refund on tax payers ( rebuild,reform,no revolving door,) also evidence
Has been ignored due to enforcements using there opinion,