Friday, February 04, 2005

Prison health is budget buster

The Statesman's Mike Ward, who has been doing a good job covering Texas prison system budget issues compared to his colleagues in the capitol press corps, checks in this morning to say the UT Medical Branch may pull out of its contract to provide healthcare to prisoners if the 79th Legislature doesn't fork over more money. UT officials expressed concerns that they can't provide a constitutionally acceptable minimum level of care. Bottom line:
Prison officials are requesting $31.8 million to cover expected health care losses through August.

In their budget requests, prison officials have also asked for $674 million for prisoner health care for the two-year budget that begins in August, according to Mike Viesca, a spokesman for the Texas Department of Criminal Justice. UTMB provides contract health care to about 119,000 of Texas' estimated 150,000 prisoners, and Texas Tech provides the rest.
Even that number is definitely low-balled. For example, a Hepatitis C epidimic is raging among prisoners, but the state does not pay for diagnostic tests to determine who has the disease, because once they knew someone had the illness, they'd be constitutionally liable for their care. But the budget crisis is deeper than that -- current levels of funding don't even allow for basic care, Ward reports:

Because of a nearly $25 million budget cut two years ago, Raimer said, UTMB was forced to lay off 370 medical employees and curtail some services at all but 25 of its 80 prison clinics. That has decreased access to health care for thousands of convicts and driven up some subsequent treatment costs, he said. At the same time, costs have increased for nurses, pharmacists, medications and an assortment of already expensive treatments.

"We can't go any farther," said [Dr. Ben] Raimer, a physician and former chairman of the state's Correctional Managed Health Care Committee. "I'm certainly not going to be involved with a system that is not constitutional. . . . We're at that line now. One step across it and we're there."

One get so used to hearing bureaucrats poor-mouthing legislative budget committees that it's easy to be dismissive of such dire predictions. But in this case Raimer's right on the money. If the state doesn't willingly pay for healthcare for people it incarcerates, ultimately a judge will likely order them to do so. And if the state doesn't want to foot those costs, maybe it should consider incarcerating fewer people.

UPDATE (2-5): Ward followed up this morning with another piece discussing Texas Tech's prison-health-related financial woes.

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