Sunday, February 01, 2009

Senate Criminal Justice Committee losing medical expertise

Having mentioned the transformation of criminal justice-related committees under the new Texas House rules, it's worth mentioning that late Friday afternoon, Lt. Gov. David Dewhurst issued the Senate's committee assignments. Here's the list of members on the Senate Criminal Justice Committee:
John Whitmire, Chair
Kel Seliger, Vice-Chair
John Carona
Rodney Ellis
Glenn Hegar
Juan "Chuy" Hinojosa
Dan Patrick
This group will handle all the issues that on the House side are divided into three different panels (Corrections, Public Safety, and Criminal Jurisprudence).

The only change from last session: Houston Sen. Dan Patrick replaces Dr. Robert Deuell; all the other members stayed the same. Patrick's addition should liven up the festivities, since he and Sen. Carona (not to mention Chairman Whitmire) had their share of run-ins last session on the senate floor.

Though the Texas prosecutors' association named him their "Freshman of the Year" in 2007, besides proposing the occasional, pro forma enhancement, I've never noticed Sen. Patrick taking a particular interest in law enforcement beyond immigration issues, which are a personal hobby horse for him.

Deuell's departure, however, to my mind, represents a significant loss. As a medical doctor, he alone on the committee took a keen interest in correctional health care issues, which are a mess right now with the prison hospital in Galveston still closed after Hurricane Ike. He was able to question medical staff about the details of their operations in a fashion I doubt any of the other members can replicate.

With TDCJ health costs rising and medical officials telling the Lege they were already "close" to providing unconstitutionally poor care before a hurricane tore up UTMB Galveston's medical facilities, Deuell's expertise will be missed.

15 comments:

  1. I am sure Robert Deuell has the technical expertise to ask questions, but I don't see anything in him to suggest he would support adequate health care for prisoners or care in any way what happened to them. I suspect his sole interest would be the profit of the medical providers involved. So, as far as prisoners are concerned, no big loss.

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  2. "I don't see anything in him to suggest he would support adequate health care for prisoners or care in any way what happened to them."

    That's never been my impression. E.g., what does it "profit ... medical providers" for him to promote needle exchange? I've personally been impressed with Bob Deuell.

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  3. Robert Duell in 2007 spent over $150,000 out of campaign contributions on gifts, political contributions and dues expenditures unrelated to running for office, not to mention $30,000 plus on food expense. Good riddance.

    Not to be outdone though, Carona spent over $275,000 and $37,000 respectively.

    And the irony of it all is it's legal!

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  4. And what does that have to do with anything, much less whether he cares about health care for prisoners?

    In fact, unless you're one of his donors, why would you care at all what he does with his campaign account? And if you are one of his donors and it offends you, just don't donate again. Lots of pols do the same thing; that's the least of my worries.

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  5. Can you point to any legislation that he authored during the past or present session that dealt with quality care issues for TDCJ inmates?

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  6. Is managed care provided by UTMB and Texas Tech Medical really the only choice there is. Apparently, these two "state owned vendors" are unable to provide the level of medical care for inmates at the current capitation level. They claim that their costs to retain physicians and other qualified staff are eating their lunch. They have to abide by standards set by DOJ, ACA and TDCJ. They are sub-contracting services in some facilities and the costs of referals to specialists is also driving costs up. The prison system remains inflexible to a large extent, in the position they have taken on the early release, dischrge of chronic care cases involving cancer and HIV, furhter excacerbating the financial crisis. Many of the docs on the payroll are there on the units because they got tired of private practice hassles with insurance companies and liability issues. Some moonlight to offset what they lose working in the prison setting as opposed to private practice. Like anything else, capitation reimbursement formulas can be a blessing or curse depending on the number of inmates being seen. If a maximum security prison has a larg number of diabetics, asmatics, and a large chronic care population, the "profits" to the state run vendors is diminshed. As the TDCJ population continues to age and their medical issues become more chronic, the costs will escalate further. I am wondering how the system worked prior to managed care, when the prisons ran the medical services themselves without contracting it out?

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  7. Sorry I forgot to sign my last post.

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  8. 8:58 - not offhand, but then neither can I think of any such legislation offered by Democrats, either.

    My point is not that he's been some tremendous progressive champion on the topic, but that, in the course of the committee's work, his participation sometimes unearthed problems (and even solutions) that other legislators couldn't get to in the discussion b/c they lacked the expertise.

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  9. I have a bit of a problem with a doctor who supports the death penalty ( he supported the bill that would give the DP to 2 time sex offenders who victimize children). I am not in favor of such crimes but a doctor who swore the hypocratic oath should not support the DP.

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  10. Thank you for your last post Scott.

    It would seem that any legislator with an idea or questions regarding subject areas like inmate care could still have some input, whether they are on the committee or not. Maybe they can’t.

    Back to the campaign contributions, while the practice is legal, it is border line unethical.
    “I've certainly been guilty of this. E.g., this blog has focused significantly on highlighting public corruption among Texas law enforcement. But what if that message - "corruption is widespread" - actually encourages more corruption instead of reduces it? It's a fascinating and complex question.”

    I’m confused sometimes where you are coming from. Again, while the spending practice is legal, it is borderline unethical, if not unethical. This money is often contributed by lobbyists and not with the intent of spreading good cheer, but for something in return. I think it’s called a “quid quo pro” and it breeds political corruption, apparently legal as it may be.


    “Still, that's a lot of money sitting around in local slush funds. In tight budget times, I wouldn't be surprised to see the Legislature insist that money is spent on things like drug treatment, diversion programs, and other public safety priorities, not just for bonuses, travel and booze.”

    These contributions, I believe, amount to nothing more than a slush fund, similar to what you described in the way of police asset forfeiture accounts. It’s the proverbial pot calling the kettle black.

    Who wrote these campaign spending laws anyway?

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  11. The reason I think it matters is Deuell won't be involved in the committee process, which is where mostly these issues come up.

    On your asset forfeiture example, the difference, I guess, is that we're talking about money that was seized in the name of the taxpayers, whereas campaign contributions are private, voluntary and anyone who's unhappy with how they're spent doesn't have to contribute.

    My personal view is that limiting campaign contributions limits free speech. While some think only "big money" gets to play in that environment, my experience has been that grassroots candidates can raise funds when they have sufficient support.

    Unlike you, apparently, I really wouldn't mind if a candidate I supported used my contribution for food expenses, or to pay extra staff during session. If it bothers you, don't contribute.

    I've never seen a public finance scheme that works, and limiting campaign expenses reduces the amount of communication with voters and harms the democratic process (which are the same arguments that caused Barack Obama, e.g., to reject public financing). It's not a perfect system, but I don't think it's unethical to play by the rules as they're written.

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  12. What does a legislator make, $600 a month?

    They need a pay raise, but don't disguise it in the way of campaign finance laws.

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  13. As usual this all over the place. It would seem to me that the good Doc might ask some good questions (are their not commissions and task forces that rate and evaluate prison healthcare/? he still must care about the welfare of the health of those incarcerated and be willing to enact appropriate levels of funding. Those persons incarcerated, are throw away humans particularly if they are ill and even more costly to the thinking of those control the purse strings. God forbid we would raise taxes and do the job properly though we would and still need to get the waste, patronage and inefficiency out or it will be a continuance of the sad state of affairs.

    When Texas begins to care about social justice and transparency in government, perhaps we will be more deserving of the term civilized”.

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  14. They should never reopen the UTMB prison hospital. It had attracted a disturbingly sadistic "caregiver" element. I'm not saying this is true of all the staff there, but I've seen some things that made my blood run cold from those in the "healing" professions.

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  15. Watch out for Dan Patrick. This is what he said on his website:

    Texas provides tax-based services to an estimated 1.6 million undocumented residents. (Houston’s entire population is 2 million.) Our hospitals, schools, jails and social services are overwhelmed by the vast number of people who have crossed our borders illegally.

    Today, illegal aliens represent 21 percent of the medical case load in Texas. At the Lyndon B. Johnson General Hospital in Houston (a public hospital), 81 percent of the babies born last year were to mothers who were illegal aliens.

    Our federal prison system reports that 17 percent of all prisoners are illegal aliens, and law-enforcement authorities estimate that as many as 30 percent of those incarcerated locally are likewise here illegally.

    Our schools face the challenge of accepting students who speak little or no English and have no meaningful educational background. Educating these students costs our system 30 percent to 40 percent more than it does to educate an American-born student.

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