Thursday, May 13, 2010

UTMB threatens to cancel TX prison health contract

Here's a startling punch in the gut for state budget writers and prison managers, as reported by Mike Ward at the Austin Statesman ("Prison health care could be cut with budget," May 13):

An early casualty of impending state budget cuts could be the health care contract that serves most of Texas' 154,000 prison convicts.

Top officials at the University of Texas System, whose Galveston medical branch provides the health services, are threatening to cancel the contract because legislative budget-writers will not fully cover a projected $82 million shortfall.

The warning, issued to the top budget-writers in the Legislature, marked the latest crisis to surface over a projected $18 billion shortfall that Texas lawmakers could face when they return to Austin in January.

In a letter dated Monday, UTMB suggested:
perhaps a "different structure" might be workable for the university — one in which it would continue to operate the prison hospital in Galveston "and provide physician and senior-level nursing expertise, while the Texas Department of Criminal Justice could employ the vast majority of nurses and other staff in the various units."

The state could then pay UTMB for services based on "free world Medicaid rates," which prison officials said would probably end up being more than the current cost of just over $8 per day per prisoners.

Texas taxpayers currently spend more than $400 million a year for prison health care.

So basically they're saying Texas' university-based managed care experiment - which California is considering emulating - didn't work out. UTMB is now urging Texas to shift toward a single-payer style system for day-to-day care, to use the parlance of national health reform debates.

MORE: From the Galveston Daily News.


Anonymous said...

TDCJ could employ medical professionals at the units? This is where I came in!

UTMB and their Legislative friends will dictate to TDCJ how health care will be dispensed. TDCJ will once again be on the receiving end without even getting kissed!

Inmate transportation could cut millions of dollars just by doing away with the majority of daily trips to Galveston.

Retired 2004

Anonymous said...

In a state as large as Texas it really doesn't make sense to only use one hospital and transport everyone there. From what I've seen, getting UTMB out of the picture couldn't help but improve things. Just try to get a straight answer from someone about an inmates lack of medical care. It's impossible. They just give you the run around until you give up.

Why not have the different state university medical programs handle inmate care in their respective regions?

Gritsforbreakfast said...

That's sort of what they do, 9:11 - Texas Tech has about 20%, UTMB the 80% in the eastern part of the state. Those are the big med schools.

Anonymous said...

There is a lot of care provided by Telemedicine (via video conference). Additionally where could you ever find care for anyone at the rate of $8 a day? That is extremely low, how could that even cover the expense of the providing facility? If anyone is on the "receiving end" I would say it would be UTMB.

Anonymous said...

154,000 inmates X $8.00 per day =$1,232,000 per day X 365 days = $449,680,000 per year.

How many of these inmates (what percent) utilize medical care on a daily basis?

How many of these inmates (what percent) do NOT use the medical care at all (per year)? So much for your $8.00 per day cost per inmate. I will admit that stat does look good but it is a pitiful account of the actual cost of medical care (Throw in security and transportation costs and see what this "daily figure" is).

I guess this isn't the time to discuss the cost of Mental Health care as it is not included (There certainly isn't any way I am going to use the term "treatment").

What is the real cost of "Telemedicine" when utilized within TDCJ? That is another topic but I need to quit this post and give others a shot!

Retired 2004

Anonymous said...

I would say if anyone is on the "receiving end" is UTMB. UTMB did not decide to take over the health care of prisoners- it was taken away from TDCJ by the legislators due to inability to fullfil responsibilities.

How many of these inmates abuse the services made available to them? How many taxpayer dollars are wasted on inmate demands under the umbrella of "it is their constitutional right"?. What constitutional rights do TDCJ and even UTMB employees have? Is there anyone out there even giving employees a thought?

Comments on this site are simply inaccurate- $8 per day is what the state wants to pay UTMB for caring for the inmates. It costs UTMB much more per day to care for these inmates. By the way, transportation and security are not part of the $8.00 and TDCJ is responsible for those expenses.


Anonymous said...

That is partially right retired. Had the legislators provided the funds they now provide UTMB there would be no need for the separate "Managed Health Care". If TDCJ didn't have to haul the inmates to the Gulf every day how much money would be saved?
Looking at the problem another way; why isn't the cost of security and transportation included in the total cost of Managed Health Care/medical care? Putting an inmate on a bus, transporting him to Galveston only to have him decline treatment (Which could have been completed at the unit) is an additional cost to TDCJ!

Transporting an inmate to Galveston for a possible pre-op appontment (just so the medical "students" can put their hands on the hernia),
AFTER a unit telemedicine appointment clearly indicated a distended hernia would require repair, is in fact a wasted trip.

Also remember that a former member of the Corrections Committee, a former Executive Director of TDCJ, and a former Deputy Executive Director of TDCJ, (And others) received very lucrative positions with UTMB Managed Health Care.

What "Rights" did these people give to the TDCJ medical employees that were not allowed to transfer to UTMB?

Do you remember when officials informed the units that Medical personnel were not on the unit to assit Employees during their medical needs, they were on site for the inmates only!

To answer your last question Retired; No, there is no person that can change anything, giving employees any thought that would cost a penney.

Retired 2004

Anonymous said...

If the Board of Pardons and Parole would release some of the 70+year old inmates with serious health problems such as terminal cancer, kidney dialysis etc. The budget would be considerably cut. There are amputees and blind individuals who could not reoffend if they wanted too. The problem is , they are "sex offenders"and the public has been scared into believing that they always reoffend. The estimate at this time is approx. 10,000 inmates are over 55and cost us taxpayers $ 80,000,000.00-per year. I hope all those citizens who want to keep everyone locked up forever don't mind paying for it. I do !

Helga Dill, Chair, TX CURE

Anonymous said...

Inmate care may not be perfect. However, the care they receive is significantly more substantial than what's available to a normal person in the "free." There are departments within correctional care that have learned to do much more with less, to the point of staff having stress-related physical ailments. Now, with the shortfall from past failure of the legislature to fulfill the budgetary requirement, seasoned and effective staff will likely be lost to a reduction in force. Secondarily, the staff left behind will face safety concerns, lawsuits, and possible licensure sanctions. As an example, there are dental patients waiting months for an extraction due to backlog. Want a filling? Expect to wait a year and a half at some facilities. If the state would pay for expenses to maintain services now, it will save $1+ billion that will be necessary to meet federal mandates in the future (see California.) UTMB-CMC and its employees have performed admirably in the provision of care to a medically needy patient base. Pay now or lose big later.

Anonymous said...

Okay folks, The TRUTH of the matter is the "offenders" have MORE rights than the employees, this thing they call "the right to access of care!!) did you know that the inmate is charge just $3 for a medical visit then they place what they call a "grievence" for it to be returned to them!! If TDCJ would make these offenders be accounted for by their families or themselves it would save the FREE alot of Money! Now they are talking about laying off some of the employees which have families support what is that going to to do our economy another thousands of people without jobs! Do you people realize what kind of Medical problems these people put in to medical for (these are called "sick calls" I cant poop, I need a Fan, I have a headache, which Tylenol is given when asked for!! All their medical care INCLUDING x-rays, MRI's, and HUGE amounts of medicine which most of the time they dont even pick up from the medication room are only $3.00!! Then they DO GET IT BACK IF THEY COMPLAIN. These folks did the crime (most of them) and they get ALL the benefits!! We in the "free world" cant even take out children to the Doctor because we cant afford it half the time, we go to work SICK to take care of these folks!! We need to take some of these "offenders " rights away that they gave up when they did the various hideous crimes that they did to get in the prison system!!

Sheila Nance said...


Sheila Nance,,,,not anonymous said...

To Anonymous above,
Until you've had a family member incarcerated, you have no idea what you are talking about. My brother has been in the TDCJ system for 10 years. 63 sick calls for bone spurs, and has yet to see a doctor. Sometimes he cannot walk, sometimes he falls down because of the pain, sometimes he cannot work because of the pain, and all he has ever received from the P.A. is Ibuprofen, 6 years of Ibuprofen. He has high blood pressure and ran out of medication for 7 days, until the unit finally got a doctor to write him an unrestricted unlimited prescription, so he doesn't' run out anymore. I also know a man that may have colon cancer. Huntsville told them to take him to Lubbock for treatment 8 months ago, he's still waiting. So don't sit there and tell me they get better medical care than we on the outside do. THERE IS NOT MEDICAL CARE IN TDCJ. I would love to see the financial records from UTMB to see where they really spend their money, because it's not on the prisoners. Oh, by the way, They had a guy die last year because of a staph infection. Never saw a doctor, just took whatever medication the R.N. gave him, died within 3 weeks.

DeathBreath said...

Goodness, UTMB has re-tooled themselves. They have a pretty new Logo to show Texas & the world. I wonder what direction the University will take? UTMB has such a rich history to draw upon. If my memory is correct, UTMB was trafficking in body parts at one time. Perhaps, they could open a Wal-Mart version of body part harvesting & open it to the public. Top bidder for that kidney? If you think this is outlandish, think again. Trust me, if money could be made & the practice was socially acceptable, they would not hesitate. So, now they are leaving Correctional Managed Care? I have always contended that this agency was profit-driven despite the caring image they frequently feign in the presence of others. You might ask, who are the true psychopaths, the patients or the administration! Initially, when they entered the void of TDCJ, I believe they thought they could siphon large profits from a population that very few cared about, the incarcerated. But, it backfired didn't it? Admittedly, they stated that they miscalculated the population regarding fast lifestyles, illicit drug dependency, & medical neglect. Now, they want out? If you did not know this, promotions within UTMB-CMC are largely contingent on political wrangling, not merit. Some of the most pathological pigs arise in the ranks of UTMB-CMC. So, who will take over after the caring ones leave? Columbia? The state boards of examiners have little insight into the medical & psychological whoring that takes place on these units. Thank God I left when I did. Screw UTMB.

DeathBreath said...

Dear Ms. Vance: If you loved one was concerned about his health, why in the hell did he break the law? Did you expect the same level of care as Johns Hopkins? Give me a break. Sue them or shut up.

Sheila Nance said...

It's Nance, not Vance. In the state of Texas, if you don't have money, you are guilty and going to prison because you get a court appointed lawyer. My brother was not guilty, he was set up by his ex-wife, and our family did not have $25,000 to hire a decent lawyer. As far as the medical issues, they surfaced after he was incarcerated. And I am sueing them, and the nurse refusing to treat him.
Better hope you never end up there, you will change your tune.

Anonymous said...

Ms. Nance,
I'm so glad I stumbled across your post. My uncle is incarcerated and is having trouble receiving appropriate medical care for his diabetes. He has had to be rushed to the hospital three times this year. I have contacted lawyers to see what needs to be done, but I am repeatedly turned away. Everyone says my uncle has to go through the proper channels at the prison. Everytime I call to talk to one of the doctors or the warden, a secretary takes my name and number but does not call me back. I have also left messages with the "patient liason" at the higher, corporate offices for TDCJ. How did you find a lawyer to take your case? Which one are you using? Are you in the Dallas area? What should my next step be?

Anonymous said...

RELEASE INMATES BECAUSE OF BUDGET ISSUES??!! SO SOCIETY NOT ONLY HAS TO PAY THE FINANCIAL BURDEN OF MAINTAINING THESE PIGS, WE ALSO HAVE TO SUFFER THE CONSEQUENCES OF THEIR ADDITIONAL CRIMES??!! KILL THEM!! DEATH PENALTY!! Saves our budget and saves our civilization. As for Sheila - of course your brother was set-up by his ex-wife. Sure. And you didn't have the money to hire an acceptable attorney to preserve your brother's freedom, but you have enough to hire one to vindicate his foot pain? I've heard of the Chinese water torture, the Rack, but - wow! Living with foot pain from bone spurs! That's egregiously inhumane! Poor guy - he didn't stand a chance in court. It's obvious his poor judgement and lack of intelligence are genetic. It's people like you who are the problem. You don't understand medicine, and you don't understand the criminal justice system. There are hard-working, law-abiding citizens who can't afford medical treatment for their chemotherapy or dialysis, but according to you we need to concentrate all of society's best efforts and resources on easing your felonious brother's foot pain.

Anonymous said...

I worked for UTMB (prison nurse) for 9 months prior to be laid off due to budgetary reasons. I

n my experience there - diabetics are cared for 1st. If your uncle is not getting care for diabetes it is because he is not getting up to get his insulin and is probably getting commissary and eating whatever he wants and not exercising. I have seen many, many non-life threatening procedures that I thought were ridiculous and the amount of money spent on acne would make your hair curl. Some of you were right about the patients - we had some we saw every night and many we never saw at all. Any patient could request to be seen by medical and we had to see them. They saw the nurse first, and if the nurse was unable to help, the patient was then scheduled with the doctor usually 7-10 days later, unless it was an emergency. If a nurse saw a patient twice within two weeks for the same complaint the patient was automatically scheduled with the doctor. We had two doctors and two NP's on my unit. We treated everything you could possibly imagine. I was the only RN and I had 3 LVN's working with me to cover over 3000 inmates. We saw approximately 50 scheduled appointments, patient emergencies, any in-patients or observations, and we did assist staff if an emergency came up with them, we also assisted with drills, etc. And that was just on the night shift, the day shift had much, much more to cover.

If the STATE and taxpayers want to save money then prison healthcare should be limited to life-threatening care only - including chronic care. Leave the acne care, keloid removal, physical therapy, knee replacements, hip replacements, etc for the families to pay for, just like in the free world. For the families complaining about the care, would they pay for their loved-ones care in the free world? If not then be happy that they are getting care at all. I can assure you that on the unit I worked, every inmate that requested care got it. It might not be what they were searching for - restrictions from working or narcotics for pain - but they got care. I cannot tell you how many times I did complete chest pain examinations on the same patient to find he was suffering from indigestion, but EVERY time he complained he received the complete work up and I did this for EVERY inmate that complained - EKG, blood work, the whole deal.

Anonymous said...

Inmates abuse their constitutional rights,staff and their medication. Many of them pocket their medicatiion just to sell it to another offender. This is not just random acts either. They even fake illnesses just to come to medical to see the nurses. Their medication just sit in the pill window because they are too lazy to come get it. Our tax dollars