Thursday, May 20, 2010

Which prison health employees getting the axe at UTMB?

Here's a little more detail from a FAQ on UTMB's home page explaining which medical staff at Texas prisons are getting the axe:
• What is the breakdown of the reduction in force by position types? Jobs affected: 133 registered nurses; 56 medical assistants; 47 facility clinical associates; 43 administrative staff; 33 dentists; 19 dental assistants; 15 dental hygienists; 5 human development consultants; 4 vocational nurses; 3 patient care technicians; 2 physicians; 1 optometrist; 1 mid‐level practitioner; and 1 clinical associate. Of the 363 employees affected, 306 are female and 57 are male. The ethnic breakdown is: 240 White; 71 African‐American; 42 Hispanic; 9 Asian; 1 Native American.

• What units/cities will be affected? The reduction in force will affect CMC employees at all 86 outpatient units that UTMB staffs in central, coastal and east Texas. These units are organized into nine geographic regions. Reductions per region follow:
  • Galveston, 12
  • Beeville, 30
  • San Antonio, 28
  • Gatesville, 33
  • Dallas, 24
  • Palestine, 64
  • Huntsville, 76
  • Houston, 51
  • Beaumont, 45
Especially noteworthy and potentially problematic are the reduction in the number of R.N.s. UTMB is also eliminating roughly half the dentists they presently employ. "UTMB estimates that the reduction in force will save approximately $22 million over the 14‐month period between July 21, 2010, and Aug. 31, 2011."

Relatedly, see this "white paper" (pdf) from UTMB's Ben Raimer titles "Healthcare in the prison system: A looming fiscal crisis." Major cost drivers for the system identified by Raimer were:
  • Aging offenders
  • HIV infection
  • Serious mental illness
  • Hepatitis C virus
  • Cardiovascular diseases
  • Kidney failure and dialysis
  • Asthma
  • Diabetes
One particularly astonishing fact bite jumped out at me: "Approximately 19,700 offenders incarcerated in a TDCJ facility in April of 2010 had a diagnosis of HCV infection." That's an enormous number. In addition, "In FY 2009, nearly 9,200 TDCJ offenders in the UTMB-CMC sector were diagnosed with a serious mental illness, compared with only about 5,600 in FY 2004. This increase in the prevalence of serious mental illness among TDCJ offenders has significantly strained the personnel resources of the mental health program."

UTMB was already skirting the borderline regarding provision of acceptable levels of inmate healthcare; these cuts may set the state up for litigation down the line of the type that's driven California's health costs through the roof.


Anonymous said...

As on of the employees who received a RIF notice yesterday, I am disgusted by the lack of care from Senior leaders in UTMB CMC. They laid off 363 frontline staff employees and of course, did not lay off any Senior Leaders. Do you really need 2 AVP of Operations, 2 Nursing Directors,the list goes on. I believe there are 21 Senior Leaders...... is that really cost effective ?

Anonymous said...

Lets be sure to save the illegals, the pregnant unmarried females that can't count to 15 and all those on welfare. When do we grow up and make people responsible for them selves? Everyone wants to be on the state dollar or fed dollar. Stop it, sent them to Mexico or jail if they can't be responsible. Stop this bullshi..t of saving all those idiots, that really don't care and are users.

Anonymous said...

TYC is having a farewell, so-long party at the Pyote park for all the employees. It will be interesting to see if those responsible for causing its closure will attend. Ray's friends - Dr FR. Free...., the nurse in charge, the acting DOS, the threes stooges (psy's), caseworkers and PA's, that all went along with Chip and Ray's youth abuses; will they be there to show how they supported the abused youth of TYC? Suck-ups to the finish, they will all probably be given some sort of plaque for their loyalty to Ray and Chip. Dust to dust.

Anonymous said...

We don't know what percentage is HIV infected. We could release them, as some advocate, so they can have access to the general population.

Do women who have sex with released prisoners think about HIV protection?

sunray's wench said...

anon @ 9pm ~ you may be surprised at how many insist on their released inmate getting tested for all diseases, not just HIV. Very few people trust TDCJ/UTMB health "care" for inmates.

Gritsforbreakfast said...

7:58, sorry about your job.

8:42, you seem to not realize that when the state chooses to incarcerate someone, federal courts have ruled they automatically take on responsibility for health care for as long as they're locked up. California's costs are the highest in the nation because their system got so bad the feds stepped in and ordered them to pay much, much, more. What's happening now risks the same result in Texas. Whatever you think "should" be the case, that's the reality. Don't want to pay all the health costs for 160,000 inmates (a number nearly half again the size of Waco)? Incarcerate fewer people.

9:00, virtually everyone in TDCJ will eventually get out. They release as many as they bring in - about 72,000 per year.

Jennie said...

What does this say? 66% are white and 85% are female.

And blaming some of the diseases? One wonders if they places were a bit cleaner if there wouldn't be so many cases of asthma.

It appeared that they were just a bit too ready to not take any blame for anything. As in nothing is their fault.

They are understaffed now. Why don't they train some of the trustee inmates to help? One would think such training might help someone get a job in the free world.

Anon 8:42 - Do you even know what you are talking about? I don't think you have a clue.

Anon 9:00 - Do women who have sex with released prisoners think about HIV protection?

Read what you wrote. Seriously. What a ignorant statment. Do you have any of your partners tested on a regular basis? One wonders.

Most adult people I know (male or female) get tested for not only HIV but HepC and STD's as well. It has nothing to do with whether one has been in prison or not.

Grow up and get a grip. Yes, the majority will be released at some point. I'm not asking for lapbands and implants. I'm asking for access to healthcare for everyone. It affects all of us. If we keep them well, then the short term and long term cost for medical goes down. Which makes my taxes go down along with not being exposed to illness.

You will pay for it one way or another. I would rather pay for preventative (short term) then a chronic condition which didn't have to happen (long term). Remember if they are ill when they are released they will still be on our dollar. Ever heard of Medicaid?

Anonymous said...

When the thug is in the house she's going to make him go down and get tested? She's going to make him use a condom? You really believe that?

Gritsforbreakfast said...

11:31, 72,000 people are released every year, and every situation is different. Your comments tell us more about your myopia than they do about the behavior of "thugs".

Anonymous said...

They your pets.

Anonymous said...

All these Layoffs will leave the prison health care systemm a disaster waiting to happen. Those laid off like myself will be ok, however UTMB has set themselves up unable to provide care and also disasterous outcomes as they run these facilities with insufficient staffing. Lawsuits!

Anonymous said...

It is truly upsetting that so many good people lost their jobs last week. However, while there may have been some lack of foresight on the part of UTMB campus and CMC leadership for the past several years, the true blame lies with the Texas state legislature, who blindly failed to appropriate requested supplemental funds to reimburse years' worth of shortfall to cover actual costs of delivering health care to inmates. The legislature and the governor's office has been warned many times in recent months that we will soon follow in California's footsteps, which will in turn lead to federal intervention, a significant increase in prison staffing, and of course, cost to the taxpayers. Inmates are guaranteed access to health care. The state has decided to ignore that right. The employees of CMC are victims in a political arena wrought with financial snake oil salesmen and others whose sole focus is on passing the problem and saving their own asses. By the time this washes out, those in office now will be gone. As far as who was released and who was not, it was apparent that no input was solicited from supervising staff who knew the employees. Granted, there may be heavy senior leadership, but with 83 units and 120,000 inmates, most should easily be kept busy dealing with a myriad of issues, both with the delivery and management of care as well as interaction with staff. I've heard that some still see patients. My heart goes out to everyone who received a RIF notice, but I can't help but be equally empathetic to everyone left to drown in the flood of care requests. Remember the Ruiz case and the definition of insanity --- doing the same thing repeatedly and expecting a different outcome each time.

Anonymous said...

@9:26 - What unit or you on where you see Senior Leaders actually see patients ? I have never seen that on any of the units I have worked on. The only time they come around is for townhall meetings and what a joke those are.

I feel sorry for all of the individuals that received RIF letters and I feel sorry for us left on the units trying to deal with the aftermath.I honestly do not know how we are going to do it. We were short handed before the RIF notices..

Senior leadership is top heavy. They only worry about themselves....

Anonymous said...

Q: What's the difference between UTMB and the Mafia?

A: When you're in the Mafia and you screw up, you get iced. When you work for UTMB and you screw up, you get promoted. Incompetent management from top to bottom!

Prison health care in Texas began going downhill from the moment UTMB took over from TDCJ and has steadily declined ever since.

UTMB uses CMC to try and funnel every dollar they can to the UTMB campus in Galveston.

I wonder what they'll do after the next hurricane washes the main campus away and leaves a nice coat of oil behind?

Oh, I know! Chop CMC some more!

Anonymous said...

Well said 5:53!