announced in an internal memo sent to employees Tuesday that 130 jobs would be cut from its prison-system health services and 120 jobs from academic, health and support services.
The memo from UTMB President David Callender said the reductions were made to compensate for $114 million the Legislature slashed from the medical school's 2012 budget.
The prison system jobs would be lost at prisons statewide that are serviced under a contract with the Texas Department of Criminal Justice.
Last summer UTMB laid off more than 350 prison healthcare employees, and before that even more were laid off after Hurricane Ike. So the cuts now must be slicing pretty near the bone. Further, regular readers know, the cuts come at a time when changes in the financing structure for inmate healthcare could boost demand for services.
Perhaps Prison Doc, Nurseypooh, and other Grits commenters who work inside the system can elaborate on what's going on and what it will mean for prisoner healthcare going forward. In the meantime, here's an FAQ (pdf) from the agency about the layoffs.
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41 comments:
Yes I would love to comment but this week has been such a stressful life changing event I'm not sure what any of you may want to know.
Here goes................
At my unit we have..........1300 inmates.
Dr.-1
PA-1
RN=Nurse mgr.=1
LVN=5 (one lvn is the CID nurse and doesn't work the floor)
Medication aides=4
Last year all the RN's were layed off. 1 was hired back as our nurse mgr.
Monday we were informed.
2-LVN's (me being one of them) were being reduced to being part-time to 20 hours a week without benefits, or accept a full RIF.
1 med aide was RIF'd
1 reduced to part time or accept a RIF.
1 was moved full time to another unit close by.
1 Social Worker was RIF'd.
Other units have the same RIF's
The purpose of offering us part time with no benefits is because our benefits cost a lot of money to provide as much as we make for some I'm told.
The nurses they kept had more nursing experience in years (not within the UTMB system) but years exp. in nursing. Same with med aides.
Our unit years ago was 24 hours medical, then 16, then last yr. reduced to 12 and now this year were going to 8 hours per week.
Currently we have 2 pill lines per day and we will go to 1.
Supposedly they've developed "The healthy prison program" and will move all high acuity (sickly) offenders to units to be grouped together on units which have at least 12-24 hr care. I will add more later.
Ask your question's I will try to answer and my next post will discuss how this will affect prison health care.
Nurseypooh may know much more than I, the physicians are kept pretty far distant from the decisions made by UTMB's enormous, bloated administrative core. Decisions are being made by persons far removed from the day to day medical operations, and it shows.
Rumors are a dime a dozen, and "official memos" are pretty worthless: most have been revoked, ignored, or otherwise changed for the last six weeks. As my old mother would have said, management seems to be "running around like chickens with their heads cut off".
The facts stated by Nurseypooh are as accurate as anything out there, but most people feel that there will be many more changes and revisions. Again, rumor has it that TDCJ is most unhappy with UTMB's proposed plans and that things are still in a state of flux. Changes that were announced to be complete by August 1 have now been pushed back to mid-September.
The only things that seem certain other than death and taxes are that there will be changes and those changes will have a negative effect on patient care and unit medical operations. Nothing else appears to be set in stone yet.
Has anyone SERIOUSLY considered reducing our huge prison population? Of course not. Keep them all locked up for as long as possible and moan about health care. Maybe when there isn't ANY health care reducing the prison population might be seriously considered.
Woah - TDCJ are to charge us more for the health care, and yet at the same time, they are reducing the availability of that care even further?
I guess they just want to get to the point where we only get $100 worth of health services, rather than TDCJ picking up the tab for anything more.
Nureypooh, I'm sorry your hours are to be cut. I've just been through my second notice of redundency where I work, so I understand how stressful the process can be.
I am not accepting the 20 hours per week with no benefits. May as well get a job somewhere else. Most of those offered that are going to turn it down, Oh and they gave us 72 hours to make a decision.
However, there is a light at the end of the tunnel for me at least I hope it's my beacon.
I have been offered a job at another unit full time, with benefits. It's a large 24 hr unit.
It is not close to my home so I will have to rent a room.
I've anticpated this change just in case it was me and had applied at 12 different units across Tx. I'm blessed to be able to do this as some of my other coworkers are not able due to family, cost, ties etc.
Prison Doc is right, decisions are being made by the UTMB high poompah Gods who most likely have only toured a prison and don't exp. the day to day happenings.
If they move all the high acuity offenders to units to be grouped together then those units are going to need more staff because they will see an increase in chronic clinic, sick calls, emergent care and psych. So why do you lay staff off of one unit but not increase staff at the other your sending them to, go figure.
How is that saving money because eventually they'll see the increase in demand for care at these high acuity units and not be able to meet the demands until they hire more staff! Wowhoo you've layed off nurses at the units they came from on to have to hire new ones at the unit they went to.
Rumor has it-more changes are on the horizon for next year!
To inmate families:
Be sure and call on Friday afternoon prior to any visit or even the morning of the visit before you travel because in the next weeks and months there will be a lot of unit transfers.
NO INMATE will be denied medical care due to ability to pay the $100.00 co/pay! Some of them already pay more than $100.00 per year with coming so often with the $3.00 charge. Rememeber the $3.00 is not charged when they come in for something associated with a chronic illness such as: diabetes, high blood pressure, boils, staph, pap smears, testing for HIV and other std's, immunizations, high cholesterol etc................
How this will impact prison health care.
It's going to take longer for the offender to see a provider (right now they have 7 days once a sick call is submitted.)
Chronic clinic's will get way behind. (They're suppose to be seen once per year for CC.)
Medical staff is going to be really stressed and wore out which results in lower quality of care just like in the free world.
It's going to be helter skelter on some units getting offender treated in between the emergencies, walk in's, fights, uof, etc.
Speciality clinic appt.s have already been canceled, we've discussed this before.
After hours on the 8 and 12 hour units if an offender needs care, security will put them on DMS, (which is a tv connecting with another unit, nurse Dr. speciality clinci etc.) with a hub unit the hub unit nurse will try to triage the offender via TV and what security is telling them about the offender's symptoms and decide whether or not to send the offender out 911, van transport, or van transport to the hub unit, or Hospital Galveston. Mind you this nurse is trying to make this decision without any vital signs etc. because security is not trained to do this and shouldn't be expected too. THE DMS nurse does have access to the offender's chart though via computer which helps.
DMS-I've heard some complain and speak negative of this tool.
I have to say it is a very good tool that has been underutilized up until recently.
When our clinics are open and we have DMS, offender's have access to be seen by some of the best Dr.'s in the state that are in Galveston that they otherwise would not have access to. It's mostly used for speiality clinic, follow up, psych appt.'s hep C, HIV etc. Offender's v/s are updated a medical staff is in the room with them, the offender and the doc on TV, the offender can see the doc, the doc can see the offender. This will be the medicine of the future in the freeworld also. It's already being used in remote area's for years!
So this is not a bad thing!
Nurseypooh.....
I would really like to speak with you concerning your situation. I do not know where you live but I am hiring a full-time LVN position with great benefits. Working in a county jail. Let's figure out a way to communicate.
Sgt - Medical Division
Whereas all of those "admin poompahs (?)" are making the decisions, CMC has been backed into a corner with respect to its funding JUST LIKE EVERY OTHER STATE AGENCY! Read the papers people. $4 BILLION dollars cut from education. Hundreds of millions cut from Health and Human Services. This is not an issue of "those people" making decisions because those people are our state legislators and our governor. If anyone reading this thinks that senior leadership within CMC makes these decisions in a cavalier meanner, please try to understand where they are coming from. UTMB did not want to do the prison healthcare at all. TDCJ wants healthcare for nothing. CMC leadership has tried to offer up some creative ideas for maintaining a system that the state has funded at $7.75 per inmate per day when it cost us $9.88 PIPD this past year. I work for those "poompahs" and a day has not gone by that they have not considered the enormous burden and pain associated with these reductions.
It is easy to personalize the reductions, but unfortunately, none of us within CMC controls any of this. We are just pawns in the game of state politics.
The 'good ole boy' network is alive and well at UTMB. I work on one of the 24 hour units and have been told to expect a doubling of our highest workload Chronic Care Patients, with no increase in staff. With the number of insulin dependent diabetics doubling, it will have a major impact upon our ability to provide care.
An example of the first statement is that UTMB is going to save lots of money by eliminating the District Teams. Unfortunately, when that was presented, the figure was not adjusted down for the hiring of 15 'NEW' positions for the 'Regional Teams'. Doing more with less is what we are being told, but that option is almost no longer an option. Everyday is a decision process to decide which of the requirements from policy we are going to meet and which we will fail to meet. Direction from on high is to follow the policies that have immediate effects and do not follow those that will not have effects for over two years down the road.
This is having a major effect on the morale of the people on the unit. Many who still have their jobs are actively looking else where.
Looking into my crystal ball, I see more federal court intervention in the management of Texas prisons in the future. Seriously, it doesn't take a crystal ball to see this...but, unfortunately, I guess the legislature needs a crystal ball to see the obvious. William Wayne Justice should have never released the system from court supervision.
These cuts are a direct result of right wing extremists taking over government to avoid paying taxes, plain & simple.
Most of these cuts could have been avoided had the right people been in office.
In the aftermath of the carnage on the slaughterhouse floor, now it is obvious what it cost us.
This is the America where dreams become nightmares & selfishness prevails.
So, I hope you're happy because if you voted GOP, you put yourself in this position.
Pigs.
When I retired in 2004, I thought the medical support could not deteriorate further at the unit level; wow! Was I wrong.
Unit transport missions will also be increased. Correctional staff will have more off unit transfers; dangerous,taking away from already short unit staffing, and transport expenses (fuel, vehicle, etc., etc.).
From TDC health care to CMC; what has been accomplished? less medical staff on the units and more six digit salaries for non-medical (not a degreed medical professional) administrators.
how many "indian" positions need to be cut before a "chief's" position is cut?
Retired 2004
Most people, particularly GOPigs, don't care about what happens behind the Sally Port. In fact, they could not care less.
Many have never stepped foot in a prison. They don't know what it is like to personally deal with all of the negative energy inside. Then, to make matters worse, in order to save taxes, they reduce funding & jobs.
Texas is headed backwards in time. Our goal, as a nation, is to relive the days of the 1950's when life was simple.
Texas, you are a sinking ship headed for the rocks. The Tea Baggers have taken over the ship. The ship's captain is a simpleton.
I know what it is like to work in a prison without adequate help. It is dangerous on your health. The stress level is very high. Of course, you generally don't notice the level of stress until after you leave. It takes time to unravel a twisted rope.
God bless those who are left in the wake of this ship.
"NO INMATE will be denied medical care due to ability to pay the $100.00 co/pay!"
Nurseypooh, I know that's what it says in the legislation, and I know that is what the politicians are saying now, but I am not confident that inmates will not die because of the changes brought in during this session including the ability to pay the $100 tax. We already know that there are some - NOT all - sadistic TDCJ staff who would take great joy in making an inmate wait longer and longer to see a medical professional, based on hearsay that the inmate had not paid the $300 tax.
Medical staff don't fetch the inmates, TDCJ guards do.
I do realize this goes way deeper than CMC management and that they're just trying to do their jobs. When I called them the "admin poompahs" it was just my frustration at my level. From mine and my coworkers standpoint we feel like, "I wonder why we're never asked, hey do you have any suggestions on how to make this better, easier, where do you think we can save money at?"
They could've even taken a poll of us as to who wanted to retire early or was thinking of leaving anyway.
As some of you have stated it goes all the way back to legislative stuff which I don't claim to be all in the know about. My perspective is from the actual day to day life of a correctional nurse.
They will change policy to accomadate the lack of staff. Such as-if an offender has a rash it's going to take longer than 7 days to be seen. They will triage and see the most acute or emergent 1st.
yes there are going to be more transports.
Hopefully they will be able to buy more of these otc items at comm.
The leg has looked at letting some non-violent inmates go early but it is my understanding it got struck down, then ignored.
I already have another job lined up but thank you for the offer. Anon.
I hope to try to stay until I can retire as I already have enough time in the system it is a big benefit me to stay until then.
However: if it becomes intolerable I will leave, not going to put my license on the line or someones life.
This is but one of many small steps toward making a giant leap backward into federal oversight of the Texas prison system. Things started going downhill in TDCJ-ID on the very same day federal oversight under Ruiz went away. I know because I was working there at the time. I must have heard, "Well, we don't have to do (fill in the blank) anymore now that Ruiz is gone away" about 10 times that afternoon.
"As far back as 2005, UTMB officials said the system was near the brink of failing to provide constitutional levels of care: '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.' Unfortunately, the state since then has taken several more steps across that line, culminating in this year's outright draconian cuts." http://gritsforbreakfast.blogspot.com/search?q=Raimer
Texas may save some money now but will likely pay a lot more later.
If UTMB CMC needs to make cuts, they have several layers of bureaucracy that could be chopped. These folks spend all their time in meetings and emailing each other. Some spend all day emailing from their homes and never cross the threshold of a unit.
"Teldar Paper has 33 different vice presidents each earning over 200 thousand dollars a year. Now, I have spent the last two months analyzing what all these guys do, and I still can't figure it out. One thing I do know is that our paper company lost 110 million dollars last year, and I'll bet that half of that was spent in all the paperwork going back and forth between all these vice presidents." Gordon Gekko in Wall Street (1987)
Linda Tampkee of Midway
I am very very satisfied with my home health agency. I feel confident in my nurses. They do an excellent job coordinating with my doctors. They keep up with my medicines very well and changes in my care is well documented.
*****This is word for word from the patient, I also have a signed marketing authorization form from the patient.*****
I'm so sad to see where this issue is heading. It's not a proud day to be a Texan, that's for sure.
The idiot politicians don't care about prisoner medical care, because being "tough" on crime, and criminals, is much more politically popular than the cost and inconvenience of having to worry about the civil rights of such a disgraceful group of human beings. Their feelings, of course, not mine.
Besides, now that these people are convicted felons, they can't vote anyway.
Since no inmate is allowed to self medicate or possess any contraban, and by being literally prisoners to THEIR version of medical "care", we are going to end up treating these people like dogs. How can we call ourselves a civilized society?
The only logical way to keep the medical care anywhere near acceptable medical standards is to lower the inmate population. We have 156,000 "Offenders", and if the already lean budget is being slashed by 10%, the ONLY logical solution is to reduce the Offender population by 10%, and close up a number of Units that house approximately 10% of the inmate population. That's roughly 12 prisons. Of course, that would also take balls. As a general rule, politicians have no balls.
God help us.
No accountability, from top to bottom.
"Ve vas chust following orders. Dose bosses, dey toldt us it vas legal."
Nursey, thank you for the heads up to the families. I am sorry you are being faced with all of this.
Cathy
Anon 0707
Thank you! WE still don't know anymore. It's looking more and more like it will be after August 1st before we go to 8 hours and moves are made. Most likely more like mid to late August or even as far as Sept. 16th which is the date the offical RIF's are in effect. You never know though they could get it in gear all of the sudden they're not telling us anything about any moves. So until all this settles call before you go.
I'm doing ok but thanks for the concern. It's been a wild week!
My pen pal on death row has suffered from severe diverticulitis since Jan. He only this month was seen and prescribed meds.
I am going to pay my love one's $100.00 medical "shake down" I mean user fee "BUT" I have instructed them they have to go to medical one time a week for the entire year for anything and everything or I will not do it again the next year. I have also told them I heard that from other readers that TDCJ and UTMB now does elective surgery. I told them to get some plastic surgery like a face pull and tuck, a little work around the eyes and some neck tightening. My point to them was if TDCJ and UTMB is going to shake me down then I am going to get my money worth. I also pay my own health insurance and I thought my taxes paid for theirs in prison to receive health care. Since I am paying twice now I think it is time to vote my state reps out of office.
Hey grandma with the penpal on deathrow just have him take an antacid and pray that his date will come before he dies of old age. He is A killer and has been convicted and sentenced to die! For crying out loud.
I've read all the opinions and comments. As a former RIF'd employee of UTMB and TDCJ it is getting more dangerous to work in a prison by the day. I am more than happy not to be working in the system any longer and I spent 16.5 years there. Those of you are right about not asking the staff how costs could be lowered. We had idea's, but no one asked us. Some of the changes they made in redistricting are a welcome site. Should have been done years ago. They are paying people out there who pass on instructions from the top to the bottom and they are the middle man. They should have cut the middle man out long time ago. Can't someone at the top communicate with the low man? They didn't get rid of people during last years RIF's that weren't doing the work, they got rid of the ones who were doing it all. They should have listened to the supervisors who knew what was going on and RIF'd staff that are still there just for a paycheck. They should have looked at there annual evaluations. They sure aren't working. What did they leave this time, the same old people. I worked in 5 different units over the years and I've seen it all. I used to be bitter being RIF'd because I was one of those people who would step in and help anyone who needed help. I didn't sit back and wait for those lazy people to step up because I knew they wouldn't. They are all about (admin staff) coming early as possible even when there is no work that early in the day and going home early and leaving everything for someone else to do. I don't miss it! I don't ever want to go back. I'm mad at myself for not doing something about it earlier and getting out. I miss my friends but can't say I miss the jobs.
Too bad many CO's don't follow the rules. Most CO's, since most TDCJ Units are located in tiny backwoods towns, are backward a** hicks with an IQ that is borderline retarded . There are a few good ones, but the bad ones far outweigh the good ones.
Hey Anon 10:25
So do you actually feel your loved ones should go to medical once a week whether they need it or not and have elective surgeries, do you really think it would only cost $100.00 per year? Just one Dr. visit with routine labs will exceed $100.00 in the freeworld.
I'm curious as to why you feel you and your loved ones are so entitled?
If your offender's do what you instructed them to do (how are you going to know they did anyway) they will contribute to a very already clogged medical system and prevent or delay other offenders from recieving timely healthcare that are really sick and need to be seen!
More or less my son who is in prison at the Hughes unit if he really needs to be seen for something legit, your loved ones might get seen first over something trivial! So my son has to sit back and wait! Might even turn into an emergency due to not being treated soon enough. GEEZ!
GOPer said...
Hey grandma with the penpal on deathrow just have him take an antacid and pray that his date will come before he dies of old age. He is A killer and has been convicted and sentenced to die! For crying out loud.
7/25/2011 05:26:00 PM
Hey GOPer.....
As a former Republican turned Libertarian, I just have to say something.... Most Republicans consider themselves to be Christian. If you do, you need to spend a little time in the Word...a little prayer might be good too. Christians are supposed to believe in things like redemption and forgiveness. I'm not saying let the killers out but I am saying that your attitude is...well.....you need to read your Bible and pray is all I'm going to say.
And, remember, we're all sinners. None of us are any better than anyone one else... Yes, that man on death row is a sinner but so am I, and so are you. It may sound kind of silly but "What would Jesus Do?" is a good question to ask yourself.
Let me see Oatmeal??? I am not entitled to my medical because I pay for it and it is a benefit THAT I PAY FOR!!! I also pay taxes and fees in this state so that is suppose to cover all the prisoner’s right there. Now that I have placed $100.00 on to their commissary account just for this I WANT MY MONEY WORTH!!! I know the system is already clogged but do not blame me I did not come up with this smoke and mirror scheme to try to fool the people who think prisoners should get no medical care. My love one now is entitled because I was "shake down" for $100.00 additional dollars. What is next meal cards that I will have to purchase? Those smarty pants LDGE should have thought this through like a normal person with common sense. I know because I have common sense the prisoners today are very smart and I am not the only one thinking this way. All the slaves in our state prisons will over load the medical system and rightfully so because now they are PAYING COMSUMERS!! Next is the best part a complete takeover of the Texas Prison System by the Federal Authorities because of like the state of CA substandard medical care. This is not my plain but it is going to happen. Do you really think TDCJ or UTMB gives a you know what about anyone much less my or you love one getting decent human medical care? What is done is done now. Since the prisoners are now consumers I am just going to sit back and watch this train wreck occur.
Oh-by the way do you think I am stupid enough to think someone deserves plastic surgery? I am being sarcastic because so many people on here if they have their way OUR love ones would get no medical and nothing but bread and water. You attacked a prison abuse advocate. I have read a many of ignorant people post remarks about the great medical care our love ones receive to include elective procedures. I have been to visitation and watch guards cuss at both visitors and the slaves they hold and call them colorful names like crack heads and prostitutes. I feel for your son down at the Hughes Unit in Gatesville because I know all the units especially the female units in Gatesville are the worst in the world. I have seen prisons in third world jungles and deserts more humane than in Gatesville.
The Dental System is getting severely cut, and we deal with many very serious infections and oral surgery. The latest trick is to move a Dentist from one uint to another,
100 miles or so, or get riffed. All the Dentists are having to move around so much just to take care of urgent care and pain that routine care is becoming a think of the past. Just another step on the way to Federal Intervention. I know lots of people will think the
patients deserve no Dental care at all, but we take care of many very serious infections which could result in life threating
situations. Before long there will be no Dentists who will want to work for the system, and many who
will just leave.
Two years ago I was told my job would be RIF in July 2010 by a friend in Huntsville and it was. They also told me, that there were to be more RIFs, until the staff was nothing more than a few nurses, a CCA, a med aide and the provider, then UTMB will throw up their hands and turn it back over except the providers who they will contract out. They have been right so far. Also for those who really want to know, there was a hold up of a couple of weeks on this last RIF, it was so District Management, Galveston CMC Mangement, etc could hide people and/or change titles so they could keep their jobs. Thank God I was RIF the first time around, because the health care that was being done was very much on the line.
have received word from reliable sources that
UTMB is doing their best to get rid of the Dental
program entirely, move it out to contract or private.
Nothing to stop them, they have the contract.
Will involve serious cutbacks in staff, and care.
Dental is expensive, requires clinical equipment maintenance, supplies, new equipment. One of the units I work at has a chair held together, literally,
with Scotch tape, parts no longer available.
Look for lawsuits.
Once again, we deal with broken jaws, trauma,
serious infections close to the brain, many things the
general public does not think of.
There will be major consequences if Dental is lost
to a company that only counts the money.
All your readers who have patients in the system need
to know about this. Right now the average time to take care of emergencies is about 2-3 months,
routine care 9 months -2 years.
As for for the dental you have your information wrong. NO dental staff was cut. I work in dental and this is fact. Does anyone remember Ruiz?? Dental is going no where there is a reason dental is access to care 1 and 2. So typical of other depts to point fingers when they have no facts. Anon 7-29 5 34 step up and name your source because I'm calling out your BS
I know someone at the Crain unit that took them 4 years to get their teeth clean and in six years that has been all they have recieved as far as dental care. Maybe it was just the guards trying to torment them but the word down there is now the only dental being received is teeth being pulled. My sources are the guards down there tormenting and telling the inmates how mad they are that they have to pay a $12.00 co-payment instead of the $3 dollar co-payment the inmates pay. My suggestion to them is either go to prison or shut their big mouths. This is typical of the day to day treatment at the Crain Unit. I pray for the federal authorities to take over the system again and put some of these SMALL people TDCJ employs in their place. You got to love the Gatesville Gulag!!!!
" I spent 3 1/2 years on the Gatesville Unit which was actually renamed The Christina Melton Crain Unit in 2009. I spent 2 years at Terrace & 1 1/2 years at Sycamore which are 2 of 7 satellites of the prison.It is a very dark place where most of the guards families have worked for many generations so all of the meaness & contempt that they have for the prisoners has been instilled in them as they were growing up. It's in there blood as their parents, grandparents, aunts, uncles, cousins, siblings hell all of them out there in Gatesville work for or have at onr time worked for the Prison or the boys home that it used to be.
I've seen women die in there because of neglect from guards to call for medical help during extreme emergencies that did result in death. There are a handful of guards that do treat you with respect if you give them respect but most of them have no business whatsoever be in charge of offenders but should in fact be in the system themselves. It was a very dark time out there during my incarceration in Gatesville & so glad I've done my time & came home already. "
The moves have begun.
Still wondering when UTMB CMC will make cuts at the EVP level. Do they really still need Steve Smock and Tony Williams ? Amazing how they still need two EVPs to run a smaller work force.
UTMB CMC.....Start at the top and then work your way down...........
UTMB announces that they have acquired funding for a new hospital. And CMC employees will still not get a merit raise for at least a four year period since the last. Another classy move added to a long list of indirect disrespect to correctional line staff. Embarrassing.
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