In a new sign that Texas' state budget crisis is far from over, officials drafting a new contract to provide medical care for Texas' 153,000 imprisoned criminals acknowledged publicly Wednesday that the approximately $900 million allocated by the Legislature will not cover the cost.
As a result, top officials with the University of Texas — which provides medical care for roughly two-thirds of all state prisoners — threatened to stop providing care unless adequate funding can be guaranteed.
Such a move would create a new crisis in a system that was once hailed as a model for containing costs but in the past year has faced spiraling costs as private vendors lobbied — with the help of top aides to Gov. Rick Perry — to provide some services.Readers of Grits, of course, knew months ago that the Lege hadn't appropriated enough money to cover prison health costs, and indeed:
For Texas taxpayers, the funding disparity could mean they will have to pay more money to provide care for prison inmates during the next two years, even if private vendors do start providing the care. For convicts, it could mean further cuts in a system that already is drawing increasing complaints about inadequate care.
Dr. Kenneth Shine, executive vice chancellor for health services for the UT System, and Dr. David Callender, president of the University of Texas Medical Branch at Galveston that provides the prison health care, said in a Wednesday letter to Brad Livingston, head of the Texas Department of Criminal Justice, which operates the state's 111-prison system, that without adequate funding, "it is our intent to cease the delivery of correctional health services."
House Corrections Committee Chairman Jerry Madden, R-Richardson, said he was not surprised by UTMB's decision.I guess that new policy (pdf) charging inmates a $100 annual fee for healthcare isn't turning out to be as lucrative as hoped. (Grits suspects the policy will actually increase demand for prisoner healthcare.)
"We cut $100 million from correctional health care spending, so we knew there was a good probability there would not be enough money to cover everything," he said. "I'm not aware of an extra $100 million laying around anywhere, but we definitely need to find a way to resolve this so it doesn't become a problem in court.
"We have these people incarcerated. We have to provide them medical care."
Madden told Ward, and I couldn't agree more, that the best way to reduce inmate healthcare costs would be to "downsize Texas' prison population." Madden is focused on release of immigrant offenders who're eligible for deportation, but it's also worth mentioning that according to a recent news report, "More than 50 percent of that cost is spent on care for inmates 55 and older." The same story mentioned that "offenders 55 and older averaged $4,853 in yearly medical costs, while the average for those below that age was $795." So to really get the most bang for the buck, paroling older offenders would generate the most savings in healthcare costs.
Older offenders also have much lower recidivism rates than their younger inmate counterparts. According to the Legislative Budget Boards's latest recidivism report (pdf, p. 40), three-year reincarceration rates for released prisoners broke out by age as follows:
25-29: 26.9%So for my money, the best budgetary and public-safety bang for the buck comes from releasing older offenders who also cost the state the most in healthcare services.
30-34: 24.6%
35-39: 24.6%
40-44: 24.2%
45+: 17.6%
Do I think the parole board will do that? Not really. But that's what would make the most sense.
UTMB President David Callender MD sent to employees this afternoon confirms the Statesman article: either pay UTMB what UTMB deems a fair amount or UTMB will immediately begin to transition out of prison health care.
ReplyDeleteObviously (we) rank-and-file employees are not happy about this development but most have been expecting a notification exactly like this.
What will happen and when? Nobody knows but probably something will start happening pretty quickly. It's been obvious for a year that UTMB Galveston wants out of this deal, so unless legislative appropriators fix the numbers quickly, I imagine UTMB will be gone.
Regarding Grits' comment on the new $100 annual fee, the immediate result has been to dramatically reduce the number of requests for elective health care. Given today's developments, the entire issue may be moot.
No were not suprised.
ReplyDeleteDitto to what prison doc said.
The $100.00 fee did not go into effect until Sept. 28th instead of the 1st reported Sept. 1st.
It most likely cost UTMB over 2 million dollars during the "Great KOP med experiment" they had numerous overdoses and the inmates went to freeworld hospitals. Ooopps!
ReplyDeleteI am so sick of the lies. You can't trust upper management. What about when owen murray went around to the units in august claiming we were all safe for 2 more years?? The message from the president sounds like more lay offs. Will TDCJ really need 6 cca's at a unit when they have their own clerks?? This is all quite frustrating
ReplyDeleteUTMB could save a lot of money by cutting several layers of bureaucratic flab currently living off the teat of prison healthcare.
ReplyDeleteI personally know of several highly paid UTMB health care "providers" who haven't seen a patient face to face in years. Some of them sit at home all day firing off emails creating more needless paperwork for the folks actually seeing the patients.
Here come da (federal) judge!
ReplyDeletetales of the $100 copay:
ReplyDelete1) "this is a follow up of the cold I had last year"
2) my rash is a chronic illness
3) "i have an emergency penile discharge"
4) "this is a pre existing condition"
5) "I need to be seen for chronic care regarding my runny nose
6) "I want to be checked for diabetes, seeing as how it runs in my family
7) "I wrote a sick call before the 9/29/11 deadline, I have to work here in the law library and it's not my fault I didn't show up to the arranged appointment"
8) and on and on
. . .
Hey, what about the $500 "one time special adjustment" due to finishing the 2nd fiscal year in a row with a positive margin to reinvest in our vital mission... for eligible UTMB & CMC employees.....email sent out by Callender on Sept 30,2011..... WHAT??? (i think I'll need it now)
ReplyDelete"What?? it's gonna cost me $100 bucks??? I didn't write that sick call! My celly did it!!!
ReplyDelete"D@M celly!"
Maybe the $500.00 is really our severence pkg.
ReplyDeleteI get tired of UTMB making us fill out useless job satisfaction surveys. How can they expect us to be happy at work when every 2-3 months we receive a letter stating that they are trying to dump us.
ReplyDeleteAnons 9.11 and 9.41 ~ you think it's funny that inmate FAMILIES have to find an extra $100 for this medical tax? If so, you are the kind of people who should not be working in that situation.
ReplyDeleteThe BPP wont parole more over 55s because Rissie Owens doesn't believe there are enough of them on TDCJ. Scott, you should send your updates to Madden and Whitemire if you don't already.
That new policy isnt charging the inmates $100.00. It is charging the families $100.00, whether we like it or not. hmmmm
ReplyDeletemaybe the offender should have made better decisions and NOT ended up in TDCJ to start with. hmmmm...
ReplyDeletewhat an easy pay system...you have 12 months to pay $100, oh and if you don't have it, you'll get seen anyway. hmmmm....
ReplyDeleteIf they would stop incarcerating people whose crimes are negligible and either put them on probation/community service or leave them on probation once they are there, they wouldn't have nearly as many people for whom they need to spend money either on medical care or just care in general.
ReplyDeletePoliticians, including judges, don't look nearly as good at election time if they can't show that they are "tough on crime". What nobody seems to realize is that it's toughest on the prisoners families. TDCJ's idea of medical care is to tell the prisoners that if they want meds, they can pay for them out of their own pocket. If they or their families don't have the money for commissary, they are SOL.
I think the reason the new fee has reduced health calls instead of increased them is that the version finally implemented is quite different from what was first proposed. Originally they were going to charge the fee to everybody whether or not they used health services, so the incentive would have been for people not using services to say, "I'm paying for it anyway, why not?"
ReplyDeleteChanging it to apply only if someone requests services changed the incentive to actually delay or forego that first sick call.
As Prison Doc says, though, given how vastly they underfunded healthcare, even that likely won't be enough to keep the sinking ship afloat. Though I doubt Perry will call one, theoretically I don't see how they fix the problem without a special session. It's not like the LBB has that much money lying around. That pretty much puts it on the parole board to expedite releases, and we all know how (un)likely that is.
If UTMB bails out does anyone have any idea who might be in the running for the contract? I've heard Scott and White is one of them. Still takes $ no matter who is providing healhcare where is this money going to come from?
ReplyDeleteNurseypooh, the private prison companies said earlier this year they couldn't do the job for the amount the Lege appropriated. Mike Ward reported in the spring on a memo speculating that "Opportunities for the private sector to deliver certain segments of inmate healthcare may be possible if funding levels remain close to the current (i.e., last biennium's) appropriation levels."
ReplyDeleteBut since they cut six-figures from prior appropriations, I doubt a private contractor would want it without the budget going up, in which case UTMB and Tech would stay. So I'm not sure what they'll do. Presumably TDCJ will have to directly employ their own healthcare staff.
I fail to understand why the Parole Board grants parole to so few inmates over the age of 45. Many of them have done all they can to rehabilitate and prepare for their entry to the free world. This is what the Parole Board states as their objective. Yet they languish growing older and in maybe cases needing more medical care. Keeping them there until they reach Old ages means that when they do get out they are a complete burden on the state being too old or too ill to work. Prison is not the healthiest environment nor is the medical care adequate. Men and women age faster in prison. I am talking now about people who have been incarcerated for over 25 years...punishment should fit the crime and the documented efforts over years of incarceration to reform one's life.
ReplyDeleteGrits, you are saying the Parole Board will NOT change their ways. Why?
Why would they, 12:48, it's the same folks who're bucking federal judges on the Condition X stuff and who've refused to follow their own guidelines on who to release. Why would they change now?
ReplyDeletePutting aside accusations of Miss Rissie and cronies misuse of justice and contradictions in following policy; Just how many of these old geezers are actually eligible for parole?
ReplyDeleteSomething else that may be a tremendous factor contributing to the dysfunctional bpp is the academic inbreeding. No, just because I used the word inbreeding I’m not talking about gatesville boss’s. What is the percentage of these people who attended Sam Houston?
Being in a technical field I don’t see a ton of resumes from people who received ordination in human suffering from Sam Houston. But the few times I have out of respect to the schools degree programs I have a policy to set those resumes to the side to be used as toilet paper. Its softer than what the offenders get.
Get this to save money Texas Tech is laying off 12 health care workers at the Allred Unit. Not the higher paid RN's but the LVN's, clerks, and other allied staff. My point is if UTMB really wanted to cut costs, they would do what Tech has done lay off people! Having just retired last yr from TDCJ, I feel that the health care needs to be funded. I wonder how much money is wasted, by UTMB and Texas Tech?
ReplyDeleteThanks for your response grits.
ReplyDeleteI predict TDCJ will have to take back the healthcare, UTMB doesn't want it anymore, no private sector wants it either.
UTMB has offered to continue speciality care services at Hospital Galveston if TDCJ will pay them.
Anon 12:48, also a lot of these older offenders had a really rough life before incarceration, drugs, alcohol, poverty, bad eating habits and lifestyle, so yes a lot of people in prison look older than they are but don't blame it all on prison. A very large percentage of the older population has Hep C.
Anon 4:51-UTMB has already layed off lots of people, read some of the previous post.
Aside from shifting the $100 cost onto the families of the inmate population, the big concern I have with the $100 charge per prisoner per year is that a minor medical problem will become much worse due to the inmate's attempt to self treat or defer medical care.
ReplyDeleteOne open heart surgery, plus the rehab costs, that could possibly have been avoided, would cancel out an awful lot of the "savings" associated with charging the 100 bucks.
Terrific and informative blog post! Thanks!!
ReplyDeleteThe parole board is the biggest problem here. If you look at the laws and when an inmate meets parole and they have behaved themselves they then should be paroled; however, the parole board plays second judges and refused to release most of them and they end up maxing out their sentences. The reason "the nature of the offense". There is no way possible to change this factor. So since there is no rehabilitation within TDCJ then why would anyone want to do right when all they have to do is sit around and watch those that do behave be refused parole many times. The "Feds" need to step in on the current parole board members who refuse to obey the law themselves. Maybe the Medical care will be the first step in reducing the prison population.
ReplyDeleteMy points exactly 6:47. The Parole Board blatantly disregards all their "standards" for parole by playing judge the second time around. The "oldtimers" were sentenced by a judge and parole guidelines were set by the Lege WHEN they were sentenced. Those guidelines have changed over the years, but I wonder if the judge's sentence would be the same if he were in 2011 instead of 24 years ago. However, forget a clean record, forget the years of rehab. All that matters is "nature of the crime". Like so many other things, the Parole Board and TDCJ should go before a Federal judge. I'd applaud it. But Texas might have to close another prison...Horrors to Betsey!!!!
ReplyDeleteYou hear all this talk about medical, but what about Dental, Lab, Radiology and the smaller services? I guess everyone will have to wait and listen to Owen Murray make his rounds at the Town Hall Meetings, please!
ReplyDeleteAt this point why would any of us believe a word that comes out of Owen Murrrays mouth?? We were all lied to in August when the pony show came to town
ReplyDeleteThe point I want to make is when one of this lesbian officers writes an inmate of a sex case it is not because they are having sex with another inmate or if they are it all comes back to retaliation because the guard cannot have their way with the inmate. The guard gets jealous because they fear they are losing their manipulation, fear, control and power over the inmate so in return they write a major case and this prevents parole. I do not know who is the dumbest her the prison trying to stop something between inmates but the guards turn around and lead by example (inappropriate relationships) when it comes to breaking the rules or the parole board for not being able to see this and denying someone parole over sex in a prison. How could the system be any more broken than this? This starts at the very top with the Wardens and Parole board members. This is the day to day life in a Gatesville prison; especially the Crain Unit and the parole board are cronies with the educational level of a 10 year old. Who in their right mind would even want to be a parole board member? Someone who is easily corruptible that is who. Have you ever heard a child say when I grow up I want to work in a prison? The roosters have come home to roost now and very soon the lawsuits will begin over the medical and other conditions in these run down and corrupted prisons that violate basic human rights and standards such as medical, food being withheld and third world country living conditions. Coercive sex is being used as a weapon to prevent parole and further isolate the prisoners. The guards write these women sex cases then turn around and openly flaunt the same life styles. How can a lesbian who openly flaunts this behavior turn around and write someone up for this and the hearing officer who holds the kangaroo court and dishes out the punishment is doing the same thing or is retaliating because the same inmate refused to have sex with them?
ReplyDeleteAmen for the last comment. My love one has served more than two thirds of his time for a sex crime that was consentual sex, but his "very intelligent attorney" told him to plead guilty and get adjudicated ten year probabtion. Okay,he was on the road one night, had a flat tire and a county man comes along and takes him in revoked his probabtion and added give more years to his sentence. the DA made the statement he could indict a ham sandwich. my son had a two minor charges since 2002.working every day. The sad part of this story is he has a 12 year old girl that worships her daddy and wants him to come home and I am 75 years old grandmother. Her mother is deceased and we desperately need him to come home. but was denied parole this year. Praying for next year to be different!
ReplyDeleteThe current medical care is lacking and will only get worst. To much fat at the top of UTMB and there will be no cuts there. The parole board is broken and will not likely be repaired in the future either. This is why women in the system will almost always max out their sentences just to keep those death traps that are crumbling around all those unmarked graves of little boys and women. This is why the parole board plays second judge to keep those inbreeds in jobs. Those units are run like concentration camps. They know these women will not be paroled so the wardens will not even allow the minimum security prisoners have contact visits with all their visitors. The wardens at the men’s prisons see this as a reward program for the behave prisoners and a motivation to continue to behave. But on the women’s prisons and the biggest offender is the Crain Unit the warden sees this as power and now the unit has turned into a defacto military prison. The staff can barely feed the inmates because of the incompetent way it is being done where many do not have the time to eat their meals and many do not even get in to the chow, mess or slop hall to even eat. The guards are stealing from the inmates and writing them up sex cases as retaliation for not having sex with them. The groups of lesbians are violating civil and human rights with these threats of write ups that stop parole and many will stand around at visitation and brag about these facts. This is all about power to deprive and there is no rehabilitation on this unit. The medical down there will probably be the first to result in a federal lawsuit and this entire unit is ripe and just waiting on a federal takeover. The guards will try their best to stop visitation and make it as miserable as possible for the family members then turn around and charge the family members $100 dollars for substandard treatment. The guards steal personal property form the prisoners so once again the family members have to buy the same items over and over again. The guards threaten prisoners with loss of good time, privileges, personal property and visitation because the prisoners will not have sex with both the male and female guards. There is a male officer stealing personal property on the Terrace unit while a group of women guards coerce sex from the prisoners. Now what kind of rehabilitation is this and what kind of people are running and working on this unit.
ReplyDeleteAnon 1104- I guess you believe EVERYTHING your offender tells you right! How much money do you send her a month? Most of the information you provide on here is only heresay from your offender, correct because I've noticed you rant and go on without any facts to back it up. Why would an officer want any offender's property maybe this is a story to gain sympathy for you to send more money. I think some of what you say is just that your being fed a load of crap by the inmate!
ReplyDeleteWOW!!! Sounds like someone got their feelings hurt here. Are you a correctional officer or rank on this unit? I can tell you for over ten years and I know hundreds of inmates in those female units and I would not put anything pass anyone working there and most of what I have read here is true. Facts! Since when has TDCJ cared about facts or anyone holding those kangaroo courts cared about facts. Everyone says all inmates lie and why is that? Because everyone knows the people working in those facilities lie also. The people who dish out punishment there do not care about facts it is always their word against mine. How do you know these are not facts? They sound pretty good to me. Why do you attack someone for sticking up for their family member or friend? Why do you think someone is sending money to someone down there and is being used? Do you have personal knowledge of any of this? What if this was your family member or friend? Oh-yea, I know, no one in my family or no one I know will ever end up in prison. How convenient just to assume a person in prison will always lie and deceive someone for money. Money does not influence everyone in this world and some people take up causes to do the right thing. I guess the gentleman who just won the boxing match last night who was in prison for over I believe 30 years and innocent “it could never happen” but he refuse to plead guilty even though he could have been release 15 years earlier. I bet you believed he was lying all those years. What about all the Death Row exonerates just here in Texas the last couple of years? I am not foolish enough to believe for one minute that the current justice system is justice. The current system and everyone who defends it is broken. I know what I have witness down there at visitation and it is disgraceful to say the least. The great thing about this country that has not been taken away from us is freedom of thought and speech but it is coming unless the people stand up and stop it. I would assume and believe that when an officer steals an inmate’s property it is all about power and to deprive them of something, to have total control over that person. It must be true if feathers have been ruffled here. Everyone is entitled to their opinion and I always caution one on the side of Karma.
ReplyDeleteY'all are blogging in the wrong thread. This is about UTMB's contract, not prison guards and inmates antics
ReplyDeleteThe spiritually inbreed indigenous specious of gatesville have been getting away with murder, literally, since that facility opened in 1889, primarily because of the population it serves. Their classic catch phrase, “you can’t trust a state boy” has been used for a century to cover up for their cruel and inhumane treatment of the woman and children they get paid to house. Even in its modern form as it pertains to the ladies there now, written by the pusillanimous anonymous ass clown 10/16/2011 6:33pm who might as well be one of them.
ReplyDeleteThis is a region that obviously everyone in our states leadership knows can’t function without the prison. Our state leaders know those miserable morons need people like the population the gatesville gulag serves to validate themselves as being better than someone else. Bulldozing the place is not an option because of the unmarked graves that would be uncovered and the publicity it would bring. Besides do we really want the indigenous specious of these little hillbilly prison towns who built their livelihood for generations on the misfortunes of others integrated into decent society? Please I’d rather have the inmates than the townspeople in my neighborhood, it would be much safer.
Health care in a prison system like TDCJ is a unique animal and has to be considered as such. Between the population it serves coupled with the foolish entitlement bureaucracy it’s expected to function under it’s a wonder any of the tax dollars that fund TDCJ health care could have an ROI above 10%. UTMB would do good by its people to tell TDCJ to take a hike. Gd forbid the health care providers of UTMB have their souls tainted by those that call themselves running TDCJ, then they would be totally, absolutely, and utterly useless to society. All that training and education for nothing just to generate another cruel humanoid under the guise of healer.
Thank you Sheldon!!! This person probably works down there or is rank trying to shift blame again. The medical down there or lack of will hopefully result in a federal lawsuit in the near future. I have had many ladies down there tell me the way they run meal time down there is abusive because many now miss meals because of time restraints. No surprises there. This is true facts that for the most part this is a minimum security unit that is run like a concentration camp. Many of people have told me the I-60's medical requests are just thrown away. Guards steal property to deprive, degrade and abuse people who have nothing much anyway. The facts are told by the officers and kangaroo courts are improperly stored and contraband. No surprises there to hide behind rules when it is convenient. Once again I would have to agree with anon 6:33 pm and that is how can an officer write up a sex case when they do the same thing and how can a hearing officer punish one for it when they do the same thing? I with you I would rather have anyone of these ladies living next door to me than any of the prison employees.
ReplyDeleteANON: 1104, I found this on another blog. It seems that several people who have visited the Crain Unit have seen and heard unspeakable things on this unit.
ReplyDeleteI have a friend that's in the Terrace Unit at Gatesville. She have told me about some of the same sexual harrassment by the guards. One in particular is a black man. I remember when leaving a visit recently he started asking the inmate I visited very personal questions that he was way out of line for asking. She told me he's perverted and one of the guards that watch them shower. The ombudsmen is a joke, they'll act like they will look in to something, but basically what they do is ask the staff at the unit about a problem and take their word for it. The people with any power to do anything about the abuse don't give a damn because it's not them or their loved ones. They don't do surprise inspections, they don't arrest these people, if they do find out about a perverted guard all they'll do is fire them. In the state of Kansas for instance if a male guard get caught doing anything sexual with an inmate, he is not given due process, he is taken straight to prison. If I remember correctly the guards up their have to sign paperwork stating they are giving up their rights to due process if they get involved with an inmate sexually. The Texas prison system is very, very sadistic.