Medical paroles plummeting while TDCJ-UTMB wrangle over healthcare costs

The Dallas News reports ("Fewer seriously ill Texas inmates being released on medical paroles," Feb. 20) that medical parole rates are at their lowest in years and that Texas' Board of Pardons and Paroles may approve fewer medical paroles in FY 2012 (they'll hit 33, at the current rate) than at any time in recent memory, despite TDCJ facing prison healthcare costs more than nine figures greater than the Legislature budgeted.:

Each of the past three fiscal years, the Texas Department of Criminal Justice said its medical providers — the University of Texas Medical Branch at Galveston and Texas Tech — referred more cases for medical release. There were 1,318 referrals in 2009 and 1,807 cases in 2011.

Another government office, the Texas Correctional Office on Offenders with Medical or Mental Impairments, narrows that pool and presents cases to the state Board of Pardons and Paroles.

In fiscal year 2011, 349 cases were formally presented for medical release, and 100 cases, or 29 percent, won approval. The previous year, 22 percent were approved. Almost always, the parole board makes the decision. In a few state jail cases, the sentencing judge decides.

Each year, some inmates approved for release die before they can be freed or their cases are reconsidered.

So far this fiscal year, from September through December, the board has approved only 16 of the 125 cases presented, or 13 percent.

The Legislative Budget Board, which monitors state spending, told lawmakers in January 2011 that expediting the release of inmates who need high-cost medical care could save the state an average of $10,545 per year per inmate. The board noted that inmates are not eligible for Medicare or Medicaid while in prison, so the state pays the full cost of care.

Strange and troublesome - from the perspective of reducing prison medical costs - that in 2011, doctors recommended more than 1,800 people for medical release, but only 349 were presented to the board, which approved less than a third of those. Most inmates/patients recommended by their doctors for medical parole are getting screened out by TDCJ parole staff (according to some criteria not described in the article) before the board ever hears about them.

The Board of Pardons and Paroles, of course, is functionally separate from TDCJ, but historically they have acted somewhat in tandem, particularly back when Rissie Owens' husband, Ed, ran TDCJ's institutional division. So it's a bit of a surprise that the parole board isn't doing more to help TDCJ out on the health-cost question, though of course they're under no obligation to do so.

Grits recognizes the board has discretion, but they should at least consider all the recommendations doctors send them. TDCJ is seriously over-budget on health care, with its major provider (UTMB) at this point outright rebelling, so paroling some of the sickest, most expensive inmates could help relieve pressure. I'd have expected to see them considering and approving more medical paroles in 2012 given the current funding situation. As it turns out, it's been substantially less.