TDCJ: Prison healthcare needs $174.8 million more to meet 'minimum standards'

According to TDCJ's Legislative Appropriations Request for FY 2016-17 (large pdf), the agency needs an extra $174.8 million over the next biennium beyond current funding to meet "minimum standards." From the memo from executive director Brad Livingston at the front of the budget:

According to university providers, additional funding of $174.8 million is critical to maintain operations and ensure effective overall quality of care within the system and deliver the level of services required by minimum standards. Of this amount, an estimated $84.9 million is required to bring the FY 2016-17 funding to the projected level of expense incurred for the delivery of services currently provided. University providers are encountering significant difficulties in the ability to recruit and retain the professional staff necessary to provide care at TDCJ correctional facilities. Therefore, $59.4 million is included in this request to provide market level adjustments (5% in FY 2016 and an additional 5% in FY 2017) to the salaries of the direct offender health care delivery staff. The correctional health care system is also facing critical capital equipment needs for x-ray units, dialysis machines, dental chairs, hospital beds, and other equipment with estimated cost totaling $6.7 million. Other initiatives at a cost of $23.8 million will provide primarily for the hiring of nursing and key health care staff to increase coverage at targeted correctional units.

They're also asking for more money for local probation departments, some of which will require staffing cuts if they don't get it:

CSCDs have limited funding sources and, without additional funding, will not be able to meet the $11.3 million required to maintain the employer's portion of state health insurance without reducing current staffing levels and programs that divert offenders from incarceration. Caseload sizes may increase by approximately 6% due to an estimated 90 community supervision officers (CSOs) statewide not being funded in order to cover these rising health insurance costs. Consistent with the FY 2016-17 LAR instructions, the agency requested consideration for the amount necessary to maintain the CSCD health insurance payments at the FY 2015 budgeted level. As such, the base request includes a portion of the necessary funding increase for the FY 2016-17 biennium.

Also:

We are requesting $28.2 million in additional funding for CSCDs basic supervision and diversion programs for the supervision of an increasing higher risk and need offender population in the community. This funding would allow for management of caseload ratio size, enhanced and expanded substance abuse treatment initiatives, assist in retaining experienced specialized officers who work with medium and high risk offenders (such as substance abuse, mental health, and intensive supervision), provide for the continuation of specialized programs and services, and allow for the implementation of specialized programs in areas where they are currently limited. In addition, this funding would address the rising costs of fuel, utilities, aging equipment, and other operational needs. These programs and services provide judges with more alternatives to incarceration, both as a sentencing option and as an alternative to revocation.

In addition, Texas' cost for private prisons is rising, making the eleven facilities with which TDCJ contracts prime targets for budget savings if the Legislature enacts policies to further reduce incarceration levels. Again from Livingston's opening letter:

In order to limit the growth of state expenditures, long-term contracts have historically been established with private vendors for the operations of seven private prisons (4,118 beds), and four privately operated state jails (5,129 beds). These competitively awarded contracts are evaluated and awarded with escalating rates, resulting in increases of approximately 2.5% annually. Based on the current funding level, we will require an additional $7.7 million for the 2016-17 biennium to maintain the current population within these correctional facilities.

A few other notable exceptional items:

We are requesting 50 additional reentry transitional coordinators to enhance agency reentry initiatives. Of these, 40 reentry transitional coordinators will provide individual community-based case management focused on identifying and removing barriers to successful reentry into society post-release. The additional transitional coordinators would provide reentry services to offenders in halfway houses and under parole supervision. Offenders will be provided with resources and classes to help them move toward sustainable employment, self-supported housing, and overall self-sufficiency. The remaining 10 requested positions will be utilized as special needs reentry transitional coordinators dedicated to address the mental health needs of incarcerated offenders by providing a full range of reentry services to this special needs population.

This item includes funding to expand jail diversion services in metro areas, providing offenders with special needs services designed to divert them from incarceration in prisons and state jails. The program expansion would serve an additional 1,250 offenders with serious mental illnesses. Also, we are requesting additional funding to expand caseloads that serve offenders with a high criminogenic risk and clinical care need through our contracts with Texas Correctional Office on Offenders with Medical or Mental Impairments (TCOOMMI) and local mental health authorities. The additional caseloads would serve an additional 1,400 offenders. The expansion of these programs in jail diversion services and caseloads will enhance our capability to provide intensive mental health case management, psychiatric assessments and diagnostics, and psychosocial rehabilitation.

Halfway house placements are made for offenders scheduled to be released on parole supervision who have no viable residential plan at the time of release. Currently, the agency contracts for 1,880 halfway house beds located throughout the state. A significant number of offenders who are approved for parole do not have a residential plan and require a halfway house placement. Since these beds turn over approximately four times a year, an additional 250 halfway house beds will allow for 1,000 additional placements annually.

These are just highlights that jumped out at me at first glance. See the full document (pdf) for MUCH more detail.