Wednesday, February 04, 2015

Draft budgets short shrift prisoner health care

Hard to avoid a sense of déjà vu when checking in on proposed funding levels for prisoner health care in the first-cut budget for the Texas Department of Criminal Justice.

The draft House and Senate budgets (here and here, respectively) both keep funding for health services at TDCJ stagnant from last biennium at $963.1 million (down from $990.6 million in the 2010-11 biennium), despite a declaration by agency administrators that they'd need an additional $175 million over the next biennium just to meet "minimum standards," or an 18 percent increase in the three main medical line items.

There are two ways to cut prison health costs: Set funding without regard to need and roll the dice regarding whether the state must pay more down the line if and when litigation comes. (Call that the California model.) Or reduce the number of offenders for which the prison system must provide health care, especially aging long-timers but also targeting categories of nonviolent offenders for reduced penalties to lower the population across the board. Obviously, your correspondent would prefer the latter.

There's a third option but it hinges on bigger questions than just prison policy. If the state were to expand Medicaid under Obamacare, Texas could be reimbursed from $110 to $240 million per biennium for prisoner hospital care. But reducing prisoner medical costs will not be the central driver behind that hot-button decision.

Eventually, perpetual underfunding of prison healthcare will bite the state in the metaphorical tuckus. When it does, legislators can't say they weren't warned. TDCJ has already told them that these funding levels won't meet "minimum standards."


He's Innocent said...

Nah, nothing that complex to reduce medical costs Grits!

Simply let 'em die. It's a constant issue, yes? Grits has of late written several posts about in custody deaths and how lawmakers and citizens just do not give a rats ass about 400+ deaths per year in TDCJ on average.

With less funding, this number could conveniently go higher, thereby saving tons of money!

Yes, yes, I do believe that's a viable solution. After all, they *are* criminals!

(All statements above should be taken as complete and utter sarcasm while noting the irony that this is a real possibility, although those in polite company would never acknowledge such ways of thinking.)

Anonymous said...

None of this augurs well for the personnel deficiencies we are already experiencing. When salaries are not competitive with the private sector, no es posible to fill your positions.

Prison Doc

Anonymous said...


Our nonviolent elderly who are also not classified as sex offenders, the female nonviolent population, and the majority of our State Jail population would be significant groups to start considering for release.


Anonymous said...

Since "hands on" sex offences are considered 3g, or "violent offences" even when consensual, and since sex offenders have the lowest re-offense rate of all crimes outside of murder, I'm curious why 11:42 would have nonviolent sex offenses excluded from this line of thinking. Based on statistics and research it would seem that that cohort would actually be one of the first places to start.

sunray's wench said...

Anon 1.07 ~ agreed, and as murderers have the lowest re-offence rate they really should not be excluded from the concept of early release, especially if the inmate is over 55, if they have a good disciplinary record while in prison and minimal background criminal history.

A sensible approach to parole based on the inmate and not the hysterical media reaction to crime could clear this mess up in just 3 or 4 years.

Anonymous said...

All the members of Parole need to be replaced! A very corrupted group.

Anonymous said...

It's my understanding that State jail offenders pay for their own medical care with their commissary money, if they are fortunate enough to have money sent to them. Otherwise they are considered indigent and the state pays...but I could be wrong...either way, Texas takes better care of animals than humans so maybe ASPCA could use those empty jails and could start a fund drive nationally to protect those warm fuzzy creatures, it's probably easier to train them to conform than possibly a free thinking human!

sunray's wench said...

Anon 10.04 ~ the first time that the inmate sees medical in a 365-day period, TDCJ will take $100 from the inmate's trust account. As the inmates cannot earn money while in TDCJ, this money is almost always from a friend or family member.

If the inmate does not have $100, TDCJ will take 50% of what the inmate does have, and will then take 50% of any subsequent deposits until the $100 has been paid for that 365-day period.

TDCJ say that no inmate will be denied medical care because they are indigent.

Anonymous said...

That's very interesting because I had a medical employee on the Crain Unit tell me that I (family member) did not pay the inmates medical fee. The inmate did. I was wondering when she got magically employed!

sunray's wench said...

Anon 7.01 ~ TDCJ sees the money in the inmate's trust account as belonging to the inmate. They don't really care where it comes from originally.