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Texas poised to end long-standing prison health care contract with UT System

Texas’ arrangement with the University of Texas Medical Branch at Galveston to cover health care for its prison population has been a troubled one for years, dogged by complaints about both the cost and quality of care — most recently in an audit released earlier this year, which complained UTMB had over-billed the state for its services and didn’t track its expenses properly.

As Texas Budget Source reported at the time, before the audit was even released, UT System officials told the state they weren’t interested in continuing to provide prisoner health care, but ultimately did go back to negotiate their contracts, which, after a small extension, are set to end Oct. 31.

Last week, though, the Austin American-Statesman’s Mike Ward reported that UT officials still weren’t happy with the $900 million allocated to their program — which provides health care to 78 percent of the state’s prison population — for the next two years. According to the Statesman, UTMB officials say the program costs $2 million more each month than the state funds, and they want out.

It’s bad timing, with so much other uncertainty in the state’s budget:

Scott Medlock, director of the Prisoners’ Rights Program at the Texas Civil Rights Project, an Austin-based advocacy program, said the letter highlights broader problems with health care for inmates.

“Prisoners already receive grossly inadequate health care that state officials have previously admitted approaches being unconstitutional,” he said. “Throwing how prisoners receive care into limbo would have disastrous consequences for prisoners’ health, and virtually invites a return to the bad old days when federal courts had to supervise how Texas prisons were run.

“Before this development, things were bad. UTMB pulling out would only make it worse.”

Friday, the Houston Chronicle reported those contract negotiations were “at an impasse,” and the Texas Department of Criminal Justice was planning to take over health care:

According to the documents, the medical school will recommend that medical services be transferred to the prison system when the contract ends.

UTMB proposes moving its prison medical personnel to the Department of Criminal Justice, the memo says.

TDCJ spokeswoman Michelle Lyons said at least five other hospitals have expressed an interest in providing medical services to the prison system, including Conroe Regional Medical Center and Huntsville Memorial Hospital.

The Statesman also reported that UTMB wanted to renegotiate a contract to provide care at its Galveston clinic, and leave prisoner care to those regional hospitals or TDCJ, along with Texas Tech University, which could still cover the remaining 20 percent of inmates.

Friday’s development came after UTMB officials declared that talks to extend their managed care contract for prisons were at an impasse and proposed to stop providing care at prisons but continue operating the prison hospital in Galveston.

The hospital, and the specialty clinics associated with it, generally are considered the financial plums of prison health care, while the prison-based clinics are much less lucrative.

None of the state’s plans look to include privatization of the prison health care system, a measure promoted by Gov. Rick Perry in a budget proposal earlier this year. As Mother Jones reported, that move would have been good news for some of Perry’s campaign donors and his former aide Mike Toomey, who’s now rustling up donors to back the Perry-for-president cause.

Despite heavy lobbying, the idea didn’t get too far with the Texas Legislature, in part because state Rep. Jerry Madden (R-Plano) kept reminding everyone there was no evidence privatization would save any money at all.

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