'State funding doesn't cover prisoner health care costs, officials say'

No regular Grits reader will be surprised at the Austin Statesman story by Mike Ward today with the same title as the headline to this post revealing that UTMB is running more than $2 million per month over the amount budgeted for prison healthcare. Reports Ward:

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.

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."

Readers of Grits, of course, knew months ago that the Lege hadn't appropriated enough money to cover prison health costs, and indeed:

House Corrections Committee Chairman Jerry Madden, R-Richardson, said he was not surprised by UTMB's decision.

"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."

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.)

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%
30-34: 24.6%
35-39: 24.6%
40-44: 24.2%
45+: 17.6%

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.

Do I think the parole board will do that? Not really. But that's what would make the most sense.