UTMB begins "transfer" of prison health services to TDCJ; are they up to it?

At the Galveston Daily News, Heber Taylor reports that, despite months of negotiation between the Texas Department of Criminal Justice and the UT Medical Branch (UTMB) over providing inmate health care:

there is no agreement.

Dr. David L. Callender, president of the medical branch, let the staff know that the transition has begun to transfer the health services to the corrections department.

The basic problem is money.

The University of Texas System has made it clear its not going to continue to subsidize care for prisoners from university funds.

The Texas Department of Criminal Justice didn’t get the money from the legislature to pay the full cost of the care.

This is not the kind of problem two state agencies can resolve.

Somebody with money simply has to pay the bill.

Ordinary taxpayers should be watching this because the state’s not going to save money by taking the Correctional Managed Care Contract away from the medical branch.

This arrangement is still a good fit in terms of controlling costs. Finding the money to pay for this contract would be cheaper than starting over again with new contractors. 

I don't necessarily believe TDCJ is prepared to take over prisoner healthcare, either from a financial nor a management perspective. Nor did I understand the failure of legislative leadership that allowed this festering problem to linger beyond last session, when it was already coming to a head. Taylor's right - this isn't an issue two state agencies can negotiate away.

In truth, after UTMB was basically told by Senate budget writers they shouldn't end the contract, I'm surprised the university feels they have the authority to back out. They're definitely thumbing their nose at Senate Finance Chairman Steve Ogden, perhaps because he's retiring from the Lege this term and won't be around to haunt them in 2013 for their defiance. (After all the Aggie senator did for UTMB after Hurricane Ike, it's particularly a slap in the face.)

Meanwhile, privatization isn't really an option, either, at current funding levels, even if that's the Governor's preferred option. Various companies (and UTMB, for that matter) want the hospital contract, which is more lucrative, but nobody really wants to contract for clinic-level care unless the Lege ponies up more money.

Bottom line: The Lege this year cut the prison health budget but failed to reduce incarceration levels, meaning demand for services wasn't commensurately cut. Texas already has among the lowest per-prisoner health expenses in the country and it's unlikely the budget can be lowered as long as we incarcerate nearly 160,000 people. The cost of overincarceration has finally caught up with Texas, and the expense is greater, even, than just TDCJ's budget.

This is a fish-or-cut-bait moment. Before next session, the state must decide how to deliver prison healthcare on a shortchanged budget. But when the Lege meets again in 2013, to avoid nine figures in additional expenditures at TDCJ, they must change policies to reduce the number of people incarcerated. Any other option will yield the same untenable result as the last budget, magnified several-fold.