Contact: Michael Warden, UT System, 512-499-4363 or
Marsha Canright, UTMB, 409-772-8785 or 409-789-5759

Date: March 10, 2005

UT System News Release

Review of prison health care presented to regents

AUSTIN -- Representatives from the Texas Medical Foundation presented the results of a six month review of prison health care services to The University of Texas System Board of Regents today (March 10). The report was requested by Mark G. Yudof, chancellor of the UT System, to provide an independent review of the current status of health care services provided by the University of Texas Medical Branch at Galveston to the Texas Department of Criminal Justice.

In September of 1994, UT Medical Branch formed a partnership with TDCJ to provide managed healthcare for inmates located in the eastern half of the state. Today, UTMB Correctional Managed Care (CMC) provides medical, dental, and mental health services to 80 percent of the state's inmate population. Texas Tech University Health Science Center and private corporations provide care for the remaining 20 percent of the inmate population in the western region of the state.

TMF contracted with UTMB CMC in June 2004 to conduct an independent review of UTMB's prison care services. Highlights of the report, "An Evaluation of Correctional Health Care Services Provided by University of Texas Medical Branch Correctional Managed Care," were presented and discussed with the regents.

The purpose of the review by TMF was to evaluate primary health care services through an assessment of the administrative infrastructure and managed care delivery systems, medical record review, and evaluation of actual clinical outcomes for offenders with a number of complex chronic health conditions.

With 4 million documented patient encounters per year, UTMB CMC is one of the largest correctional managed healthcare systems in the United States. All of its health services departments are outpatient, medical-surgical centers that provide primary care for all inmates at each unit. UTMB Correctional Managed Care also manages a correctional pharmacy, which processes more than 13,000 prescriptions per day. The UTMB CMC system incorporates more than 86 adult units and 17 youth facilities throughout the state of Texas.

TMF personnel evaluated the quality of care being delivered by UTMB CMC using published correctional health care standards, established state standards for "free world" managed care delivery systems, and accepted medical practice guidelines for preventative and chronic disease management.

The report presented to the regents concluded that there are consistent, ongoing efforts by UTMB to provide quality health care services to offenders. They found that UTMB CMC "consistently meets or exceeds community standards for managed care organizations."

Executive vice chancellor for health affairs and former president of the the Institute of Medicine , Kenneth I. Shine emphasized that the TMF review was a state-of-the-art quality-of-care assessment of UTMB's program. "We are proud of the quality prison health care UTMB provides. While maintaining that quality, the program is still the most cost-effective of its kind in the United States, but we acknowledge that it faces major challenges to its future unless adequate state funding is available to support its continuation."

Two areas were noted in the report as requiring improvement: the need to form a quality-improvement committee and document a plan that formally describes the existing activities and persons responsible; and the need to establish more subcategories of complaints to provide additional information for tracking, trending, and evaluation.

The reviewers determined that current quality-improvement programs have already improved offender access to all kinds of care, reduced wait times for appointments with medical staff, sped the scheduling of specialty consultations, and improved health care coordination. Data demonstrated that complaints are addressed in a systematic way with excellent documentation of compliance with established time frames.

UTMB initiatives such as the use of comprehensive Electronic Medical Records and expansion of telemedicine services to the prison population have improved access to specialists, continuity and follow-up care while decreasing costs. The telemedicine program has not only allowed offenders greater access to the expertise of specialists, but has provided many opportunities for the academic community to gain experience with complex patient cases not available in other clinical settings. These initiatives have allowed UTMB to provide a wider range of services while anticipating needs and controlling administrative costs.

That UTMB CMC demonstrates compliance with certified correctional health care standards. TMF's review of a representative sample of offender medical records demonstrated improved patient outcomes in UTMB CMC's delivery of medical care. Comparisons of UTMB data to benchmarks consistently showed offender health outcomes were comparable to or surpassed established benchmark goals when compared to those of the "free world," according to the report.

TMF investigators concluded that the partnership created by the State of Texas between corrections and UTMB addresses a need for quality prison health care while controlling costs and has become "a model for the nation."

"I am pleased with the results of this independent review," said Chancellor Yudof. "Clearly UTMB is delivering quality medical care to the state's prison population under very challenging, often dangerous conditions. We intend to fully implement [Texas Medical Foundation's] recommendations for improvements."

TMF is a private, nonprofit organization of licensed physicians committed to improving the quality and efficiency of health care. TMF contracts with state and federal government agencies and private industry to offer medical peer review services, quality of care assessment and individualized consulting services.

The UT System has an annual operating budget of $8.5 billion (FY 2005). Student enrollment exceeded 182,000 in the 2004 academic year. The UT System confers one-third of the state's undergraduate degrees and educates three-fourths of the state's health care professionals annually. With more than 76,000 employees, the UT System is one of the largest employers in Texas.

UTMB Correctional Medical Care

UT Medical Branch at Galveston

Texas Medical Foundation

Presentation to the Board:

Texas Medical Foundation presentation to the UT System Board of Regents (PowerPoint)

Texas Medical Foundation presentation to the UT System Board of Regents (PDF)

TMF Report: An Evaluation of Correctional Health Care Services provided by University of Texas Medical Branch Correctional Managed Care to The Texas Department of Criminal Justice (January 2005)

>>Executive Summary and Abstract (PDF)

>>Full Report (PDF)