Private providers seeking piece of prison health care pie in Texas

The Austin American-Statesmen has this fascinating new piece on prison health care cost debates in Texas. The piece is headlined "Lawmakers chafe as push continues to privatize prison health care," and here are excerpts:

Efforts by private companies to get a piece of Texas' nearly $1 billion prisoner health care system are quietly continuing behind the scenes as company representatives make sales pitches to lawmakers and seek changes in state law to authorize privatization.

Some legislative leaders and others are chafing about the continued privatization push, saying the idea has not been studied or vetted publicly — and is being advanced by outside interests even though neither the House nor the Senate has embraced it.... The American-Statesman first reported the privatization efforts in March and that top aides to Gov. Rick Perry have been involved in some of the meetings with vendors and lobbyists....

Under current law, the University of Texas Medical Branch at Galveston and Texas Tech University Health Sciences Center are in charge of providing health care to Texas' 154,000 imprisoned felons.  Skeptics say Texas could be embarking on the next privatization boondoggle.

"Privatization usually means significantly higher costs and poorer care," said Tom "Smitty" Smith, Texas director of Public Citizen, a government watchdog group.  "This should be done in the open, not in the dark, after a full-blown analysis ... or it will end up just being another corporate giveaway."...   Ana Yanez Correa, executive director of the Texas Criminal Justice Coalition, also opposes the idea.... "It's a horrible idea. The only way to save money is to minimize the care that's provided."

Under the House-approved budget, correctional health programs would receive more than $700 million over the next two years.  The Senate version, not yet voted on, would allocate about $900 million.  At either amount, it's a big prize for private vendors.  Though officials with the various companies decline to discuss their lobbying or their proposals, lawmakers confirm that the sell is on.

In a written proposal circulated to lawmakers, Correctional Medical Services Inc. — which provides prison medical services to 277,000 inmates in 330 lockups in 18 states — says it could save Texas $30 million to $50 million annually.

Company officials could not be reached to elaborate, but its written proposal says it would cut costs by reducing admissions of prisoners to hospitals and by reducing the number of inpatient days that prisoners are there — a rate that the company says is 300 percent higher in Texas than the average at its locations.  It would also enhance medical treatment in prison clinics, as a way to keep convicts from being sent to a hospital, where the costs would be higher. Reducing annual admissions by 140 percent would yield a potential savings of $34 million, the proposal states....

Though state prison officials have indicated that they will probably seek information from potential bidders to determine whether privatization would provide savings, they and legislative veterans say they are wary of pushing ahead for privatization based on experiences with past prison outsourcing projects.

For example, the Texas Department of Criminal Justice has several times hired private companies to provide substance-abuse treatment programs in state prisons, only to face rising costs after the contracts started because the companies lowballed their bids and could not continue providing the services at the low prices....

Despite the concerns, members of the Board of Criminal Justice, which governs the prison system, say the potential savings are worth exploring, as a start....  Board members Tom Mechler of Amarillo and David Nelson of Lubbock said the continuing losses of the two university health care providers, and the state's tight budget, are driving interest in alternatives.  "We should be considering every option — to reduce the cost to taxpayers, to improve the quality of care, to make the system better," said Nelson, who until last month headed the board's health care committee. "In my view, everything is on the table."