Correctional Managed Health Care Committee (CMHCC)
Welcome to the Texas Correctional Managed Health Care Committee
The Correctional Managed Health Care Committee (CMHCC) is authorized by Chapter 501, Subchapter E of the Texas Government Code. The CMHCC was originally established by the 73rd Legislature in 1993 to address the rising costs and operational challenges involved in providing health care to prisoners confined in the Texas Department of Criminal Justice (TDCJ).
Organizationally, the CMHCC is composed of nine voting members and one nonvoting member as follows:
- one member employed full-time by the department, and appointed by the executive director;
- one member who is a physician and employed full-time by the UTMB at Galveston, appointed by the president of the medical branch;
- one member who is a physician and employed full-time by the TTUHSC, appointed by the president of the university;
- two public members who are physicians, each of who is employed full-time by a medical school other than UTMB or TTUHSC, appointed by the governor;
- two members appointed by the governor who are licensed mental health professionals;
- two members appointed by the governor who are not affiliated with the department or with any contracting entity, at least one of whom is licensed to practice medicine in this state, and
- the state Medicaid director or a person employed full-time by the Health and Human Services Commission and appointed by the Medicaid director, is to serve as an ex officio non-voting member.
The CMHCC coordinates the development of statewide policies for the delivery of correctional health care and serves as a representative forum for decision making in terms of overall health care policy. CMHCC representatives are empowered by their respective organizations to represent them on health care matters and make decisions that are binding on their organizations. The shared communication, coordination, decision making, and dispute resolution roles performed by the committee are key elements to the ongoing success of the correctional health care partnership.
The correctional health care system represents a unique collaboration between the state’s prison system and two of its leading health sciences centers. This health care partnership between the Texas Department of Criminal Justice (TDCJ), Texas Tech University Health Sciences Center (TTUHSC) and the University of Texas Medical Branch (UTMB) is operated under the guidance and direction of the CMHCC. The primary purpose of the CMHCC partnership is to ensure that TDCJ offenders have access to quality health care while managing costs.
This material is designed to acquaint new CMHCC members with the operations of the CMHCC. In addition, educational material relating to the requirements of the open meetings, and ethics laws of the State are included. This material is intended to be a ready reference which will be updated periodically as necessary.
Each member of the Committee is required by the CMHCC’s enabling legislation to review and achieve an understanding of the information included in this reference prior to participating in CMHCC meetings (Section 501.140, Texas Government Code).
The correctional health care system represents a partnership between Texas Tech University Health Sciences Center, The University of Texas Medical Branch at Galveston and the Texas Department of Criminal Justice. Through the leadership of the CMHCC, the following shared mission, vision, values and goals are set for this partnership:
The mission of the Correctional Managed Health Care Committee is to develop a statewide managed health care plan that provides TDCJ offenders with timely access to quality health care while also controlling costs.
The CMHCC is an organization that is committed to excellence; strives to set national standards in correctional medicine; focuses on building and maintaining open communications; and, serves as a model for inter-governmental cooperation.
||The CMHCC strives to provide health care services of recognized high quality and deliver them uniformly, promptly and efficiently within the limits of appropriated resources.
||The CMHCC strives to uphold the public’s trust through ethical and accountable personal and professional behavior.
||The CMHCC is dedicated to restoring and preserving the health of TDCJ offenders.
||The CMHCC recognizes that our mission and goals are achieved through teamwork, with each partner fully participating and contributing to the organization and sharing in its success.
Ensure Access to Care:
The CMHCC recognizes that a key challenge for correctional health care is to maintain appropriate levels of access to medically necessary health care for offenders, in the face of an unprecedented growth of the criminal justice system.
Ensure and Maintain Quality of Care:
The CMHCC is committed to a program of continuous improvement that assures the services delivered are of high quality and consistent with community standards.
The CMHCC is dedicated to the development of initiatives to control the cost of delivering health care, to the extent possible, while remaining loyal to the goals of ensuring access to quality health care. The CMHCC works to anticipate changes in standards of care or demographics which may modify resource needs.
The Texas Correctional Managed Health Care innovative partnership exemplifies the success possible by redefining traditional roles. It represents a unique collaboration between the state’s prison system, two leading health science centers, and a number of community hospitals.
In 1993, the Texas Department of Criminal Justice (TDCJ), The University of Texas Medical Branch (UTMB) at Galveston and the Texas Tech University Health Sciences Center (TTUHSC) joined forces to form the Correctional Managed Health Care Advisory Committee (CMHCAC). Subsequently amended through refinement of its legislative authority as the Correctional Managed Health Care Committee (CMHCC), the CMHCC has developed a statewide provider network to provide medical services to TDCJ offenders. Its primary purpose is to improve access to quality health care while containing cost by maximizing the use of the state’s medical schools, securing efficiencies through improved intergovernmental collaboration and using managed care tools.
In Texas prior to the implementation of the program, costs for prison medical care had been increasing at a rate of 6% per year and represented 10 – 14% of the state prison system’s operating costs. Additionally, in response to overcrowding, Texas had embarked upon an aggressive prison construction program that would soon confine nearly 150,000 offenders. Since many new prison locations were in rural areas, the economic problems faced by rural hospitals further impacted upon the state’s ability to provide cost-effective health care. Traditional delivery systems were also strained by increased rates of infectious diseases such as HIV, Hepatitis C and tuberculosis.
From its inception the Correctional Managed Health Care program has operated as a cooperative partnership between TDCJ, UTMB and Texas Tech. This partnership is embodied in the legislation that formed the committee and included equal representation from each entity. The Correctional Managed Health Care Committee (CMHCC) is established by the provisions of Section 501, Subchapter E of the Texas Government Code. This legislation originally enacted by the 73rd Legislature and amended and re-authorized by the 76th and 83rd Legislatures in response to Sunset reviews provides the structure for the correctional health care system now in place.
This partnership significantly changed how medical care is delivered in the TDCJ. Traditionally offender health care was provided by employees of the prison system and through fee-for-service arrangements with hospital providers. These arrangements offered little incentive to control costs. Under the managed health care plan, complete medical services are provided through contracts with state medical school universities. TDCJ contracts with the UTMB and TTUHSC for the provision of health care services. The offenders for which UTMB and TTUHSC receive payment are determined by the geographic location of the prison units. TTUHSC contracts with the TDCJ for defined regions in West Texas, approximately 22% of the offenders. UTMB contracts for nearly all the remaining defined geographic regions; approximately 78% of the offenders. The TDCJ Health Services Division retains the functions of preventive medicine, offender Step II medical grievances, health services operational reviews, health services quality monitoring, and coordination of offender medical transfers.
UTMB and Texas Tech are responsible for the provision of medically necessary health care services. Responsibilities include recruiting and hiring health care personnel to staff the prison medical departments, diagnosing prisoners’ health problems, and providing treatment or making referrals to specialists. These services include unit primary care services, all specialty care services, all pharmaceuticals, community provider outpatient and ancillary services, and all in-patient hospital services. Both UTMB and TTUHSC enter into subcontracts with community providers to provide locally based services when they determine such action is warranted.
Beginning January 1, 1996, UTMB and TTUHSC assumed operational responsibilities for all TDCJ mental health services in their respective university sectors. All psychiatrists and former TDCJ mental health staff were transitioned to the university systems.
These arrangements provide incentives for controlling utilization and generate an increased interest in preventative care. Use of telemedicine and most recently, electronic medical record technologies also enable cost-effective access to specialty care.
The CMHC partnership has resulted in lower medical costs. It has also resulted in the establishment of a statewide network of health care providers and a uniform standard of care. While maintaining a commitment to accreditation and significantly improving access to care, the Texas State Comptroller has estimated that the correctional health care partnership saved the taxpayers of Texas at least $125 million over its first five years. It also serves as a model of intergovernmental collaboration for other states to use to manage access, quality and cost of correctional health care.
In fiscal year 2005, medical costs were about $6.80 per offender per day. In FY 1993, prior to the implementation of the managed health care system, those costs were $5.99 per offender per day. On a per capita basis this represents an increase of about 1% per year over that time frame, compared to the 6% a year increase experienced prior to implementing the program. An independent actuarial review conducted in October 2002 found that correctional health care costs are approximately 44% lower than comparably adjusted public sector HMO’s in Texas (when age, population and patient acuity factors are taken into account).
At the same time, health care provider vacancy rates dropped significantly; the average number of days spent waiting for a specialty clinic appointment dropped by over 50%; access to care indicators show marked improvement and every TDCJ health care facility has received national accreditation. Since the implementation of the managed care system, and based on an independent review of medical records conducted by the Texas State Auditor in 1998, access to care compliance improved 27.7%, clinical encounter compliance increased by 35.7% and most dramatically, chronic care compliance rose 158%. In all, twenty-two individual performance indicators showed statistically significant gains.
The managed care partnership has also implemented a series of disease management guidelines. A retrospective review conducted in FY2002 indicates that overall compliance with key disease indicators rose from 40.1% in 1995 to 91.3% in 2001. That same review noted improvements in health outcomes including a 17% decrease in fasting glucose values among insulin dependent diabetics, a 19% decrease in the LDL cholesterol values of patients with hyperlipidemia and a 114% increase in the number of hypertensive patients with controlled blood pressures.
It is also important to note that these positive results were obtained at the same time that the correctional population served more than doubled.
In 1995, the CMHCAC partnership was awarded Special Mention by the National Managed Health Care Congress in their annual Astra Merck/NMHCC Partnership Award program. Even though the program traditionally focused on private sector partnerships, the judges noted that the TDCJ-CMHCAC partnership “does reflect the innovative spirit celebrated by the awards, and therefore grabbed our attention as deserving of a special mention.”
In 1996, the correctional pharmacy program was awarded the “Innovative Practice Award” by the Texas Society of Health-Systems Pharmacists.
In 1997, the James Byrd Diagnostic Unit in Huntsville was selected from over 400 nationally accredited facilities nationwide as the National Commission on Correctional Health Care’s “Facility of the Year.” Four of the top five finalists selected for the award were Texas facilities.
In 1998, the Texas correctional health care program was recognized by the American Correctional Association as one of the nation’s “Best Practices.”
In 1999, the federal court that for years had oversight of Texas prisons released the medical care issues from federal supervision recognizing that “there can be no doubt that the vast improvements in TDC’s provision of medical and psychiatric care to inmates have been made…there are now two of the state’s finest medical teaching institutions, The University of Texas Medical Branch at Galveston and Texas Tech University Health Sciences Center, giving treatment to inmates.”
In June of 2001, the federal court relinquished the State of Texas from all remaining federal oversight, including the issue of providing mental health care services to offenders in administrative segregation.
The CMHCC partners believe that the results of their cooperative venture represent long-term benefits to the state and each respective partner. The partnership emphasizes “win-win” scenarios where the motivations for the participation of each partner are recognized and addressed. The criminal justice agency is seeking quality, cost-effective health services. The universities are seeking teaching and placement opportunities as well as financial support. The participating hospitals are seeking financial stability. By understanding these motivating factors and integrating them into the work of the partnership, a successful venture has been formed.
Historical Key Events In Committee History
Key events relating to the development of the CMHCC are summarized by the timeline below:
- “Against the Grain”, January 1993 – Texas Performance Review recommends formation of managed health care structure for TDCJ health care system.
- 73rd Legislature, 1993 – Senate Bill 378 passed establishing the Managed Health Care Advisory Committee (MHCAC).
- “Health Services Review”, September 1993 – State Auditor releases report on TDCJ Health Care Services that endorses managed health care concepts.
- August 1993 – Organizational meeting of the MHCAC is held.
- September 1993 – February 1994 – MHCAC and university providers develop transition plans.
- February 1994 – September 1994 – Transition to university managed system under the MHCAC authority begins.
- “Behind the Walls”, April 1994 – Texas Performance Review, in a comprehensive review of TDCJ, recommends that MHCAC conduct a staffing analysis.
- September 1994 – Transition to university management completed.
- December 1994 – MHCAC adopts staffing analysis guidelines.
- December 1994 – House Corrections Committee completes interim charge study of implementation of the correctional managed health care system and reports positively to the 74th Legislature, recommending continuing monitoring.
- 74th Legislature, 1995 – HB 1567 amends MHCAC statutory authority, charging name to reflect correctional mission (becoming the Correctional Managed Health Care Advisory Committee, CMHCAC), extending authority of the committee to contract with other jurisdictions and authorizing the universities to report ERS benefits in accordance with intent to protect transitioned employee benefits.
- 74th Legislature, 1995 - General Appropriations Act consolidates prison hospital and prison health services budgets into one strategy for managed health care. University appropriations include rider prohibiting other funds to be used for offender health care.
- January 1996 – CMHCAC and TDCJ agree to proceed with transition of psychiatric services to the correctional managed care program.
- March 1996 – The State of Texas files a motion to vacate the provisions of the Final Judgment in the Ruiz litigation. (The Final Judgment was entered into by the State and the Ruiz plaintiffs in August of 1992 which vacated hundreds of earlier specific requirements and replaced it with continuing permanent injunctive orders on eight substantive areas, including health care).
- The U.S. Congress passes the Prison Litigation Reform Act (PLRA).
- October 1996 – Office of the State Auditor initiates a comprehensive review of the correctional health care system (estimated completion October 1997).
- December 1996 – House Corrections Committee completes second interim charge study continuing its review of the implementation process and reports positive finding to the 75th Legislature.
- May 1997 – CMHCAC added to Sunset Advisory Commission review cycle to coincide with review of the Texas Department of Criminal Justice.
- July 1997 – The Fifth Circuit rules on motions and discovery issues in pending motion to vacate the Final Judgment. Plaintiffs attorneys and experts afforded access to prison facilities and records for various inspection and discovery purposes.
- Fall 1997 – CMHCAC and TDCJ conduct comprehensive review and updating of HIV related policies and practices.
- January 1998-1998 – Office of the State Auditor issues SAO Report Number 98-013 noting that the system had achieved the overall objective of controlling the increasing costs of providing health care to offenders and recommended a number of areas of potential improvement/and or legislative clarification for consideration.
- December 1998 – CMHCAC initiates comprehensive examination of issues related to the management of Hepatitis C.
- January 1999 – Federal District Judge William W. Justice begins hearing on State’s motion to vacate the Ruiz Final Judgment. Extensive medical and mental health testimony and evidence is presented before the court.
- March 1999 – Judge Justice issues Memorandum Opinion and Order on Motion to Vacate, denying State’s Motion due to findings in the areas of conditions of confinement in administrative segregation, safety for assaulted and abused inmates, and excessive use of force. The Court’s Orders did however relieve the State of the obligation under the Final Judgment relating to health services. These findings and orders have been appealed.
- May 1999 – Recommendations of the Sunset Advisory Commission are adopted by the Legislature in Senate Bill 371. Name of the Committee is changed to the Correctional Managed Health Care Committee and public member participation is added.
- May 2001 – The CMHCC enabling legislation was amended to require reasonable efforts to participate in the purchase of prescription drugs under Section 340B, Public Health Services Act (42 USC Section 256b)
- April 2002 – UTMB becomes certified by the federal authorities to access 340B drug pricing for prison inmates confined in facilities operated by UTMB, resulting in significant reductions in overall CMHCC drug costs.
- February 2003 – All agencies are asked to develop budget reductions geared to address State’s projected overall funding shortfall. During FY 2003, the CMHCC, in conjunction with the university providers, implement budget reductions totaling $8.1M. To implement these measures, a statewide reduction in force of almost 400 health care staff takes place and resulted in significant changes in the hours of health care coverage at many facilities.
- May 2003 – Sunset date for CMHCC was extended to 2011 to coincide with the Sunset Commission evaluation of TDCJ.
- November 2004 – The State Auditor’s Office released a report on the management of contracts by the CMHCC calling for significant improvements in financial reporting and monitoring of the contracts with the university providers.
- January-May 2005 – 79th Legislature: Working with the Legislative appropriations process and the SAO, strategies are developed to address concerns raised by the audit report on management of contracts. Additionally, supplemental appropriations for FY 2004-2005 are approved and appropriations for the FY 2006-2007 biennium are increased. The Sunset review date for TDCJ and the CMHCC are moved forward to 2007.
- October 2006 – Sunset Commission Staff Report issued following a comprehensive review by the Sunset staff outlining recommendations to update CMHCC’s enabling legislation and improve public access to information about the program.
- October 2006 – The State Auditor releases a report on the costs of the State’s Correctional Managed Health Care program finding that the university provider financial reports are supported by each institutions accounting system, that the methods used to account for and report the cost of care are reasonable and that the CMHCC had made changes in its operations to address issues raised in the November 2004 SAO report.
- December 2006 – Sunset Advisory Commission formally adopts staff recommendations relating to the correctional health care program.
- March 2007 – The State Auditor issues an audit report on Correctional Managed Health Care Funding Requirements noting that the projected deficit reported by the CMHCC had been reduced since originally projected; that UTMB’s projected deficit should be adjusted to account for discrepancies identified by the auditors; and that the CMHCC properly complied with two appropriation riders reviewed by the State Auditor’s Office.
- May 2007 – The 80th Legislature adopts SB 909 reauthorizing the CMHCC and enacting the recommendations of the Sunset Advisory Commission.
- February 2011 – State Audit Report on correctional Managed Health Care at the University of Texas Medical Branch at Galveston, SAO Report #11-019.
- February 2011 – State Audit Report on the Correctional Managed Health Care at the Texas Tech University Health Sciences Center, SAO Report #11-019.
- May 2013 – The 83rd Legislature adopts SB 213 reauthorizing the CMHCC and enacting the recommendations of the Sunset Advisory Commission.
- May 2013 – Senate Bill 1, 83rd Legislature, Regular Session, Article V, Rider 50 prohibits any of the funds appropriated for correctional managed health care to be used for payment of salaries, operating expenses or travel expenses for staff of the CMHCC.
Description of Functional Responsibilities
To accomplish the mission of the Correctional Managed Health Care Committee (CMHCC), the partners have agreed to the assignment of various functional responsibilities to each of the partner agencies. The following narrative descriptions are intended to further clarify the roles and responsibilities of the Correctional Managed Health Care partners. The mission of the Correctional Managed Health Care Committee is to develop a statewide managed health care plan that provides TDCJ offenders with timely access to quality health care while also controlling costs.
By sharing functional duties, the expertise of each partner contributes to a stronger delivery system and avoids unnecessary duplication of resources. Delineation of these responsibilities facilitates information sharing and increases understanding of the lines of communication. The fulfillment of individual responsibilities is assigned to the individual partner’s management team and remains under the oversight of the respective Executive Director or University President and that partner’s governing board.Collectively, the CMHCC, like TDCJ and the universities are responsible to the Legislature and Governor’s Office.The CMHCC is also subject to the same oversight from the State Comptroller, State Auditor, and the Legislative and Governor’s Budget Offices.
Each assigned function is briefly described below.
- Statutory Duties:The CMHCC performs specific duties as outlined in Chapter 501, Subchapter E, Texas Government Code.
- Legislative and Legal Coordination: The TDCJ and the CMHCC both serve as points of contact for legislative matters and coordination of statewide legal issues.
- Monitoring Coordination: The CMHCC ensures that monitoring processes are in place to measure, evaluate, and report on activities of the health care system.
- Cost Containment Initiatives: In conjunction with each of the partners, the CMHCC coordinates individual and joint initiatives for cost reduction strategies.A key element of the CMHCC role in this area is to facilitate sharing of innovations developed within each sector.
- Coordination of Joint Committees: The CMHCC ensures central coordination, partner representation and direction to a number of standing and ad hoc joint committees that provide coordination of necessary services on a statewide basis. Joint committees address such issues as statewide policy development, review and approval; joint peer review activities; statewide pharmacy and therapeutics issues; and coordination of specialized clinical focus groups.
- Alternative Dispute Resolution: The CMHCC serves as a dispute resolution forum in the event of a disagreement relating to inmate health care services between the department and the health care providers or contracting entities.
- Development of Services/Benefit Plan: the CMHCC serves as the final authority on determination of services to be provided to the offender population.These services are generally outlined in the contractual documents and in policy statements approved by the CMHCC.
TDCJ Business and Finance Division Responsibilities
- Fiscal Oversight:The TDCJ’s Business and Finance Division’s staff monitor the overall financial status of the correctional health care program, work cooperatively with each partner agency in developing system-wide reporting mechanisms, track and evaluate cost trends and project future needs.
- Budget Formulation/Submission: The TDCJ Business and Finance Division staff work cooperatively with each partner agency to formulate budget submissions for the health care program.
- Financial Monitoring:The TDCJ Business and Finance Division conducts financial monitoring of the correctional managed health care program; and may contract with an individual for financial consulting services including actuarially studies.
TDCJ Health Services Division Responsibilities
- Monitoring/Central Reporting: TDCJ Health Services staff provides monitoring activities related to investigating medical grievances, ensuring access to medical care, conducting periodic operational reviews of medical care provide at its units and cooperating with the university providers in monitoring quality of care. Staff also report on the results of those monitoring activities.
- Accreditation Tracking: TDCJ staff track the progress of each unit through the accreditation process and provide that information to management for follow-up necessary.
- Policies/Standards: the TDCJ Division Director for Health Services serves as the final approval authority on all statewide health care policies. Such policies are developed in accordance with procedures implemented by the Joint Health Services Policy and Procedure Committee and are approved by the respective university medical directors.
- Operational Reviews:As a part of the monitoring program, TDCJ staff conduct operational reviews to evaluate the health care delivery systems in place at each facility.This process is based on assessing compliance with the accreditation standards of the American Correctional Association (ACA), statewide policies and applicable laws. A review and corrective action plan process is required from the provider management team in response to indentified deficiencies.
- Public Health: the Office of Public Health section in the Health Services Division is responsible for coordination of the statewide Infection Control Committee. The Office of Public Health staff provide education, orientation and training programs to CID nurses (i.e., public health) statewide. This staff establishes, maintains and monitors statewide offender data bases for HIV/AIDS, TB, hepatitis, syphilis, and sexually transmitted infections. It serves as the central point of contact for reporting purposes to the Texas Department of State Health Services (DSHS) and other applicable state and federal agencies.
- Grievance and Correspondence Tracking: the Patient Liaison Office provides tracking, investigation and response to all correspondence regarding patient care issues. The Office of Professional Standards tracks, conducts inquiries and responds to Step 2, Division-level offender medical grievances.
- Research Approval: The TDCJ Director of Health Services or designee shall have the final approval for all biomedical research involving TDCJ offenders. All medical research projects will be reviewed by the Director of Health Services or designee in accordance with TDCJ Administrative Directive 02.28 (rev. 2) “TDCJ Research” and Correctional Managed Health Care Policy I-72.1 “Medical Research”. Depending on its nature and proposed methodology, such research may also be subject to review and approval through one or more of the university institutional review boards.
- Quality Improvement/Quality Management (QI/QM) Coordination: the TDCJ Health Services Division provides statewide coordination of the QI/QM program. Registered Nurses provide technical assistance, collect reports of QI/QM results, analyze for trends and communicate those results systemwide.
- Liaison Activities: The TDCJ Health Services Division functions as TDCJ’s single point of contact for communications related to offender health care. This enables TDCJ departments, the CMHCC, the university providers and other contracting entities to work with a single point of contact.
TDCJ Responsibilities Involving Multiple Divisions
- Legislative Coordination: The TDCJ in coordination with the CMHCC and the universities, serves as the central point of contact for legislative matters including communications with the legislature regarding the financial needs of the correctional health care system.
- Contracting/Provider Network Coordination: The TDCJ develops, maintains and administers the master contracts between TDCJ and UTMB; and TDCJ and TTUHSC that establish responsibilities for the statewide provider network. The TDCJ also has statutory authority to contract with any entity to fully implement the managed health care plan.
- Classification/Transportation Coordination: TDCJ Health Services Liaison staff coordinate with TDCJ classification and transportation staff to assist in ensuring that offender patients are appropriately classified, assigned to facilities and transported consistent with their medical needs.
- Emergency Coordination: the TDCJ Correctional Institutions Division, in conjunction with TDCJ Health Services, provides statewide coordination and liaison between the health care providers and TDCJ in the event of an emergency.
University Providers Responsibilities:
- Utilization Management: establishing and maintaining a system for review and authorization of care to ensure that services are provided in a timely appropriate and cost-effective manner.
- Provider Network Management: each university, either through its own staff, through its component or affiliated hospitals or through contractors retained by the university must ensure that a comprehensive network or providers is in place to efficiently serve the system.
- Credentialing: Each university provider is responsible for ensuring that all health care providers have and maintain appropriate credentials in accordance with state and federal requirements and that processes are in place to verify and document the credentials of its staff.
- Regional Operations: Each university provider is responsible for providing the management and operation of regionalized facilities and services as appropriate.
- Health Care Services: Each university is responsible for providing nursing, medical, dental, and mental health services at contracted TDCJ units:
- Onsite Services: may include sick call, chronic care, infirmary care, medical record management, medication administration, health education/training and related ancillary services.
- Offsite Services: Emergency care, hospitalization, specialty physician consults, diagnostic procedures, surgeries, and emergency medical transportation.
- Pharmacy Services: medications, as prescribed by authorized providers and pharmaceutical management.
- Institutional Committees/Peer Reviews: Each university provider is responsible for maintaining its own institutional committees and conducting its own internal peer review actions.
- TDCJ Employee Health Services: Each university provider is responsible for providing employee health care services specified by contract including immediate medical attention to TDCJ employees injured in the line of duty, TB screening, treatment and immunizations as clinically indicated for bonafide occupational exposures.
- Research Coordination: For research involving TDCJ offenders, the university providers are required to receive approval from the TDCJ Director of Health Services or designee in accordance with applicable TDCJ policies. The university providers are also responsible for obtaining approval through an Institutional Review Board which meets requirements as set forth in 45 CFR 46, revised October 1, 1999. The university providers are responsible for maintaining accurate, current and accessible records on all protocols involving offenders. The university providers are required to provide access to such records to the TDCJ Director of Health Services or designee on request.
- Telemedicine: the university providers are individually responsible for the operation and implementation of telemedicine within their sectors.
- Emergency Preparedness: each university provider is responsible for ensuring an emergency preparedness program is in place at each facility consistent with the ACA standards. Statewide coordination during emergencies will be provided by the TDCJ staff.
Centralized Statewide Services Provided by UTMB:
- Medical Records Coordination: UTMB provides statewide technical support, policy development and forms control services related to the medical records system, to include the maintenance of the medical records archives and death records.
- Radiology: UTMB provides statewide liaison with the Bureau of Radiation Control, provides radiation safety services, equipment registration and coordination of related policy and procedures.
- Funerals/Autopsy Services: UTMB coordinates offender funeral/autopsy services on a statewide basis.
- Medical Training: UTMB provides health-related training required for security staff during pre-service and in-service training academies for TDCJ staff. Topics include HIV (AIDS), Hepatitis, Suicide Prevention, CPR, etc.
- Clinical Services: The following clinical services are provided by UTMB on a statewide basis:
- all female offender health services
- management of offenders with solid organ transplants
- management of offenders with hemophilia
- triple drug therapy Hepatitis C management
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