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Texas Department of Criminal Justice
Inmate Managed Health and Psychiatric Care Program
Purchaser: Texas Department of Criminal Justice
Program: Managed Health and Psychiatric Care Program

Description: The Texas Department of Criminal Justice (TDCJ) operates 113 correctional facilities housing 130,000 inmates. This figure does not include approximately 16,000 inmates incarcerated in privately owned facilities.

A full range of medical and mental health care is available at each facility. Medical and psychiatric care is provided through a managed health care system financed completely by state general revenue. Including administrative costs, Texas spent more than $296 million on these programs in fiscal 1998.

TDCJ contracts with the Texas Correctional Managed Health Care Committee (CMHCC) for the programs. The committee is a six-member, appointed board with two members from TDCJ, two members from the University of Texas Medical Branch at Galveston (UTMB) and two members from the Texas Tech University Health Sciences Center at Lubbock. CMHCC, in turn, contracts with each of the medical facilities at a negotiated cost for medical and psychiatric care. Texas Tech subcontracts with local providers for about 70 percent of the health care services it provides. UTMB usually uses its own staff to provide care.

UTMB serves prison units in South and East Texas, comprising 78 percent (102,000) of TDCJ’s inmates. UTMB’s $5.45 capitation rate (cost per inmate, per day) is higher than Texas Tech’s $5.07 because it serves special inmate populations–all OB/GYN, mobility impaired, hospice and HIV/AIDS patients. UTMB receives 76.5 percent of TDCJ’s total health care spending. Texas Tech serves the remaining 22 percent of inmates in North and West Texas facilities, and receives a 22.5 percent share of TDCJ medical spending. TDCJ and CMHCAC administrative expenses make up the remaining 1 percent.

Texas Total, Fiscal 1998
Amount Spent: $296,511,670  
  $253,633,120 Medical care based on 129,620 inmates
  $ 42,878,550 Psychiatric care based on 129,620 inmates
Administrative expenses:    p $ 2,370,000

Sources: Texas Department of Criminal Justice and Sunset Advisory Commission