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					TDCJ Presentation to the UT System Board of Regents
Dr. John D. Stobo President, UTMB
UT System Board of Regents Quarterly Meeting August 11, 2004

Here for the Health of Texas

UTMB
UTMB provided unsponsored care to patients coming from 177 of Texas’s 254 counties in 2003.

TDCJ/UTMB Correctional Units
Gainesville 
TYC-GSS Roanoke  TYC-WH TYC-MCR HJ CL  Bonham CM

TO  New Boston
JT  Winnsboro

Ft Worth   Dallas

TYC-CH CO ND  MI  Palestine Corsicana TYC-CSH B1 B2 Teague  BY Rusk HD SV FE Crockett Diboll   NG GG TYC-CSS Jasper 
EA WY HV DU

GV MV WM HT  Gatesville AH LM San Saba  TYC-SS Burnet  BB

HB  Marlin

TYC-TH  Austin

Livingston  TL E1 Huntsville  TYC-GSS NF GR E2 GL Bryan  LJ  TYC-H ST BJ NF FED Giddings Dayton   Beaumont P1,2  NavasotaHM AJ HI LT BA TYC-JCSS Houston  GC Sugarland  C  J 1,2,3,4 Rosharon  DA
R 1,2,3 RV

Texas City

TE Hondo  HF
DB Dilley  N4 Cotulla 

BX  San Antonio TYC-AH SB  Cuero CY  Kennedy NI  Beeville NH ML Corpus Christi 
TYC-NH

 Galveston
HG

(Hospital)

Brazoria  CN

UTMB

UTMB cares for 106,000 of Texas’s prison population.

San Diego  SO

TYC-ERJC

Raymondville 
McAllen 
TYC-BH EN

 Edinburg TYC-VH RL  Harlingen

Opened July 1983

General Acute Care Inpatient Hospital Accredited by Joint Commission (December 2003) First multi-categorical prison hospital on the campus of a U.S. academic health science center

CMHCC Organizational Relationships
GOVERNOR
Committee includes nine Members appointed as follows:
• Two Physicians and One Public Member appointed by the Governor •A Physician and Administrator from TDCJ appointed by TDCJ Executive Director •A Physician and Administrator from UTMB appointed by the President of the University •A Physician and Administrator from Texas Tech Health Sciences Center appointed by the President of the Health Sciences Center

LEGISLATURE
Correctional Managed Health Care Committee
CMHCC
Executive Director

TDCJ Health Services Division

UTMB Correctional Managed Care

TTUHSC Correctional Health Care

Telehealth Delivery System

Telehealth Module

Components of Telehealth Delivery System
• Telecommunication with multiple attachments • Pharmacy management • Electronic medical record—HIPAA compliant • Voice activated dictation • Disease management/practice guidelines

Monthly Telemedicine Visits
6,000 5,000

5,044
4,000

4,155 3,791 3,348 2,773 2,934

4,350 3,934 3,462 3,894 3,951 3,818

4,191

3,000

2,000

1,000

591
21%

629
21%
'03

736
19%
3 l '0 Ju

766
23%

911
22%

1,370 1,237 1,175 1,091 1,288 1,007 1,047 1,066
26% 30%

27%

30%

29%

26%

31%

30%

0

M

ay

3 '0

n Ju

g Au

3 '0

p Se

3 '0

'0 ct O

3

v No

3 '0

c De

3 '0

n Ja

'04

b Fe

4 '0 M

' ar

04

4 '0 r Ap

M

ay

4 '0

All visits Free world visits

Inmate Deaths by Fiscal Year
3.5
Deaths per 1,000 population

3 2.5 2 1.5 1 0.5 0

3.3 3.1 2.6 2.2 1.7

3.4 2.7 2.5 2.1 2.1 2.5 2.5 2.5

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Average Compliance of All Diseases All Indicators*
120 100

percent compliance

80 60 40

96.8

40.1
20 0 FY95 FY03

* Operational Performance Evaluation System Data, 2001.

Clinical Endpoint Comparison
300 250 249 200 150 100 50 25 0 Percent Blood Pressure Control Average Blood Glucose Average LDL 49 187 131.5 172

FY 95

FY 03

TDCJ Treatment Guidelines and Asthma Deaths
3.5 3

TDCJ Asthma Deaths
2.5

UTMB Asthma UTMB Asthma Treatment Treatment Guideline Guideline Initiated Initiated

Deaths per 100,000

2

Texas Asthma Deaths
1.5

U.S. Asthma Deaths
1

0.5

0 FY95 FY96 FY97 FY98 FY99 FY00 FY01 FY02

Pharmaceutical Costs
40
Expenses in Millions

30
Drug costs down 18.4% in four years.

20

10

0 FY 2000 FY 2001 FY 2002 FY 2003

Comparison of Prison Health Care Costs
(Per Member Per Day)
$10 $9 $8 $7 $6 $5 $4 $3 $2 $1 $0
Based on data from The Corrections Yearbook 1999 Published by Criminal Justice Institute, Inc.

Texas Ohio Oregon Illinois Georgia New York Connecticut Federal Florida

PMPD Cost

Correctional Managed Health Care
Savings Comparison to National Average Medical Costs
$300 $280 $260 $240 $220
$182 PMPM Savings: $784.3 Million

$267.5 PMPM

National Average Zero Growth Rate
Actual Rate

$200 $180 $160 $140 $120

$183.6 PMPM

FY 93 FY 94 FY 95 FY 96 FY 97 FY 98 FY 99 FY 00 FY 01 FY 02 FY 03
Sources: Actual data for Texas; National Averages based on Corrections Yearbook; Corrections Health Care Costs-Trends Alert, Council of State Governments, January 2004. Years 2001-2003 projected based on estimated 4.5% growth.

CMHC Appropriations* 1996-2005
FY 04-05 Appropriations represent a reduction of $26.6M from FY 02-03 base

$350
Appropriations (millions)

$300 $250 $200 $150 $100 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

*Includes designated self-funding and supplemental appropriations (legislative salary increases)

CMHC Financial Review
Adjusted Operating Margin per Year
$40.00 $20.00

Millions

$0.00 ($5.7) -$20.00 ($22.3) -$40.00 ($45.7) -$60.00 -$80.00
Fiscal 2001 Fiscal 2002 Fiscal 2003 Forecast 2004 Forecast 2005 Forecast 2006

($4.4)

($9.0)

($6.5)

($70.7)
Forecast 2007

Note: (1) Includes TDCJ Hospital, UTMB Faculty Group Practice and CMCH

Texas Medical Foundation Audit
• Administrative Audit (July 2004) – Policy and Procedures – Utilization Review Process – Quality Services – Credentialing Process – Peer Review • Medical Record Audit (August 2004) – Quality of care / Outcomes – Documentation of care • Audit Report (December 2004)


				
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