UT & Prison Health Care

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The University of Texas and Prison Health Care

Thanks to UT and the Texas Legislature, you don’t have to commit a capital crime in Texas to get a death sentence.

In 1993, the job of providing health care to Texas prisoners was handed over to the University of Texas Medical Branch (UTMB) and Texas Tech.

Hundreds of inmates die every year in Texas prisons, yet reviews of those deaths and the medical care given to those inmates is kept secret from the public.

500 Texas prison deaths in 2000. Most are Black men aged 40-49.

Some reports by outside agencies have been made public. They reveal a pattern of improper care and neglect that has made many inmates sicker upon release, and likely contributed to the deaths of others.

Left to die ...

Prison health care has become a 7 million per year business for the universities, paid for with public money, but without meaningful public scrutiny.

UTMB provides care in most of the prisons, which include 80% of the inmates. Only UT is notorious for their operation—lawyers and doctors representing inmates in a federal lawsuit have concluded that UTMB does a worse job at inmate care than Tech.

Since UTMB and Tech took over healthcare of state prisoners, more than 1,000 inmates have died of disease, injury or old age.

In July of 1997, the Department of Health inspected the dialysis office at the Estelle prison. Conditions were so bad, the dialysis facility was closed. We may never know exactly what was wrong because, like so much of this information, these facts are kept secret by law.

In 1996, prison doctors conducted an audit at the Stiles unit that has become public. They found that 16 dead inmates had received improper care including Alexander Oris who had "starved to death in [the] infirmary" according to the internal review. Others were neglected or simply "left to die."

In 1998, out-of-state doctors did another audit. In 20 of 59 deaths examined, it was found that inmates received poor or very poor care. The doctors concluded that Ophelia Rangel was left "lying in feces, menstruel fluid and urine" until she died of "severe dehydration." The doctors also found that Arthur Hines repeatedly complained of chest pains and shortness of breath, but received "no particular treatment" in the weeks preceding his death from heart failure.

As recently as last March, half of the prisoners discharged from clinics and prison hospitals had incomplete documentation, and one in every ten required "emergency, acute care or readmission following discharge," according to a prison system report.

A 2000 study by two doctors at UTSA found that women and black inmates were prescribed more advanced, and more expensive, anti-psychotic drugs 'less frequently than whites, implying that there may be bias in prescribing patterns in (TDCJ) Mental Health Services," according to a TDCJ analysis.

This poor care threatens everyone’s health. In 2000, Dr. William O’Brien announced he had found that "patients in the Texas prison system infected with (HIV) frequently have a drug-resistant form of the virus." The cause of the resistance, O’Brien reported, "is often related to inconsistent administration of medication, and it results in diminished responses to drug therapy."



Medical experimentation and Texas prisoners as captive subjects ...

UTMB does operate a prison hospital in Galveston which supposedly provides exemplary care, but it is difficult for many prisoners to get there. One easy way, however, is to sign-up to be a biomedical "guinea pig" for UTMB.

During the 1970’s, the FDA decided that doctors who received public money could only do two types of research in prisons: those examining conditions or diseases peculiar to prisons, or those that "have the intent and reasonable probability of improving the health or well-being of the subject." Otherwise, when federal money is involved, biomedical research "shall not involve prisoners as subjects." Such controversial testing , by 1975, was only done in 7 states, including Texas.

UTMB’s Office of Clinical Trials boasts that one of the "special features" available at UTMB that "support clinical research" is the prison hospital, and the tens of thousands of Texas inmates who look to that hospital for medical care.

In 2000, the federal Office of Human Research Protections ordered UT to suspend a broad range of medical research trials because the university was not following proper procedures for using human subjects in medical research. The agency found problems in more than half of the 25 UTMB research projects it reviewed. In nine, it questioned whether prisoners should have been allowed to participate at all.

These tests on prisoners may violate the 1947 Nuremberg Code which set 10 conditions for using human subjects in medical experiments, making the voluntary consent of the human subject absolutely essential.

"There's a long history of this kind of thing," said Dr. David Egilman, a professor in the community health department at Brown University. "Prisoners who join trials get better care. Better care is coercive."



How can this happen?

Since 1993, no independent agency monitors the care given to Texas inmates; the universities decide for themselves what care is proper. Even TDCJ can't provide oversight. The prison system has to contract with another layer of bureaucracy—the Correctional Managed Health Care Committee—to buy medical care. When this committee was first set up by the legislature, UTMB, Tech and the prison system each got two seats. Not surprisingly, UTMB and Tech were hired to provide care. In 1996, according to the state auditor, the schools together "realized a net profit of .3 million (10.47% of revenues) after returning million" to the state.

Most of the information regarding prison health care is kept secret by legislative enactment. When the Austin American-Statesman attempted to obtain some of this information, Attorney General John Cornyn ruled that most of it would remain off limits.

Most of the information above was compiled from a 4-part series of in-depth reports in the Austin American-Statesman—"Sick in Secret: The hidden world of prison health care," by Mike Ward and Bill Bishop—published on December 16, 17, 18 and 19 of the year 2001. As of February 16, 2002, these articles were still available at:

http://www.statesman.com/specialreports/content/specialreports/prisons/index.html

Further Research on Prison Health Care:

Cronyism at UTMB (1/22/98)

UT Prison Healthcare Mismanagement (1/22/98)

UT prison health care under fire again (11/22/02)

More:

UT ties to the for-profit prison industry