Texas House, Senate budget plans tens of millions apart on prisoner health care

While the state's Republican leaders appear in sync on issues like school finance and property taxes, they clearly see things differently when it comes to at least one thing: prison health care.

In the budget proposals the Texas House and Senate released this week, the amount of money allocated to the Texas Department of Criminal Justice to care for sick inmates varies drastically.

While neither spending plan gives the department anything close to what it requested, the House budget boosts prisoner health care funding by $159 million while the Senate cuts it by about $1.3 million — a total difference of about $160 million.

Last year, TDCJ officials asked state lawmakers to give the department an additional $281 million in the next, two-year budget cycle, which begins this fall — a sum it said it needed just to meet the minimum standards of care.

With escalating health care costs and an aging inmate population, the prison system routinely racks up medical expenses that far exceed the amount of money it gets from the state. In its budget request, TDCJ described its proposed funding boost as "critical."

The prison health care system has a base funding level of about $1.1 billion for the current biennium, according to the Legislative Budget Board. The funds cover medical, dental and mental health services to prisoners.

“Less funding could lead to the elimination of some services, data system failures and lapses in information security,” said Bryan Collier, the prison system’s executive director, in a written statement at the time of the request.

Included in TDCJ’s request was money to upgrade current equipment, like computer systems and X-ray machines, and to give raises to help retain prison medical staff. But the department stated that nearly $250 million of the funds requested are needed just to be able to pay for existing services.

“Over the last several sessions, there’s definitely been a sense that the [prison health care system] has been teetering on the edge of unconstitutionality, because it is so underfunded, and they’re not able to deliver the care that’s needed at appropriate levels,” said Michele Deitch, a senior lecturer at the University of Texas at Austin with expertise in prison conditions.

When asked about the difference between the two chambers’ proposals in prison health care funding, state Sen. Jane Nelson, the Senate's chief budget writer, deflected, saying that one of her priorities this session is helping sexual assault and human trafficking victims. The Flower Mound Republican described it as a "personal mission" in a written statement.

Overall, the Senate budget proposal puts slightly more money toward public safety funding than the House. But it gives more money to the Department of Public Safety, in part to fund human trafficking task forces and rape kit testing.

Still, budget writers in both chambers are poised to help pay down existing prison health care debt.

The Senate's recently-filed supplemental bill — which plugs holes in the current budget cycle — calls for $160 million to address the current shortfall in prison health costs. The House has not yet filed its supplemental bill, but a spokesperson for House Speaker Dennis Bonnen said the same amount of money will likely be included.

Both chambers also proposed boosting funding for vocational training programs and to install more video surveillance cameras in maximum security prisons.

The budget proposals are only starting points that are likely to be significantly altered during the legislative session, which runs through May 27. With lawmakers so focused on public school funding and property taxes, it’s unclear how much attention prison health care will get, but a prison spokesman noted its a necessary service.

“We need to provide health care services to offenders that need it,” said Jeremy Desel. “Now we spend the next five months carefully — not just monitoring but actively involved — in discussions with lawmakers on how to best fund the agency.”

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