CORRECTIONAL MANAGED HEALTH CARE COMMITTEE …...Sep 16, 2020 · Dr. Owen Murray, UTMB CMC Offender Care Services recognized Dr. Susan Morris, Medical Director of Telemedicine who

CORRECTIONAL MANAGED HEALTH CARE

COMMITTEE

AGENDA

September 16, 2020

10:00 a.m.

Conference Call Dial In: (877) 226-9790 Access Code: 1101666

CORRECTIONAL MANAGED HEALTH CARE COMMITTEE September 16, 2020

10:00 a.m.

Conference Call Dial in Number: (877) 226-9790

Access code: 1101666

I. Call to Order

II. Recognitions and Introductions

III. Consent Items

1. Approval of Excused Absences

2. Approval of CMHCC Meeting Minutes, June 17, 2020

3. TDCJ Health Services Monitoring Reports- Operational Review Summary Data- Grievance and Patient Liaison Statistics- Preventive Medicine Statistics- Utilization Review Monitoring- Capital Assets Monitoring- Accreditation Activity Summary- Active Biomedical Research Project Listing- Restrictive Housing Mental Health Monitoring

4. University Medical Directors Reports- Texas Tech University Health Sciences Center- The University of Texas Medical Branch

5. Summary of CMHCC Joint Committee / Work Group Activities

IV. Update on Financial Reports

V. Medical Directors Updates

1. Texas Department of Criminal Justice- Health Services Division Fiscal Year 2020 Third Quarter Report

2. Texas Tech University Health Sciences Center

3. The University of Texas Medical Branch

CMHCC Agenda (Continued) September 16, 2020 Page 2

VI. Update on the CMHCC Joint Pharmacy & Therapeutics Committeeand an Overview of Pharmacy OperationsStephanie Zepeda, Pharm.D., Director, Pharmacy ServicesUTMB Correctional Managed Care

VII. Public Comments

VIII. Adjourn

Consent Item

Approval of CMHCC Meeting Minutes

June 17, 2020

CORRECTIONAL MANAGED HEALTH CARE COMMITTEE

June 17, 2020

Chairperson: Robert D. Greenberg, M.D

CMHCC Members Present: Cynthia Jumper, M.D., Lannette Linthicum, M.D., CCHP-A, FACP, F. Parker Hudson III, M.D., Preston Johnson, Jr.,

Philip Keiser, M.D., Erin Wyrick, John Burruss, M.D., Jeffrey Beeson, D.O., Dee Budgewater

CMHCC Members Absent: None

Location: Teleconference – (877) 226-9790, Access Code: 5032791

Agenda Topic / Presenter Presentation Discussion Action

I. Call to Order

- Dr. Robert Greenberg

II. Recognitions and

Introductions

- Dr. Greenberg

Dr. Robert Greenberg called the Correctional Managed

Health Care Committee (CMHCC) meeting to order at 10:00

a.m. then called roll and noted that a quorum was present on

the line, and the meeting would be conducted in accordance

with Chapter 551 of the Texas Government Code, the Open

Meetings Act.

Dr. Greenberg acknowledged that all wishing to offer public

comment must be registered and would be allowed a three-

minute time limit to express comments. There were no public

members on the line wishing to register to offer public

comment.

Dr. Greenberg welcomed and thanked everyone for being in

attendance. He then moved on to recognitions and

introductions.

Dr. Greenberg announced that Dr. Rodney Burrow resigned

as presiding officer of the CMHCC, and the Governor has

appointed him to the Texas Board of Criminal Justice. Dr.

Greenberg shared that he is the Vice President and Chief

Medical Officer of Emergency Services, Baylor Scott &

White Health and was appointed by the Governor to serve the

remainder of Dr. Burrow’s term as the presiding officer of the

CMHCC. Dr. Greenberg shared that he is a native Texan;

however, he was raised in Louisiana and he returned to Texas

after his residency. He has been with Baylor, Scott & White

for 26 years.

II. Recognitions and

Introductions (cont.)

- Dr. Greenberg

Dr. Greenberg shared that he has served on and chaired the

Governor’s EMS and Trauma Advisory Council. Dr.

Greenberg concluded by stating he is looking forward to

working on the committee.

Dr. Greenberg announced that Dr. Ben Raimer has resigned

from the CMHCC. Dr. Raimer, in his role as the University of

Texas Medical Branch (UTMB) President, ad interim, has

appointed Dr. Philip Keiser, Professor, Division of Infectious

Diseases, Internal Medicine to serve on the committee as the

physician representative for UTMB. Dr. Greenberg welcomed

Dr. Keiser to the committee.

Dr. Cynthia Jumper, VP Health Policy & Special Health

Initiatives Texas Tech University Health Sciences Center

(TTUHSC) Correctional Managed Care (CMC) recognized

Mike Jones, Director of Nursing Services who retired June 12,

2020 with 30 years of service and Dr. Guillermo Garcia,

Director of Psychiatry and Behavioral Health who is resigning

effective June 30, 2020. Dr. Jumper introduced Dr. Shirley

Marks who will assume the role of Director of Psychiatry and

Behavioral Health effective July 1, 2020 and Dr. Melinda

Schalow, Southern Regional Medical Director.

Dr. Owen Murray, UTMB CMC Offender Care Services

recognized Dr. Susan Morris, Medical Director of

Telemedicine who retired May 30, 2020 with 25 years of

service.

Dr. Lannette Linthicum recognized Dr. Keiser for his ongoing

public health and infectious disease consultation to the Joint

Medical Directors during the COVID-19 pandemic.

III. Approval of Consent Items

- Dr. Greenberg

- Approval of Excused

Absences

- Approval of CMHCC

Meeting Minutes –

December 4, 2019

- Approval of TDCJ

Health Services

Monitoring Report

- University Medical

Directors Reports

- TTUHSC

- UTMB

- Summaries of CMHCC

Joint Committee / Work

Groups Activities

Dr. Greenberg next moved on to agenda item III approval of

consent items.

Dr. Greenberg stated that the following five consent items

would be voted on as a single action:

The first consent item was the approval of excused absences-

from the December 4, 2019 meeting – Dr. Ben Raimer and

Erin Wyrick

The second consent item was the approval of the CMHCC

meeting minutes from the December 4, 2019 meeting. Dr.

Greenberg asked if there were any corrections, deletions or

comments. Hearing none, Dr. Greenberg moved on to the

third consent item.

The third consent item was the approval of the Fiscal Year

2020 First and Second Quarter Texas Department of Criminal

Justice (TDCJ) Health Services Monitoring Report. There

were no comments or discussion of these reports.

The fourth consent item was the approval of the Fiscal Year

2020 First and Second Quarter University Medical Directors

Report. There were no comments or discussion of these

reports.

The fifth consent item was the approval of the Fiscal Year

2020 First and Second Quarter summaries of the CMHCC

Joint Committee/Work Groups Activities. There were no

comments or discussion of these reports.

Dr. Greenberg then called for a motion to approve the consent

items.

Dr. Jumper made a motion

to approve all consent

items, and Dr. Jeffrey

Beeson seconded the

motion which prevailed by

unanimous vote.

III. Approval of Consent Items

(cont.)

- Dr. Greenberg

IV. Update on Financial

Reports

- Rebecca Waltz

Dr. Greenberg next called on Ms. Rebecca Waltz to present

the financial report.

Ms. Waltz reported on statistics for the Second Quarter of

Fiscal Year (FY) 2020, as submitted to the Legislative Budget

Board (LBB). The report was submitted in accordance with

the General Appropriations Act, Article V, Rider 43. Details

of Ms. Waltz report may be found in Tab B in your CMHCC

agenda book and are also posted on the CMHCC website.

Ms. Waltz answered that prior years have been less. A spend-

forward request has been prepared and submitted to the

Governor’s Office and the Legislative Budget Board that will

allow funds from FY21 to be used to cover this anticipated

FY20 shortfall. This will also let them know that moving

forward into the next legislative session a supplement

appropriation will be required.

Dr. Greenberg asked how the items in the

Monitoring Report under Operational Review

that show red or below the compliance threshold

are addressed.

Dr. Linthicum answered that within the Health

Services Division is an Office of Health

Services Monitoring. For any areas of non-

compliance, the unit is required to submit a

Corrective Action Plan (CAP) to this office to

address those areas. The CAP is then staffed and

either approved or disapproved. If approved, it

is closed out. If it is not approved, it sent back to

the unit for additional action until there is an

acceptable CAP in place.

Dr. Beeson asked about blank items in the

monitoring report and whether this would

indicate a zero for that field.

Dr. Linthicum answered that may indicate no

data and those items will be checked. In the

future, that will be more clearly defined.

Dr. Greenberg asked how the projected 100.7

million shortfall compares to previous shortfalls.

IV. Update on Financial

Reports (cont.)

- Ms. Waltz Ms. Waltz answered yes, they are required to submit cost

savings initiatives to the legislature. The universities

continuously take measures to reduce costs.

Mr. Preston Johnson, Jr. asked if there are cost

saving measures being looked at.

Dr. Parker Hudson added that supplemental

funding may be an issue with budgets in the state

that they are currently in.

Dr. John Burruss asked about the pressure on the

universities. The care and therefore the costs are

inescapable. The population is aging and the

portion of those whose care is most costly is

increasing.

Dr. Murray answered that is all correct.

Historically, the supplemental requests have

been approved and the deficits covered.

However, this amount does continue to grow. It

is really during the last six months when the

university has to assist with funding. This

session will be a challenge with budgets as they

are due to COVID-19. Cost saving initiatives are

ongoing. The 340b program represents their

largest cost savings to the state. Dr. Murray

shared reducing staff would reduce service

levels and they have still not recovered fully

from the last reduction in force (RIF). They try

to save by using technologies; using

telemedicine; using the electronic health record;

using reporting platforms to provide the best

care and keep patients as healthy as possible.

Dr. Jumper concurred with Dr. Murray.

Dr. Linthicum shared that in May the Governor,

Lt. Governor and the Speaker issued a letter to

state agencies requesting a 5% reduction in their

funding levels for the next biennium. TDCJ

requested that an exemption be made for

correctional managed health care.

VI. Medical Director’s Updates

- TDCJ – Health

Services Division FY

2020 Second Quarter

Report

-Dr. Lannette Linthicum

- Texas Tech University

Health Sciences

Center

- Dr. Cynthia Jumper

Dr. Greenberg thanked Ms. Waltz and then called on Dr.

Linthicum to present the Fiscal Year 2020 Second Quarter

TDCJ Medical Director’s Report.

Dr. Linthicum began by explaining that the Managed Health

Care statute 501.150 requires TDCJ to do four things

statutorily; ensure access to care, conduct periodic operational

reviews or compliance audits, monitor the quality of care and

investigate health care complaints. The Medical Director’s

Report is a summary of those activities and may be found in

Tab C in your CMHCC agenda book and is also posted on the

CMHCC website.

Dr. Linthicum answered, yes, all direct patient care is

provided by the universities. There is a program in the Reentry

and Integration Division (RID) called the Texas Correctional

Office on Offenders with Medical or Mental Impairments

(TCOOMMI) who receive an appropriation from legislature

for continuity of care services. They provide services along

the continuum of corrections, including pre-adjudication, jail,

prisons and parole. The universities coordinate with

TCOOMMI for the placement of behavioral health patients as

part of their continuity of care plan. All unit-based care is

provided by the universities and includes approximately 2,000

inpatient psych beds at 4 facilities and approximately 24,000

patients on the outpatient caseload. The universities also

participate in civil commitments.

Dr. Greenberg thanked Dr. Linthicum and then called on Dr.

Jumper to present the report for TTUHSC.

Dr. Jumper stated that she had nothing further to report.

Dr. Greenberg asked if all behavioral health care

is provided by the universities. He asked if they

utilize any of the state behavioral health services

for continuity of care.

Dr. Joseph Penn, UTMB Director of Mental

Health Services shared that he is available to any

member who would like additional information

about behavioral health at TDCJ facilities. He

stated they provide patients with full access to

care while they are in the system.

VI. Medical Director’s Updates

(cont.)

- University of Texas

Medical Branch

- Dr. Owen Murray

VII. Pandemic Response

- Dr. Linthicum

Dr. Greenberg thanked Dr. Jumper and then called on Dr.

Murray to present the report for UTMB.

Dr. Murray stated that he had nothing further to report.

Dr. Greenberg thanked Dr. Murray and then called on Dr.

Linthicum to begin the presentation on the pandemic

response.

Dr. Linthicum stated her report would focus on the TDCJ

pandemic response. Historically, and to give a timeline of

some key events; In January, Dr. Olugbenga Ojo, Chief

Medical Officer and Chief Physician Executive for Hospital

Galveston (HG) sent out an email advising that the UTMB

had created a corona virus task force in light of the virus in

China and the confirmed cases in the USA. This task force

included participants from the Centers for Disease Control

and Prevention (CDC) and UTMB’s emergency response

team. In February, Dr. Ojo organized a meeting with the

CMHCC Joint Medical Directors, Dr. Philip Keiser and Dr.

Janak Patel to address coronavirus within the correctional

managed health care program. In March, daily conference

calls with the Department of State Health Services (DSHS)

and Texas Division of Emergency Management (TDEM)

began. Also, in March, Dr. Linthicum hosted a meeting that

included representation from all divisions within TDCJ and

the universities. At this meeting she presented a Pandemic Flu

Plan and an extensive action list for the agency was created.

Following this meeting, the TDCJ Executive Director put out

a mandate for all divisions titled Procedures Implemented in

Response to COVID-19. On March 16th, the TDCJ Command

Center was activated and is still ongoing. Also, in March,

meetings were held with the Correctional Institutions Division

(CID) and the Manufacturing, Agribusiness and Logistics

Division (MAL) to coordinate distribution of the personal

protective equipment (PPE). Dr. Linthicum reported that due

to previous experience with the H1N1 pandemic, a stockpile

of PPE had been maintained. The first COVID-19 specific

policy was formulated March 20th and currently, this policy is

on its sixth revision. Collaboration has been ongoing with

DSHS and Dr. Keiser.

VII. Pandemic Response (cont.)

- Dr. Linthicum

Dr. Linthicum stated that originally the state guidelines for

testing had to be followed. In March, the UTMB requested

deviation from these testing guidelines to conduct focused

testing of targeted vulnerable populations. This request for

deviation from the state guidelines was made to and approved

by DSHS.

Dr. Linthicum reported shortly after the UTMB began

targeted testing, Bryan Collier, TDCJ Executive Director was

advised that adequate supplies were available through TDEM

for mass testing. Mass testing began on May 11th and as of

June 15th 107,684 offenders had been tested with 7,445

positive results. 54 parolees in residential facilities have been

tested, with 54 positive results. For employees tested the

numbers are; TDCJ 30,769 tested with 970 positive; 6 Board

of Pardons and Paroles with 2 positive; 14 Windham School

District with 2 positive; 465 UTMB with 78 positive; 121

TTUHSC with 27 positive and 172 other contract staff and

community facilities with 37 positive.

Dr. Linthicum shared that as of June 15th 4 staff members and

74 offenders are hospitalized due to COVID-19 and 8

employees have died. As of June 16th, 93 offender deaths are

presumed to be COVID-19 related.

Dr. Linthicum reported that as of June 15th there are 18,653

offenders on medical restriction. 18,452 are on preventative

medical restriction due to positive case. These offenders will

be removed from restriction within 14 days from their

potential exposure provided that they remain symptom free.

201 are on preventative medical restriction due to exposure to

suspected cases with results pending. These offenders will be

removed from restriction as negative test results are received.

There are 31 units currently on lockdown due to COVID-19

positive offenders or employees.

Dr. Linthicum reported that the agency continues to receive

additional PPE from TDEM.


- Dr. Linthicum


- Dr. Murray


- Dr. Olugbenga Ojo

Dr. Linthicum reported that CMC established family member

hotlines in the TDCJ Health Services Patient Liaison Program

for third parties and UTMB and TTUHSC for family

members. These hotlines are specifically for COVID-19.

They are all staffed by registered nurses. In addition to these

call-in lines, the Chaplaincy Program and others assigned to

the Rehabilitations Programs Division have made over 68,000

calls to family members of offenders whose units are on

lockdown. The TDCJ is also hosting family member and

advocacy group conference calls weekly.

Dr. Greenberg thanked Dr. Linthicum and called on Dr.

Murray to present the pandemic response for the UTMB.

Dr. Murray stated he would like to avoid duplicating

information already provided by Dr. Linthicum. He shared

that workloads have increased for both security and health

care staff. For offenders in medical restriction and isolation,

temperatures must be taken, and rounding must be conducted.

Dr. Murray stated HG has played a pivotal role in the

pandemic response. Dr. Murray introduced Dr. Olugbenga

Ojo and invited him to provide highlights regarding Hospital

Galveston’s pandemic response.

Dr. Ojo began by explaining that Hospital Galveston is the

only freestanding prison hospital in the nation, it is unique.

Dr. Ojo reported that to date there have been 341 admissions

and 210 discharges. There are 50 patients today hospitalized

with COVID-19 related issues, 15 of those are in intensive

care and 11 of those 15 are on mechanical ventilation. In May,

Remdesivir antiviral agent was approved for use by the FDA

and 27 patients have received this treatment and 25 patients

have received convalescent plasma therapy. The COVID-19

patient population have had longer length of stay. The length

of stay (LOS) ranges between 10 to 58 days.

Dr. Ojo stated offsite numbers are low to mid-twenties

currently. Outpatient face-to-face encounters have been

significantly reduced. Patients are being seen instead through

telemedicine.


- Dr. Olugbenga Ojo


- Dr. Jumper

Dr. Ojo reported ambulatory face-to-face specialty clinics on

a smaller scale are scheduled to resume June 22, 2020.

Appropriate precautions have been put in place to

accommodate this through a collaborative effort between

CMC and the TDCJ CID. Every admit to HG is tested for

COVID-19. All patients will be in surgical mask prior to

departure from their units, all HG staff will be in surgical

mask as well. Dr. Ojo stated they have been able to change the

staffing ratio to accommodate the pandemic. They have also

been fortunate to have Dr. Keiser as a partner and resource

throughout the pandemic. Dr. Ojo asked Dr. Keiser to speak

to where we are with this pandemic.

Dr. Greenberg thanked Dr. Ojo and then called on Dr. Jumper

to present the pandemic response for TTUHSC.

Dr. Jumper reported that they have designated their Regional

Medical Facility (RMF) and infirmary clinics as repositories

for the COVID patients that have required more extensive

monitoring. The groups that have been the most effected in

the sector are in El Paso, Abilene, Amarillo and Lamesa. Dr.

Jumper stated that she believes we need to start thinking about

our post COVID-19 plans as it relates to some of the higher

acuity patients. They currently have 4 hospitalizations in the

sector, 2 in Amarillo and 2 in Lubbock. There have been 10-

11 deaths.

Dr. Keiser stated the TDCJ has done an

outstanding and remarkable job in responding to

this pandemic. There was so much unknown

about this disease, and plans had to be

developed. They built an Intensive Care Unit

(ICU) for COVID-19 patients and those patients

are receiving Remdesivir. UTMB now has an

experienced staff to treat COVID.

Dr. Hudson asked about testing strategies and as

the cases increase is there a plan in place to

handle that.


VIII. Public Comments

- Dr. Greenberg

IX. Adjourn

Dr. Linthicum answered that yes, we have access to additional

tests through TDEM. The Joint Medical Directors are

continuously developing strategies to deal with current and

future needs. Strategies follow CDC Guidelines and

consultation with Dr. Keiser. Of particular concern is the

long-term care facilities, geriatric and sheltered housing.

Surveillance testing continues.

Dr. Linthicum stated that they have used the guidelines that

the CDC published for recommendations for corrections.

They continue to collaborate with state and local public health

authorities. At this point, we have conducted more testing than

any other jurisdiction.

Dr. Greenberg thanked Dr. Linthicum, Dr. Jumper and Dr.

Ojo and then noted that in accordance with the CMHCC

policy, during each meeting the public is given the

opportunity to express comments. He asked if there was

anyone on the line wishing to express comments. Hearing

none, he next moved on to meeting adjournment.

Dr. Greenberg next called for a motion to adjourn the meeting.

Dr. Hudson asked where we stand when

compared to what other states are doing in the

prison setting.

Dr. Linthicum made a

motion to adjourn the

meeting, and Dr. Jumper

seconded the motion

which prevailed by

unanimous vote.

________________________________________ _______________________________________

Robert D. Greenberg, M.D., Chairperson Date

Correctional Managed Health Care Committee

Dr. Greenberg thanked everyone for their attendance and

adjourned the meeting. Dr. Greenberg announced that the next

CMHCC meeting is scheduled for September 16, 2020 in

Dallas, Texas.

The meeting was adjourned at 11:37 a.m.

Consent Item

TDCJ Health Services Monitoring Reports

TEXAS DEPARTMENT OF CRIMINAL JUSTICE

Health Services Division

Quarterly Monitoring Report

Third Quarter, Fiscal Year 2020

(March, April, and May 2020)

Rate of Compliance with Standards by Operational Categories

Third Quarter, Fiscal Year 2020

March 2020 - May 2020

Unit

Operations/

Administration

General

Medical/Nursing

Coordinator of

Infectious Disease Dental Mental Health Fiscal

n

Items 80% or

Greater

Compliance n

Items 80% or

Greater

Compliance n

Items 80% or

Greater

Compliance n

Items 80% or

Greater

Compliance n

Items 80% or

Greater

Compliance n

Items 80% or

Greater

Compliance

Connally 32 32 100% 11 11 100% 26 23 88% 2 2 100% 24 21 88% 2 2 100%

Garza East 31 31 100% 13 11 85% 24 20 83% NA NA NA 11 11 100% 2 2 100%

Garza West 31 30 97% 13 12 92% 36 26 79% 3 2 67% 14 14 100% 2 2 100%

Glossbrenner 29 28 97% 13 13 100% 24 17 71% 11 11 100% 2 2 100% 4 4 100%

Lopez State Jail 31 31 100% 15 15 100% 25 21 84% 10 10 100% 16 14 88% 5 5 100%

McConnell 31 31 100% 11 8 73% 30 25 83% 2 2 100% 21 17 81% 2 2 100%

Sanchez State Jail 31 31 100% 13 13 100% 33 32 97% 2 2 100% 16 15 94% 2 2 100%

Segovia 31 31 100% 13 13 100% 26 23 88% 10 10 100% 2 2 100% 4 4 100%

Stvenson 30 30 100% 11 11 100% 29 27 93% 2 2 100% 2 2 100% 2 2 100%

Willacy State Jail 31 31 100% 13 13 100% 22 20 91% 10 10 100% 14 13 93% 6 6 100%

n = number of applicable items audited.

Compliance Rate By Operational Categories for

CONNALLY FACILITY

April 07, 2020


GARZA EAST FACILITY

May 05, 2020


GARZA WEST FACILITY

May 05, 2020


GLOSSBRENNER FACILITY

March 04, 2020


LOPEZ FACILITY

March 03, 2020


MCCONNELL FACILITY

May 06, 2020


SANCHEZ FACILITY

April 01, 2020


SEGOVIA FACILITY

March 03, 2020


STEVENSON FACILITY

April 08, 2020


WILLACY FACILITY

March 03, 2020

Dental Quality of Care Audit

Urgent Care Report

For the Three Months Ended May 31, 2020

CORRECTED 6/23/2020 Urgent Care Definition: Individuals, who in the dentist’s professional judgment, require treatment for an acute oral or maxillofacial

condition which may be accompanied by pain, infection, trauma, swelling or bleeding and is likely to worsen without immediate

intervention. Individuals with this designation will receive definitive treatment within 14 days after a diagnosis is established by a

dentist. Policy CMHC E 36.1

Facility Charts Assessed by

TDCJ as Urgent Urgent Care Score *

Offenders receiving

treatment but not within timeframe **

Offenders identified as

needing definitive care***

B. Moore 10 100 0 0

Bradshaw 10 100 0 0

Briscoe 10 70 2 1

Clements 10 100 0 0

Cotulla 10 10 7 2

Crain 10 100 0 0

Formby 10 100 0 0

Goodman 10 100 0 0

Goree 10 20 3 5

Hamilton 10 100 0 0

Hilltop 10 100 0 0

Hodge 10 100 0 0

Hughes 10 100 0 0

Huntsville 10 100 0 0

Johnston 10 100 0 0

Kegans 10 100 0 0

Lychner 10 100 0 0

Montford 10 90 1 0

Mountain View 10 90 1 0

Ney 10 100 0 0

Ramsey 10 100 0 0

Rudd 9 23 1 6

Scott 10 90 1 0

Skyview 10 100 0 0

Smith ECB 10 60 0 4

Smith GP 10 20 6 2

Stringfellow 10 80 2 0

Telford 10 100 0 0

Torres 10 100 0 0

Wheeler 10 100 0 0

Woodman 10 90 1 0

Young 4 50 2 0

* Urgent Care score is determined: # of offenders that had symptoms and received definitive treatment with 14 days = 100%

Total # of offenders in audit.

** A Corrective Action is required by TDCJ Health Services if the Urgent Care score is below 80%

*** A Corrective Action is required by TDCJ Health Services giving the date and description of definitive care.

PATIENT LIAISON AND STEP II GRIEVANCE STATISTICS QUALITY OF CARE/PERSONNEL REFERRALS AND ACTION REQUESTS

STEP II GRIEVANCE PROGRAM (GRV)

Total numberof Action Total number of Action

Total number of Total number of Total number of Percent of Action Requests Referred to Requests Referred to Texas

GRIEVANCE GRIEVANCE Action Requests Requests from University of Texas Tech University Health

Fiscal Correspondence Correspondence (Quality of Care, Total # of Medical Branch- Sciences Center-

Year Received Each Closed Each Personnel, and GRIEVANCE Correctional Managed Correctional Managed

2020 Month Month Process Issues) Correspondence Health Care Health Care

Percent of Percent of

Total Action Total Action

Requests Requests

Referred QOC* Referred QOC*

March 305 396 53 13.38% 42 12.12% 6 11 3.54% 3

April 403 372 48 12.90% 48 14.78% 7 0 0.00% 0

May 395 439 63 14.35% 50 12.53% 5 13 3.19% 1

Totals: 1,103 1,207 164 13.59% 140 13.09% 18 24 2.32% 4

PATIENT LIAISON PROGRAM (PLP)

Fiscal

Year

2020

Total numberof

Patient Liaison

Program

Correspondence

Received Each

Month

Total numberof

Patient Liaison

Program

Correspondence

Closed Each

Month

Total number of

Action Requests

(Quality of Care,

Personnel, and

Process Issues)

Percent of Action

Requests from

Total number of

Patient Liaison

Program

Correspondence

Total number of Action

Requests Referred to

University of Texas

Medical Branch-

Correctional Managed

Health Care

Total number of Action

Requests Referred to Texas

Tech University Health

Sciences Center-

Correctional Managed

Health Care

Percent of

Total Action

Requests

Referred

Percent of

Total Action

Requests

Referred QOC* QOC*

March 1,302 1,277 34 2.66% 28 2.19% 0 6 0.55% 1

April 1,935 1,761 42 2.39% 38 2.90% 13 4 0.23% 0

May 1,702 1,428 21 1.47% 19 1.61% 4 2 0.21% 1

Totals: 4,939 4,466 97 2.17% 85 2.28% 17 12 0.31% 2

GRAND

TOTAL= 6,042 5,673 261 4.60%

*QOC= Quality of Care

Quarterly Report for 3rd Quarter of FY2020

Texas Department of Criminal Justice

Office of Public Health

Monthly Activity Report

March 2020

Reportable Condition

Reports

2020

This

Month

2019

Same

Month

2020

Year to

Date

2019

Year to

Date*

Chlamydia 9 4 24 32

Gonorrhea 5 4 20 19

Syphilis 156 161 423 441

Hepatitis A 0 0 0 1

Hepatitis B, acute 0 0 0 0

Hepatitis C, total and (acute£) 172 213 668 421

Human immunodeficiency virus (HIV) +, known at intake

119 142 441 632

HIV screens, intake 2,931 4,024 10,932 16,962

HIV +, intake 0 7 87 88

HIV screens, offender- and provider-requested 470 614 1,731 2,440

HIV +, offender- and provider-requested 0 0 0 0

HIV screens, pre-release 2,080 3,056 8,671 12,916

HIV +, pre-release 0 0 0 0

Acquired immune deficiency syndrome (AIDS) 0 0 6 9

Methicillin-resistant Staph Aureus (MRSA) 139 141 300 391

Methicillin-sensitive Staph Aureus (MSSA) 18 35 55 109

Occupational exposures of TDCJ staff 3 14 19 37

Occupational exposures of medical staff 0 2 3 12

HIV chemoprophylaxis initiation 1 5 8 13

Tuberculosis skin test (ie, PPD) +, intake 83 119 248 372

Tuberculosis skin test +, annual 21 25 92 87

Tuberculosis, known (ie, on tuberculosis medications) at intake 0 1 0 2

Tuberculosis, diagnosed at intake and attributed to county of

origin (identified before 42 days of incarceration) 0 0 0 0

Tuberculosis, diagnosed during incarceration

(identified after 42 days of incarceration) 1 5 6 9

Tuberculosis cases under management 18 24

Peer education programs¶ 0 0 100 100

Peer education educators∞ 48 12 7556 7,083

Peer education participants 6,617 8,881 20,566 22,210

Alleged assaults and chart reviews 59 63 202 174

Bloodborne exposure labs drawn on offenders 25 19 106 54

New Sero-conversions d/t sexual assault ± 0 0 0 0

Year-to-date totals are for the calendar year. Year-to-date data may not equal sum of monthly data because of late reporting. £ Hepatitis C cases in parentheses are acute cases; these are also included in the total number reported. Only acute cases are reportable to the Department of State Health Services ¶ New programs are indicted in the column marked “This Month”; total programs are indicated in the column marked “Year to Date.” ∞ New peer educators are indicted in the column marked “This Month”; total peer educators are indicated in the column marked “Year to Date.” ± New sero-conversions. * New reporting beginning August 1, 2011




April 2020


Reports

2020

This

Month

2019

Same

Month

2020

Year to

Date

2019

Year to

Date*

Chlamydia 4 19 28 51

Gonorrhea 2 3 24 22

Syphilis 57 168 480 609

Hepatitis A 0 0 0 1


Hepatitis C, total and (acute£) 112 256 780 696


119 184 560 674

HIV screens, intake 2,931 4,599 13,863 17,537

HIV +, intake 27 30 114 111




















Peer education educators∞ 4 13 7560 7,112

Peer education participants 1,073 8,230 21,639 27,646




Services

£ Hepatitis C cases in parentheses are acute cases; these are also included in the total number reported. Only acute cases are reportable to the Department of State Health

Year-to-date totals are for the calendar year. Year-to-date data may not equal sum of monthly data because of late reporting.




May 2020


Reports

2020

This

Month

2019

Same

Month

2020

Year to

Date

2019

Year to

Date*

Chlamydia 1 16 29 67

Gonorrhea 5 8 27 30

Syphilis 11 164 491 773

Hepatitis A 0 0 0 1


Hepatitis C, total and (acute£) 225 281 1,005 977


44 178 604 852

HIV screens, intake 276 4,959 14,139 22,496

HIV +, intake 29 37 143 148




















Peer education educators∞ 7 16 7,567 7,128

Peer education participants 133 6514 21,772 34,160




Year-to-date totals are for the calendar year. Year-to-date data may not equal sum of monthly data because of late reporting. £ Hepatitis C cases in parentheses are acute cases; these are also included in the total number reported. Only acute cases are reportable to the Department of State Health

Services

Health Services Utilization Review Hospital and Infirmary Discharge Audit

During the 3rd Quarter of Fiscal Year 2020, ten percent of the UTMB and TTUHSC hospital and infirmary discharges were audited. A total of 303 hospital discharge and 28 infirmary discharge audits

were conducted. This chart is a summary of the audits showing the number of cases with deficiencies and their percentage.

Freeworld Hospital Discharges in Texas Tech Sector

Month

Charts

Audited

Vital Signs Not Recorded1

(Cases with Deficiencies)

Appropriate Receiving Facility2


No Chain-In Done3


Unscheduled Care within 7 Days4


Lacked Documentation5

(Cases with Deficiences)

March 43 7 16.28% 0 N/A 14 32.56% 0 N/A 24 55.81%

April 35 10 28.57% 0 N/A 8 22.86% 0 N/A 16 45.71%

May 32 7 21.88% 0 N/A 11 34.38% 1 3.13% 23 71.88%

Total/Average 110 24 21.82% 0 N/A 33 30.00% 1 0.91% 63 57.27%

Freeworld Hospital Discharges in UTMB Sector

Month

Charts

Audited





No Chain-In Done3






March 35 3 8.57% 0 N/A 3 8.57% 3 8.57% 7 20.00%

April 28 1 3.57% 0 N/A 1 3.57% 3 10.71% 4 14.29%

May 40 2 5.00% 0 N/A 1 2.50% 3 7.50% 11 27.50%

Total/Average 103 6 5.83% 0 N/A 5 4.85% 9 8.74% 22 21.36%

UTMB Hospital Galveston Discharges

Month

Charts

Audited

Vital Signs Not Recorded 1




No Chain-In Done3






March 37 2 5.41% 0 0.00% 11 29.73% 3 8.11% 0 N/A

April 29 7 24.14% 0 N/A 10 34.48% 0 N/A 0 N/A

May 24 1 4.17% 0 N/A 8 33.33% 0 N/A 0 N/A

Total/Average 90 10 11.11% 0 N/A 29 32.22% 3 3.33% 0 N/A

GRAND TOTAL: Combined Hospital Discharges (Texas Tech Sector, UTMB Sector and Hospital Galveston)

Month

Charts

Audited





No Chain-In Done3






March 115 12 10.43% 0 N/A 28 24.35% 6 5.22% 31 26.96%

April 92 18 19.57% 0 N/A 19 20.65% 3 3.26% 20 21.74%

May 96 10 10.42% 0 N/A 20 20.83% 4 4.17% 34 35.42%

Total/Average 303 40 13.20% 0 N/A 67 22.11% 13 4.29% 85 28.05%

Texas Tech Infirmary Discharges

Month

Charts

Audited





No Chain-In Done3






March 3 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

April 2 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

May 3 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

Total/Average 8 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

UTMB Infirmary Discharges

Month

Charts

Audited





No Chain-In Done3






March 9 3 33.33% 0 N/A 2 22.22% 0 N/A 3 33.33%

April 5 0 N/A 0 N/A 0 N/A 1 20.00% 1 20.00%

May 6 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

Total/Average 20 3 33.33% 0 N/A 2 10.00% 1 5.00% 4 20.00%

GRAND TOTAL: Combined Infirmary Discharges (Texas Tech and UTMB)

Month

Charts

Audited





No Chain-In Done3






March 12 3 25.00% 0 N/A 2 16.67% 0 N/A 3 25.00%

April 7 0 N/A 0 N/A 0 N/A 1 14.29% 1 14.29%

May 9 0 N/A 0 N/A 0 N/A 0 N/A 0 N/A

Total/Average 28 3 10.71% 0 N/A 2 7.14% 1 3.57% 4 14.29%

Footnotes: 1. Vital signs were not recorded on the day the offender left the discharge facility. 2. Receiving facility did not have medical services available sufficient to meet the offender's current needs. 3. Chart not reviewed by a health care member and referred (if

applicable) to an appropriate medical provider as required by policy. 4. The offender required unscheduled medical care related to the admitting diagnosis within the first seven days after discharge. 5. Discharge information was not available in the offender's

electronic medical record within 24 hours of arriving at the unit.

FIXED ASSETS CONTRACT MONITORING AUDIT

BY UNIT

THIRD QUARTER, FISCAL YEAR 2020

March 2020

Numbered Property Total

Number Total

Number Total

Number

On Inventory

Report

of

Deletions of Transfers

of New

Equipment

Glossbrenner 10 0 0 0

Lopez 24 0 0 0

Segovia 20 0 0 0

Willacy 16 2 0 0

Total 70 2 0 0

April 2020


Number Total

Number Total

Number

On Inventory

Report

of


of New

Equipment

Connally 53 0 0 0

Sanchez 5 0 0 0

Stevenson 22 0 0 0

Total 80 0 0 0

May 2020


Number Total

Number Total

Number

On Inventory

Report

of


of New

Equipment

Garza East 6 0 0 0

Garza West 81 0 0 0

McConnell 50 0 9 9

Total 137 0 9 9

CAPITAL ASSETS AUDIT

THIRD QUARTER, FISCAL YEAR 2020

Audit Tools March April May Total

Total number of units audited 4 3 3 10

Total numbered property 70 80 137 287

Total number out of compliance 0 0 0 0

Total % out of compliance 0.00% 0.00% 0.00% 0.00%

AMERICAN CORRECTIONAL ASSOCIATION

ACCREDITATION STATUS REPORT

Third Quarter FY-2020

University of Texas Medical Branch

Unit Audit Date % Compliance

Mandatory Non-Mandatory

Wynne March 2-4, 2020 100.00% 98.3%

Estelle March 9-11, 2020 100.00% 98.4%

Texas Tech University Health Science Center

Unit Audit Date % Compliance

Mandatory Non-Mandatory

The ACA 2020 Summer Conference will be held in Cincinnati, OH on August 6-11, 2020. During

this conference, the following CID Facilities will be represented: Clements, Byrd, Administrative

Review and Risk Management, Daniel, Glossbrenner, Formby-Wheeler, Wynne, Estelle, Training

and Leadership Development Division, Skyview-Hodge, Roach, Ramsey, Correctional Industries,

Smith, Jester Complex.

Note: The following unit ACA audits were postponed due to the COVID-19 pandemic: Skyview-

Hodge, Roach, Ramsey, Correctional Industries, Smith, and Jester Complex.

Update: The 150TH Congress of Correction, August 6-11, 2020 Cincinnati, Ohio, has been

cancelled due to the ongoing COVID-19 Pandemic.

Executive Services

Monthly Active Academic Research Projects

Correctional Institutions Division

FY-2020 Third Quarter Report: March, April, and May

Project Number: 202-RL02

Researcher: IRB Number: IRB Expiration Research Began:

Kymn Kochanek 11.07.04 7/19/2023 1/16/2002

Title of Research: Data Collection Began:

National Longitudinal Survey of Youth 1997 9/24/2018

(Bureau of Labor Statistics)

Data Collection End

Proponent: 6/30/2020

NORC – National Organization for Research at the University of Chicago

Project Status: Progress Report Due: Projected Completion:

Data Collection 3/01/2021



Kymn Kochanek 12.06.05 7/19/2023 6/6/2002


National Longitudinal Survey of Youth 1979 (for Bureau of Labor 9/24/2018

Statistics)

Data Collection End:


NORC at the University of Chicago



Project Number: 587-AR09


Marcus Boccaccini 2009-04-032 7/20/2020 1/1/2009


Item and Factor Level Examination of the Static-99, MnSOST-R, and 7/15/2010

PCL-R to Predict Recidivism



Sam Houston State University

Project Status: Progress Report Due: Projected Completion

Data Analysis 12/4/2020 12/31/2021



Byron Johnson 656915 7/9/2018 1/7/2013


Assessing the Long-Term Effectiveness of Seminaries in Maximum 1/7/2013

Security Prisons: An In-Depth Study of the Louisiana State

Penitentiary and Darrington Prison Data Collection End:

8/31/2017

Proponent:

Baylor University


Formulating Results 12/31/2020 1/6/2020



Jeffrey Bouffard 10-12362 10/12/2014 12/6/2013


Criminal Decision Making Among Adult Felony Inmates 4/11/2014





Data Analysis 11/20/2020 10/30/2020



David Pyrooz 00001971 1/13/2020 8/5/2015


Gangs on the Street, Gangs in Prison: Their Nature 4/8/2016

Interrelationship, Control, and Re-entry




Project Status: Progress Report Due: Project Completion:

Data Analysis 12/31/2020 12/1/2018



Kathryn Whiteley 2015-061 3/20/2020 3/21/2017


Self-Identities of Women Incarcerated for Acts of Violence 1/07/2019

Proponent: Data Collection End:

Messiah College 1/10/2019

Project Status: Progress Report Due: Project Completion:

Data Analysis 10/30/2020 3/21/2020

Project Number:

Researcher:

778-AR17

IRB Number: IRB Expiration Research Began:

Lisa Muftic EXEMPT

Title of Research:

Predicting County Victim Impact Statement Form Completion Rates Data Collection Began:

Based on Victim Assistance Coordinator Practices



Project Status: Monitored Only!

Progress Report Due: 9/30/2020

Projected Completed



Stephen Tripodi 00000446 3/14/2020 5/1/2018


Multi-Site Randomized Controlled Trial of the 5-Key Model for Reentry 5/3/2018



Florida State University


Data Analysis 10/23/2020 4/1/2025



Erin Orrick 2018-03-38251 8/30/2020 5/15/2018

Title of Research:

Correctional Officer Attrition Data Collection Began:

Proponent:

11/6/2018


Sam Houston State University 7/1/2020


Data Analysis 9/30/2020 7/30/2020

Project Number:

Researcher:

786-AR18 IRB Number: IRB Expiration Research Began:

Flavio Cunha Title of Research:

EXEMPT 10/24/2018

Evaluation of TDCJ Workforce Reentry Programs Data Collection Began:

5/20/2019


Rice University

Project Status: Progress Report Due: Projected Completion

Data Analysis 10/30/2020 09/30/2020

Project Number:

Researcher:

793-AR18 IRB Number: IRB Expiration Research Began:

Byron Johnson 1361257 12/17/2020 2/8/2019

Title of Research Data Collection Began:

A Study of ROD Ministries Program in Texas Prisons 7/15/2019


Baylor University


Data Collection 9/30/2020 12/30/2023



Bryon Johnson 1432377 5/6/2020 11/20/2019


"Human and Transcendent Accountability" 03/16/2020


Baylor University


Data Collection 9/30/2020 12/31/2023

Executive Services

Monthly Pending Academic Research Projects

Correctional Institutions Division

FY-2020 Third Quarterly Report: March, April, and May



Marilyn Armour 2003-11-0076 1/6/2014 3/10/2004


Victim Offender Mediated Dialogue: Study of the Impact of a Victim- 8/31/2004

Oriented Intervention in Crimes of Severe Violence


University of Texas- Austin 5/31/2017


Pending Manuscript 12/1/2020 12/31/2020



Robert Morgan 501024 12/31/2012 6/11/2008


Re-Entry: Dynamic Risk Assessment 6/11/2008


Texas Tech University 8/30/2012


Pending Manuscript 2/20/2018 10/1/2012



Janet Mullings 19302 08/18/2018 05/30/2015


Understanding Prison Adjustment and Programming 08/11/2015

Needs of Female Offenders Survey


Sam Houston State University 05/30/2016


Manuscript Review 11/20/2020 05/30/2017

Executive Services

Monthly Active Medical Research Projects

Health Services Division

FY-2020 Third Quarter Report: March, April, and May

Project Number: 615-RM10

Researcher: IRB Number: IRB Expiration: Research Began:

John Petersen Flexible IRB 9/12/2013


Serum Markers of Hepatocellular Cancer 1/1/2014



University of Texas Medical Branch at Galveston


Data Collection 12/6/2020 3/1/2023

_



Zbigniew Gugala 14-0351 7/17/2020 6/29/2015


The Efficacy of the Air Barrier System in the Prevention 9/21/2015

of Surgical Site Data Collection End:

8/31/2020

Proponent:



Data Analysis 12/31/2020 3/31/2021



Jacques Baillargeon 14-0283 12/13/2021 10/1/2015


The Health and Healthcare Needs of Older Prisoners - 6/1/2015

Epidemiology in the Texas Prison System Data Collection End:

12/31/2022

Proponent:



Data Analysis 12/31/2020 12/31/2022



Beilin Wang 20-0126.007 12/12/2020 06/01/2020


Prognostication model of predicting severe COVID 19 pneumonia 07/01/2020


Proponent:




3rd Quarter FY 2020

TDCJ Office of Mental Health Monitoring &

LiaisonMental Health Segregation Audit Summary

Reporting months: March 2020, April 2020, May 2020

Date of Audit Unit Observed Interviewed

Mental

Health

Referrals

Requests

Fwd

911

Tool

ATC

4

ATC

5

ATC

6

2/10/2020 Travis 25 25 0 0 100% 100% 100% 100%

2/19/2020 Formby 18 18 0 0 100% 100% 0% 100%

2/5-6/2020 Eastham 427 323 1 7 100% 100% 100% 100%

2/12-13/2020 Ferguson 428 358 0 4 100% 100% 100% 100%

2/20/2020 Robertson 334 277 0 10 100% 100% 100% 100% 2/29/2020 Kegans* N/A N/A N/A N/A N/A N/A N/A N/A

3/12/2020 Dominguez 27 27 0 0 100% 100% 100% 100%

3/31/2020 Ellis* N/A N/A N/A N/A N/A N/A N/A N/A

3/31/2020 Clements N/A N/A N/A N/A N/A 100% 100% 100%

3/31/2020 Connally* N/A N/A N/A N/A N/A N/A N/A N/A

3/31/2020 Lindsey* N/A N/A N/A N/A N/A N/A N/A N/A

3/31/2020 Beto* N/A N/A N/A N/A N/A N/A N/A N/A

3/31/2020 Cole* N/A N/A N/A N/A N/A N/A N/A N/A

3/31/2020 Telford N/A N/A N/A N/A N/A 100% 100% 100%

4/30/2020 Allred N/A N/A N/A N/A N/A 100% 100% 100%

4/30/2020 McConnell N/A N/A N/A N/A N/A 100% 100% 100%

4/30/2020 Polunsky N/A N/A N/A N/A N/A 100% 100% 100%

4/30/2020 Willacy* N/A N/A N/A N/A N/A N/A N/A N/A

4/30/2020 Bradshaw* N/A N/A N/A N/A N/A N/A N/A N/A

4/30/2020 East Texas* N/A N/A N/A N/A N/A N/A N/A N/A

Total 20 1,259 1,028 1 21

*No offenders in the targeted restrictive housing status were currently housed at the Kegans, Ellis, Connally,

Lindsey, Beto, Cole, Willacy, Bradshaw, and East Texas Units.

COMPELLED PSYCHOACTIVE MEDICATION AUDIT

3rd Quarter FY 2020 Audits Conducted in March 2020, April 2020, May 2020

UNIT Reporting

Month

Compelled Medication Cases Documented in

Medical Record1

Reviewed Applicable

Instances Compliant Score

Corrective

Action

Clements March 2020 0 0 N/A N/A N/A

Jester IV March 2020 6 6 6 100% NO

Montford March 2020 7 7 7 100% NO

Skyview March 2020 13 13 13 100% NO

Reviewed Applicable Compliant Score Corrective Action

Clements April 2020 0 0 N/A N/A N/A

Jester IV April 2020 2 2 2 100% NO

Montford April 2020 15 15 15 100% NO

Skyview April 2020 16 16 16 100% NO

Reviewed Applicable Compliant Score Corrective

Action

Clements May 2020 0 0 N/A N/A N/A

Jester IV May 2020 5 5 5 100% NO

Montford May 2020 10 10 10 100% NO

Skyview May 2020 12 12 12 100% NO

1. Documentation supports that psychoactive medication was compelled because the patient refused to

voluntarily comply and failure to take the medication would have resulted in: 1.Emergency - imminent

likelihood of serious harm to the patient and/or to others, or 2. Non-emergency – likelihood of continued

suffering from severe and abnormal mental, emotional and physical distress or deterioration of the

patient’s ability to function independently.

INTAKE MENTAL HEALTH EVALUATION (MHE) AUDIT 3rd Quarter of 2020

Reporting months– March 2020, April 2020, May 2020

FACILITY Charts

Reviewed

Charts

Requiring

MHE (1)

MHE’s completed

within 14 days

(at Intake Unit)

Charts

Excluded

(2)

MHE Audit

Score

Baten 25 20 18 5 90%

Bradshaw 80 45 23 35 51%

Byrd 40 19 18 21 95%

Dominguez 28 20 19 8 95%

East Texas

40

29 25 11 86%

Formby 27 10 8 17 80%

Garza West 40 25 24 15 96%

Gist 30 18 18 12 100%

Glossbrenner 27 9 8 18 89%

Gurney 40 6 3 34 50%

Halbert 38 20 12 18 60%

Holliday 24 20 19 4 95%

Hutchins 40 13 9 27 69%

Jester I 20 20 20 0 100%

Johnston 33 11 11 22 100%

Kegans 36 28 28 8 100%

Kyle N/A N/A N/A N/A N/A

Lindsey 38 15 14 23 93%

Lychner 20 18 18 2 100%

Middleton 26 20 19 6 95%

Plane 28 20 20 8 100%

Rudd 27 18 18 9 100%

Sanchez 39 19 17 20 89%

Travis 25 20 20 5 100%

Woodman 23 20 20 3 100%

Sayle 18 6 5 12 83%

GRAND

TOTAL 812 469 414 343

1. Offenders entering TDCJ who are identified during the Intake Mental Health Screening/Appraisal process as having a history

of treatment for mental illness, currently receiving mental health treatment, history of self-injurious behavior or current

symptoms/complaints of symptoms of mental illness will have a Mental Health Evaluation (MHE) completed by a Qualified

Mental Health Professional (QMHP) within 14 days of identification.

2. If the offender was transferred from the intake unit within 14 days of identification, the chart is excluded from the sample of

charts requiring an MHE.

A Corrective Action Plan is required of all units scoring below 80%.

Consent Item

University Medical Director’s Report

Texas Tech University Health Sciences Center

Correctional Health Care

MEDICAL DIRECTOR’S REPORT

3rd Quarter

FY2020

Medical Director’s Report:

MARCH APRIL MAY Qtly Average

Average Population 28,241.98 27,864.05 26,942.08 27,682.70

Rate Per Rate Per Rate Per Rate Per

Number Offender Number Offender Number Offender Number Offender

Medical encounters

Physicians 3,302 0.117 1,758 0.063 1,636 0.061 2,232 0.081

Mid-Level Practitioners 8,381 0.297 5,267 0.189 4,239 0.157 5,962 0.215

Nursing 13,282 0.470 8,194 0.294 7,538 0.280 9,671 0.349

Sub-total 24,965 0.884 15,219 0.546 13,413 0.498 17,866 0.645

Dental encounters

Dentists 3,324 0.118 1,716 0.062 1,675 0.062 2,238 0.081

Dental Hygienists 671 0.024 22 0.001 16 0.001 236 0.009

Sub-total 3,995 0.141 1,738 0.062 1,691 0.063 2,475 0.089

Mental health encounters

Outpatient Mental Health Visits 5,081 0.180 3,619 0.130 3,024 0.112 3,908 0.141

Crisis Mgt. Daily Census 57 0.002 50 0.017 43 0.002 50 0.002

Sub-total 5,138 0.182 3,669 0.132 3,067 0.114 3,958 0.143

Total encounters 34,098 1.207 20,626 0.740 18,171 0.674 24,298 0.878

Encounters as Rate Per Offender Per Month Encounters by Type

0.400

Outpatient 0.349 Mental Health 0.350

Visits

Dental 7.8%

0.300 Hygienists 1.0%

0.250 Dentists 9.2% Crisis Mgt. 0.215

Daily Census 0.200 0.2%

0.141 0.150

Physicians 9.2%

0.100 0.081 0.081

0.050

0.009 0.002 0.000

Physicians

Mid-Level Practitioners

Nursing Mid-Level

Dentists Practitioners 4.7%

Dental Hygienists Nursing

Outpatient Mental Health Visits 39.8%

Crisis Mgt. Daily Census

Medical Director’s Report (Page 2):

MARCH APRIL MAY Qtly Average

Medical Inpatient Facilities

Average Daily Census

Number of Admissions

Average Length of Stay

Number of Clinic Visits

95.34

133.33

7.52

472.00

106.38

202.00

10.19

707.00

87.47

59.00

4.96

384.00

92.17

139.00

7.42

325.00

Mental Health Inpatient Facilities

Average Daily Census

PAMIO/MROP Census

365.00

363.33

360.00

374.00

385.00

368.00

350.00

348.00

Specialty Referrals Completed 1,973.00 1,075.00 1,007.00 1,351.67

Telemedicine Consults 2393 2,359 1,775 2,175.67

MAY APRIL MARCH 0.00

2.00

4.00

4.96 6.00

7.42 8.00

10.00

10.19

12.00

Average Length of Stay

Consent Item

University Medical Director’s Report

Fiscal Year 2020

3rd Quarter

The University of Texas Medical Branch

UTMB-Correctional Health Care MEDICAL DIRECTOR'S REPORT

THIRD QUARTERFY 2020

Medical Director's Report:

Average PopulationMarch April May Qtly Average

142,920 140,285 134,671 139,292

NumberRate PerOffender Number

Rate PerOffender Number

Rate PerOffender Number

Rate PerOffender

Medical encountersPhysiciansMid-Level PractitionersNursing

14,89239,733862,169

0.100.286.03

10,77727,240893,716

0.080.196.37

9,56822,673

987,016

0.070.177.33

11,74629,882

914,300

0.080.216.56

Sub-total 916,794 6.41 931,733 6.64 1,019,257 7.57 955,928 6.86Dental encounters

DentistsDental Hygienists

9,8521,327

0.070.01

3,61168

0.030.00

3,48794

0.030.00

5,650496

0.040.00

Sub-total 11,179 0.08 3,679 0.03 3,581 0.03 6,146 0.04Mental health encounters

Outpatient mental health visitsCrisis Mgt. Daily Census

12,429986

0.090.01

9,336983

0.070.01

7,945941

0.060.01

9,903970

0.070.01

Sub-total 13,415 0.09 10,319 0.07 8,886 0.07 10,873 0.08

Total encounters 941,388 6.59 945,731 6.74 1,031,724 7.66 972,948 6.98

Encounters as Rate Per Offender Per Encounters by TypeMonth

7.00 6.56

6.00

Dental Hygienists5.000.1% Outpatient mental health

visits4.00 Dentists

0.6% 1.0%

3.00


2.00 0.1%

Physicians1.00 1.2%

0.08 0.21 0.04 0.00 0.07 0.010.00

1 Mid-Level PractitionersNursing 3.1%94.0%

Physicians Mid-Level Practitioners

Nursing Dentists

Dental Hygienists Outpatient mental health visits


Medical Director's Report (Page 2):

March April May Qtly AverageMedical Inpatient Facilities

Average Daily Census 81.8 77.0 81.7 80.2Number of Admissions 340 309 225 291Average Length of Stay 6.6 7.7 10.6 8.3Number of Clinic Visits 6,388 3,787 3,756 4,644

Mental Health Inpatient FacilitiesAverage Daily Census 985.93 982.67 941.39 970.00DDP Census 727.77 723.30 704.87 718.65

Telemedicine Consults 10,617 6,675 5,103 7,465

Consent Item

Summary of CMHCC Joint Committee/ Work Group Activities

Correctional Managed Health Care

Joint Committee/Work Group Activity Summary

for September 16, 2020, CMHCC Meeting

The Correctional Managed Health Care Committee (CMHCC), through its overall management

strategy, utilizes a number of standing and ad hoc joint committees and work groups to examine,

review and monitor specific functional areas. The key characteristic of these committees and work

groups is that they are comprised of representatives of each of the partner agencies. They provide

opportunities for coordination of functional activities across the state. Many of these committees

and work groups are designed to insure communication and coordination of various aspects of the

statewide health care delivery system. These committees work to develop policies and procedures,

review specific evaluation and/or monitoring data and amend practices in order to increase the

effectiveness and efficiency of the program.

Many of these committees or work groups are considered to be medical review committees allowed

under Chapter 161, Subchapter D of the Texas Health and Safety code and their proceedings are

considered to be confidential and not subject to disclosure under the law.

This summary is intended to provide the CMHCC with a high-level overview of the ongoing work

activities of these workgroups.

Workgroup activity covered in this report includes:

System Leadership Council

Joint Policy and Procedure Committee

Joint Pharmacy and Therapeutics Committee

Joint Infection Control Committee

Joint Dental Work Group

Joint Mortality and Morbidity Committee

Joint Nursing Work Group

System Leadership Council

Chair: Dr. Owen Murray

Purpose: This group’s membership consists of discipline directors in medical, nursing, mental health,

dental and allied health care staff appointed by the Joint Medical Directors. This group is

charged with implementation of the CMHCC Quality Improvement/Quality Management

(QI/QM) Plan. The purpose of this plan is to provide a streamlined, integrated, clinically

driven state-of-the-art Quality Improvement Program, which adds value to the quality of

health care services provided to the Texas Department of Criminal Justice (TDCJ)

offenders. The plan demonstrates that quality will be consistently/continuously applied

and/or measured and will meet or exceed regulatory requirements. The CMHCC strongly

endorses and has administrative oversight for implementation of the plan. The agents of

the CMHCC and the TDCJ Health Services Division will demonstrate support and

participation for the plan. The committee meets on a quarterly basis.

Meeting Date: August 19, 2020

Key Activities:

I. Call to Order

II. Approval of Minutes

III. Reports from Champions/Discipline Directors

A. Access to Care – Dental Services

B. Access to Care – Mental Health Services

C. Access to Care-Nursing Services

D. Access to Care-Medical Staff

E. Sick Call Request Verification Audit (SCRVA)

IV. FY 2020 SLC Indicators

A. Dental: Total Open Reminders with Delay >60 days

B. Mental Health: Restrictions Audit

C. Nursing: Annual TB Screening

D. Support Services: Inpatient/Outpatient Physical Therapy

E. Clinical Administration: Missed Appointments (No Shows)

F. Joint Medical/Pharmacy: Hepatitis C

V. Standing Issues

A. CMHCC Updates

B. CMHC Pharmacy Report

C. Hospital Galveston Report

VI. Miscellaneous/Open Discussion Participants

A. ATC Accuracy Evaluation

B. Nurse Protocol Audits

C. Nursing QA Site Visit Audits

VII. Adjournment

Joint Policy and Procedure Committee

Co-Chair: Chris Black-Edwards, RN, BSN

Co-Chair: Carrie Culpepper, RN, FNP-C, MBA

Purpose: This group’s membership consists of clinicians, nurses, health care administrators and

dentists appointed by the Joint Medical Directors. This group is charged with the annual

review of all Correctional Managed Health Care (CMHC) policies and procedures. The

committee meets on a quarterly basis and one fourth of the manual is reviewed at each

of its quarterly meetings.

Meeting Date: July 9, 2020

Sub Committee Updates:

Dr. Guillermo Garcia of TTUHSC and Chair of the Joint Mental Health Working Group

has resigned from his position as Director of Psychiatry and Behavioral Health. Dr. Shirley

Marks will be replacing him in this role.

Committee Updates:

Michael (Mike) Jones, Director of Nursing Services, TTUHSC and the Policy and

Procedure (P&P) Committee Co-Chair has retired after 31 years of service. Ms. Carrie

Culpepper of TTUHSC will be filling in for Mr. Jones.

Committee Referrals:

Joint Mental Health Working Group – Shirley Marks, M.D.

THESE POLICIES ARE UP FOR REVIEW AND OPEN FOR RECOMMENDED CHANGES

DURING THIS QUARTER.

A-08.3 A-08.4* A-08.5* A-08.6* A-08.7* A-08.8 C-22.1 C-23.1 D-28.1 D-28.5

D-29.1 E-36.5 E-36.6 E-36.8 E-37.6 E-39.1 E-40.1 E-41.1 E-41.2* E-42.1

E-42.4 F-49.1 G-51.11* G51.12 G-52.1 G-53.1* G-53.3 G-54.1 H-60.3 H-61.1*

I-70.1* I-71.1* I-72.1 *Indicates Attachment(s) included in the policy.

THE FOLLOWING POLICIES HAVE BEEN SUBMITTED WITH CHANGES OR FOR

DISCUSSION:

POLICY # POLICY NAME SUBMITTED BY

E-36.1 Dental Treatment Levels of Care Manuel Hirsch

E-36.2 In Processing Offenders – Dental Examination,

Classification, Education & Treatment

Manuel Hirsch

G-52.4 Serious Mentally Ill – Sheltered Housing (SMI-SH) Shirley Marks

Adjournment

The Next Meeting is scheduled for October 8, 2020

Joint Pharmacy and Therapeutics Committee

Chair: Dr. Benjamin Leeah

Purpose: This group’s membership consists of physicians, nurses, clinicians, dentists and pharmacists appointed by the Joint Medical Directors. This group is charged with

developing and maintaining the statewide drug formulary, drug use policies and disease

management guidelines. This group also establishes policy regarding the evaluation,

selection, procurement, distribution, control, use and other matters related to medications

within the health care system. This group further serves to support educational efforts

directed toward the health care staff on matters related to medications and medication use.

Disease management guidelines are reviewed annually and updated as needed by the

CMHCC Joint Pharmacy and Therapeutics Committee. All changes to consensus

guidelines published by the Centers of Disease Control and Prevention and the National

Institutes of Health or other nationally recognized authorities are considered. In addition,

CMHCC Joint Pharmacy and Therapeutics Committee reviews adverse drug reaction

reports, drug recalls, non-formulary deferral reports and reports of medication errors.

Clinical pharmacists present reviews of drug classes to the committee for education and

consideration of new updates to the formulary. Clinical pharmacists also periodically

conduct medication usage evaluations. Finally, this group reviews and evaluates all

pharmacy and therapeutic policies and procedures annually. This group meets on a bi-

monthly basis.


I. Approval of the Minutes from the May 14, 2020 Meeting

II. Reports from Subcommittees

A. Carbamazepine – Dr. Penn

B. Diabetes – Dr. Agrawal

1. Opioid Discontinuation

2. Gout

C. Hypertension – Dr. Nguyen

D. Psychiatry – Dr. Patel

III. Monthly Reports

A. Adverse Drug Reaction Reports (none)

B. Pharmacy Clinical Activity Report

C. Drug Recalls (April 1 – July 1, 2020)

D. Non-Formulary Deferral Reports

1. UTMB Sector (April – June 2020)

2. Texas Tech Sector (April – May 2020)

E. Utilization Reports FY20 through May

1. HIV Utilization

2. HCV Utilization

3. HBV Utilization

4. Psychotropic Utilization

F. Quarterly Medication Error reports – 3rd Quarter FY20

1. UTMB Sector (report not available)

2. Texas Tech Sector

3. Pharmacy Dispensing Errors

G. Special Reports

1. Top 50 Medications by Cost and Volume – 3rd Quarter FY20

2. Top 10 Non-Formulary Medications by Cost and Volume – 3rd Quarter FY20

3. Pharmacy Diabetes Clinic Report 3rd Quarter FY20

a. UTMB Sector

b. Texas Tech Sector

4. Pharmacy Warfarin Clinic Reports – 3rd Quarter FY20

a. UTMB Sector

b. Texas Tech Sector

H. Policy Review Schedule

IV. Old Business (none)

V. New Business

A. Action Request

1. Clozapine MUE Data Collection Form

2. Probenecid Formulary Deletion

B. Category Reviews

1. Antihypertensive Agents

2. Psychotropic Agents

3. Topical Agents

C. MUE – Carbamazepine General MUE

D. FDA Medication Safety Advisories (none)

E. Manufacturer Shortages and Discontinuations

F. Policy and Procedure Revisions – Policies 40-10 through 75-30 due in November

1. KOP Medication Distribution Program (50-05)

VI. Miscellaneous

VII. Adjournment

Joint Infection Control Committee

Co-Chair: Carol Lynn Coglianese, MD

Co-Chair: Chris Black-Edwards, RN, BSN

Purpose: This group’s membership consists of physicians, nurses, clinicians, dentists and

pharmacist appointed by the Joint Medical Directors. This group is charged with

developing and promulgating policies and procedures for infection control prevention

and treatment. This group is charged with the annual review of all Correctional

Managed Health Care Infection Control Policies and meets on a quarterly basis.


Key Activities:

I. Standing Reports:

A. HIV – Hepatitis- Peggy Davis

B. MRSA & MSSA & Occupational Exposure – Latasha Hill

C. Syphilis – Regina InmonD. Tuberculosis – Mary Parker

E. SANE – Kate Williams

F. Peer Education- Dianna Langley

II. Old Business: None

New Business: None

These policies were up for review with no recommended changes this quarter

B-14.23 B-14.24 B-14.25 B-14.26 B-14.27

* Indicates Attachment(s) included in the policy.

The following policies have been submitted with changes or for discussion:

# POLICY # POLICY NAME SUBMITTED BY

1 B-14.5 Occupational Exposure Counseling and Testing for TDCJ and

Correctional Managed Health Care Employees Justin Robison

2 B-14.19 Disease Reporting Carol Lynn Coglianese

3 B-14.20 Standard Precautions Carol Lynn Coglianese

4 B-14.21 Transmission Based Precautions Carol Lynn Coglianese

5 B-14.22 Handwashing Carol Lynn Coglianese

III. Adjourn

Next Meeting: October 8, 2020

Joint Dental Work Group

Chair: Dr. Cecil Wood

Purpose: This group’s membership includes the TDCJ Director for the Office of Dental Quality

and Contract Compliance, the University of Texas Medical Branch (UTMB)

Correctional Managed Care (CMC) Dental Director and the Texas Tech University

Health Sciences Center (TTUHSC) CMC Dental Director. This group is charged with

the development of dental treatment and management guidelines, as well as the

development of dental initiatives. It reviews changes to the Dental Scope of Practice

Act and makes recommendations for policy changes as needed. Finally, this group also

reviews and makes recommendations to the CMHCC Joint Policy and Procedure

Committee on all dental policies and procedures.


I. Call to order

A. Minutes Confirmation-Review/Approval of Minutes from May 27, 2020 meeting.

II. Dental Policy Review

1. E-36.4 Dental Prosthodontic Services

2. E-36.5 Dental Utilization & Quality Review Committee

3. E-36.6 Periodontal Disease Program

4. E-36.7 Dental Clinic Operations Reporting

III. Dr. B. Horton

1. Discussed “Ramp Up” plan for re-opening dental clinics.

2. Ordering of PPE.

IV. Dr. M. Hirsch

1. Acceptance / Non acceptance of written responses.

2. Discussion of PPE samples provided by TDCJ Industry.

V. Dr. C. Wood – None.

VI. P. Myers, Dental Hygiene Program Manager

1. Reminder of need for high volume evacuation for ultrasound use in the future.

VII. Sector Updates – None at this time.

A. TDCJ

B. UTMB

C. TX Tech

VII. Round the Table

Next meeting: September 10, 2020

Policies scheduled for Review: Dental Comprehensive Treatment Plan E-36.8; Dental Health

Education & Promotion; Dental Health Record F-46.1 – Organization & Maintenance H-60.1.

Joint Mortality and Morbidity Committee

Co-Chair: Dr. Eidi Millington

Co-Chair: Dr. Olugbenga Ojo

Purpose: This group’s membership consists of physicians and nurses appointed by the Joint

Medical Directors. The group is charged with reviewing the clinical health records of

each offender death. The committee makes a determination as to whether or not a

referral to a peer review committee is indicated. This group meets on a monthly basis.

For the Three Months Ended May 2020:

There were 71 deaths reviewed by the Mortality and Morbidity Committee during the months of

March, April and May 2020. Of those 71 deaths, 1 was referred to peer review committees.

Joint Nursing Work Group

Chair: Kirk Abbott, MBA, BSN, RN

Purpose: This group’s membership includes the TDCJ Director of Nursing Administration, the

UTMB CMC Northern Geographical Service Area (GSA) Regional Chief Nursing

Officer, the UTMB CMC Southern GSA Regional Chief Nursing Officer and the

TTUHSC CMC Director of Nursing Services. This group is charged with the

development of nursing management guidelines and programs. It reviews changes to

the Nursing Scope of Practice Act for Registered Nurses and Licensed Vocational

Nurses and makes recommendations for policy/practice changes as needed. Finally,

this group also reviews and makes recommendations to the CMHCC Joint Policy

and Procedure Committee on all nursing policies and procedures.


Old Business

None

New Business

Establish Frequency for Ongoing Joint Nursing Work Group Morning

Meetings (to address COVID-19 Pandemic Management)

County Jail Intake Ramp Up

COVID-19 Policy Revisions Based on Revised CDC Guidance

o Updates to COVID Flowsheets

o Revisions to NoteBuilder Forms

Hurricane Laura Preparations

Adjournment

Next Meeting Date: August 31, 2020

Financial Report on

Correctional Managed Health Care

Quarterly Report

FY2020 Third Quarter

September 2019 – May 2020

Second Quarter Financial Report on Correctional Managed Health Care

Overview

➢ Pursuant to the FY2020-21 General Appropriations Act, Article V, Rider 43, 86th

Legislature, Regular Session 2019

➢ FY2020 TDCJ Correctional Managed Health Care Appropriations:

• Strategy C.1.8, Unit and Psychiatric Care, $317.9M

• Strategy C.1.9, Hospital and Clinical Care, $251.3M

• Strategy C.1.10, Pharmacy Care, $72.4M

Method of Finance Summary FY2020

HB 1, Article V, TDCJ Appropriations

C.1.8. Unit and Psychiatric Care 317,916,293$

C.1.9. Hospital and Clinic Care 251,343,853$

C.1.10. Pharmacy Care 72,440,252$

TOTAL 641,700,398$

Allocation to Universities

University of Texas Medical Branch



C.1.10. Pharmacy Care 58,472,430$

Subtotal UTMB 522,959,486$

Texas Tech University Health Sciences Center



C.1.10. Pharmacy Care 13,967,822$

Subtotal TTUHSC 118,740,912$

TOTAL TO UNIVERSITY PROVIDERS 641,700,398$

Allocation to Capital Budget

Expand Infirmary Capacity at Stiles Unit 3,000,000$

TOTAL ALLOCATED 644,700,398$

Population

➢ Overall offender service population has decreased 3.4% from FY2019

• Average daily census through 3rd quarter

▪ FY2019: 147,480

▪ FY2020: 142,500

➢ Offenders aged 55 or older population has increased 2.7% from FY2019

• Average daily census through 3rd quarter

▪ FY2019: 19,454

▪ FY2020: 19,981

• While comprising about 14.0% of the overall service population, these offenders

account for 48.3% of the hospitalization costs received to date.

➢ Mental health caseloads:

• FY2020 average number of psychiatric inpatients through 3rd quarter: 1,710

• FY2020 average number of psychiatric outpatients through 3rd quarter: 26,810

130,000

135,000

140,000

145,000

150,000

155,000

13,000

14,000

15,000

16,000

17,000

18,000

19,000

20,000

21,000

To

tal

Po

pu

lati

on

Off

end

ers

Ag

e 5

5+

CMHC Service Population

Offenders Age 55+

Total Population

Health Care Costs

➢ Total expenditures through 3rd quarter, FY2020: $578.5M

• Unit and Psychiatric Care expenses represent the majority of total health care costs -

$306.3M or 52.9% of total expenses

• Hospital and Clinical Care - $213.9M or 37.0% of total expenses

• Pharmacy Services - $58.3M or 10.1% of total expenses

▪ HIV related drugs: 29.7% of total drug costs

▪ Hepatitis C drug therapies: 29.9% of total drug costs

▪ Psychiatric drugs: 5.1% of total drug costs

▪ All other drug costs: 35.3% of total drug costs

➢ Cost per offender per day increased 5.1% from FY2019 to FY2020

• Cost per offender per day through 3rd quarter FY20

▪ FY2019: $14.10

▪ FY2020: $14.82

FY 16 FY17 FY18 FY194-Year

Average

FYTD 20

1st Qtr

FYTD 20

2nd Qtr

FYTD 20

3rd Qtr

Population

UTMB 116,828 116,574 118,737 117,987 117,531 116,288 115,730 114,356

TTUHSC 30,004 29,807 29,448 28,992 29,563 28,293 28,375 28,144

Total 146,832 146,381 148,185 146,979 147,094 144,581 144,105 142,500

Expenses

UTMB $523,473,857 $554,779,025 $589,220,522 $631,955,233 $574,857,159 $162,357,021 $322,692,765 $481,355,222

TTUHSC $118,262,289 $115,982,376 $118,282,720 $124,707,572 $119,308,739 $32,524,779 $64,549,380 $97,103,462

Total $641,736,146 $670,761,401 $707,503,242 $756,662,805 $694,165,898 $194,881,800 $387,242,145 $578,458,684

Cost/Day

UTMB $12.24 $13.04 $13.60 $14.67 $13.39 $15.34 $15.32 $15.36

TTUHSC $10.77 $10.66 $11.00 $11.78 $11.05 $12.63 $12.50 $12.59

Total $11.94 $12.55 $13.08 $14.10 $12.92 $14.81 $14.76 $14.82

Note: UTMB total expenses do not include the final Hospital Cost Reconciliations.

Documents

CORRECTIONAL MANAGED HEALTH CARE COMMITTEE …...Sep 16, 2020 · Dr. Owen Murray, UTMB CMC Offender Care Services recognized Dr. Susan Morris, Medical Director of Telemedicine who