Kimbrough, UTMB Officials Testify About TYC Care

AUSTIN Special Master Jay Kimbrough, appointed to oversee the investigation of the troubled Texas Youth Commission (TYC), testified Wednesday -- explaining that he was trying to keep representatives and senators in the loop on key issues and methods involved in the investigation and oversight of the state’s juvenile justice system.

The topic during this latest hearing was the often convoluted medical care provided (or not provided) to children in custody of the state.

Kimbrough appeared before the joint committee alongside Dr. Ben Raimer and Chief Administrative Officer John Allen of the University of Texas Medical Branch at Galveston (UTMB).

UTMB and Texas Tech hold contracts for providing medical care for the estimated 5,000 juveniles incarcerated in various Texas Youth Commission facilities across the state. Tech handles the western part of the state while UTMB provides care for the eastern part.

Kimbrough described individual cases where he felt the system had failed -- including one situation where a patient with a broken foot had not gotten an x-ray in a reasonable time frame and another where a patient missed doses of a critical anti-convulsive medication.

“It doesn’t sound right. It doesn’t look right. It doesn’t work right,” Kimbrough said.

Dr. Raimer told the committee that UTMB felt handling the medical care for TYC was “a liability” for his institution and that the renowned hospital had sought to not renew the contract. Raimer admitted that UTMB would still prefer to get out of the business of providing care for TYC patients if it was possible. Raimer said the Legislative Budget Board had asked UTMB to continue the contract.

Raimer noted that UTMB only handles hospitalizing and providing medical care for children in the system, and that psychiatric and psychological care is contracted out to individual practitioners who are often paid to drive to the various facilities from their offices -- creating higher expenses and often resulting in multiple doctors treating a single individual. Raimer said child psychiatrists are often paid $225 per hour.

Raimer said that in one month at TYC’s Corsicana unit, which houses some 200 juveniles, there were over 11,000 ‘pill window encounters’ -- instances where children are receiving medications prescribed by visiting physicians or psychologists. He said at such a rate, a high number of medications had to be kept on hand at each facility -- resulting in further expenses and a risky situation should someone get access. Raimer also pointed out that the turnover rate among nurses in TYC facilities was 32 percent -- an extreme figure for any industry.

Committee Chair Sen. John Whitmire, D-Houston, expressed dismay that neither the commission’s board nor its administrators had cited the need for more resources while before Senate or House appropriations bodies.

Whitmire at one point held one hand to the side of his head and said, "What a mess…"

Speaker Pro Tempore of the Texas House Sylvester Turner, D-Houston, agreed that the medical care side of the juvenile system was just one further instance of an agency that is "dysfunctional."

Turner said he feared that Texas was "warehousing kids and not treating these kids."

Turner said the system has grown from 1,000 children in its custody to 5,000.

"We have grown TYC to the point that it is dysfunctional," Turner said. "It needs to be significantly downsized."

Testimony continued into the evening with State Auditor John Keel and John Moriarty of the Texas Department of Criminal Justice's Office of the Inspector General scheduled.