1. UTMB CMC Employee Training
State Funding for the Texas Offender Population

2. Objectives
1. The employee will be able to describe the allocation of state funding for UTMB Correctional Managed Care.
2. The employee will be able to discuss appropriate and inappropriate utilization of state funding in accordance with Correctional Managed Health Care Policy A “Treatment of Injuries Incurred in the Line of Duty.” (Referred to as CMHC Policy A-02.2 throughout the rest of the training presentation.)

3. Objectives
3. The employee will be able to explain the disciplinary action
which will occur when misappropriation of state funds occurs.
4. The employee will sign an agreement, at the end of the
training, acknowledging their understanding of the course
intent and consequences of misappropriation of state
funding.

4. UTMB CMC Contracts
In 1993, UTMB began a contractual relationship with Texas Dept. of Criminal Justice (TDCJ) by providing medical, dental and mental health services for 126,000 patients or 80% of the state’s offender population.
In 1994, CMC was awarded the Texas Youth Commission (TYC, now known as Texas Juvenile Justice Dept.) health care contract.
In 1996, CMC was selected to pilot a program with the Federal Bureau of Prisons in Beaumont, Texas. In 1997, CMC was awarded the contract.
TDCJ & TJJD contracts are funded via State appropriations. Federal contracts are funded by the United States government.

5. Allocation of Funding
The employee will be able to describe the allocation of state funding for UTMB Correctional Managed Care “UTMB CMC”.
How are funds obtained and distributed?
TDCJ requests funding via Legislative Appropriation Request (LAR).
Senate Finance Committee and House Appropriations Committee meet and decide on a specific budget amount biennially.

6. TDCJ Allocation of Funding Diagram
Funds are appropriated to TDCJ
TDCJ contracts with UTMB and Texas Tech
TDCJ distributes funds on a quarterly basis
Funds are distributed to UTMB CMC services

7. Allocation of Funding UTMB CMC Services
CMC service lines include, but are not limited to, the following:
Administration
Clinical Education
Clinical Support
Dental
Finance & Contracting
Hospital Galveston & Free World
Human Resources
Medical
Mental Health
Nursing
Pharmacy
Risk Management
Utilization Management
Medical Warehouse/Purchasing
The following are line items budgeted within the UTMB CMC service lines: agency, benefits, distributions, equipment, medications, overtime and salaries.

8. Allocation of Funding – TDCJ Contract Conclusion
Funding is generated from the state level and distributed accordingly to individual departments. Utilization of the budget is monitored closely by UTMB and TDCJ.
The process of monitoring the budget is critical in determining future financial goals.
In conclusion, funding is distributed from the state budget and given to UTMB CMC via TDCJ. All funds are for offender health care and not the routine health care of UTMB CMC and/or TDCJ employees.

9. Appropriate Utilization of Funding
The employee will be able to discuss appropriate and inappropriate utilization of state funding in accordance with Correctional Managed Health Care Policy A-02.2
Purpose:
To establish responsibilities of the health care staff in the treatment of injuries incurred by employees in the line of duty. Emergent/Urgent care will be provided to both UTMB CMC and TDCJ employees.

10. CMHC Policy A-02.2 Treatment of Injuries Incurred in the Line of Duty
Definitions:
Emergent or Urgent Situations – For purposes of this policy, “emergent” or “urgent” situations are cases of injury incurred in the line of duty or sudden onset of serious illness occurring while at work in which there is a need for medical intervention and stabilization. Intervention and stabilization may require utilization of State resources (e.g. laboratory or x-ray services) for conditions including, but not exclusive of, broken bones, dislocations, blood sugar fluctuations, chest pain, occupational exposures, heat illness, etc.

11. CMHC Policy A-02.2 Treatment of Injuries Incurred in the Line of Duty Continued
UTMB CMC health care providers are responsible for providing necessary medical attention to all TDCJ and CMC employees who are injured in the performance of their duties.
Health care staff is required to respond to urgent and emergent situations, as necessary, within the scope of their professional discipline.
If you are not certain if the situation is an emergent or urgent condition, consult your Nurse Manager, Medical Provider or their designee on unit the for guidance.

12. CMHC Policy A-02.2 Treatment of Injuries Incurred in the Line of Duty Continued
As a UTMB CMC health care employee, you are not authorized to provide non-emergent/urgent care to a UTMB CMC, TDCJ, or another TDCJ contract employee.
State resources are not to be used for injuries not incurred in the line of duty or for illnesses not requiring emergent or urgent intervention or stabilization.

13. CMHC Policy A-02.2 Treatment of Injuries Incurred in the Line of Duty Continued
Health care staff MAY NOT fill prescriptions or provide routine lab and x-ray services for UTMB CMC, TDCJ, or TDCJ contract employees.
Health care staff is not permitted to provide routine or follow-up care for chronic illnesses for above mentioned employees.
Health care staff is not allowed to take or administer any medication to above mentioned employees except in the circumstances of urgent or emergent care.
At no time is any UTMB employee allowed to take medications, equipment, state resources, or any item belonging the state off the unit for personal use.

14. Is this an emergent/urgent situation?
Test Your Knowledge
Is this an emergent/urgent situation?
A TDCJ correctional officer presents to your clinic requesting medical care. He states that he burned his hand while supervising offenders in the kitchen.
Yes No
You have received a call to medical to respond to the training academy for an officer who is having tightness in his chest. The academy is on state property adjacent to the unit but several yards away. Do you respond or not?
Yes No

15. Answers
Yes
This is an Emergent situation because the officer has a severe burn to
his hand.
Even though the Academy is not attached to your unit, it is still on
state property and you must render Emergent Care in accordance with
CMHC Policy A-02.2

16. Test Your Knowledge
A co-worker asks if you will check her throat because it hurts to swallow. You notice it is red with exudate and will require a throat culture. In accordance with CMHC policy A-02.2 you should:
1. Help out your peer and complete the swab.
2. Refer her to the Unit Provider for testing.
3. Give her a Cold Buster and Tylenol out of offender stock.
4. Explain to peer you cannot assess and treat non-emergent/urgent conditions based on CMHC Policy A-02.2.

17. Answer
#4. Explain to peer you cannot assess and treat non-emergent/urgent conditions based on CMHC Policy A You should inform her to report to her supervisor. The supervisor will use their discretion to decide if the situation warrants the employee to remain at work or be sent home to seek further treatment from the employee’s personal medical provider.

18. Test Your Knowledge
While in the clinic, you receive a call from the warden’s secretary. She tells you the warden is clutching his chest and complaining of severe pain. He is diaphoretic and short of breath. She asks you to come and help him. According to Policy CMHC A-02.2, should you respond with emergency equipment and begin stabilization until EMS arrives?
Yes No

19. Test Your Knowledge YES
You should tell the secretary to call 911 immediately and let her know you are on your way. Conduct necessary life saving measures to stabilize the patient until EMS arrives and takes over care.
Remember – If you are non-licensed personnel, you are still required to respond to emergencies when your assistance is needed. Work within your professional scope of practice!

20. Test Your Knowledge
While eating lunch, you notice that you have a toothache. You return to the clinic and ask the unit dentist to examine your tooth and request pain medication to help you get through the rest of your shift. The dentist numbed your mouth and said you should be fine until you see your dentist.
Is this misappropriation of State Funds according to CMHC Policy
A-02.2?
Yes No

21. Answer
YES
According to CMHC Policy A-02.2, this is not considered to be an Emergent/Urgent situation and is misappropriation of State funds. You should inform your supervisor of your dental complaint. The supervisor will use their discretion to decide if the situation warrants the employee to remain at work or be sent home to seek further treatment from their personal dental provider.

22. Test Your Knowledge
You overhear a co-worker talking to the provider requesting a prescription for her daughter’s albuterol inhaler because it will save her a $35.00 office co-pay. According to CMHC Policy A-02.2, what is your responsibility?
Provide an inhaler from the offender medication stock at the provider’s request to save the co-worker money.
Even though you know it is a policy violation, you give the pharmacy keys to the to the provider and allow him/her access to obtain the inhaler because you don’t want to appear that you are not a “team player.”
Report the situation to the Nurse Manager for guidance.

23. Answer
3. Report the situation to your Nurse Manager for guidance. This is in direct violation of CMHC Policy A It is the responsibility of UTMB CMC Employees to act in accordance with policies and report any violation.

24. Test Your Knowledge
You are drawing blood from an offender and accidently stick your finger with a contaminated needle. According to CMHC Policy A-02.2 and CMHC Policy B.14.5, you are authorized to receive immediate treatment, counseling and then follow up care will be required from your personal Provider.
True
False

25. Answer
True
According to CMHC Policy A-02.2, employees that receive injuries on the job will be given immediate medical attention. If an occupational exposure occurs, the CMHC Policy B.14.5 will be followed and the employee should:
Wash off body fluid and get first aid ASAP.
Report to the medical department for evaluation of the exposure.
Treatment to prevent HIV should be started within a few hours after an exposure if it is needed.
Remove and replace contaminated clothing.
Report to the supervisor and CID nurse.
Obtain a baseline blood test within 10 days after the exposure (for proof of eligibility for Workers Compensation benefits).

26. Documenting Treatment of TDCJ Employee Job Related Injury
Documentation of a TDCJ employee job related injury must be placed on a clinic note (HSM-1) labeled “CONFIDENTIAL MEDICAL INFORMATION” and forwarded to the Unit TDCJ Human Resources Representative. Clinic notes, laboratory work, or x-ray results shall not remain on the Unit.

27. Remember:
In accordance with CMHC Policy A-02.2 and CMHC Policy B.14.5, Treatment of Injuries Incurred in the Line of Duty –
All injuries incurred in the line of duty by employees of UTMB CMC and TDCJ should be initially evaluated and treated by facility health care staff.
Follow-up evaluation and treatment of employee’s injuries, if necessary, will be provided by the employee’s private health care provider.

28. Remember:
According to CMHC Policy A-02.2, Providing medical treatment for UTMB CMC and TDCJ employees includes but not limited to medication distribution, x-rays, and lab services is strictly prohibited unless the condition is clearly defined as an emergent or urgent situation.

29. Misappropriation & Discipline
The employee will be able to explain the disciplinary action which will occur when misappropriation of state funds occurs.
Providing health care to UTMB CMC and TDCJ employees is not permitted unless the injury occurred in the line of duty or the illness is emergent requiring immediate intervention and/or stabilization. Writing prescriptions, administering injections, distributing medications, providing lab and x-ray services is not allowed.
UTMB CMC has zero tolerance for the misuse and/or abuse of state allocated resources. Employees engaging in the misuse of state resources will receive disciplinary action which may include termination.

30. Discipline, Dismissal and Appeal for Classified Employees – IHOP Policy
Unacceptable Conduct
All employees are expected to maintain standards of conduct suitable and acceptable to the work environment. Disciplinary action, including dismissal, may be imposed for unacceptable conduct. Examples of unacceptable conduct include, but are not limited to:
7. abuse or waste of tools, equipment, fixtures, property, supplies, time, or goods of the institution;
13. theft, dishonesty, or unauthorized use of institutional property, including records and confidential information.

31. Thank You!
As an employee of UTMB CMC it is required that you understand and comply with all mandatory training courses as they relate to policy. If you have further questions regarding the course you have just taken, please consult your immediate supervisor.

32. The End
This concludes our “State Funding for the Texas Offender Population” program. You have successfully completed this course! In order to receive your Contact Hours for this course, please continue to the next slide.

33. Congratulations!!! Return to the CLP and complete the
Evaluation and Test for this course.
See how on the next slide.
REMEMBER: In order to complete the Test, you will need the Pass Key # from one of the following sources –
The enrollment sent to your webmail address,
The Pass Key list in your NEO packet, OR…
Your classroom Facilitator.
Continue to next slide

34. CLP Completion Instructions
Sign in the to CLP
Enroll in the course
Complete these sections –
“View The Course”
“Evaluation”
“Test”
Once you have completed the above items, the course will show up in your “My Transcript” folder in the CLP.
You may print your Certificate from the “My Transcript” folder.
Continue to next slide

35. CLP Completion Instructions
Find the “State Funding for the Texas Offender Population” course.
Look to the right, in the Certificate column.
Click on “Print Transcript.”
Continue to next slide

36. CLP Completion Instructions
Give your printed Certificate to your Supervisor.
It will be kept in your personnel file on your Facility of Assignment.