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Corrections health care and plan for in‑house long‑term acute care cited as major driver of budget growth
Summary
GDC officials told lawmakers that higher offender counts, hospital claims, pharmacy costs and long‑term acute care needs are increasing medical spending; the budget includes electronic health records and funding to bring long‑term acute care behind prison walls.
Commissioner Tyrone Oliver and department health leaders told the appropriations subcommittee that increases in offender population and the costs of off‑site acute care are driving requests for additional health‑care funding.
The department said it transitioned physical‑health providers on July 1, 2024, and that despite that transition it is experiencing rising costs for physical health, pharmacy, mental health and dental services tied largely to population increases. "GDC and Centurion have worked diligently to reduce hospital length of stay, reducing claims expense," the commissioner said, noting that claims expense growth can trigger a risk‑share mechanism in the vendor contract.
Key health‑care proposals: - Electronic health records (EHR): The presentation showed a line item to support the department maintaining its own electronic health records to avoid future vendor lock‑in; the slide cited $15,000,000 in the amended FY25 line and a smaller FY26 figure shown on the slide (presentation text showed $146,000 for FY26 in that line item; the department said the funding would allow the state to maintain its own records and ease future transitions between health vendors). - Long‑term acute care (LTAC) unit behind the wire: The department requested capital and operating funding to establish a long‑term acute‑care unit within state facilities, which it expects would reduce off‑site claims expense and the need to staff hospital posts; a FY26 slide cited $6.2 million (and related capital outlay references) as part of that plan. The department said it currently spends roughly $2,000 per day in claims for off‑site acute care and that about 20 patients are in LTAC settings on any given day.
Committee questions: Lawmakers asked how long inmates stay in LTAC and how many patients are currently in those settings; health leadership said stays vary widely (weeks to years), the longest current item cited was about three years and the daily census in LTAC settings was around 20 at the time of testimony. Committee members also requested an itemized per‑inmate per‑day breakdown of current contract spending and a clearer split between population‑driven costs and contractual increases.
Follow up: The department agreed to provide a more detailed breakdown of health‑care spending per inmate day and the projected savings timelines for bringing LTAC services behind the wire.
