TMC PULSE

t m c » p u l s e | a p r i l 2 0 1 7 26 "Three years later they come back and the HIV isn't controlled because they didn't take their meds," he said. "Now all of a sudden what was maybe a $500-a-month regime is now $5,000." Although horrified, Murray gets it. "Am I really going to be worried about following up with mental health or going to the doctor for my HIV care when I don't have a home, I don't have a job, and I have no food?" Controlling hepatitis C is even more chal- lenging, with its prevalence considerably higher in prisons compared to the free world. "Curative treatment runs about $80,000, but if you do the math, that becomes a significant economic challenge for the state," Murray said. "Then there's the ethical question of whether every inmate should get that kind of treatment. And then there's the public health concern that we've got all these high-risk groups, known patients, and we could actually begin to eradi- cate the disease if we really had an aggressive treatment program in prisons and jails. It's a clinical issue and a public health issue, but, ultimately, it's a cost issue." While the program has restrained costs in every corner it could find, ongoing funding is essential. The RMF is in dire need of new dialysis chairs, the telehealth network could benefit from higher bandwidth and updated technology, and staff need their salaries. Even in the pharmacy, where achievements in automation and effi- ciency feel futuristic, the most proficient tool for the simple yet critical job of peeling labels off returned blister packs turned out to be hands. "We try to be judicious and respectful of the fact that there's not an infinite amount of dollars out there to take care of these patients, yet we're going to do what's necessary in terms of a reasonable clinical level of care and expect a reasonable clinical outcome," Murray said. "We've looked at every aspect of our care provision and our health system and are always looking for ways to improve things and cut costs, but eventually, you kind of run out of new tricks." An alternate ending Thirteen miles south of the Estelle Unit is the Huntsville Unit, nicknamed "the Walls." It is the oldest prison in the state and home to the execution chamber, the busiest in the nation. Like all prisons in the area, it is built with a ruddy red brick, which stands in stark contrast to the glistening brass railings guarding the entrance. As the legend goes, these railings have been polished daily since the prison's opening in 1849. Each day, there is a release. Men from the Estelle Unit and other regional facilities serve their time, and when they make parole they are transferred to the Walls. Across the narrow street, mothers, fathers, lovers, sons, cousins and friends sit on picnic benches under trees, waiting. If an inmate is lucky, he will be met there with a handshake or an embrace. He may feel grateful, even blessed that he didn't leave in a wooden box on its way to Boot Hill, where unclaimed prisoners lie buried. Or he might scan the crowd, hold his breath until he is absolutely sure, then walk to the Greyhound station alone. He will worry about housing and food, his past and his future. And if he is ill, he will worry about how to manage his health—today and every day— in the free world. * Statistics collected from the 2011-12 National Inmate Survey published by the U.S. Department of Justice CITY PARK 1,462 - 2,600 SF MODEL HOME: 12102 Paseo Place Houston, TX 77047 MINUTES from the MEDICAL CENTER, RELIANT CENTER and the GALLERIA AREA! Call our Online Sales Counselor at 281-853-8418 for more information or to make an appointment! drhorton.com/houston Why rent when you can own? Prices, plans, features, options and co-broke are subject to change without notice. Additional restrictions may apply. Square footages are approximate. Move-In Package with home purchase! Mention this ad to receive a From the $190s

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