An employee publication of the Texas Department of Criminal Justice
June 2024
Estelle Unit Emergency Department and Mobile Medical Provides Compassionate and Timely Care
by Mike Jones
An alarm blares in the Estelle Unit Emergency Room. In rushes an inmate with a history of diabetes and several other underlying medical conditions. His blood sugar is a concern, but a more immediate issue takes center stage: a large blood blister on his foot burst.
Registered Nurse Bryan Hancock, a familiar face at Estelle for years, wastes no time. He quickly assesses the inmate’s vitals and begins stabilizing his condition while treating the infected blister. Relief washes over the inmate as he expresses his gratitude for being housed near the new Emergency Room (ER). Its proximity likely made a significant difference in his timely treatment.
The Estelle Unit ER, established in February 2023, operates 24/7 to serve not only its own population, but also inmates from eight other units: Byrd, Ellis, Ferguson, Goree, Huntsville, Holliday, Wainwright, and Wynne.
To provide better medical services for incarcerated individuals, the Texas Department of Criminal Justice (TDCJ) collaborated with the University of Texas Medical Branch (UTMB) to create the Estelle ER. This partnership allows both organizations to deliver high-quality, 24/7 urgent and emergency care to those in TDCJ’s custody.
“The creation of the Estelle ER and our joint efforts to expand services across units is a significant accomplishment for the TDCJ and UTMB,” said Marjorie Cisneros, associate vice president of Inpatient Operations at UTMB. “This collaboration demonstrates the power of working together to achieve more than either agency could alone. It’s a testament to the synergy and combined effort that led to innovative new services for the units we serve. I’m incredibly proud of everyone involved in making this a success.”
The Estelle Unit ER delivers not only critical medical care, but also an extra layer of security by minimizing the need to transport inmates to free-world hospitals. Deputy director of the TDCJ Health Services Division, Chris Black-Edwards, explained the advantage, “The Estelle ER allows us to treat medical emergencies more swiftly and reduce the number of inmates transported outside the system.”
Black-Edwards highlighted the time saved compared to using an ambulance, “An inmate experiencing a crisis can be transported by a TDCJ van directly to Estelle, ensuring a quicker and more secure response. Free-world ambulances face additional security protocols upon arrival and departure, adding crucial minutes to the transport time.”
Even after hours, correctional officers assigned to the housing areas are trained to assist an ailing or injured inmate by transporting them to the unit’s medical area and setting up a telehealth conference. The Estelle ER remains fully staffed with medical professionals, ensuring a doctor is always on-call or physically present on the unit. This approach allows the TDCJ to fulfill its dual objective: delivering exceptional medical care for inmates while prioritizing public safety.
With over 20 years of correctional clinical experience, Jamie Williams-Collins, senior business manager with UTMB, leads the Emergency Room operations along with Dr. Co Nguyen. With this new emergency room she said, “Inmate access to timely and urgent care has been significantly improved.”
The Estelle Unit
Left to right: Dr. Margarta Hammeke, Envision Emergency Department Physician; Dr. Co Nguyen, Estelle Medical Director and Shelly Hanson Miller, Estelle Cluster Nurse Manager.
The Estelle Unit transcends its reputation as a maximum-security prison. While it houses a general population, it also specializes in providing comprehensive medical and ophthalmic care for inmates across the state.
Estelle goes further, providing specialized care for a diverse population. This includes geriatric inmates, those with visual or hearing impairments, diabetic patients, and individuals with chronic illnesses. As a dedicated dialysis treatment facility, it ensures further support for those in need.
Warden Michael Britt, who began his career at Estelle in 1995, acknowledged the unique challenges of leading such a multifaceted facility. His dedication to both inmates and staff is readily apparent.
A recent example? During his daily operations, Britt took a moment to personally guide a disoriented blind inmate, demonstrating the unit’s commitment to compassionate care. This act embodies the spirit of a typical day at Estelle – a place where security and specialized care coexist.
Mobile Medical Healthcare
While stepping up to deliver emergency medical care, the TDCJ along with UTMB are also improving their ability to better provide diagnostic and preventative medical services.
Before February 2023, inmates requiring an MRI, mammogram, or specialized care faced a significant hurdle. They, along with all their belongings, would travel for days to units with the necessary medical equipment or to Hospital Galveston. This involved overnight stays in unfamiliar units, making annual mammograms, particularly crucial for women over 50, a daunting prospect. Consequently, many inmates neglected this vital healthcare.
Now, the TDCJ and UTMB bring that care to the inmate. Mobile MRI and mammogram units eliminate the need for risky off-site transport, enhancing security for everyone involved. This convenience also removes the burden and anxiety of travel, encouraging inmates to prioritize preventative and diagnostic care.
An alarm blares in the Estelle Unit Emergency Room. In rushes an inmate with a history of diabetes and several other underlying medical conditions. His blood sugar is a concern, but a more immediate issue takes center stage: a large blood blister on his foot burst.