To facilitate inmate health care, in 1994 the State's prison population was divided into east and west regions. UTMB contracted with TDCJ to streamline health care for the eastern inmate population, which composes approximately 80 percent of the State's inmate population. Currently, UTMB's Correctional Managed Care (CMC) system services all the State's inmates with medical, dental, and mental health treatment. The development of the CMC was driven by an increase in inmate population, the need for heightened security, and a lawsuit against the State that required an upgrade in health care for inmates. The CMC provides both emergency and nonemergency transportation for thousands of inmates who need health care services. Regional EMS officers station a portion of TDCJ's 16 ambulances in addition to 3 ambulatory transport vans. If any of these vehicles are not available for a transport request, outside ambulance services are obtained. A large part of the ambulance staff's responsibility is to transport inmates to and from the TDCJ Hospital in Galveston. If a patient is in a facility located far from the Galveston hospital and needs immediate assistance, a local hospital will be used. After being stabilized, however, the patient is usually sent to Galveston. This article describes the facilities at the TDCJ Hospital in Galveston, which is designed to function as a secure prison unit while medical services are being provided. Management of the approximately 12,000 yearly transports and the ambulance fleet is the job of EMS dispatchers, who are charged with finding an ambulance to respond to service calls from prison staff. A minimum of two dispatchers are on duty around the clock. In addition to providing transportation to the hospital, the CMC provides a mini-emergency room at each prison, which is staffed by a physician and nurses.