WILLIAMSON COUNTY, Texas - There is a place we are all guaranteed healthcare by law. It's called jail. Criminals know their way around the system and look for chances to get treatment on the taxpayers' dime. It's up to jail staff to keep inmates healthy while keeping costs down. FOX 7's Noelle Newton explores the balancing act in this week’s Crime Watch.
"We have folks who show up who need dialysis three times a week, wound care, some people who may be missing limbs," said Douglas Wheless, Williamson County Jail Medical Supervisor.
Cancer, HIV and diabetes are among the ailments currently being treated. One offender is in a nursing home recovering from years of alcohol abuse at the cost of $250 a day.
"A lot of them get better treatment here than on the outside, better than they can ever afford on the outside," said Williamson County Sheriff’s Office Captain Kathleen Pokluda.
"The burden is totally on the staff to do everything right because we know there is a looming lawsuit," said Wheless.
Last year, the sheriff's office spent more than $568,000 on total in-house medical care and another $528,000 for outside medical care.
Two inmates hit the indigent health care act cap of $30,000. In actuality, their bills exceeded $150,000 and $180,000, but the hospitals absorbed excess costs.
In the much larger Travis County Jail, medical services added up to more than $6.4 million.
The most expensive patient's bill was $67,000, followed by a person who cost the county $60,000.
In Hays County, health care program services for the 2015 fiscal year were over one million dollars which is slightly higher than Williamson County's bill.
Most medical treatment cannot be helped as violent criminals must be locked away, but there are those who attempt to milk the system, turning themselves in for warrants just when they happen to need a doctor.
"When they're pregnant that's really big. They may have to have some kind of a surgery of some kind, back surgery, shoulder surgery," said Pokluda. "We've had them come out and say 'I don't have insurance.'"
Captain Kathleen Pokluda recalls a case where a woman came into the lobby in active labor, "She's turning herself in on a traffic ticket, but it's a Travis County traffic ticket, so we call EMS for her and her mother who was with her at the time said, 'no we'll just take her to Travis County.'"
If the inmate is a non-violent offender and has a medical condition that becomes a financial burden, Pokluda can ask a judge to release the person on certain conditions.
"They put them on a monitor, they have to report in, they take drug tests, things like that," said Pokluda.
For those who must stay and are insured Williamson County Sheriff’s Office Financial Manager Kurt Showalter has established co-pays.
Showalter says the program generates $40,000 a year and has eliminated frivolous doctor visits.
"We really do feel strongly that folks are paying for this. They're paying for their healthcare," said Showalter.
He says he cut the pharmacy in half by trading pill bottles for individually-sealed blister packs.
"Any pill that has not been popped from the pack we return for full credit," said Showalter.
Showalter is in the budget process again trying to trim whatever he can with taxpayers in mind.
"I think people are out there working hard, teaching school, laying asphalt. We owe it to them to get the best price," he said.
Prescription drugs are the second highest expense after general medical care. Psychiatric treatment is next, followed by medical equipment and dental care.