Curry County Sheriff John Bishop says he's sitting on a time bomb.
On any given day, an inmate could present themselves with a medical problem that requires more than a Band-Aid or aspirin.
"What if we get a woman who's arrested and pregnant and has complications?" Bishop said. "Or the people with sleep apnea machines? We've had a couple people brought to jail with wheelchairs.
Oregon's counties, including cash-strapped Curry County, are paying the bills for often costly health care for inmates. Even if inmates have private health insurance at the time of their arrest, that coverage ends as soon as they are incarcerated
Officials are looking to the Oregon Legislature to remove that burden by requiring insurance companies to at least continue paying for inmate's care until they've been convicted.
"And you want to talk about mental health - the psychotropic drugs we have to give some of these people are hugely expensive," Bishop said. "One inmate was running about $5,000 a month - just in medication. And we are required by law - no ifs ands or buts - to provide that. And if we don't, I get sued, which means the county gets sued."
He estimates 65 to 70 percent of the jail population is on some form of medication - "from Prilosec to psychotropics," Bishop said.
House Bill 4110
At issue is not only the costs the inmates incur, but when they take effect.
House Bill 4110 hopes to address that and force insurance companies - and not just private firms but the Veterans Administration, Oregon Health Plan and Medicaid - to continue insuring the individual until they are remanded to jail or prison.
Bishop is particularly galled that the Veterans Administration cuts off insurance to people before they are convicted of crimes.
"I am appalled," Bishop said. "With all the sacrifices they've done our government will not pay their medical expenses if they get arrested? It's just wrong to me."
He and other sheriffs have testified on House Bill 4110, hoping for a change that will close the insurance loophole.
"Insurance should not stop until you're convicted," Bishop said. "I think when they put this law in the Constitution, they were only looking at people who were convicted and required to stay in jail a long time and we were required to take care of them. What they didn't take into account is that two-thirds of those in jail are presentenced; they haven't been convicted."
And those inmates can rack up a bill.
Years ago, an inmate had a heart attack, resulting in procedures that cost the county $80,000, Bishop said. The county was flush with money in those days, and paid for the services from its contingency funds. Those are long gone.
"If we get another big one like that, we'll end up laying people off to pay for that," he said.
Bishop crosses his fingers that he doesn't get someone needing dialysis, where treatment runs in the thousands each month.
There are insurance programs to help counties pay for such events, Bishop said.
"The insurance is more expensive, and it only covers the major stuff," he said. "Some years it would pay for itself, but most years it is too expensive. We looked at it last year and it just didn't pencil out."
Of note is Glenn Burkhow Jr., who has been in the Curry County Jail since January 2013, accused of attempted murder in the assault of Russell Peters of Port Orford.
"He's a good example," Bishop said. "It's been a year now, he's still going through the hearings, and while his compadre (Allen Vonnevin) has been convicted, he hasn't been convicted."
Inmates get a lot of procedures done - and they're all paid for by taxpayers.
Bishop said his office spends about $100,000 a year in medical expenses, of which 40 percent is for prescription medicine.
"By the time you budget for doctors, general services, hospital stays, medical labs, prescriptions - that doesn't even include the cost to send two deputies with an inmate to the doctor, and usually on overtime," Bishop said.
Deals with pharmaceutical companies, a local doctor, retired nurse Georgeanne Green, Curry General Hospital and Cal-Ore Life Flight, have cut those costs to half of what they were six years ago when Bishop took office.
"We've done just about everything we can to get by at minimal costs, and it's still $100,000 a year; it's just the cost of doing business," Bishop said. "And it's a statewide problem. A lot of people don't think about it."
He's grateful for Green, a retired nurse who works on an as-need basis providing basic medical care to inmates.
"With Georgeanne here it has saved us from taking so many inmates to the hospital," Bishop said. "We've saved a lot of money that way. The problem will be when she quits, we may not find anyone else to do that, and our costs will skyrocket."
Bishop said he could not discuss details of any prisoner's medical care, citing HIPPA laws.
But he did say Burkhow's "playing the game," threatening to sue the county because the jail isn't up to federal standards and, while he's getting the medical care he needs, it isn't all he wants.
"What he wants and what he needs and what we're required to give him are obviously different," Bishop said. "We had an inmate come in with a blown-out knee and they want us to send them to surgery. Or they've been in a fight and broken their hand and we have to pay for that. We're knocking on wood right now that we haven't had a huge expense."
House Bill 4110 is headed to the Joint Budget Committee after having passed the House Health Care and Rules committees. From there, it should head to the House floor.