A recent ruling by the Oklahoma Supreme Court could be financially ruinous for counties, which were ruled to be “primarily liable” for the cost of treating an inmate’s pre-existing illness or injury.

District 1 Commissioner Gene Wallace said the number of inmates in Muskogee County/City Detention Facility who have pre-existing illnesses is significant. Wallace said the cost of providing health care to those individuals alone is huge.

At least one state lawmaker vowed to reverse the ruling, which was issued Dec. 18 in an unpublished opinion. Sen. Owen Laughlin, R-Woodward, filed a bill in response to the decision.

“This court ruling could literally bankrupt some county governments, especially in rural areas like my district,” Laughlin said. “My bill will make it clear that an inmate in custody at a county jail is responsible for the cost of his medical care for pre-existing conditions or self-inflicted injuries,”

Muskogee County Sheriff Charles Pearson said the ruling “is going to sink us.”

“We have several inmates with AIDS, several others who are HIV positive, and many more who are suffering from the effects of meth use,” Pearson said. “A lot of these people have had no health care before they arrive here. I don’t know how the Supreme Court can put that burden (of paying to treat an inmate’s existing illnesses and injuries) on the counties.”

The case decided last week began as an attempt by HCA Health Services of Oklahoma to collect more than $2.25 million for medical care provided to inmates of the Oklahoma County Jail. County officials declined to pay, citing prisoners’ pre-existing illnesses and injuries to justify nonpayment.

HCA officials argued that because the county has a constitutional and statutory duty to provide health care to its inmates, it must also bear the burden of paying for that care. The trial court agreed and issued an interim decision. Oklahoma County appealed, and the high court affirmed the lower court’s ruling.

In its ruling in favor of HCA, the Supreme Court reaffirmed the county’s duty to provide medical care to its prisoners and held for the first time that county government, “which is to be regarded as primarily liable for the cost of treating the prisoners’ pre-existing conditions, has a reimbursement claim against the treated patient.”

Wallace said he is concerned that adding the costs of an inmate’s medical bills to the court costs and legal expenses that add up while mounting a defense to criminal charges will exacerbate the recidivism rate. Pearson said he agrees.

“I can charge them already for a jail stay or for their medical care, but that just contributes to the problem of recidivism,” Pearson said. “The sheriff’s office would be the last person to get any of that money, and if a person defaults on their monthly payment they’re going to end up right back in jail, and it all starts over again.”

The language of Laughlin’s legislation, Senate Bill 1168, would amend existing state law by identifying the inmate receiving care for a pre-existing illness or injury as the primary party liable for payment, which “shall be charged ... by the provider of the care.”

Pearson, however, said he is eyeing other options in case SB 1168 falters in the Legislature.