Oklahoma County Jail Responsible for Initial Cost of Treating Prisoners’ Pre-Existing Conditions

by David Reutter

The Oklahoma Supreme Court has held that a county’s liability for prisoners’ medical care includes pre-arrest health conditions. The Court further held that a county must pay the initial cost of such treatment, but may seek reimbursement from the prisoner via means of a civil judgment.
The matter was before the Supreme Court after the Oklahoma County district court entered summary judgment to HCA Health Services of Oklahoma, Inc. (HCA). The controversy was created by the Oklahoma County Sheriff’s office, which refused to pay HCA $2,250,575.58 for medical services rendered to prisoners between February 2003 and September 2006.
Over that period, OCS had brought prisoners in need of medical care to HCA for treatment. OCS determined that much of the expense charged was for treatment of conditions that pre-existed the prisoners’ arrests, and refused payment. After the district court entered judgment in favor of HCA, OCS sought an interlocutory appeal to the Supreme Court.
The Supreme Court found OCS had a federal constitutional and state statutory duty to provide medical treatment for prisoners in custody. It found that two Oklahoma statutes pertained to this duty. The provisions of 57 O.S. 2001 § 52 pertain to the duty of providing medical care to prisoners. The provisions of 19 O.S. 2001 § 746 specify the procedural steps for payment of medical treatment bills.
In reference to this case, the following three provisions applied: 1) The county stands liable only for that cost of medical care which is for conditions that do not pre-exist a prisoner’s arrest and arise from acts or omissions of the county; 2) “An inmate receiving medical care for a pre-existing condition or a condition not caused by the acts or omissions of the county shall be liable for payment of the cost of care...”; and 3) “The Court shall order the offender to reimburse the sheriff for all medical care and treatment for pre-existing conditions and injuries....”
The Supreme Court held that § 746 identifies two parties from whom a provider may seek payment for medical care – the prisoner and the county. The law also creates a limited exception to a county’s liability.
Under the statute, the Court held that liability is placed on both the prisoner and the county without declaring any precondition for involving the liability of either. Those two methods of recovery have been placed on “ostensibly equal footing” by the Oklahoma legislature. Thus, the county can seek recovery of costs by a civil judgment if it initially pays the cost of care for prisoners’ pre-existing conditions.
The district court’s grant of summary judgment to HCA to recover medical care costs form OCS was affirmed. See: HCA Health Services of Oklahoma, Inc. v. Whetsel, 173 P.3d 1203 (Okla. 2007).

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