Prisoner’s cancer care may strain budget

SEQUIM — Mounting medical bills for an accused murderer undergoing cancer treatment are being paid by the city of Sequim — and if the treatment costs continue to climb, city leaders could find themselves facing some difficult budget choices.

The trial of Nathan Hipsher, 25, for the alleged beating death of his girlfriend in December has been delayed because of chemotherapy and stem cell replacement treatment.

As the arresting agency — the crime occurred in a Sequim motel room, according to prosecutors — the Sequim Police Department is responsible for his medical bills while he’s in the Clallam County Jail. Hipsher was evaluated at a Seattle cancer center after he was taken into custody.

If he’s convicted, Hipsher becomes the state’s responsibility.

Six-figure medical bill?

Sequim budgeted $75,000 this year to pay for all costs associated with housing city inmates at the county jail. Since December, the county has billed Sequim $19,300 just for medical care of Sequim inmates, according to city records — but Police Chief Robert Spinks said Hipsher’s expenses could reach six figures.

“If the city of Sequim were to get hit by a six-figure medical bill (for one person), you either dig deep into reserves or start laying people off,” Spinks said.

Medical expenses are part of the criminal justice system’s normal routine — evaluations, for example, or the treatment of injuries sustained during an arrest or while an inmate is in custody. That’s fair, Spinks said — indeed, the U.S. Supreme Court has ruled that adequate medical care must be provided.

“When you start talking stem cell replacement as something a prisoner may need — I’m not sure if the average citizen in Sequim, who may or may not have health insurance, has access to stem cell replacement,” Spinks said.

The state Department of Social and Health Services used to have money available for situations like this. Known as the Medically Indigent program, it provided money to hospitals that cared for uninsured patients. A portion of those patients included prisoners, said department spokesman Jim Stevenson.

An $86 million request for the program was axed in the 2003-05 budget because of revenue shortfalls, he said. While about $60 million in replacement money was found, it came from Medicaid — and Medicaid money cannot be used to treat prisoners.

“We did manage to cushion the blow for hospitals, but it didn’t solve the problem you’re talking about, which fell on counties,” Stevenson said.

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