Mills County Attorney Eric Hansen said while the Eighth Amendment and U.S. Supreme Court rulings have constitutionally required health care for inmates, the law does not make it clear who should foot the bill. Stamets said the hospital is asking the Mills County Sheriff’s Office, on behalf of the county, to pay for the medical bills. Under Iowa law, it is the duty of the “keeper of each jail” or a sheriff to “furnish each prisoner with necessary bedding, clothing, towels, fuel and medical aid.”

Stamets said two Iowa Supreme Court cases call for counties to take responsibility for inmates arrested in their jurisdictions. Those cases, he said set the standard to define “furnish” as “make available.” However, it remains unclear whether “make available” means “payment.”

Mills County does not house female prisoners because the current jail does not have a way to separate male and female inmates. Until the Mills County Law Enforcement Center and Jail, now under construction and which can house female prisoners, opens, female inmates will be taken to the Adams County Jail. In December 2013, the Montgomery County Board of Supervisors told Montgomery County Sheriff Joe Sampson to no longer accept inmates from Mills County.

Mills County pays Montgomery County $55 per day for each prisoner, according to Hansen. The counties do not have an existing contract for who is responsible for inmate medical expenses. Both sides are going through initial legal proceedings. A court date has not been set.