Each year, county jails in the Tampa Bay area spend millions on inmate healthcare. Since 2005, Hillsborough's annual totals have hovered around $21 million. That's 6 percent of the agency's budget, funded by public money. Treating them is not optional, said Col. Kenneth Davis, who is in charge of Hillsborough's jails. The sheriff's offices are required by law to provide inmates with care when it is "medically necessary," which is anything a physician determines is needed to alleviate, prevent, diagnose or correct a painful, chronic or life-threatening condition. Once an inmate enters the jail, he does not have the option to leave for a medical procedure, even if he has the means to pay for it himself. The jail bills inmates who have insurance, but that is infrequent. The Sheriff's Office is not allowed to bill Medicaid.