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  1. RoboCodeine7610

    Sitting in the driver's seat of his Chevy Cavalier, Chris Burns gripped a 20-ounce soda bottle and waited for his "shake and bake" methamphetamine to cook.

    Then came the explosion and fire.

    Burns and passenger Bobby Joe Joyner fled as blazing chemicals scorched their skin.

    When police caught up with the pair, they admitted to cooking meth and causing the explosion while sitting at a stop sign on a rural Fayette County road. But it was months before either faced criminal charges.

    To have charged the men en route to the hospital would have shifted the burden of paying for their care to the Fayette County Sheriff's department.

    Two weeks later, Burns walked out of the Regional Medical Center at Memphis owing $160,000 -- a tab he can't pay that is the problem of a much larger group of taxpayers in Shelby County and throughout the region served by the hospital.

    "We took them straight to the grand jury after they got out of the burn unit because we could not afford to arrest them ...," Fayette County Sheriff Bobby Riles said. "I mean, that would bankrupt the county in a minute."

    The practice of delaying charges to avoid medical bills has long been practiced by law enforcement. But the staggering cost of dealing with meth burn patients has made it even more common -- especially in small communities where a single case can quickly overwhelm a county's budget.

    "My experience is that's the way it's always been," said Scott Burns, executive director of the National District Attorneys Association. "I was a D.A. for 16 years, and if somebody was injured and they weren't an immediate danger to themselves or others, we'd wait until after they'd healed up before we would arrest them.

    "I just have to be honest. It's just a flat-out attempt to avoid paying astronomical medical bills by taxpayers."

    Similar cases have turned up in other states as well, including Indiana and Oklahoma.

    Malcolm Gwinn, a deputy prosecutor for Vanderburgh County in Indiana, delayed prosecution of a man who was severely burned last year after an alleged meth explosion because of the cost of an extensive skin transplant. He knew the man wasn't a flight risk and didn't consider him a danger to the community.

    "Most of the people that we're talking about are probably going to receive some sort of public assistance for the payment of their health care, and that cost would then be borne by the taxpayers statewide as opposed to the individual county," he said.

    The Firefighters Regional Burn Center located at The Med treats nearly 500 patients annually, with between 200 and 300 being admitted for extended care. Unlike at Vanderbilt University Hospital where one-third of burn injuries are meth-related, the number at The Med is relatively small, said Dr. William Hickerson, a professor of plastic surgery and the unit's medical director.

    No matter what the cause, somebody has to pay for the care, and oftentimes people who are burned in meth-related incidents don't have health insurance, which means taxpayers cover all or some of the bill.

    Funding for that care at The Med comes from a variety of sources, including Shelby County residents. But Mississippi, Arkansas and Tennessee state governments also provide funding for burn and trauma care because The Med is home to the only Level 1 burn and trauma centers in a 150-mile radius.

    Hospitals such as Vanderbilt and The Med are considered "disproportionate share hospitals" because they serve a significantly disproportionate number of low-income patients so they receive federal dollars to help cover some of the cost as well.

    If the costs aren't covered, they're considered uncompensated care, and hospitals write that off at the end of each year, said John Howser, assistant vice chancellor for news and communications at Vanderbilt.

    In the March 2009 Fayette County case, law enforcement officials found Burns in the back room of a house covered in blankets. He suffered third-degree burns over 16 percent of his body, including his face, arms, legs and hands. Joyner was in the back seat of a pickup that officers stopped for reckless driving. He had second-degree burns on his back, shoulder and left arm.

    Joyner was taken by ambulance to Methodist Fayette Hospital, and Burns was sent to The Med, where he stayed for two weeks, including one week in the intensive-care unit, he said. He had to learn to walk again.

    Without health insurance, Burns was left with a $160,000 medical bill. He pays a little on it when he can, he said.

    Sheriff Riles has never had another case like it before or since. He knew the men weren't a flight risk and that they'd eventually be charged.

    But he also knew their medical bills would overwhelm his annual health care budget of $120,000, which covers every toothache, ear infection and head cold for the 180-plus inmates who can be housed at the jail at any given time.

    Burns was indicted by a Fayette County grand jury in July 2009 and pleaded guilty to initiation of process to manufacture methamphetamine. He was at home and still in bandages when he was arrested.

    Burns served 90 days in jail and will be on probation until 2017, he said. Joyner pleaded guilty to the same charge and was given the same sentence.

    Dist. Atty. Gen. Mike Dunavant, who serves five counties including Fayette, said he doesn't want citizens to get the impression that badly injured criminals won't pay for their crimes.

    "All manner of ailments and diseases and injuries that jails have to address, medications -- it can certainly be costly to a county budget," Dunavant said. "But that's the constitutional mandate of holding somebody in custody.

    "We try to be sensitive to that, but I want to make it clear that, in my opinion, no one is ever too sick or too injured to be held accountable. We move forward with those charging decisions as soon as we can, logistically and reasonably, to hold them accountable."

    Burns has been back to jail twice since serving his initial 90 days for breaking his probation for failure to report. But he's tired of going back to jail and has kept out of trouble since December.

    Scars from the meth burns are still visible on his arm and leg, though the pain has subsided in the years since the fire.

    As for meth, Burns said he won't touch it again. It wasn't worth the jail time or the injuries.

    "I don't even want to mess with it," he said.



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