If a budget catastrophe, mixed with competing law enforcements' interests and federal healthcare law, could blow up a county jail, inmate Gerardo Valerio Romero represents the detonator.

The Utah County Attorney's Office has been trying to prosecute the 49-year-old construction worker on child sexual abuse charges for nearly 1.5 years. Immigration officials have the Mexican national on their radar, and have even asked the jail to notify them if he's to be released, as he is living in the country illegally. And many days he's not even being held in the Utah County Jail. Instead, he receives expensive medical treatment for a life-threatening illness, court records show, all at taxpayer expense.

The situation is costing a fortune for Utah County. The local sheriff, whose jail budget is in shambles as mounting medical bills approach $1 million, is resigning out of frustration. And no one knows how long it will take for Romero's case — or his health problems — to be resolved. But even with the rising costs, Utah County authorities still want to prosecute Romero, especially because they're not confident that he'll be deported.

U.S. Immigration and Customs Enforcement did not respond to questions about the case before publication.

Credit Utah County Police Department Utah County Jail inmate Gerardo Valerio Romero was booked on six counts of sexual abuse of a child. He pleaded not guilty to all six charges.

Interviews and court records show that Romero, who has pleaded not guilty, is suffering from a life-threatening disease. Romero declined to be interviewed because he prefers to make his case in court, said his attorney Clayton Simms, who would not comment on or even confirm Romero's medical condition.

The Utah County Commission has directed the sheriff's office to shift money earmarked for other jail expenses to cover the medical costs. Commissioners also said that they would dip into the county's reserve account in August to find more cash. But Utah County Undersheriff Darin Durfey said that's not enough.

"That's not even a Band-Aid," Durfey said. "It's a temporary fix to pay a bill. But now these other bills that are going to come due, we're not going to be able to pay."

Commissioner Nathan Ivie said the county was able to negotiate LDS hospital to reduce some of the payments.

"But there is some anticipation that his medical treatment is still ongoing and may potentially be more expensive, so he could definitely break the million-dollar mark."

It's a situation jailers face in Utah and across the country in all but the largest jails. Dane County (Wis.) Sheriff David Mahoney said counties are finding it increasingly difficult to pay for inmate medical bills.

"Particularly with the growing increase of mental illness in our county jails, the costs have been astronomical," he said.

Federal law requires jails and prisons to provide inmates with necessary medical care, regardless of cost. Inmates who have Medicaid lose their benefits once incarcerated, shifting the cost of medical coverage to local jails. This can be especially tough for small counties with limited resources.

Mahoney, who has leadership positions with both the Major County Sheriffs of America and the National Sheriffs' Association, said as mental hospitals across the country have closed, policy makers have promised community-based mental health care, but many of those programs were never funded. More people with serious mental illnesses are winding up behind bars, but jails were never meant to be hospitals.

"It's very rare that you find a jail that has full-service medical and full-service mental health beds or an infirmary," he said.

Public safety on the line

Lehi Police arrested Romero in March 2017, after the Utah Department of Child and Family Services reported that his 8-year-old stepdaughter accused him of sexually abusing her, police records show.

Since then, Romero has spent almost 1.5 years in the custody of the Utah County Sheriff waiting to stand trial for six counts of sexual abuse of a child.

But the trial keeps getting delayed because of his illness and regular trips to LDS Hospital for treatment. Medical costs and the security required to accompany Romero to the hospital has blown a hole in the jail's annual medical budget, which is about $450,000.

"Right now we're almost $600,000 in medical bills," Durfey said. "As you can see there's not enough money to cover just his individual medical expenses."

Frustrated that the County Commission wouldn't help him address the budget shortfall, Utah County Sheriff Jim Tracy announced this month he would resign in August. Tracy had begged commissioners for guidance, according to internal sheriff's office emails obtained by KUER through a GRAMA request.

None of the commissioners responded by email, but Commissioner Nathan Ivie said in an interview that he did address the issue with Tracy this June in private. In order to pay his bills, Tracy told commissioners when he announced his resignation, the sheriff's office would have to release more than 100 inmates from the jail and lay off 15 employees. The Commission rejected that proposal.

This wasn't the first time the Commission had been warned about the financial burden of inmate's medical treatment. Durfey said he alerted them to the issue years before Romero arrived, saying the county was one expensive inmate away from a budget disaster. Durfey suggested the Commission consider catastrophic insurance or a restricted account for unexpected medical expenses. But that has not materialized.

Imagine that in a smaller jail — a million-dollar expense. Or a $500,000 expense. That could be as much as your annual budget in some jails. — Utah County Undersheriff Darin Durfey

Durfey said most jails are at risk for this kind of problem. He does annual inspections for jails across the state for the Utah Sheriffs' Association, to make sure they're safe and run properly.

"Imagine that in a smaller jail," he said. "A million-dollar expense. Or a $500,000 expense. That could be as much as your annual budget in some jails."

No resolution in sight

Romero's arrest also put him on the radar of Immigration Customs Enforcement, which has the authority to deport him.

Simms, Romero's attorney, said he thinks Utah County could avoid the stress and save taxpayer dollars if it would just release Romero to immigration officials.

"He's already lost because he's spending time in jail," Simms said. "ICE has a hold on him. He will be deported."

The best-case scenario is for Romero to be cleared of the sex abuse charges and sent back to Mexico, Simms said, adding that his client has been falsely accused.

For Romero, he sees only has two choices: serve jail or prison time and then be deported, or be deported immediately.

"He doesn't have a third choice, which is go back to your life. Go back to working at a construction company and build houses in Utah County," Simms said. "That choice is not available for him."

Durfey, the undersheriff, said the county has no plans to release Romero or defer his prosecution. Based on conversations with federal officials, he does not believe Immigration and Customs Enforcement will push to deport Romero should the county release him. He said he's not willing to risk sending him back out into the community.

"It's not as simplistic as people want it to be," Durfey said. "If you were the victim, would you want this individual to not have any accountability?"

For now, Durfey said the county will continue trying to solve the problem. But he won't be around for the resolution. Durfey is retiring from the jail just a few days after his boss, Tracy. Pleasant Grove Police Chief Mike Smith is expected to step in.

Clarification 7/25/18 An earlier version of this story reported that immigration officials have asked Utah County to keep Romero locked up, even if he's found not guilty, as he's living in the country illegally. Immigration and Customs Enforcement lodged a request with the Utah County jail that the agency be notified if Romero is to be released from custody. But that would not mean he would remain detained indefinitely.