Bexar County Sheriff Javier Salazar says weekly hospital visits by jail inmates have roughly doubled, from about 100 to about 200, with some weeks approaching 300 — and he's now moving to rehire approximately six former deputies to help curb the overtime costs those trips generate. The plan would station rehired deputies at the hospital to take over inmate supervision duties currently handled by transporting deputies.
Under current practice, a single deputy typically transports an inmate to the hospital and stays with that person throughout treatment, according to Salazar, speaking to Fox San Antonio. “A deputy, a single deputy, has to transport them to the hospital and babysit them,” Salazar said. Deputies remain with inmates as they move through radiology, pharmacies, and waiting rooms, and the waits can run far longer than for the general public. “Our wait may be two, three hours. When an inmate goes for the same thing, their wait may be 14, 15 hours,” Salazar said.
Those extended stays trigger overtime pay at time and a half, and the sheriff says hospital trips and jail overtime costs are directly correlated. During one week in May, the jail recorded 288 hospital visits, though the station reports Salazar cited two different totals for the associated overtime hours — 672 and 682 — during the interview.
Rehired Deputies and a Zone-Defense Approach
Salazar's plan brings approximately six former deputies back through the county's hiring process specifically to staff hospital posts, freeing up transporting deputies sooner. His office is also discussing whether hospital appointments can be grouped so that one deputy could watch over several inmates at once when security and medical circumstances allow it.
Salazar compared the approach to zone defense rather than one-on-one man-to-man coverage, framing it as a way to stretch deputy coverage without adding bodies for every single hospital run. He said he's optimistic the hospital will cooperate, while emphasizing its obligation to provide quality medical care. The station reports it has not independently confirmed that University Health has agreed to any specific scheduling or staffing changes tied to the sheriff's plan.
The sheriff pointed to the Dallas County Sheriff's Office as one model worth watching: that agency runs a Special Hospital Observation Team, known as SHOT, at Parkland Hospital, where transport officers hand off security duties to a dedicated hospital observation officer once an inmate arrives. Fox San Antonio notes it has not verified whether Dallas County's program actually reduces overtime spending or allows a single officer to supervise multiple inmates.
A Push for More Medical Care Inside the Jail
Beyond hospital staffing, Salazar wants more medical treatment space inside the jail itself to cut down on the need for outside transports in the first place. He said changes to county booking and magistration procedures could eventually free up space in the South Tower for additional medical services, though he has not provided a verified cost estimate or projected overtime savings for that expansion, per Fox San Antonio's reporting.
Salazar said jail overcrowding, staffing shortages, and inmates' medical needs are all feeding into the overtime problem, and that increasing numbers of medically ill inmates requiring outside treatment are part of what's driving costs higher. He argued that ignoring inmates' medical needs isn't realistic and risks lawsuits, and separately warned that untreated medical needs among a large jail population could lead to more deaths in custody.
Burnout, Pay, and a Budget Under Strain
The sheriff said mandatory overtime is contributing to deputy burnout and retention problems, with some departing deputies citing the inability to keep up with the workload as a reason for leaving. He also said his deputies haven't received a pay raise even as nearby law enforcement agencies have raised theirs, adding that the department's collective bargaining agreement remains unresolved and that the office faces competition for recruits from surrounding agencies offering higher pay.
The overtime strain shows up in the county's books. Bexar County paid out an estimated $16,474,797 in overtime for jail deputies in fiscal year 2026, according to a News 4 San Antonio investigation, which found that overtime hours worked increased by 500 percent between 2022 and 2025. A separate analysis from the San Antonio Express-News estimated that detention-division overtime payouts rose from $5.3 million in fiscal year 2018 to $22.5 million in 2024, and found that nearly 180 of the Sheriff's Office's 1,323 employees earned more than a third of their total pay from overtime in fiscal year 2023. That same reporting found the jail has operated above 80 percent capacity nearly every month since the start of 2022.
County Budget Talks and Jail Reform Efforts
County budget officials have recommended setting aside $11.2 million in contingency funding for detention overtime for fiscal year 2026-27 as the jail continues operating with staffing vacancies, according to the San Antonio Report. The Sheriff's Office had separately requested $12.8 million to create 128 new positions and reclassify 26 others, but budget officials did not recommend approval and left the request out of the proposed budget. Budget and Finance Director Tanya Gaitan said the department still had about 192 vacancies shortly before the budget presentation.
Commissioners Court has repeatedly scrutinized jail staffing costs and overtime, questioning both the growth in spending and the effectiveness of current cost controls. Salazar, for his part, has questioned the county's continued reliance on outside consultants. The county has also moved on separate jail health reforms: Commissioners Court unanimously approved a $250,000 agreement with University Health in August to expand clinical screening and directed staff to develop recommendations for a public-facing dashboard, according to Texas Public Radio. A separate analysis cited by the San Antonio Report found that 39 of the 91 people who died in Bexar County custody since 2020 died within seven days of booking.
