At first glace, it looks like a hospital -- white hallways filled with wheelchairs, walkers, and dialysis machines, but the people in the building are not your average patients.
The Estelle Prison Unit in Huntsville houses the most medically-challenged inmates in the state. Some inmates suffer from chronic diseases, while others are undergoing intensive rehabilitation.
"I wasn't able to walk, move, move my hands, or nothing for about the last three months," inmate David Graves said.
He suffered a heatstroke while playing basketball at another prison facility and has just begun to regain control of his legs.
With each surgery, prescription, and treatment, inmates at the Estelle Unit and throughout the Texas prison system are racking up millions of dollars in medicals bills.
Dr. Owen Murray with the University of Texas Medical Branch oversees the prison health care system.
"Hypertension, HIV, Hepatitis C, diabetes, any patient that comes in with that as a diagnosis, or that we diagnose them with that while they're here with us, we obviously provide all the care associated," Dr. Murray said.
Dr. Murray says treatment isn't optional. Inmates are the only population with a constitutional right to health care, no matter the complexity or the cost.
"Whether you're a death row guy or you're just in for 12 months, if you have that cancer diagnosis, I don't have the option to choose to not treat you. So you're going to get that treatment," Dr. Murray said.
In 2011, medical care for Texas inmates cost taxpayers $494 million. That's $30 million more than in 2010.
The KVUE Defenders took a closer look at the treatments inmates receive. KVUE Defenders found medications like anti-depressants, sleeping pills, and generic Viagra, which Dr. Murray says was prescribed for pulmonary hypertension and not erectile dysfunction.
The most expensive was $24 million spent on HIV medication for about 1,800 inmates.
"As our patient population gets older, as they get sicker, using more medication is smart way to treat disease. It keeps people healthy and keeps them from the hospital, but there's costs associated with it," Dr. Murray said.
Then there are treatments a bit more controversial. Some inmates have received tattoo removal while others received cosmetic surgery.
"There may have been a case where someone might have had a facial lesion that was really contributing to their mental health issues and how they saw themselves. There may have been a case where we might have granted the opportunity for that lesion to be removed just because it was in the best interest of their mental health treatment," Dr. Murray said.
KVUE Defenders also uncovered TDCJ policy allows for sex change surgery for hermaphrodites, and hormone replacement therapy for transsexual inmates.
"If you're in the process of going to get the surgery, and you're going to be here for a period of time, we may continue that therapy so that when you get out, you can continue down the road," Dr. Murray said.
Sen. John Whitmire hadn't heard about that policy. He's served on the Senate's Criminal Justice Committee for 20 years.
"I don't think we ought to have any cosmetic surgery or elective surgery," Whitmire said.
Whitmire says a growing number of aging inmates is putting the largest strain on health care spending. The "Over 55" prison population has jumped from three percent to eight percent in the last 10 years. Whitmire has his own strategy for cutting costs.
"I think there's some inmates we're wasting millions of dollars on," Sen. Whitmire said. "You don't need 80-year-old, worn out, bed-fastened inmates locked up in a secure, maximum security prison. I would put them in a less secure, but secure facility. You lower your costs, and if you got them totally out of a confined correction facility, the federal government would pay for their care."
Inmates like 61-year-old John Williams have applied for TDCJ's "medically recommended intensive supervision" program.
"I've had 10 heart attacks and five stints. I've had bilateral lower limb amputations," Williams said.
Lester Starnes, an 84-year-old inmate with severe Parkinson's disease, said he'd like to be released too.
Both men are convicted sex offenders with numerous health problems, but due to their crime, they don't qualify for supervised medical release.
"You might as well say I've got a life sentence without any hope," Starnes said.
What is certain -- inmates will continue to receive every prescription, treatment and surgery needed to keep them alive courtesy of Texas taxpayers.