Last week I wrote about how jails sometimes seek to limit medical expenses by having an inmate released. Today’s post is about the related issue of “refusing” an inmate on the front end when it appears he or she is in need of immediate medical attention. Common scenarios include a person who is injured in the course of committing a crime, or an impaired driver who is very drunk. Can the sheriff’s office refuse to accept such a person into the jail? And if so, does that refusal relieve the county of liability for the costs of the person’s care?
Under G.S. 15-126, “every sheriff or jailer to whose jail any person shall be committed by any court or magistrate of competent jurisdiction shall receive such prisoner and give a receipt for him, and be bound for his safekeeping as prescribed by law.” That law indicates that the jail has no choice but to receive a person—even a very sick, very intoxicated, or seriously injured person—once a judicial official has committed him or her to the sheriff’s custody. (Of course, if the person is in bad enough shape, the initial appearance should be delayed. G.S. 15A-511(a)(3) (allowing the initial appearance to be delayed for a reasonable time if a defendant is unruly, unconscious, or grossly intoxicated).)
G.S. 15-126 does not, however, require the sheriff to take every inmate with a signed release order into the jail itself. A sheriff or jail administrator might reasonably have a standing order requiring immediate diversion of would-be inmates with, among other things, certain types of injuries, or a blood alcohol concentration above a particular limit. Such rules are permissible and often sensible, but they generally do not operate to relieve the county of liability for the costs of emergency medical care under G.S. 153A-224(b) once a judicial official has placed the defendant in the sheriff’s legal custody.
What about defendants who haven’t yet appeared before a judicial official? Is the county responsible for the costs of their care? The answer appears to be sometimes, depending on the circumstances of the person’s arrest.
The leading case in this area is Spicer v. Williamson, 191 N.C. 487 (1926). In Spicer, a sheriff’s deputy shot and wounded a man who had resisted his arrest for a robbery. Recognizing that the man was in bad shape, the deputy took him directly to the hospital for surgery. The hospital sued the county for the costs of care. The county argued that it was not liable because the man was not actually confined in the jail. The supreme court disagreed, extending the duty of the county to pay for a person in the custody of the sheriff who is unable, because the of the defendant’s condition, to take him at once to the jail.
The court of appeals applied Spicer in Annie Penn Memorial Hospital, Inc. v. Caswell County, 72 N.C. App. 197 (1984). In Annie Penn, a sheriff’s deputy shot a man who pointed a shotgun at him. The deputy handcuffed the man and took him directly to the hospital for emergency medical treatment. As in Spicer, the hospital sued the county for the costs of the defendant’s care. The county argued that the defendant was not in custody when the care was provided. The court of appeals disagreed, noting that deputies escorted the man into the emergency room, and then asked hospital staff to notify them when the man was ready to be discharged so they could pick him up. The man was therefore in county custody, and the county was obligated under Spicer to pay for the man’s care even though he never actually entered the jail.
Contrast Spicer and Annie Penn with Craven County Hospital Corp. v. Lenoir County, 75 N.C. App. 453 (1985). In Craven County Hospital, a habitual inebriate was picked up by city policy officers under authority of the public intoxication law (then in Chapter 122, now in G.S. 122C-303). They planned to take him to the jail to sober up, but as they helped him from the car he fell and was knocked unconscious. He underwent neurosurgery and eventually died 10 days later. The hospital sued the city, the county, and the sheriff for the costs of the man’s care. The court of appeals determined that the county and the sheriff were not liable because the man never actually came into the custody of any county officer. The court likewise concluded that the city was not liable for the costs of the man’s care—not because the man was not in the custody of the transporting officers, but rather because the General Statutes impose no duty upon cities to pay for medical services provided to persons in police custody. The court recognized the “apparent gap” in the law with respect to a “detainee in medical treatment who happens to be in the custody of city police officers rather than a sheriff or his deputy,” but concluded that “the gap must be filled, if at all, by the General Assembly.”
Some jails do a medical screen of arrestees when they arrive at the jail, before they process before a magistrate. If certain medical issues are identified (serious injury, high BAC, etc.), the jail staff ask the arresting officer to take the person to receive medical attention. Assuming any resultant delay in a person’s initial appearance is not unnecessary in light of the person’s condition, that practice seems a sensible way to get a person the care he or she may need. Ultimately, however, considering the cases discussed above, it appears that the county is still on the hook for the costs of care if the arresting officer was a sheriff’s deputy, but not liable if a municipal officer made the arrest.