When Tennessee sheriffs transport someone for involuntary mental health commitment across county lines, which county pays for the transportation, and can a sheriff refuse to transport someone first detained in another county?

Subject

Opinion No. 11-22, Reimbursement for Transportation of Individuals to be Involuntarily Hospitalized, March 14, 2011

Plain-English summary

Cross-county scenarios are routine when Tennessee transports people for involuntary mental health commitment. A person may be detained in one county, found to need hospitalization, and have to be moved to a hospital that admits patients from elsewhere. Or a person may live in one county and be detained in another. Or yet another county may have to do the actual driving. The state representative asked who pays.

The AG worked through Tenn. Code Ann. § 33-6-901(b), which provides:

Transportation of persons to be involuntarily hospitalized is the responsibility of the county in which the person is initially detained. The sheriff or secondary transportation agent providing transportation may bill the county of residence for transportation costs.

Three answers:

1. Yes, County A may bill County B when County A first detains a County B resident. When the person is initially detained in County A and found to need involuntary hospitalization there, the statute makes County A responsible for the transportation and lets County A's sheriff bill the county of residence (County B) for the costs. The fact that the person was first detained in County A, not in County B, does not block the billing.

2. No, County A is not limited to billing County B only when the person was first detained in County B. The plain text of § 33-6-901(b) authorizes the county providing transportation to bill the county of residence regardless of where the initial detention happened. The reimbursement right runs to the county of residence based on residence, not based on the location of the initial detention.

3. Yes, a sheriff in County A may refuse to transport someone first detained in another county. Section 33-6-901(b) places the transportation responsibility on the county where the initial detention occurred. The detaining county's duty does not end until § 33-6-406(b) is satisfied (the person is admitted, or the detaining county's sheriff has provided proper advance notice, arrived within the anticipated window, and the 1-hour-45-minute wait has expired). Until then, the duty stays with the initial-detention county, and County A's sheriff is not obligated to step in.

The reasoning relies on the specific-over-general construction principle. Section 33-6-901(a)(1) provides a general rule that "[t]he sheriff in a county in which a person with mental illness or serious emotional disturbance is to be transported under part 4 or 5 of this chapter, shall transport the person except for persons who are transported by: . . . (C) A person authorized under other provisions of this title . . . ." Section 33-6-901(b) is a more specific rule for situations where someone has been detained under § 33-6-402 for emergency examination. The specific provision controls over the general one (Drennon v. General Electric Co., 897 S.W.2d 243, 247 (Tenn. 1994)), and exceptions to general statutes are construed strictly (Anderson Fish & Oyster Co. v. Olds, 277 S.W.2d 344 (1955)). Subsection (a) must therefore be read to apply only when the person was not initially detained in a different county under § 33-6-402.

For very large counties (population 600,000 or more per 1970 or subsequent federal census), Tenn. Code Ann. § 33-6-406(b)(4) provides a different rule: the sheriff is relieved of further transportation duties upon delivering the individual to the hospital or treatment facility, regardless of admission status.

Currency note

This opinion was issued in 2011. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

What if the person was detained in County A and lives in County B but is being transported through County C?

The transportation duty stays with County A (the initial-detention county). County A's sheriff can bill County B (the county of residence) for the costs. County C, as a pass-through county, has no statutory obligation under § 33-6-901(b).

What if County B refuses to pay?

The statute creates the billing right but does not specify the enforcement mechanism. As a practical matter, counties typically work out reimbursement arrangements or, if necessary, pursue collection through ordinary civil channels. Cross-county disputes are sometimes mediated by county-attorney associations or state-level coordination, but the underlying right to bill is statutory.

What is "initial detention"?

Detention under Tenn. Code Ann. § 33-6-402, which authorizes officers, licensed physicians, qualifying psychologists, and certain professionals designated by the Commissioner of Mental Health and Developmental Disabilities to hold a person who has a mental illness or serious emotional disturbance and poses an immediate substantial likelihood of serious harm under § 33-6-501. The initial-detention county is the county where that § 33-6-402 detention happens.

What if the person crosses county lines after detention but before transport?

The statute is keyed to where the initial detention occurred, not where the person currently is. Even if a detained person is physically moved to another county before formal transport, the financial responsibility remains with the initial-detention county under § 33-6-901(b).

How long must the initial-detention county's sheriff stay with the person?

Under Tenn. Code Ann. § 33-6-406(b)(2), if the sheriff or transportation agent has provided advance notice to the hospital and arrives within the anticipated time window, the sheriff must remain only long enough for the evaluation under § 33-6-407, but not longer than one hour and forty-five minutes. After that window expires, the duty to remain ends. In counties of 600,000 or more (1970 or subsequent census), § 33-6-406(b)(4) relieves the sheriff of further transportation duties immediately upon delivery.

What if the patient is found not to require admission?

Tenn. Code Ann. § 33-6-407(c) and (d) handle the return-transport question. If the sheriff is still under a duty to remain under § 33-6-406, the sheriff returns the person to the county. If the sheriff has been relieved of that duty (e.g., the wait window has expired), the hospital is responsible for returning the person.

What about transportation under part 5 (judicial commitment)?

Tenn. Code Ann. § 33-6-901(a)(1) is the general rule for transportation under both part 4 (emergency involuntary admission) and part 5 (judicial commitment). The more specific § 33-6-901(b) rule applies only to part 4 emergency detention scenarios. Part 5 transportation costs follow the general rule in subsection (a).

Background and statutory framework

Tennessee's emergency involuntary hospitalization framework is in Title 33, Chapter 6, Part 4:

1. Detention (§§ 33-6-401, -402): an authorized person (a peace officer, licensed physician, qualifying psychologist, or professional designated by the Commissioner of Mental Health and Developmental Disabilities) may detain a person who has a mental illness or serious emotional disturbance and poses an immediate substantial likelihood of serious harm under § 33-6-501.
2. Initial examination (§ 33-6-404): the detained person is examined to determine whether the person is subject to admission under § 33-6-403. If yes, the examiner completes a certificate of need, assesses clinical needs and the need for physical restraint or vehicle security, and determines the mode of transportation.
3. Transportation to hospital (§ 33-6-406(a)): the sheriff or designated transportation agent under Title 33, Chapter 6, Part 9, transports the person for proceedings under § 33-6-407.
4. Advance notice and wait window (§ 33-6-406(b)): the transporter must notify the hospital of arrival timing. If notice is given and arrival is on time, the transporter must remain only long enough for the evaluation but no longer than one hour and forty-five minutes.
5. Second examination at hospital (§ 33-6-407): a licensed physician examines the person to determine whether the person is subject to admission. If yes, the examiner completes a second certificate of need and the person is admitted under § 33-6-407(b). If no, the return-transport rule under § 33-6-407(c) and (d) applies.

The transportation cost-allocation rules are in Title 33, Chapter 6, Part 9:

• § 33-6-901(a)(1): general rule. The sheriff in a county in which a person with mental illness or serious emotional disturbance is to be transported under Parts 4 or 5 shall transport the person, except where another statutory provision applies.
• § 33-6-901(b): specific rule for emergency detentions under Part 4. Transportation is the responsibility of the county where the person is initially detained. The sheriff or secondary transportation agent providing transportation may bill the county of residence.

The interpretive framework:

• Hayes v. Gibson County, 288 S.W.3d 334, 337 (Tenn. 2009): courts give effect to the purpose of the legislature without exceeding its intended scope.
• State v. Flemming, 19 S.W.3d 195, 197 (Tenn. 2000): unambiguous statutes are construed from the natural and ordinary meaning of the words.
• Wilson v. Johnson County, 879 S.W.2d 807, 809 (Tenn. 1994); Freeman v. Marco Transp. Co., 27 S.W.3d 909, 911 (Tenn. 2000); National Gas Distribs. v. State, 804 S.W.2d 66, 67 (Tenn. 1991): standard rules of construction.
• In re C.K.G., 173 S.W.3d 714, 722 (Tenn. 2005): statutes on the same subject matter are read in pari materia.
• State v. Northcutt, 568 S.W.2d 636, 637-38 (Tenn. 1978): no part of a statute should be inoperative, superfluous, void, or insignificant.
• Barnett v. Barnett, 27 S.W.3d 904, 908 (Tenn. 2000): statutes should not be construed to produce absurd results.
• Drennon v. General Electric Co., 897 S.W.2d 243, 247 (Tenn. 1994): specific provisions take precedence over general provisions on the same topic.
• Anderson Fish & Oyster Co. v. Olds, 197 Tenn. 604, 611, 277 S.W.2d 344 (1955): exceptions to general statutes are strictly construed.

Applying these principles, the AG concluded that subsection (b) of § 33-6-901 must be given operative force over subsection (a) in initial-detention scenarios, otherwise (b) would be rendered insignificant: if (a) controlled in all cases, the county where the person was currently located would always be responsible, regardless of where the initial detention happened, and (b)'s rule would never apply. To give (b) effect, (a) must be read as the default rule for situations not involving an initial detention in a different county under § 33-6-402.

Citations

• Tenn. Code Ann. § 33-6-401 (detention authorization)
• Tenn. Code Ann. § 33-6-402 (who may detain)
• Tenn. Code Ann. § 33-6-403 (admission requirements)
• Tenn. Code Ann. § 33-6-404 (initial examination)
• Tenn. Code Ann. § 33-6-406 (transport to hospital)
• Tenn. Code Ann. § 33-6-406(a) (sheriff or transportation agent)
• Tenn. Code Ann. § 33-6-406(b)(1) (advance notice)
• Tenn. Code Ann. § 33-6-406(b)(2) (1-hour-45-minute wait window)
• Tenn. Code Ann. § 33-6-406(b)(4) (600,000-population exception)
• Tenn. Code Ann. § 33-6-407 (physician examination at hospital)
• Tenn. Code Ann. § 33-6-407(b) (admission decision)
• Tenn. Code Ann. § 33-6-407(c) (return transport by sheriff)
• Tenn. Code Ann. § 33-6-407(d) (return transport by hospital)
• Tenn. Code Ann. § 33-6-427(a) (qualifying psychologists)
• Tenn. Code Ann. § 33-6-427(b) (designated professionals)
• Tenn. Code Ann. § 33-6-501 (immediate substantial likelihood of serious harm)
• Tenn. Code Ann. § 33-6-901(a)(1) (general transportation rule)
• Tenn. Code Ann. § 33-6-901(b) (initial-detention county responsibility)
• Hayes v. Gibson County, 288 S.W.3d 334 (Tenn. 2009)
• State v. Flemming, 19 S.W.3d 195 (Tenn. 2000)
• Wilson v. Johnson County, 879 S.W.2d 807 (Tenn. 1994)
• Freeman v. Marco Transp. Co., 27 S.W.3d 909 (Tenn. 2000)
• National Gas Distribs. v. State, 804 S.W.2d 66 (Tenn. 1991)
• In re C.K.G., 173 S.W.3d 714 (Tenn. 2005)
• State v. Northcutt, 568 S.W.2d 636 (Tenn. 1978)
• Barnett v. Barnett, 27 S.W.3d 904 (Tenn. 2000)
• Drennon v. General Electric Company, 897 S.W.2d 243 (Tenn. 1994)
• Anderson Fish & Oyster Co. v. Olds, 197 Tenn. 604, 277 S.W.2d 344 (1955)

Source

• Landing page: https://www.tn.gov/attorneygeneral/opinions.html
• Original PDF: https://www.tn.gov/content/dam/tn/attorneygeneral/documents/ops/2011/op11-022.pdf

Original opinion text

Reimbursement for Transportation of Individuals to be Involuntarily Hospitalized

QUESTIONS

1. Is a sheriff in County A entitled to be reimbursed for transportation costs from County B for transporting a resident of County B who has been involuntarily hospitalized if the individual was first detained and determined to be in need of involuntary hospitalization in County A?

2. May a sheriff in County A bill County B for the sheriff's transportation costs only if the individual from County B who has been involuntarily hospitalized was first detained in County B?

3. May a sheriff in County A refuse to transport an individual located in County A who has been determined to be in need of involuntary hospitalization if the individual was initially detained in another county by some other law enforcement agency?

OPINIONS

1. Yes. Tennessee Code Annotated § 33-6-901(b) expressly authorizes County A to bill County B for the cost of transporting a resident of County B who has been involuntarily hospitalized when the individual was first detained and determined to be in need of involuntary hospitalization in County A.

2. No. Tennessee Code Annotated § 33-6-901(b) expressly authorizes the county in which the individual was initially detained to seek reimbursement for travel costs from the individual's county of residence. Therefore, County A may bill County B for the costs of transporting a resident of County B, even though the individual was not first detained in County B.

3. Yes. Tennessee Code Annotated § 33-6-901(b) places the responsibility for transportation upon the county in which the individual was initially detained. The detaining county is not relieved of this duty until the provisions of Tenn. Code Ann. § 33-6-406(b) are met. Therefore, the sheriff in County A may refuse to transport an individual located in County A who has been determined to be in need of involuntary hospitalization if the individual was initially detained in another county by some other law enforcement agency.

ANALYSIS

I.

You ask whether Tenn. Code Ann. § 33-6-901(b) entitles a county ("County A") to be reimbursed for transportation costs from an individual's county of residence ("County B") when the individual was first detained and determined to be in need of involuntary hospitalization in County A. This question requires application of the statute to determine who is financially responsible for transporting individuals in need of involuntary hospitalization. The statute provides:

Transportation of persons to be involuntarily hospitalized is the responsibility of the county in which the person is initially detained. The sheriff or secondary transportation agent providing transportation may bill the county of residence for transportation costs.

Tenn. Code Ann. § 33-6-901(b).

When construing a statute, the primary goal of the courts is to give effect to the purpose of the legislature without exceeding its intended scope. Hayes v. Gibson County, 288 S.W.3d 334, 337 (Tenn. 2009). When a statute is unambiguous, a court will construe its meaning from the natural and ordinary meaning of the words chosen. State v. Flemming, 19 S.W.3d 195, 197 (Tenn. 2000).

Applying these principles, Tenn. Code Ann. § 33-6-901(b) authorizes reimbursement to County A in this situation. The statute's plain text provides that the county in which an individual is initially detained is responsible for transporting that individual. Tenn. Code Ann. § 33-6-901(b). The sheriff or secondary transportation agent providing transportation may bill the county of residence for the transportation costs. Id. Therefore, Tenn. Code Ann. § 33-6-901(b) specifically entitles the sheriff in County A to be reimbursed from County B for the costs of transporting a resident of County B who was initially detained and determined to be in need of involuntary hospitalization in County A.

II.

You next ask whether Tenn. Code Ann. § 33-6-901(b) entitles the sheriff in County A to be reimbursed by County B for transportation costs only if the individual was initially detained in County B. Because County A is entitled to be reimbursed by County B for transportation costs when a resident of County B was initially detained in County A, the plain text of the statute clearly authorizes reimbursement in instances when the individual was not originally detained in County B.

III.

You finally ask whether the sheriff in County A may refuse to transport an individual located in County A who has been determined to be in need of involuntary hospitalization if the individual was initially detained in another county by some other law enforcement agency. This question requires us to review the procedures for emergency involuntary hospitalization under Title 33, Chapter 6, Part 4.

Under Tenn. Code Ann. § 33-6-401, if an individual has a mental illness or serious emotional disturbance, and poses an immediate substantial likelihood of serious harm under Tenn. Code Ann. § 33-6-501 because of that mental illness or serious emotional disturbance, that individual may be detained under Tenn. Code Ann. § 33-6-402 to obtain examination for certification of need for care and treatment. Tenn. Code Ann. § 33-6-401. Only officers authorized to make arrests in the state, licensed physicians, psychologists authorized under Tenn. Code Ann. § 33-6-427(a), and professionals designated by the Commissioner of the Department of Mental Health and Developmental Disabilities under Tenn. Code Ann. § 33-6-427(b), are authorized to detain an individual for examination without a civil order or a warrant. Tenn. Code Ann. § 33-6-402.

Upon detention, the individual must first be examined pursuant to Tenn. Code Ann. § 33-6-404, to determine whether the person is subject to admission to a hospital or treatment resource under Tenn. Code Ann. § 33-6-403. If the individual is subject to admission, the examiner is required to complete a certificate of need, assess the individual's clinical needs and needs for physical restraint or vehicle security, and determine the mode of transportation to the hospital. Tenn. Code Ann. § 33-6-404. If the individual is not already at the facility, hospital or treatment resource at which the individual is proposed to be admitted, the examiner who completed the certificate of need shall turn the individual over to the custody of the sheriff or transportation agent designated under Title 33, Chapter 6, Part 9, who shall transport the individual for proceedings under Tenn. Code Ann. § 33-6-407. Tenn. Code Ann. § 33-6-406(a). The sheriff or transportation agent is required to notify the hospital or treatment resource as to where the individual is and the best anticipated time of arrival. Tenn. Code Ann. § 33-6-406(b)(1). If the sheriff or transportation agent provides notice and arrives within the anticipated time of arrival, the sheriff or transportation agent is required to remain at the hospital or treatment resource only long enough for the individual to be evaluated for admission under Tenn. Code Ann. § 33-6-407, but not longer than one hour and forty-five minutes. Tenn. Code Ann. § 33-6-406(b)(2). Only in counties having a population of 600,000 or more according to the 1970 federal census or any subsequent federal census is the sheriff or transportation agent relieved of further transportation duties upon delivering the individual to the hospital or treatment facility. Tenn. Code Ann. § 33-6-406(b)(4).

Finally, if the individual is examined under Tenn. Code Ann. § 33-6-407 and the examiner determines that the individual is subject to admission under Tenn. Code Ann. § 33-6-404, the examiner shall complete a second certificate of need, and the individual may then be admitted for emergency diagnosis, evaluation and treatment. Tenn. Code Ann. § 33-6-407(b). If the individual is not subject to admission, the sheriff or transportation agent is responsible for returning the person to the county unless the sheriff or transportation agent is no longer under a duty to remain at the hospital or treatment resource under Tenn. Code Ann. § 33-6-406. Tenn. Code Ann. § 33-6-407(c) and (d). Thus, the sheriff or transportation agent designated under Title 33, Chapter 6, Part 9, remains responsible for the individual's transportation needs until the individual is admitted to the hospital or treatment facility unless the sheriff or transportation agent has been relieved of that duty by Tenn. Code Ann. § 33-6-406(b).

Generally, the county in which an individual is located will be responsible for providing transportation under Title 33, Chapter 6, Parts 4 and 5. Tennessee Code Annotated § 33-6-901(a)(1) states, in pertinent part:

The sheriff in a county in which a person with mental illness or serious emotional disturbance is to be transported under part 4 or 5 of this chapter, shall transport the person except for persons who are transported by: . . . (C) A person authorized under other provisions of this title . . . .

Tenn. Code Ann. § 33-6-901(a)(1). While Tenn. Code Ann. § 33-6-901(a)(1) provides the general rule for transporting individuals under Title 33, Chapter 6, Parts 4 and 5, Tenn. Code Ann. § 33-6-901(b) provides a more specific rule in instances where an individual has been detained under Tenn. Code Ann. § 33-6-402. As discussed in Part I above, in instances where an individual has been detained under Tenn. Code Ann. § 33-6-402, transportation of that individual is the responsibility of the county in which the person is initially detained. Tenn. Code Ann. § 33-6-901(b).

In construing statutes, courts must "ascertain and give effect to the legislative intent without unduly restricting or expanding a statute's coverage beyond its intended scope." Wilson v. Johnson County, 879 S.W.2d 807, 809 (Tenn. 1994). When the statute is unambiguous, legislative intent is determined from the plain and ordinary meaning of the language used in the statute. Freeman v. Marco Transp. Co., 27 S.W.3d 909, 911 (Tenn. 2000). The statutory language must be "read in the context of the entire statute, without any forced or subtle construction which would extend or limit its meaning." National Gas Distribs. v. State, 804 S.W.2d 66, 67 (Tenn. 1991). Statutes that are related to the same subject matter should be read in pari materia. In re C.K.G., 173 S.W.3d 714, 722 (Tenn. 2005). In addition, a statute should be construed so that "no part will be inoperative, superfluous, void or insignificant." State v. Northcutt, 568 S.W.2d 636, 637-38 (Tenn. 1978). At the same time, a statute should not be construed to produce an absurd or incongruous result. Barnett v. Barnett, 27 S.W.3d 904, 908 (Tenn. 2000). Furthermore, under the rules of statutory construction, statutes which address the specific are given precedence over those that address the general. Drennon v. General Electric Company, 897 S.W.2d 243, 247 (Tenn. 1994). The courts strictly construe exceptions to general statutes. Anderson Fish & Oyster Co. v. Olds, 197 Tenn. 604, 611, 277 S.W.2d 344 (1955).

Applying these principles of statutory construction, we conclude that the specific provision of Tenn. Code Ann. § 33-6-901(b), rather than the more general provisions of Tenn. Code Ann. § 33-6-901(a), dictates which entity is responsible for transporting an individual who has been detained under Tenn. Code Ann. § 33-6-402. Subsections (a) and (b) must be read in pari materia. In re C.K.G., 173 S.W.3d at 722. Furthermore, because subsection (b) specifically addresses situations in which an individual has been detained under Tenn. Code Ann. § 33-6-402, it will be given precedence over the general transportation provisions of subsection (a). Drennon v. General Electric Company, 897 S.W.2d at 247. If subsection (a) were meant to apply to all instances in which an individual needed to be transported under Title 33, Chapter 6, Parts 4 and 5, subsection (b) would be rendered insignificant, because the county in which the individual is located would always be responsible for providing transportation, regardless of whether the individual was initially detained there. In order for subsection (b) to be effective, subsection (a) should be read as requiring the county in which the individual is located to provide transportation unless the individual was initially detained in a different county under Tenn. Code Ann. § 33-6-402.

Turning to your hypothetical, you ask whether the sheriff in County A may refuse to transport an individual located in County A who has been determined to be in need of involuntary hospitalization if the individual was initially detained in another county ("County C") by some other law enforcement agency. It is the opinion of this office that the sheriff in County A may refuse to transport the individual. Because the individual was initially detained under Tenn. Code Ann. § 33-6-402, we must look to Tenn. Code Ann. § 33-6-901(b) to determine who is responsible for providing transportation. The plain language of Tenn. Code Ann. § 33-6-901(b) obligates County A to provide transportation only for an individual who has been detained under Tenn. Code Ann. § 33-6-402 when the initial detention occurred in County A. Tenn. Code Ann. § 33-6-901(b). In this situation, the individual was initially detained in County C, making County C responsible for the individual's transportation needs. Id. Unless County C falls within the exception set forth at Tenn. Code Ann. § 33-6-406(b)(4), it is responsible for providing transportation to the individual until the individual is either admitted or, if the sheriff provided adequate notice and arrives within the anticipated time of arrival, not longer than one hour and forty-five minutes after arrival. Tenn. Code Ann. § 33-6-406(b).

ROBERT E. COOPER, JR.
Attorney General and Reporter

CHARLES L. LEWIS
Deputy Attorney General

MARCIE E. GREENE
Assistant Attorney General

Requested by:
Honorable David A. Shepard
State Representative
34 Legislative Plaza
Nashville, TN 37243-0169