§ 508. Removal of sick prisoners from jail. 1. A sheriff, in his or
her discretion, may by written order permit incarcerated individuals
confined in a local correctional facility to receive medical diagnosis
and treatment in outside hospitals, upon the determination that such
outside treatment and diagnosis is necessary by reason of inadequate
facilities within the local correctional facility. Such incarcerated
individuals shall remain under the jurisdiction and in the custody of
said sheriff while in a hospital, other than a secure facility, as such
term is defined in paragraph b of subdivision two of this section, and
said sheriff shall enforce proper measures in each case to safely
maintain such jurisdiction and custody.

2. a. If a physician to a jail or in case of a vacancy a physician
acting as such and the warden or jailer certify in writing that a
prisoner confined in a jail, either in a civil cause or upon a criminal
charge, is in such a state of mental health that he or she is in need of
involuntary care and treatment and in their opinion should be removed to
a psychiatric hospital for treatment, the warden or jailer shall
immediately notify the director who shall have the responsibility for
providing treatment for such prisoner. If such director after
examination of the prisoner by an examining physician designated by him
or her shall determine that such prisoner is in need of involuntary care
and treatment, the director shall file an application for the
involuntary hospitalization of such prisoner pursuant to article nine of
the mental hygiene law in a hospital or secure facility, as defined in
paragraph b of this subdivision, operated by the office of mental health
or in the case of a prisoner confined in a jail in a city or county
which maintains or operates a general hospital containing a psychiatric
prison ward approved by the office of mental health to such prison ward
for care and treatment or to any other psychiatric hospital if such
prison ward is filled to capacity. Such application shall be supported
by the certificate of two physicians in accordance with the requirements
of section 9.27 of the mental hygiene law and thereupon such prisoner
shall be admitted forthwith to the hospital or secure facility in which
such application is filed, and the procedures of the mental hygiene law
governing the hospitalization of such prisoner. The jailer or warden
having custody of the prisoner shall deliver the prisoner to the
hospital or secure facility with which the director has filed the
application. If such jailer or warden shall certify that such prisoner
has a mental illness which is likely to result in serious harm to
himself, herself or others and for which care in a psychiatric hospital
is appropriate such jailer or warden shall effect the admission of such
prisoner to a hospital or secure facility forthwith in accordance with
the provisions of section 9.37 or 9.39 of the mental hygiene law and the
hospital shall admit such prisoner. Upon admission of the prisoner,
pursuant to section 9.37 or 9.39 of the mental hygiene law, the jailer
or warden shall notify the director, the prisoner's attorney, and his or
her family, where information about the family is available. While the
prisoner is in the hospital, other than a secure facility, he or she
shall remain in the custody under sufficient guard of the jailer or
warden in charge of the jail from which he or she came. When the
prisoner is in a secure facility, the jailer or warden may transfer
custody of the incarcerated individual to the commissioner of mental
health, pursuant to an agreement between such jailer or warden and such
commissioner. A prisoner admitted to a psychiatric hospital pursuant to
section 9.27, 9.37 or 9.39 of the mental hygiene law may be retained at
the hospital or secure facility pursuant to the provisions of the mental
hygiene law until he or she has improved sufficiently in his or her
mental illness so that hospitalization is no longer necessary or until
ordered by the court to be returned to the jail whichever comes first
and in either event, the prisoner shall thereupon be returned to jail.
The cost of the care and treatment of such prisoners in the hospital or
secure facility shall be defrayed in accordance with the provisions of
the mental hygiene law in such cases provided.

From the time of admission of a prisoner to a hospital under this
section the retention of such prisoner for care and treatment shall be
subject to the provisions for notice, hearing, review and judicial
approval of continued retention or transfer and continued retention
provided by article nine of the mental hygiene law for the admission and
retention of involuntary patients.

b. As used in this section, the following terms shall have the
following meanings:

(i) "Director" means (a) the director of a state hospital operated by
the department of mental hygiene, or (b) the director of a hospital
operated by any local government of the state that has been certified by
the commissioner of mental hygiene as having adequate facilities to
treat a person with a mental illness or (c) the director of community
mental health services or the designees of any of the foregoing. The
appropriate director to whom a jailer or warden shall certify the need
for involuntary care and treatment and who shall have the responsibility
for such care and treatment shall be determined in accordance with rules
jointly adopted by the judicial conference and the commissioner of
mental hygiene.

(ii) "Mental illness" shall mean an affliction with a mental disease
or mental condition which is manifested by a disorder or a disturbance
in behavior, feeling, thinking, or judgement to such an extent that the
person afflicted requires care and treatment.

(iii) "In need of involuntary care and treatment" shall mean that a
person has a mental illness for which care and treatment as a patient in
a hospital is essential to such person's welfare and whose judgement is
so impaired that he is unable to understand the need for such care and
treatment.

(iv) "Likelihood to result in serious harm" shall mean (1) substantial
risk of physical harm to himself as manifested by threats of or attempts
at suicide or serious bodily harm or other conduct demonstrating that he
is dangerous to himself or (2) a substantial risk of physical harm to
other persons as manifested by homicidal or other violent behavior by
which others are placed in reasonable fear or serious physical harm.

(v) "Secure facility" shall mean a facility operated or licensed by
the office of mental health that has been approved and designated by the
commissioner of mental health to receive and retain prisoners pursuant
to this section, based upon a determination by such commissioner that
the physical and internal security of the facility are sufficient to
protect the safety and security of staff and persons served by the
facility.

c. If at any time the hospital in which a prisoner is hospitalized
pursuant to this subdivision determines that the prisoner is not in such
state of mental health to be in need of involuntary care and treatment
the prisoner shall be returned to the jail forthwith.

d. If at any time the director of a hospital in which a prisoner is
hospitalized pursuant to this subdivision has reason to believe that the
prisoner may be an incapacitated defendant as defined in article seven
hundred thirty of the criminal procedure law he shall so notify the
court in which the criminal charges are pending and such court shall
thereupon issue an examination order pursuant to the provisions of
article seven hundred thirty of the criminal procedure law.

e. Nothing in this subdivision shall prevent the release of the
prisoner from custody where appropriate by recognizance, bail, or
otherwise as the court may direct.