HPR V Regional Protocol For Locating A Bed For Individuals .

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HPR V Working Protocol June 10 2014Page 1 of 26HPR V Regional Protocol for Locating a Bed for Individuals Requiring TDORevised June 10, 2014Effective July 1 2014Next Planned Revision - June 23, 2014Editor Notes: The Revised Protocols are effective July 1 and coincides with the effective date ofVirginia Code as revised § 37.2-808 J and § 37.2-809 et. seq.The practice of law enforcement officers to notify the Community Services Board (CSB)precedes this revision in many localities.IntroductionIn an effort to develop a consistent and timely response, these guidelines follow the nine steps asdeveloped by the Department of Behavioral Health and Developmental Services (DBHDS)(Appendix B).HPR V has utilized emergency bed protocols for several years. These revised protocols enhancethose currently in place and affirms the following core principles:1. The time frames to vacate a bed will remain the same or similar to the current HPR VGuidelines for Psychiatric/Behavioral Emergencies and the use of the Eastern State HospitalEmergency Beds. The state facility and Community Services Board (CSB) workers willmake every effort to locate a local hospital bed at the time of the commitment hearing or ifno local bed is appropriate, identify an alternative.2. Emergency service workers and local hospital workers will continue to make every effort toprovide care within the individual’s community.3. ESH beds will be displayed on the Virginia Acute Psychiatric and CSB Bed Registry (BedRegistry) and all vacant beds are considered safety net beds. The emergency service workersand local hospital workers will also utilize the Bed Registry to assist locating and identifyingavailable beds. However, the state facility may not refuse an adult or a juvenile under aTemporary Detention Order even if no bed vacant. The Facility Management Committeewill oversee bed utilization as well as continue to oversee the requests for local inpatienttransfer to ESH.Procedures for Emergency Service StaffAt the time a law enforcement officer initiates custody under either an emergency custody orderor law enforcement authority:1. The officer executing the ECO or initiating law enforcement custody will notify the CSBemergency services office that a person is in custody and the emergency service staff

HPR V Working Protocol June 10 2014Page 2 of 26shall then notify the state facility by phone that an evaluation will commence (refer toAppendix H for the ESH information on the process).2. The custody officer will provide the detainee a copy of the Explanation of EmergencyCustody Procedures (DC-4050)in advance of the prescreening.At the time of an emergency evaluation,1. Emergency services worker will prescreen an individual and determine if a TDO isrequired. A medical evaluation1 will be arranged to assure no medically emergentcondition exists which may prevent/delay acceptance by a treatment facility. Theemergency services worker should request transport to a medical facility for medicalevaluation be directed in either an ECO or TDO whenever a potential treatment facilitymay require a medical evaluation. A provisional treatment plan, including the possibleservice adjuncts, will be arranged when necessary prior to the expiration of the ECOperiod. A partial list of support services is summarized in Appendix A.2. Procedures that apply during the period of evaluation (these steps do not preclude otherrequirements during an evaluation):a. The emergency services worker seeks admission to a psychiatric bed at a localhospital, starting with any hospital in the HPR V geographical area (Appendix D).The emergency services work may consult the Bed Registry as well as contactfacilities not listed on the Bed Registry or listed as not having vacant beds. Theemergency services will continue to maintain their own records for eachindividual of facilities contacted and responses by their intake workers when anongoing search is required.b. As soon as possible after the evaluation is completed, the CSB emergency servicestaff wi

evaluation be directed in either an ECO or TDO whenever a potential treatment facility . In the event that a safety net bed is needed, the emergency services supervisor will . DBHDS staff is monitoring and tracking outcomes with CSBs, private hospitals, state hospitals, the use of Bed Registry data, and will introduce continued quality .

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