Title 40.1
Behavioral Healthcare, Developmental Disabilities and Hospitals

Chapter 5
Mental Health Law

§ 40.1-5-7. Emergency certification.

(a) Applicants. Any physician or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 who, after examining a person, has reason to believe that the person is in need of immediate care and treatment, and is one whose continued unsupervised presence in the community would create an imminent likelihood of serious harm by reason of psychiatric disability, may apply to a facility for the emergency certification of the person. The medical director, or any other physician, or a licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 employed by the proposed facility for certification, may apply under this subsection if no other physician or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 is available and the medical director or physician certifies this fact. If an examination is not possible because of the emergency nature of the case and because of the refusal of the person to consent to the examination, the applicant on the basis of his or her observation may determine, in accordance with the above, that emergency certification is necessary and may apply therefor. In the event that no physician or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 is available, a qualified mental health professional as defined herein who believes the person to be in need of immediate care and treatment, and one whose continued unsupervised presence in the community would create an imminent likelihood of serious harm by reason of psychiatric disability, may make the application for emergency certification to a facility. Application shall in all cases be made to the facility that, in the judgment of the applicant at the time of application, would impose the least restraint on the liberty of the person consistent with affording the person the care and treatment necessary and appropriate to the person’s condition.

(b) Applications. An application for certification hereunder shall be in writing and filed with the facility to which admission is sought. The application shall be executed within five (5) days prior to the date of filing and shall state that it is based upon a personal observation of the prospective patient by the applicant within the five-day (5) period. It shall include a description of the applicant’s credentials and the behavior that constitutes the basis for his or her judgment that the prospective patient is in need of immediate care and treatment and that a likelihood of serious harm by reason of psychiatric disability exists, and shall include, as well, any other relevant information that may assist the admitting physician and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 at the facility to which application is made. The application shall state whether the facility, in the judgment of the applicant at the time of application, would impose the least restraint on the liberty of the person consistent with affording him or her the care and treatment necessary and appropriate to his or her condition. Whenever practicable, prior to transporting or arranging for the transporting of a prospective patient to a facility, the applicant shall telephone or otherwise communicate with the facility to describe the circumstances and known clinical history to determine whether it is the proper facility to receive the person, and to give notice of any restraint to be used or to determine whether restraint is necessary.

(c) Confirmation; discharge; transfer. Within one hour after reception at a facility, the person regarding whom an application has been filed under this section shall be seen by a physician or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2. As soon as possible, but in no event later than twenty-four (24) hours after reception, a preliminary examination and evaluation of the person by a psychiatrist, a physician under the psychiatrist’s supervision, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 shall begin. The psychiatrist, physician under the supervision of the psychiatrist, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 conducting the preliminary examination and evaluation shall not be an applicant hereunder. The preliminary examination and evaluation shall be completed within seventy-two (72) hours from its inception by the psychiatrist, physician under the supervision of the psychiatrist, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2. If the psychiatrist, physician under the supervision of the psychiatrist, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 determines that the patient is not a candidate for emergency certification, the patient shall be discharged. If the psychiatrist, physician under the supervision of the psychiatrist, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 determines that the person who is the subject of the application is in need of immediate care and treatment and is one whose continued unsupervised presence in the community would create an imminent likelihood of serious harm by reason of psychiatric disability, the psychiatrist, physician under the supervision of the psychiatrist, and/or licensed advanced practice registered nurse (APRN) as defined in § 40.1-5-2 shall confirm the admission for care and treatment under this section of the person to the facility, provided the facility is one that would impose the least restraint on the liberty of the person consistent with affording the person the care and treatment necessary and appropriate to the person’s condition and that no suitable alternatives to certification are available. If at any time the official in charge of a facility, or the official’s designee, determines that the person is not in need of immediate care and treatment, or is not one whose continued unsupervised presence in the community would create an imminent likelihood of serious harm by reason of psychiatric disability, or suitable alternatives to certification are available, the official shall immediately discharge the person. In addition, the official may arrange to transfer the person to an appropriate facility if the facility to which he or she has been certified is not one that imposes the least restraint on the liberty of the person consistent with affording him or her the care and treatment necessary and appropriate to his or her condition.

(d) Custody. Upon the request of an applicant under this section, to be confirmed in writing, it shall be the duty of any peace officer of this state or of any governmental subdivision thereof to whom request has been made, to take into custody and immediately transport the person to the designated facility for admission thereto.

(e) Ex parte court order. An applicant under this section may present a petition to any judge of the district court or any justice of the family court, in the case of a person who is the subject of an application who has not yet attained his or her eighteenth birthday, for a warrant directed to any peace officer of the state or any governmental subdivision thereof to take into custody the person who is the subject of the application and immediately transport the person to a designated facility. The application shall set forth that the person who is to be certified is in need of immediate care and treatment and the person’s continued unsupervised presence in the community would create an imminent likelihood of serious harm by reason of psychiatric disability, and the reasons why an order directing a peace officer to transport the person to a designated facility is necessary.

(f) Notification of rights. No person shall be certified to a facility under the provisions of this section unless appropriate opportunity is given to apply for voluntary admission under the provisions of § 40.1-5-6 and unless the person, or a parent, guardian, or next of kin, has been informed, in writing, on a form provided by the department, by the official in charge of the facility: (1) That the person has a right to the voluntary admission; (2) That a person cannot be certified until all available alternatives to certification have been investigated and determined to be unsuitable; and (3) That the period of hospitalization or treatment in a facility cannot exceed ten (10) days under this section, except as provided in subsection (g) of this section.

(g) Period of treatment. A person shall be discharged no later than ten (10) days measured from the date of his or her admission under this section, unless an application for a civil court certification has been filed and set down for a hearing under the provisions of § 40.1-5-8, or the person remains as a voluntary patient pursuant to § 40.1-5-6.