TABLE OF CONTENTS TITLE 8 ADMISSIONS AND RECORDS 8.1-3 CHAPTER 8.1 ADMISSIONS POLICY AND SECTIONS: 8.1.1 MISSION STATENIENT 8.1-3 8.1.2 PRE-ADNIISSION 8.1-4 8.1.3 MEDICAL SCREENING 8.1-7 8.1.4 VOLUNTARY REFERRALS FOR CARE - ADULT 8.1-9 8.1.5 ADULT VOLUNTARY REFERRAL BY A LEGAL GUARDIAN, DURABLE POWER OF ATTORNEY FOR HEALTHCARE OR NEXT OF KIN 8.1-11 8.1.6 VOLUNTARY REFERRALS FOR CARE - 8.1-13 8.1.7 ADMISSION OF EMANCIPATED MINORS (VOLUNTARY) 8.1-15 8.1.8 ADMISSION OF FIVE-DAY ENIERGENCY AND HEARING PROCEDURES - ADULTS 8.1-17 8.1.9 ADMISSION OF INVOLUNTARY NINETY (90) DAY COMNIITMENTS - ADULTS 8.1-21 8.1.10 MENTAL ILLNESS HEARINGS FOR EMERGENCY ADMISSIONS - MINORS 8.1-22 8.1.11 ADIVIISSION OF INVOLUNTARY FORTY-FIVE (45) DAY CONIMITMENTS (MINOR) I 8 .1-26 8.1.12 CONVERTING VOLUNTARY PATIENT TO EMERGENCY 8.1.13 8.1.14 8.1.15 8.1.16 8.1.17 8.1.18 8.1.19 8.1.20 8.1.21 8.1.22 8.1.23 8.1.24 STATUS (PATIENT EXECUTED A WRITTEN REQUEST FOR RELEASE) 8.1-27 - CONVERTING VOLUNTARY PATIENT TO EMERGENCY STATUS (PATIENT DID NOT EXECUTE WRITTEN REQUEST FOR RELEASE) 8.1-29 CONVERTING EMERGENCY COMMITMENTS TO VOLUNTARY STATUS PRIOR TO HEARING 8.1-30 DISCHARGE OF AN EMERGENCY ADMISSION PRIOR TO A HEARING 8.1-32 MONITORING ADOLESCENT ADNIISSIONS WHO REACH THE AGE OF MAJORITY 8.1-33 COORDINATING AND SCHEDULING NIENTAL ILLNESS HEARINGS 8.1-35 OBJECTION BY MINOR OR GUARDIAN TO INPATIENT HOSPITALIZATION 8.1-37 FORTY-FIVE DAY REVIEW HEARINGS 8.1-40 NINETY (90) DAY REVIEW HEARINGS 8.1-42 SIX MONTH REVIEW HEARINGS 8.1-44 YEARLY REVIEW HEARING 8.1-46 DEVELOPMENTAL DISABILITY HEARINGS 8.1-48 TRIBAL COURT COMMITMENT 8.1-50 8.1.25 8.1.26 8.1.27 8.1.28 8.1.29 8.1.30 8.1.31 8.1.32 8.1.33 8.1.34 8.1.35 8.1.36 8.1.37 8.1.38 8.1.39 8.1.40 8.1.41 8.1.42 8.1.43 8.1.44 8.1.45 8.1.46 8.1.47 NATIVE AMERICAN REFERRALS TO THE ADOLESCENT TREATMENT PROGRAM WHO RESIDE ON RESERVATION OR TRUST LANDS OR WHOSE PARENTS RESIDE ON RESERVATION OR TRUST LANDS 8.1-52 TRANSFER BETWEEN TREATNIENT PROGRAMS AT 8.1-54 TRANSFER OF COMMITNIENT FROM MENTAL HEALTH A OPERATED COMMUNITY BASED PROGRAM 8.1-56 TRANSFER OF CONINIITMENTS AND OUTPATIENT COMMITIVIENTS TO MENTAL HEALTH A OPERATED COMMUNITY-BASED MENTAL HEALTH PROGRAM 8.1-58 INTER-INSTITUTIONAL TRANSFERS 8.1-60 REFERRAL FOR EVALUATION THROUGH THE CRIMINAL PROCEDURE 8.1-62 REFERRALS FOR TREATMENT THROUGH THE CRIMINAL PROCEDURE 8.1-64 - JUVENILE COURT REFERRALS 8.1-68 FEDERAL COURT REFERRALS 8.1-70 VOLUNTARY ADMISSIONS TO THE ALCOHOL AND DRUG ABUSE PROGRAMS (SDCL 34-20A) 8.1-72 INVOLUNTARY ALCOHOLISM AND DRUG ABUSE COMMITMENTS (SDCL 34-20A) 8.1-74 INITIATION OF CHEMICAL DEPENDENCY COMMITMENT FOR AN ADULT INPATIENT AT 8.1-76 OUT-OF-STATE REFERRALS 8 .1-78 INTERSTATE COMPACT REFERRALS 8.1-80 RETURNING PATIENTS FROM AUTHORIZED LEAVE 8.1-83 WRIT OF HABEAS CORPUS APPLICATIONS AND HEARINGS 8.1-85 FLAGGING RECORDS FOR NOTIFICATION COORDINATION OF FORCED MEDICATION HEARINGS 8.1-90 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM HEALTH CARE DECISIONS 8.1-92 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM ELECTRO-CONVULSIVE 8.1-94 MENTAL ILLNESS HOLD PROCEDURE FOR ADULT CHEMICAL DEPENDENCY PATIENTS 8.1?96 NON-SURVEILLANCE VIDEO AND AUDIO RECORDING PROCEDURE 8.1-99 CLINICAL REVIEW OF NURSING FACILITY REFERRALS AND ASSISTED LIVING 8.1-101 . Human Services Center - Chapter 8.1 Admissions Policy and Procedures 8 ADMISSIONS AND RECORDS 8.1 ADMISSIONS POLICY AND PROCEDURES 8.1.1 MISSION STATEMENT TO provide an efficient and effective system that guarantees that all admissions to the are consistently in compliance with all laws and regulations governing voluntary and involuntary hospitalizations at To ensure all patients are admitted pursuant to applicable statutes and guidelines and all patients are provided with periodic review and recommitment hearings as defined by the law. To advise community agencies, families and prospective patients Of admission procedures and policy for to review and interpret all accompanying legal documents for completion and accuracy and to monitor all inpatients so that appropriate mental illness hearings are scheduled pursuant to statute. Last Revised: 07/01/02 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.2 PRE-ADMISSION ARRANGENIENTS Policy: It shall be the policy of the that adult and chemical dependency admissions be pre-arranged with the Admissions Office. Arrangements for admission shall be made on a bed availability basis. Pu__rp0se: To identify necessary procedures associated with'the admission process and to obtain appropriate information. To ensure all legal requirements are met pursuant to state and federal regulations. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks House Supervisors Admission RNs Co?Occurring Coordinator Procedures: Non?emergency admissions shall be encouraged to arrive between the hours of 8:00am to 4:30pm, Monday through Friday. Emergency admissions, which are considered an immediate danger to self or others due to a severe and persistent mental illness, may be admitted any time, unless already hospitalized in a health/care facility and in need of additional medical care that exceeds the capability of is notified of all patients presenting for admission. Call Intake information shall become part of the patient?s electronic health record. Complete Call Intake in Health Information System. Obtain name and title of the individual making the admission arrangements as well as name, date of birth, legal status, county of referral, and county of residence of the proposed patient. Identify reason for admission, special precautiOns or needs and general behavior of proposed patient. Human Services Center Chapter 8.1 Admissions Policy and Procedures Identify legal status of hospitalization (voluntary or involuntary). Suggest that voluntary admissions be pre?screened by the community mental health center .or other mental health professionals to determine the appropriateness of admission to the For emergency admissions, the mental health center serving the area in which the board of mental illness is located, shall be contacted by the board chair of the committing county. Identify physical condition of pr0posed patient. If there is any indication of physical problems that may exceed the capability of the medical information shall be reviewed by the primary care physician, Clinical Director, House Supervisor or the Admission Nurse. may refuse the admission of any individual whose medical needs exceed the capacity of the Center (SDCL 27A-10-l7 and If proposed patient is a veteran, inquire to determine if a referral for hospitalization at a VA facility if appropriate. If proposed patient is a Native American living on a reservation or trust land, recommend that a contact be made with the Indian Health Services mental health office on the reservation to ensure that proper court orders and documentation are in place for a tribal commitment. The transporting officer completes the Custody document for all adult acute admissions. Any patient charged with murder, manslaughter, rape, or escape from a secure facility will be admitted to the Intensive Treatment Unit. After proper assessment, the attending will determine if the patient can be moved to another unit. Prepare an Alert flag for the chart if charges are verified via detainer or court order. Charges can be verified by contacting the Sheriff or States Attorney if the Custody document is signed on admission. Inquire if proposed patient has a legal guardian or Durable Power of Attorney for healthcare and, if so, request a copy of court order. Request copies of appropriate records accompany patient to the Center. Examples: progress notes, recent laboratory, etc. Ask about insurance coverage and who is the responsible payer for the admission fee and daily costs. Request that appropriate information be sent to as soon as possible. Admission to HSC is not dependent on a patient? financial resources or ability to pay. No admission or transfer shall be delayed or denied based on financial consideration. Chapter 8.1 Human Services Center Admissions Policy and Procedures Calls shall be made directly to the Admission office for referral. All calls should be routed to HSC Communications once the Admission nurse is no longer on duty. Communications routes calls to the House Supervisor. Pre-adrnission (call intake) information shall be entered into the Health Information computer system. Call Intake information shall become part of the patient?s record. Once the patient is medically cleared for admission, unit assignment is made by accessing the Admission Rotation located on the N: Drive. For complicated admissions, contact the Medical Director if there are concerns regarding or physical condition. CD information is identified on intake in Health Information System Call Intake. Transport personnel are informed that they will be required to wait up to30 minutes once the patient presents for admission to ensure the patient meets criteria for admission. If the patient was not prescreened prior to arrival or admission criteria are questionable, the wait could be longer. Last Revised: 07/01/16 Last Reviewed: 07/0 1/ 16 Next Review Date: 07/01/ 17 AR.8.1-6 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.3 NIEDICAL SCREENING Policy: It shall be the policy of the that all admissions be screened for medical needs that may exceed the capacity (capability) of the Center in accordance with SDCL 27A- 10? 17, 10? 18, 34? 20A 51, and 34? 20A- 77 Purpose: To ensure the physical safety of patients admitted to by determining prior to admission, that the patient?s medical needs-can be provided for within the capability of the Center. To ensure that outside medical services and equipment can be arranged for the patient prior to admission at the Center. Responsible Parties: Admissions Officer - House Supervisors Admission Nurses - Primary Care Physician Co?Occurring Coordinator Medical Director Director of Quality Management 0 Administrator Procedure: The Admissions Officer, Admission Nurse, Co-Occuiring Coordinator, Admissions Social Worker, or House Supervisor shall complete the Call Intake in the Health Information System. may refuse the admission of any individual whose medical needs exceed the capacity (capability) of the Center (SDCL and 27A-10-18). . Physical condition of proposed patient shall be identified. If the patient is currently hospitalized, the Admissions staff, or House Supervisors shall request that all medical records which may include the History and Physical, Evaluation, Medication List, Medical Consultation Reports and pertinent lab values be transmitted or faxed to the Center for review. - Chapter 8.1 . Human Services Center Admissions Policy and Procedures The medical information shall be reviewed by the Medical Director, Primary Care Physician, House Supervisor or the Admission Nurse. If it is determined that has the capability to meet the medical needs of the proposed patient, the admission will be accepted. If it is determined that the patient?s medical needs may exceed the capability of the Center to provide care, the assigned on?call or Medical Director shall review the medical information received and if necessary shall consult with the referring physician or agency. If the assigned on?call Medical Director, or Primary Care Physician determines that the patient?s medical needs exceed the capacity of the Center, the admission shall be denied. The physician who makes the determination for denial based on the patient?s needs exceeding the capability of the facility shall document clearly what needs cannot be met by Any patient that has been denied admission based on these criteria may be reconsidered at any time if the condition that precipitated denial has resolved to a level that can now be met by the The physician who denies the admission on behalf of shall infOrm the Admissions RN or House Supervisor to enter a note in the Call Intake in the Health Information System that explains why the patient?s medical needs exceed the capacity of the Center as well as . any communication that occurred between the physician and the referring agency. The Medical Director shall be consulted for any complex medical situations that need more extensive review and evaluation. The Medical Director, Director of Quality Management and Administrator shall be notified of any patient who was denied admission to Origination Date: 09/ 13/07 Last Revised: 01/14/15 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 (Hold down on the ?Ctrl? key and click once on the below hyperlink to access the ?Medical Clearance for Admission to document. Select ?File, Close? to return to this document) N:\Policies\Documents\Medical Screening Process for Admission to HSC.pdf Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.4 VOLUNTARY REFERRALS FOR CARE - ADULT Policy: It shall be the policy of the that any adult may be hospitalized as a voluntary patient at the if deemed clinically suitable and on a bed availability basis. (Out?of?State resident referrals must be reviewed with the Medical Director or on?call Physician prior to acceptance.) Purpose: To ensure mental health services are available to all adults who voluntarily desire treatment and if hospitalization is indicated. To identify necessary procedures associated with the admission process. To comply with State statute SDCL Responsible Parties: Medical Director Admissions Officer Senior Secretary (Admissions Office) Physician and Admissions Clerks Medical Records House Supervisor Admissions Nurse Co?Occurring Coordinator Procedure: Refer to this Chapter, Section entitled? Pre?Admission Arrangements? of the Policy and Procedure Manual. Person must be able to understand the nature of voluntary inpatient treatment. Patient must be capable of giving informed consent. Person must be willing to execute a written Application for Admission, Form ?001. A less restrictive alternative is inappropriate or unavailable. Person is in need of and will likely benefit from inpatient treatment. AR.8.1-9 Chapter 8.1 Human Services Center Admissions Policy and Procedures Person understands that his treatment will involve inpatient status. Person is willing to be admitted to the facility. Person consents to admission voluntarily, without any element of force, duress, threat or other form of coercion. Person shall be provided a copy of the South Dakota Human Services Center Patient Handbook. Written application for admission shall not be signed by the patient until the admitting physician determines appropriateness and ability to give informed consent. Pursuant to 27A-13-5 a $600 admission fee must be tendered at the time of admission or authorization received from the county of residence or some other governmental agency. The authorization process is completed with the Business Office. Admission fee may be waived for out-of?state referrals (SDCL 27A-l3?19. 1). Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-10 Human Services Center . Chapter 8.1 Admissions Policy and Procedures 8.1.5 ADULT VOLUNTARY REFERRAL BY A LEGAL GUARDIAN, DURABLE POWER OF ATTORNEY FOR HEALTHCARE OR NEXT OF KIN Policy: It shall be the policy of the that any adult presenting for admission without any element of force, duress, threat or other form of coercion and who is incapable of exercising an informed consent to his admission, may be admitted pursuant to a substitute informed consent of a legal guardian or next of kin as defined in 27A?l?l and 27A?8~l, and in accordance with 27A?8?18.l and if clinically suitable for inpatient treatment and on a bed availability basis. Purpose: To ensure mental health services are available to any adult individual who requests voluntary treatment but is unable to give informed consent to admission. To identify necessary procedures associated With the admission process. To comply with state statute (SDCL and 27A-8-l9.) Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Physician/PA?C/CNP?S Admissions Clerks Medical Records 0 House Supervisors Admissions Nurse Co?Occurring Coordinator Procedures: Refer to this Chapter, Section entitled ?Pre?Admission Arrangements? of the Policy and Procedure Manual. Evaluate to determine if a less restrictive treatment alternative is appropriate or available. Individual must be in need of and will likely benefit from inpatient treatment. Guardian or next of kin must accompany the patient to the and sign the admission documents unless pre?admission arrangements are made with the Admissions Officer or designee. - AR.8.l-ll Chapter 8.1 Human Services Center . Admissions Policy and Procedures Guardianship must be over the person and durable power of attorney must address healthcare decision?making authority. Guardian must provide a copy of the Guardianship Order, and Durable Power of Attorney (DPOA) must provide DPOA document for file. - Application for admission must Hn_o? be signed by the guardian/next of kin until the admitting Physician/PA?C/CNP determines appropriateness. If guardian or DPOA is not present upon admission, forms can be faxed for signature. Forms must be signed by the guardian or DPOA before patient can be admitted. If there is no guardian or DPOA, the parent?s next of kin may consent to admission providing the following conditions are adhered to: - SDCL (34?1203) Preference for Delegation of Authority: Spouse, if not legally separated, adult child, a parent, adult sibling, grandparent or adult grandchild, adult aunt or uncle, or adult niece or nephew. 0 Next of kin consent SDCL valid for fourteen (14) days. If a petition is filed with the circuit court by the consenting next of kin within the 14 days, admission of the non-objecting person may continue pending hearing. I If a petition is not filed within the 14 days, the person shall be discharged upon the expiration of the 14-day admission period. 0 The court may authorize continued admission if the person continues to be in agreement and if criteria are met. a The person is entitled to all rights accorded other voluntary patients. Such person is entitled to all rights accorded other voluntary patients including his right to Sign a written request for release. The guardian, durable power of attorney, next of kin and the patient shall be given copies of the Patient Handbook. A $600 admissionfee must be tendered at the time of admission or authorization received from the county of residence or some other governmental agency. The authorization process is completed with the Business Office. Last Revised: 09/29/ 14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.6 VOLUNTARY REFERRALS FOR CARE - MINOR Policy: It shall be the policy of the that any minor may be hospitalized as a voluntary patient at the pursuant to SDCL if deemed clinically and medically stable and on a bed availability basis. Purpose: To ensure mental health services are available to all minors who are in need of inpatient treatment and care. To identify necessary procedures associated with the admission of minors. To comply with existing state statutes (SDCL Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Program Director for Adolescent Services Physicians and Admissions Clerks Medical Records Social Worker or designee Admissions Nurse Co-Occurring Coordinator Adolescent Admissions Coordinator Criteria: The minor has a serious emotional disturbance as defined in SDCL The minor needs and is likely to benefit from inpatient treatment. The minor has a right to be treated in the least restrictive treatment setting. The facility has determined that: Alternatives have failed to meet the minor's treatment-needs, Less restrictive treatment alternatives will not meet the minor?s diagnostic needs. The parent or guardian has exercised an informed consent to inpatient treatment. Chapter 8.1 Human Services Center Admissions Policy and Procedures Procedures: Pre?admission arrangements are made by the Adolescent Admissions Coordinator. Application for admission shall be made by a parent, guardian or legal custodian. If application is made by a guardian (non-parental) or legal custodian, proof of guardianship (court order) must accompany minor to the facility. The Department of Social Services may place a child in an inpatient facility on a voluntary by guardian basis upon the recommendation of a qualified mental health professional if applicable criteria are met. An explanation of the written application and nature of inpatient status pursuant to SDCL shall be given to both the parent! guardian and the minor, including the minor's . right to Object to admission. Informed consent to inpatient treatment shall be obtained orally and in writing from the parent/guardian. Application for admission must n_ot be signed until physician examines patient and determines appropriateness. Prior to admission the minor must be evaluated by a qualified mental health professional. If admission is denied, the Administrator/designee shall refer the parents and minor to other programs or services that may be appropriate. Patient and parent/ guardian shall be provided with a copy of the Patient Handbook. A $600 adm'issiOn fee must be tendered at the time of admission or authorization received from the county of residence or some other governmental agency. The authorization is completed with the Business Office. Admission fee may be waived for out? of?state referrals (See SDCL 1). If patient is Title 19, then the admission fee 1s waived for minors only. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.7 ADMISSION OF EMANCIPATED MINORS (VOLUNTARY) Policy: It shall be the policy of the that minor patients who are emancipated pursuant to SDCL 25-5-19 and 25?5-26 may be admitted to the for treatment and care, if deemed clinically suitable and on a bed availability basis. Purpose: To comply with existing state statutes concerning the emancipation of minors (SDCL 25-5? 19, 25-5-26). To identify necessary procedures with the admission process. To ensure that mental health services are available to all emancipated minors who are in need of inpatient treatment and care. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Medical Records House Supervisor Social Worker Program Director Admissions Nurse Co-Occurring Coordinator Procedures: Refer to this Chapter, Section entitled ?Pre?Admission Arrangements? of the Policy and Procedure Manual. Person must be able to understand the nature of voluntary inpatient treatment. Patient must be capable of giving informed consent. Person must be willing to execute a written Application for Admission Form, which is the same form as an adult signs. A less restrictive alternative is inappropriate or unavailable. Chapter 8.1 . Human Services Center Admissions Policy and Procedures Person is in need of and will likely benefit from inpatient treatment. Person understands that his treatment will involve inpatient Status. Person is willing to be admitted to the facility. Person consents to admission voluntarily, without any element of force, duress, threat or other form of coercion. -. Person shall be provided with a copy of the Patient Handbook. Written application for admission must not be signed by the patient until the admitting physician determines appropriateness and ability to give informed consent. Pursuant to a $600 admission fee must be tendered at the time of admission or authorization received from the county of residence or some other governmental agency. The authorization is completed with the Business Office. Admission fee may be waived for out?of?state referrals (SDCL If patient is Title 19, then the admission fee may be waived for minors only. A copy of the Express Agreement of Emancipation and a copy of the Declaration of Emancipation (issued by the court) shall accompany the patient to the center (should be on file with the clerk of courts). Emancipated minors shall be admitted to the adult admission units, unless, programmatically, their needs can best be met in the adolescent program. Emancipated minors shall be allowed to execute a written request for release, if requested. Emancipated minors shall be entitled to all rights accorded adult voluntary patients. Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.8 ADNIISSION OF FIVE-DAY EMERGENCY AND HEARING PROCEDURES - ADULTS Policy: It shall be the policy of the that any patient admitted to the pursuant to the emergency procedures of the mental health code shall be provided with a mental illness hearing, unless discharged prior to hearing or patient is converted to voluntary status. Purpose: To maintain compliance with state statute To identify necessary procedures involved with the hearing process. Responsible Parties: Admissions Clerks Attending Physician Admissions Officer Senior Secretary (Admissions Office) Nurse on the Unit Medical Records House Supervisors - Admissions Nurse Co-Occurring Coordinator Procedures: Option 1: Refer to this Chapter, Section entitled ?Pre-Admission Arrangements? of the Policy and Procedure Manual. A copy of the Emergency Order for Detention, Application for Emergency Treatment/Petition and Report of the Qualified Mental Health Professional shall accompany the patient to the Center. If the Order for Detention is not available upon admission, a verbal order must be obtained from the referring County Board Chair. V,erbal orders can only be accepted from the Yankton County Board Chair. An exception can be made if the Administrative person on?call or Admissions Officer gives approval for a verbal order to be faxed to the next working day. If a certified Copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a certified order or duplicate original. Chapter 8.1 Human Services Center Admissions Policy and Procedures If the Order for Detention does not include findings of residency, the Admissions Clerk will attempt to collect information from the patient or petition/certificate. If the county of residence still remains unclear, the mental health board will make the final determination of residency. Information must be obtained as to when the person was taken into protective custody so that an appropriate hearing date can be set. Contact the attending Physician/designee prior to hearing for recommendations. The attending Physician shall complete a Physician?s Assessment form indicating whether the patient meets commitment criteria. If criteria is not met, the patient must be discharged or sign the Voluntary Application for Treatment. Signs voluntary prior to hearing (See Chapter 8.1 (Admissions), Section entitled ?Converting Emergency Commitments to Voluntary Status Prior to Hearing? of the Policy and Procedure Manual). Discharge prior to hearing as not meeting commitment criteria (Refer to this Chapter, Section entitled ?Discharge of an Emergency Admission Prior to a Hearing? of the Policy and Procedure Manual). The Board Chair in the referring county shall be notified if: The patient signs a voluntary agreement. The patient shall be discharged as not meeting commitment criteria. If commitment is recommended, the attending Physician shall complete a Physician?s Assessment form indicating the patient meets commitment criteria with a copy of the form to Social Services. Notify the chair of the Yankton County Board of Mental Illness acknowledging the admission (name of committing county and/or county of residence and date of hearing). Send copies of legal documents to the State's Attorney and chair of the Yankton County Board of Mental Illness, including affidavits and police reports. The Authorization to Inspect Document signed by the chair of the Yankton County Board of Mental Illness shall be placed in the patient?s file so that the independent examiner and defense counsel may have access to the medical records file. The Authorization to Inspect Document submitted by the Yankton County Board Chair may not be available until the day following the hearing; therefore the Admissions Secretary shall notify the Unit staff verbally and by documenting in the Health'Information System Progress Notes of the appointment of counsel and assignment of the Qualified Mental Health Professional. AR.8.1-18 Human Services Center Chapter 8.1 Admissions?Policy and Procedures The day prior to the hearing, the treatment unit area shall be notified by phone of the time for hearing so that the patient shall be available. The patient's medical records file and electronic health record shall be brought to the hearing room containing information on medication and treatments. The Admissions Senior Secretary or designee shall attend the hearings, record the decisions of the Board, assist in getting patients to the hearings and secure the patient?s medical record. If commitment criteria is met, the board of mental illness may commit the person to for a period of time not to exceed ninety (90) days. At the time of the initial hearing, and without further notice, a review hearing in addition to the statutory review hearing may be ordered by the board of mental illness. The Board decision shall be transmitted to the Admissions Senior Secretary or designee so that legal status changes can be entered into the Health Information System. A certified copy of the Board's order shall be obtained from the chair of the Yankton County Board of Mental Illness to be filed in Medical Records with a copy for the treatment unit chart and the Business Office. If commitment criteria is not met, the Board shall order the immediate release of the patient. The patient may remain as a voluntary patient, if clinically indicated. If the patient is not appropriate for voluntary status, a discharge must occur the date of release by the Board, unless the patient signs a ?Notice of Request? for permission to remain at the form indicating he/she agrees to remain at pending transportation arrangements. The patient must also give consent for continued hospitalization by signing the Voluntary Application form. Option #2 (If the alleged mentally ill person is a non?resident of the state, the South Dakota Human Services Center may be used as an appropriate regional facility) (SDCL 27A-10-2): A copy of the Application/Petition for Emergency Treatment and Detention Order shall accompany the patient to the Center. The Chair of the Yankton County Board of Mental Illness shall be notified to designate a qualified mental health professional (QMHP) to conduct an evaluation. Once the QMHP is designated, an evaluation shall be completed within 24 hours of the time the individual was taken into custody. AR.8.l?l9 Chapter 8.1 Human Services Center Admissions Policy and Procedures The QMHP shall submit a copy of the evaluation to the Yankton County Board of Mental Illness Chair. The Yankton County Board of Mental Illness Chair shall contact the Admissions Office with the Verbal Order for detention. A copy of the Order for Detention shall be faxed to the Admissions Office the next business day. Follow the same procedures as Option Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center I Chapter 8.1 Admissions Policy and Procedures 8.1.9 ADMISSION OF INVOLUNTARY NINETY (90) DAY COMNIITNIENTS - ADULTS Policy: It shall be the policy of the that any adult committed by the county board of mental illness shall be admitted for treatment. Pumose: To maintain compliance with State Statute To facilitate mental health services for adult referrals. To identify necessary procedures with the admission process. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Admissions Nurse Co-Occurring Coordinator House Supervisor Procedures: Refer to this Chapter, Section entitled ?Pre-Admission Arrangements? of the Policy and Procedure Manual. A certified copy of the Findings and Order for Commitment, a copy of the Emergency Petition and a copy of the Examination by Qualified Mental Health Professional shall accompany patient to the Center. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a certified order or duplicate original. If the referring county does not make a findings of residency, may carry the referring county as the county of residence until a determination of residency is made by the mental health board. Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.10 NEENTAL ILLNESS HEARINGS FOR EMERGENCY ADMISSIONS - MINORS Policy: It shall be the policy of the that any minor patient admitted to the pursuant to the emergency procedures of the mental health code shall be provided with a mental illness hearing, unless discharged or converted to a voluntary by parent or guardian. Purpose: To maintain compliance with state statute (SDCL To identify necessary procedures involved with the hearing process. To provide emergency services fer minor referrals who require immediate intervention. Responsible Parties: Admissions Clerks Admissions Officer Senior Secretary (Admissions Office) Program Director, Adolescent Services Social Worker Medical Records Admissions Nurse Co?Occurring Coordinator 0 House Supervisor . Adolescent Admissions Coordinator Procedures: Option Pie?Admission arrangements are made by the Adolescent Admissions Coordinator. I A certified or original copy of the Emergency Order for Detention, Application for Emergency Treatment/Petition and Report of the Qualified Mental Health Professional shall accompany the patient to the Center. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a 'Certified order or duplicate original. Human Services Center Chapter 8.1 Admissions Policy and Procedures If the referring county does not make a findings of residency, may carry the referring county as the county of residence until a determination of residency is made by the mental health board. Obtain information as to when the minor was taken into protective custody?so that an appropriate hearing date can be set. Contact the attending Physician/designee the day prior to the hearing for recommendations: Signs voluntary by parent or guardian prior to hearing. Discharge prior to hearing as not meeting commitment criteria. Refer for commitment by completing the Physician? Assessment - Minor. - If commitment is not recommended, the attending Physician shall complete a Physician's Assessment Minor form indicating that the minor does not meet commitment criteria. The patient must then be discharged pursuant to SDCL 27A-15-26 or the parent or guardian must give consent for continuing hospitalization. The Board Chair in the referring county shall be notified by the Admissions Office if: - The parent or guardian signs a voluntary agreement. The minor shall be discharged as not meeting commitment criteria. If commitment is recommended, the attending Physician shall complete a Physician's Assessment form indicating the patient meets commitment criteria with a copy of the form to assigned social worker. Notify the chair of the Yankton County Board of Mental Illness acknowledging the admission (name of committing county and/or county of residence and date of hearing. Send copies of legal documents to the state?s attorney and chair of the Yankton County Board of Mental Illness, including affidavits and police reports. The Inspection of Records order signed by the chair of the Yankton County Board of Mental Illness shall be placed in the patient?s file so that the independent examiner and defense counsel may have access to the medical records file. The Authorization to Inspect document signed by the Yankton Board Chair may not be available until the day following the hearing; therefore the Admissions Secretary . AR.8.1-23 Chapter 8.1 I Human Services Center Admissions Policy and Procedures or designee shall notify unit staff verbally and document information in the Health Information System Progress Notes. The day prior to the hearing, the treatment unit area shall be notified by phone of the time for hearing so that the patient will be available. A record of all drugs, medication and other treatments or interventions since the patient's admission to the facility shall be provided to the Board of Mental Illness at the time of the hearing. (Medical Records chart and electronic health record is made available to the Board of Mental Illness). The Admissions Senior Secretary or designee shall record the decisions of the Board, assist in getting patients to the hearings, and secure the clinical file. If commitment criteria are met, the Board of Mental Illness may commit the minor to for a period of time not to exceed forty-five (45) days (SDCL At the time of the initial hearing, and without further notice, a review hearing in addition to the statutory review hearing may be ordered by the Board of Mental Illness. The Board?s decision shall be transmitted to Admissions Senior Secretary or designee so that legal status changes can be entered into the Health Information System. - A filed copy of the Board's order shall be obtained from the chair of the Yankton County Board of Mental Illness to be filed in Medical Records with a copy for the treatment unit chart and Business Office. If commitment criteria are not met, the Board shall order the immediate release of the patient. The patient may remain as a voluntary by parent or guardian, if clinically indicated. Option #2 (After office hours, weekends and holidays): A certified or original Order for Detention, a Certificate of Mental Health Professional and a copy of the petition shall accompany the minor to the Center. Verbal order from Yankton County Board Chair is accepted. Administration approval is required for verbal orders from other County-Board Chairs. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a certified order or duplicate original. The Chair of the Board of Mental Illness shall telephone the Admissions Office indicating he/ she has reviewed .the petition, obtained a report from the Qualified Human Services Center Chapter 8.1 Admissions Policy and Procedures Mental Health Professional and would authorize the minor?s admission with the order to be telefaxed to the next morning. Verbal orders can only be accepted from the Yankton County Board Chair. An exception can be made if the Administrative person on?call or Admissions Officer gives approval for admission. A signed copy of the order must be telefaxed to the next working day. Follow the same procedures as Option Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.11 ADMISSION OF INVOLUNTARY FORTY-FIVE (45) DAY COMNIITMENTS (MINOR) Policy: It shall be the policy of the that any minor committed by the county board of mental illness shall be admitted for inpatient treatment on a bed-availability basis. Purpose: To maintain compliance with State Statute To identify necessary procedures with the admission process. To facilitate mental health services for minor referrals. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Social Worker for Adolescent Services Program Director, Adolescent Services Admissions Nurse Co?Occurring Coordinator House Supervisor Procedures: Pre?admission arrangements are made with Adolescent Services. A certified copy of the Findings and Order of Commitment, a copy of the Emergency Petition and a copy of the Report of Qualified Mental Health Professional shall accompany the patient to the Center. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a certified order or duplicate original. Adolescent Services shall advise Admissions Office of admission date and time, including county of residence. Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-26 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.12 CONVERTING VOLUNTARY PATIENT TO EMERGENCY STATUS (PATIENT EXECUTED A WRITTEN REQUEST FOR RELEASE) Policy: It shall be the policy of the that a voluntary patient, who executed a written Request for Release may be brought before the Mental Health Board when the treatment team recommends commitment. Pumose: To ensure that voluntary patients, who require inpatient hospitalization, are presented to the Mental Health Board for commitment purposes. To identify specific procedures necessary to implement the commitment process. To comply with existing statute SDCL 1. Responsible Parties: Administrator Treatment Team Treating Physician Administrator on?call Admissions Officer Senior Secretary (Admissions Office) Supervising Nurse Medical Records Admissions Nurse Co?Occurring Coordinator House Supervisor Procedures: Emergency detention of voluntary patient who executes a written Request for Release. 0 Attending Physician/on-call physician indicates emergency intervention is indicated. 0 Patient shall be immediately provided with the 24?hour hold notice and a copy with an explanation of the hold by treatment staff. The Administrator on?call must be notified once the patient is placed on a hold'via email sent by the Senior Secretary or designee. During Business Hours the Admissions Office assists unit staff to ensure all legal documents are completed. Chapter 8.1 Human Services Center Admissions Policy and Procedures The petition is completed by any staff member having knowledge of the patient? 5 dangerousness. Notify the Yankton County Board Chair once the petition is completed. The Qualified Mental Health Certificate is completed by a QMHP at at the time of the petition or no later than 24 hours of the hold. The documents (hold notice, petition and QMHP Certificate) are brought to the Admissions Officer or designee. The petition is notarized or verified by affidavit pursuant to The Yankton County Board Chair is contacted for a verbal order for detention. Legal status changed in Health Information System. The original petition and QMHP Certificate are forwarded to the Yankton County Board Chair. Copies shall be sent to the unit and States Attorney?s office. After Hours (Fridays after 4:30pm, Saturdays, Sundays, and holidays) the House Supervisor or supervising nurse of the unit shall ensure all legal documents are completed. The patient shall be immediately provided with a Hold notice and a copy with explanation of the hold by unit staff. The pink copy is forwarded to Admissions Officer or designee for follow?up the next business day. A petition is completed by any staff member with first-hand knowledge of patient?s dangerousness. The petition is notarized or verified by affidavit. The Yankton County Board Chair is notified of the petition. A QMHP is designated by the Board Chair. The Qualified Mental Health Certificate must be completed within 24 hours of the petition by a QMHP other than the petitioner. A verbal order for detention is Obtained from the Yankton County Board Chair. Change of legal status is made in Health Information System. Original documents shall be forwarded to Yankton County Board Chair with copies to the unit and States Attorney?s office. Procedures for Native Americans who reside on Reservation or Trust Lands. Follow the initial procedures above, but notify Tribal Judge or Tribal Prosecutor rather than the County Board Chair. Obtain date and time for hearing. If unable to reach tribal officials, contact the Yankton County Board Chair. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures - 8.1.13 CONVERTING VOLUNTARY PATIENT TO EMERGENCY STATUS (PATIENT DID NOT EXECUTE WRITTEN REQUEST FOR RELEASE) Policy: It shall be the policy of the that a voluntary patient may be converted to an emergency commitment status even though he/she has not submitted a written request for release. Purpose: To comply with existing statute SDCL 27A-8-11.2. Patient is unwilling or unable to continue to give informed consent to admission. Patient is unwilling or unable to continue to give informed consent to treatment. Patient meets the criteria for involuntary commitment. Responsible Parties: Treatment Team Treating Physician Supervising Nurse Admissions Officer Senior Secretary (Admissions Office) Medical Records Co?Occurring Coordinator House Supervisor Procedures: Attending Physician recommends that commitment proceedings be initiated. Patient shall be provided with a 24-Hour Hold Notice with an explanation of the hold. The Administrator must be notified once the patient is placed on hold via email sent by the Senior Secretary or designee. Refer to Admissions policy entitled ?Converting Voluntary Patient to Emergency Status (Patient Executed A Written Request for Release)? for business and after hour? procedures. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.14 CONVERTING EMERGENCY COMIVIITMENTS T0 VOLUNTARY STATUS PRIOR TO HEARING m: It shall be the policy of the that Emergency Admissions (as identified in SDCL may be converted to voluntary status prior to formal hearing if deemed appropriate by the treatment team. Purpose: To encourage voluntary treatment. To identify necessary procedure to implement the change of legal status from involuntary to voluntary. To comply with existing State Statute Responsible Parties: Treatment Team - Admissions Officer Admissions Clerks 0 Senior Secretary (Admissions Office) Medical Records Admissions Nurse Co?Occurring Coordinator House Supervisor Procedures: The treatment team shall decide the appropriateness of converting an emergency admission to voluntary status based on clinical determination. The patient shall be accompanied to the Admissions Office to sign the voluntary admission agreement. Legal status change is entered into health information system by Admissions staff. Human Services Center Chapter 8.1 Admissions Policy and Procedures The Senior Secretary or designee shall notify the mental illness board chair in the county which initiated the commitment indicating that the patient signed a voluntary agreement. Last Revised: 12/22/15 Last Reviewed: 07/0 1/ 16 Next Review Date: 07/01/17 AR.8.1-31 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.15 DISCHARGE OF AN EMERGENCY ADMISSION PRIOR TO A HEARING @1331: It shall be the policy of the that an emergency admission may bedischarged prior to a mental health board hearing. Purpose To avoid a hearing before the mental health board when the patient does not meet the criteria for commitment. To facilitate the least restrictive treatment environment. Compliance with SDCL 27A-l4- .2 and 27A-l4~l .3. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Physicians Treatment Team Co-Occurring Coordinator Admissions Nurse House Supervisor Procedures: The treatment team shall decide the appropriateness of discharge prior to hearing based on clinical information. Recommendation shall be submitted to the Admissions Office as soon as possible because of time constraints. If discharge is recommended, the patient shall be released no later than the day his/her mental illness hold expires unless the patient signs a Voluntary Application for Treatment indicating that he/she is willing to remain in the hospital pending transportation arrangements. The patient must also sign the Notice of Request for Permission to Remain at the SD Human Services Center form. The Senior Secretary or designee shall notify the mental illness board chair in the referring county so that the Emergency Petition may be dismissed. Last Revised: 07/01/ 16 I Last Reviewed: 07/01/16 Next Review Date: 07/01/ 17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.16 . MONITORING ADOLESCENT ADMISSIONS WHO REACH THE AGE OF MAJORITY Policy: It shall be the policy of the that any adolescent patient, whoseapplication for admission was executed by a parent or legal guardian, cannot be retained at the once the patient reaches the age of majority unless a voluntary admission agreement is signed by the patient or unless committed pursuant to state statute. Purpose: To ensure that the patient is not detained illegally at the once he/she has reached the age of majority. To encourage and provide on?going care for the adolescent, if appropriate. To identify necessary procedures associated with this policy. Responsible Parties: Administrator Treatment Team Attending Physician Admissions Officer Senior Secretary (Admissions Office) House Supervisor Social Worker Admissions Nurse Co?Occurring Coordinator Procedures: Per SDCL any minor admitted by a parent/guardian shall be informed orally and in writing five (5) days prior to minor?s 18th birthday that continued hospitalization requires the minor?s consent. Approximately three weeks prior to the adolescent's 18th birthday, social worker shall. contact the Admissions Officer or designee if patient will remain hospitalized after turns 18. Legal status change and transfer to an Adult unit shall be determined. The patient shall be discharged by his 18th birthday, or sign an Adult Voluntary Admission Agreement, or be committed pursuant to state statute. The patient could also remain hospitalized pursuant to and 19. Chapter 8.1 Human Services Center Admissions Policy and Procedures If mental illness commitment is recommended, please follow the procedures in this Chapter, Section entitled ?Converting Voluntary Patient to Emergency Status (Patient Executed a Written Request for Release)? of the Policy and Procedure Manual. If chemical dependency commitment is recommended, the treatment team shall notify the HSC Co?Occurring Coordinator. Last Revised: 09/29/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.17 COORDINATING AND SCHEDULING MENTAL ILLNESS HEARINGS Policy: It shall be the policy of the that all patients who have been involuntarily committed shall be afforded review and recommitment hearings as set forth by state statute. Purpose: To ensure that no patient is denied his/her right to a hearing. To identify procedures associated with the hearing-process. To comply with state statute. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Co?Occurring Coordinator Procedures: Maintain daily records concerning all involuntarily committed patients. Assess upcoming hearing report in Health Information System. Prepare listing each month of all patients eligible for forty?five day review hearings, ninety? day review hearings, six-month review hearings and yearly review hearings. The hearing list includes residence counties and due date for hearing. A separate listing shall be proposed for all Native American referrals committed by the Tribal Court to Indian Health Service and placed at the Set dates for mental illness hearings. Make copies of listings for the Program Directors in Acute, Geriatric, Rehab, Adolescent, Director of Social Services, and the Chair of Yankton County Board of Mental Illness. Send Physician Assessments to appropriate units for physician signature two to three weeks prior to hearing. Coordinate the scheduling of hearings with the Yankton County Board of Mental Illness- Chair. Chapter 8.1 Human Services Center Admissions Policy and Procedures Monitor patient discharges and notify Yankton County Board Chair if a committed patient has been released. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-36 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.18 OBJECTION BY MINOR OR GUARDIAN TO INPATIENT HOSPITALIZATION Policy: It shall be the policy of the that a minor shall have the right to execute a written objection to continued inpatient treatment. m3 To comply with existing state statute (SDCL 27A-15, and To identify necessary procedures for the objection process. To facilitate hearings for minors objecting to hospitalization. Responsible Parties: Admissions Officer Treatment Team Treating Physician Supervising Nurse Program Director, Adolescent Services Social Worker Senior Secretary (Admissions Office) Admissions Nurse Co-Occurring Coordinator House Supervisor Procedures: When a minor or his or her guardian submits an oral or written objection to hospitalization, the staff on the unit shall supply the minor and his or her guardian with the Voluntary Patient?s Notice of Written Objection to Continued Treatment (Minor) form and assist the minor in its proper execution. The Administrator or Administrator on?call must be notified once the form is signed. A copy of the Objection to Treatment Form shall be provided to the minor and guardian. The minor shall be notified verbally and in writing of his/her rights pursuant to SDCL 15? 15.2. A copy of the written objection 'shall forthwith be filed with the Chair of the Yankton County Board of Mental Illness (responsibility of Admissions Office) or House Supervisor nurse on weekends and holidays). Chapter 8.1 I Human Services Center Admissions Policy and Procedures Minor shall be examined by a Qualified Mental Health Professional within 24 hours of the filing of the objection including weekends and holidays. Report of Qualified Mental Health Professional shall be filed with the Chair of the Yankton County Board of Mental Illness (responsibility of Admissions Office during normal working hours or House Supervisor on weekends and holidays). - Minor shall immediately be given a copy of his/her rights (responsibility of treatment staff). Inpatient treatment of minor may continue pending hearing. may discharge the minor prior to hearing, if he/she no longer meets criteria in SDCL The Chair of the Yankton County Board of Mental Illness shall notify the Admissions Office of the date, time and place of hearing. The attending Physician shall complete a Physician?s Assessment form to be placed in the medical records file. A copy of the Physician?s Assessment form shall also be sent to the Social Worker. The day prior to the hearing, the treatment unit area shall be notified by phone of the time set for the hearing. The patient's medical record file including the electronic health records shall be brought to the hearing room containing information on medications and treatments the patient has received since admission, up to a maximum of one year. The Admissions Senior Secretary or designee shall attend the hearings, record the decisions of the Board, assist in getting patients to the hearings and secure the clinical file. If the board determines that criteria in SDCL are met, the minor's and/or guardian?s objection shall be over-ruled and the minor shall continue his/her inpatient treatment for the duration of the 45-day admission period. If the board determines that criteria are not met, the minor shall be immediately discharged to the custody of the guardian or County authorities as designated in statute. If the board finds that inpatient treatment is inappropriate under the criteria in SDCL 27A- 15?5, such treatment may only be authorized through involuntary commitment procedures. AR.8.1-38 Human Services Center Chapter 8.1 Admissions Policy and Procedures A certified COpy of the Board?s order shall be obtained from the Chair of the Yankton County Board of Mental Illness to be filed in Medical Records with a copy made for the treatment unit chart. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-39 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.19 DAY REVIEW HEARINGS Policy: It shall be the policy of the that all minor patients who are involUntarily committed to the for a period of time not to exceed forty-five (45) days shall be provided with a review hearng every forty?five (45) days unless discharged or converted to voluntary by parent or guardian. Purpose: To comply with existing state statute (SDCL 27A-15-41). To identify necessary procedures with the admission process. Responsible Parties: Attending Physician Admissions Officer Senior Secretary (Admissions Office) Social Worker Medical Records Co-Occurring Coordinator Unit Staff Procedures: The Chair of the Yankton County Board of Mental Illness shall be provided with the names of patients who would be entitled to a forty-five (45) day review hearing at least ten (10) days prior to the date of the scheduled review hearing. If commitment is not recommended, the attending Physician shall complete a Physician?s Assessment Minor form indicating that the patient does not meet commitment criteria. The patient must then be discharged or the parent/ guardian must sign the Voluntary Application for Treatment consenting to continued hospitalization. The Chair of the Yankton County Board of Mental Illness shall be notified to cancel the scheduled review hearing. If the patient remains as a voluntary by signature of parent or guardian, Senior Secretary or designee shall be notified to run a legal status change in Health Information System once the signed document is received. Human Services Center - Chapter 8.1 Admissions Policy and Procedures If commitment is recommended, the attending Physician shall examine the patient and complete a Physician Assessment- Minor form indicating that the patient meets commitment criteria. The day prior to the hearing, the treatment unit area shall be notified of the time set for the hearing, the appointment of Legal Counsel and assignment of QMHP. The information shall be entered 1n the Health Information System. The patient?s medical chart, Medication Administration Record (MAR), and the electronic health record shall be brought to the hearing room at the time of the scheduled review hearing. The Admissions Senior Secretary or designee shall record the decisions of the Board, assist in getting patients to the hearings and secure the clinical file. If commitment criteria is met, the board of mental illness may commit the person to the with provisions for a rehearing every forty?five days. The Board decisions shall be transmitted to Admissions Senior Secretary or designee so that a legal status change can be entered into the Health Information System. A filed copy of the Board's order shall be obtained from the Chair of the Yankton County Board of Mental Illness to be filed in Medical Records with a copy made for the treatment unit chart and Business Office. If commitment criteria are not met, the Board shall order the immediate release of the . patient. The patient may remain as a voluntary by parent or guardian, if clinically indicated. If patient is not appropriate for voluntary by parent or guardian, a discharge shall occur the date of release by the Board. Last Revised: 07/01/16 Last Reviewed: 07/0 1/ 16 ext Review Date: 07/01/17 AR.8.l?4l Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.20 NINETY (90) DAY REVIEW HEARINGS Policy: It shall be the policy of the that all patients who are involuntarily committed to the for a period of time not to exceed ninety (90) days shall be provided with a ninety? day review hearing unless discharged or converted to voluntary status. Purpose: To comply with existing state statute (SDCL To identify necessary procedures with the hearing process. Responsible Parties: Attending Physician Admissions Officer Senior Secretary (Admissions Office) 0 Unit Staff Medical Records Co-Occurring Coordinator Social Worker Procedures: The Chair of the Yankton County Board of Mental Illness shall be provided with the names of patients Who would be entitled to a ninety (90) day review hearing at least ten (10) days prior to the date of the scheduled review hearing. If commitment is not recommended, the attending Physician shall complete a Physician's Assessment form indicating that the patient does not meet commitment criteria. The patient shall then be discharged or sign the Voluntary Application for Treatment form. The Chair of the Yankton County Board of Mental Illness shall be notified to cancel the scheduled review hearing. If the patient remains on a voluntary basis he/she shall sign the Application for Voluntary treatment. Admissions staff shall be notified to enter a legal status change in the Health Information System. If commitment is recommended, the attending Physician shall complete a Physician?s Assessment form indicating that the patient meets commitment criteria. The Physician?s Human Services Center I Chapter 8.1 Admissions Policy and Procedures Assessment form indicates the date the hearing is scheduled. The Social Worker shall be provided with a copy of the Physician?s Assessment form. The day prior to the hearing, the treatment unit area shall be notified by phone of the date and time set for the hearing as well as appointment of legal counsel and the assigned QMHP. This information shall be entered in the Health Information System. The patient?s medical record file including the electronic health record shall be brought to the hearing room for the scheduled review hearing. The Admissions Senior Secretary or designee shall record the decisions of the Board, assist in getting patients to the hearings and secure the clinical file. If commitment criteria are met, the board of mental illness may commit the person to with provisions for a rehearing in six months. The Board?s decisions shall be transmitted to Admissions Senior Secretary or designee so that a legal status change can be entered into the Health Information System. A filed copy of the Board?s Order shall be obtained from the Chair of the Yankton County Board of Mental Illness and filed in Medical Records with a copy made for the treatment unit chart and Business Office. If commitment criteria is not met, the Board shall order the immediate release of the patient and discharge shall occur the date of release by the Board. If the patient remains at HSC beyond the date of release by the Board, the patient shall sign a Notice of Request for Permission to Remain at South Dakota Human Services Center and the Application for Hospitalization for Voluntary Patient (Adult) Services. Admissions staff or designee shall enter a legal status change in the Health Information System. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/ 17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.21 SIX MONTH REVIEW HEARINGS Policy: It shall be the policy of the that all patients, who are involuntarily committed to the for a period of time not to exceed ninety (90) days shall be provided with two (2) six-month review. hearings unless discharged or converted to voluntary status. Purpose: To comply with existing state statute (SDCL 27A-10-l4). To identify necessary procedures with the hearing process. Responsible Parties: Attending Physician Admissions Officer Senior Secretary (Admissions Office) Unit Staff Medical Records Co?Occurring Coordinator Social Worker Procedure: The Chair of the Yankton County Board of Mental Illness shall be provided with the names of patients who would be entitled to a six-month review hearing at least ten (10) days prior to the date of the scheduled review hearing. If commitment is not recommended, the attending Physician shall complete a Physician's Assessment form indicating that the patient does not meet commitment criteria. I The patient shall then be discharged or sign the Voluntary Application for Treatment form. The Chair of the Yankton County Board of Mental Illness shall be notified to cancel the scheduled review hearing. If the patient remains on a voluntary basis he/she shall sign the Application for Voluntary Hospitalization. Admissions staff shall enter a legal status change in the Health Information System. If commitment is recommended, the attending Physician shall complete a Physician's Assessment form indicating that the patient meets commitment criteria. The Physician?s Human Services Center Chapter 8.1 Admissions Policy-and Procedures - Assessment form indicates the date the hearing is scheduled. The Social Worker shall be provided with a copy of the Physician?s Assessment form. The day prior to the hearing, the treatment unit area shall be notified of the date and time set for the hearing as well as appointment of legal counsel and assigned QMHP. This information shall be entered in the Health Information System. If commitment criteria is not met, the Board shall order the immediate release of the patient and discharge shall occur the date of release by the Board. If the patient remains at HSC beyond the date of release by the Board, the patient shall sign a Notice of Request for Permission to Remain at South Dakota Human Services Center and the Application for Hospitalization for Voluntary Patient (Adult) Services. The Admissions Senior Secretary or designee shall record the decisions of the Board, assist in getting patients to the hearings, and secure the clinical file. If commitment criteria is met and this is patient?s first six (6) month commitment review, the Board of Mental Illness may commit the person to with provisions for a second rehearing in six (6) months. If the person is currently under commitment on their second six (6) month review, the Board of Mental Illness may commit the person for a rehearing in one (1) year. The Board decisions shall be transmitted to the Admission?s Secretary or designee so that a legal status change can be entered into the Health Information System. A filed copy of the Board's Order shall be obtained from the Chair of the Yankton County Board of Mental Illness and filed in Medical Records with a copy made for the treatment unit chart and Business Office. If commitment criteria is not met, the Board shall order the immediate release of the patient and discharge shall occur the date of release by the Board. If the patient remains at HSC beyond the date of release by the Board, the patient shall sign a Notice of Request for Permission to Remain at South Dakota Human Services Center and the Application for Hospitalization for Voluntary Patient (Adult) Services. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.22 YEARLY REVIEW HEARING Policy: It shall be the policy of the that all involuntarily committed patients who have been provided with two (2) six-month review hearings shall then be provided with a yearly review hearing thereafter unless discharged or converted to voluntary status. mm: To comply with existing state statute (SDCL 10-14). To identify necessary procedures with the hearing proceSs. Responsible Parties: Attending Physician Admissions Officer Senior Secretary (Admissions Office) Unit Staff Medical Records 0 Co-Occurring Coordinator Social Worker Procedures: The Chair of the Yankton County Board of Mental Illness shall be provided with the names of patients who would be entitled to a yearly review hearing at least ten (10) days prior to the date of the scheduled review hearing. If commitment is not recommended, the attending Physician shall complete a Physician's Assessment form indicating that the patient does not meet commitment criteria. The patient shall then be discharged or sign the Voluntary Application for Treatment. The Chair of the Yankton County Board of Mental Illness shall be notified to cancel the scheduled review hearing. If the patient remains on a voluntary basis he/she shall sign the Application for Voluntary Hospitalization. The Admissions staff shall enter a legal status change in the Health Information System. If commitment is recommended, the attending Physician shall complete a Physician's Assessment form indicating that the patient meets commitment criteria. The Physician?s Human?Services Center .. Chapter 8.1 Admissions Policy and Procedures Assessment form indicates the date the hearing is scheduled. The Social Worker is provided with a copy of the Physician?s Assessment form. The day prior to the hearing, the treatment unit area shall be notified by phone of the time set for the hearing as well as appointment of legal counsel and assigned QMHP. This information shall be entered in the Health Information System. The patient's medical chart, the Medication Administration" Record (MAR), and the electronic health record shall be brought to the hearing room at the time of the scheduled review hearing. The Admissions Senior Secretary or designee shall record the decisions of the Board, assist in getting patients to the hearings, and secure the clinical file. If commitment criteria are met, the board of mental illness may commit the person to with provisions for a rehearing in one (1) year. The Board decisions shall be transmitted to Admissions Secretary or designee so that a legal status change can be entered into the Health Information System. A filed copy of the Board's Order shall be obtained from the Chair of the Yankton County Board of Mental Illness and filed in Medical Records with a copy made for the treatment unit chart and Business Office. - If commitment criteria is not met, the Board shall order the immediate release of the patient and discharge shall occur the date of release by the Board. If the patient remains at HSC beyond the date of release by the Board, the patient shall sign a Notice of Request for Permission to Remain at South Dakota Human Services Center and the Application for Hospitalization for Voluntary Patient (Adult) Services. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 - Human Services Center Admissions Policy and Procedures 8.1.23 DEVELOPMENTAL DISABILITY HEARINGS Policy: It shall be the policy of the that if the treatment team determines that a patient is primarily deveIOpmentally disabled and not mentally ill, the patient shall be released or a petition shall be filed alleging developmental disability in accordance with SDCL Purpose: To ensure that the patient is provided services in appropriate programs that are designed to meet his/her needs. To comply with State Statute. To identify necessary procedures in the petitioning process. Responsible Parties; 0 Attending Physician Admissions Officer 0 Senior Secretary (Admissions Office) Unit Staff Co?Occurring Coordinator Procedures: Referrals shall originate with the attending Physician. Prepare petition. Petition shall include all elements described in SDCL Petition shall be prepared by the attending or Forward petition to the Chair of the Yankton County Board of Developmental Disabilities with a copy to the Yankton County State's Attorney?s Office. The Chair of the Board of Developmental Disabilities shall appoint a "qualified person" to prepare the required report. Please refer to SDCL content of report in accordance with SDCL 1. Request a filed copy of the order from the Chair of the Board of Developmental Disabilities to retain patient at the for examination. . Send signed original report by "qualified person" to the Chair of the Board of Developmental Disabilities in the county when the hearing is to be held with a copy to the 1 AR.8.1-48 Human Services Center Chapter 8.1 Admissions Policy and Procedures state?s attorney in the same county. The Board Chair shall provide the Division of Developmental Disabilities with a copy of the report. Notify Admissions Senior Secretary or designee to run a change of legal status to MR/Protective Custody. The Chair of the Board of Developmental Disabilities shall notify Admissions Office as to date and time of hearing. The physician and direct care staff shall be notified by the Admissions Officer or designee. The patient?s medical chart, the Medication Administration Record (MAR), and the electronic health record shall be brought to the hearing room at the time of the scheduled review hearing. A filed copy?of the Board?s findings shall be obtained for records, with a copy to treatment unit chart and the Business Office. If commitment is ordered pursuant to Chapter Senior Secretary or designee enters a second legal status change in the Health Information Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-49 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.24 TRIBAL COURT Policy: It shall be the policy of the that Native Americans living on reservations or trust lands may be committed to Indian Health Service by the Tribal Court and placed at the for treatment and care on a bed availability basis. . ngose: To provide mental health services to Native Americans living on reservations or trust lands who are in need of involuntary hospitalization. To identify necessary procedures associated with the commitment process. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Admitting Physicians Medical Director - House Supervisors Admissions Nurse Co?Occurring Coordinator Unit Staff Procedures: This policy applies only to Native Americans who are residents of a reservation and trust lands, only for involuntary hospitalization and only for care. Please refer to general policies applicable to all admissions found in this Chapter, Section entitled ?Pre?Admission Arrangements? of the Policy and Procedures Manual. The language in the court order must re?ect that the patient is committed to Indian Health Service, not to The certified original commitment order, petition and physician's certificate shall accompany the patient to the Center. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for i a certified copy, a copy of a certified order or duplicate original. Human Services Center Chapter 8.1 Admissions Policy and Procedures The legal documents must indicate that the patient was afforded due process (present at hearing, represented by an attorney or advocate, testimony taken by mental health professional). The Admissions Officer or designee notifies the Business Office and Medical Records of these types of admissions in writing (White vs. Califano letter). Original letter to chart. Notice of review hearings and copies of the Physician?s Assessment shall be sent to Indian Health Service mental health office on the reservation of residence and to the Tribal Court. Because of jurisdictional issues, these cases must be reviewed by the tribal court that entered the Order for Commitment. If the individual is referred on an emergency basis, the referring tribal court shall either retarn the patient to the reservation for his hearing. or conduct the hearing at (per tribal code). The patient?s medical file including the electronic health record shall be brought to the hearing containing information on medications and treatments the patient has received. Following the hearing an order shall be provided by the Tribal Court. For detailed procedures, refer to this Chapter, Section entitled ?Mental Illness Hearings for Emergency Admissions - Adults? of the Policy and Procedure Manual. If commitment criteria are met, the tribal court may commit the person to IHS with placement at an appropriate facility. Additional review hearings shall be scheduled according to tribal ordinances. A legal status change is entered in the Health Information System by the Senior Secretary or designee once the certified copy of the order is received. If commitment criteria are not met, the tribal court shall order the immediate release of the patient and discharge shall occur when the release order is received from the tribal court. If the patient remains at beyond the date of the release order for purpose of transportation, the patient or guardian/POA shall sign a Notice of Request for Permission to Remain at and sign the Voluntary Application for Treatment. Refer to this Chapter, Section entitled ?Mental Illness Hearings for Emergency Admissions Adults? of the Policy and Procedure Manual. Insert the words "Tribal Court" when reference is made to "Board". Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center - Admissions Policy and Procedures 8.1.25 NATIVE AMERICAN REFERRALS TO THE ADOLESCENT TREATMENT PROGRAM WHO RESIDE ON RESERVATION OR TRUST LANDS OR WHOSE PARENTS RESIDE ON RESERVATION OR TRUST LANDS Policy: It shall be the policy of the that Native American adolescents may be admitted to the Adolescent Treatment Program when their application is made by a parent or pursuant to a tribal committal, if deemed clinically suitable, medically stable and on a bed availability basis. . Purpose: Provide mental health services to Native American adolescents who reside on reservation or trust lands. To comply with the requirements of the IHS agreement. To identify necessary procedures associated with the admission of Native American referrals from the reservation or trust lands. Responsible Parties: Social Worker, Adolescent Services Admissions Clerks Medical Records Admissions Officer Program Director, Adolescent Services Senior Secretary (Admissions Office) Admissions Nurse Co?Occurring Coordinator House Supervisor Adolescent Admissions Coordinator Procedures: Voluntary referrals for admission to the program. Application for admission may be made by natural parent or appointed legal guardian. All adolescents shall be seen by a QMHP prior to admission. Mandatory $600 admission fee shall be submitted at the time of admission or pledge to pay by the tribal authorities or some other governmental agency. If patient receives Title 19, the admission fee is waived. Human Services Center Chapter 8.1 Admissions Policy and Procedures The parent/ guardian shall sign the necessary admission documents. If the parent/ guardian does not accompany the patient, then the admission documents shall be faxed to them. Tribal appointed court guardians may sign adolescents into the hospital for treatment. Guardianship documents must be available on admission. If no natural parents are available to make the application for admission, it would be necessary to commit the adolescent pursuant to a tribal committal. Involuntary Tribal commitments. A petition for involuntary commitment is filed with the Tribal Prosecutor on the respective reservation. The adolescent is evaluated by a qualified mental health professional and a written report completed. If there is probable cause to warrant an involuntary commitment hearing, the Tribal Court shall then set a date and time for hearing. The adolescent shall be provided with the basic due process requirements to include his/her presence at the hearing, unless waived by his/her attorney, representation by legal counsel or an advocate, and testimony from a qualified mental health professional. If grounds for involuntary commitment are established, the Tribal Court may commit the person to Indian Health Service to be placed at an appropriate treatment facility. The Tribal Conrt has no authority to commit the adolescent directly to the Adolescent Treatment Program. A certified copy of the Order for Commitment, a copy of the petition for involuntary commitment, and a copy of the report of the mental health professional shall also accompany the adolescent at the time of admission. It should be noted that the language of the commitment order must re?ect that the patient is committed to Indian Health Service and not to the If commitment criteria is not met, the tribal court shall order the immediate release of the patient and discharge shall occur when the release order is received. If the patient is to remain at beyond the date of the discharge order for purpose of transportation, the guardian shall sign a Notice of Request for Permission to Remain at and the Voluntary Application for Treatment form. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center- Admissions Policy and Procedures 8.1.26 TRANSFER BETWEEN TREATMENT PROGRAMS AT may: It shall be the policy of the that appropriate procedures need to be taken when transferring an adult patient from a unit to the chemical dependency program and when transferring an adult patient from the chemical dependency program to a unit. Pumose: To ensure that all legal requirements are in compliance when transferring patients between programs. To identify necessary procedures in the transfer process. Responsible Parties: Unit Staff Chemical Dependency Treatment Unit Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Chemical Dependency Supervisor Co?Occurring Coordinator Admissions Nurse Procedures: Co? Occurring Coordinator completes the Treatment Needs Assessment and required paperwork to be sent to Division of Community Behavioral Health Once approval is . obtained transfer will be arranged. Whenever a voluntary patient is transferred to the chemical dependency programs, the patient must sign a Voluntary Application for Treatment and Authorization for Disclosure for that program. The Co?Occurring Coordinator is responsible to advise patient of the daily per diem rate. Whenever a voluntary patient in the chemical dependency program is transferred to a unit, the patient must sign a Voluntary Agreement for that program or if patient refuses or not competent to give informed consent, he/she may be committed on an emergency basis pursuant to SDCL Human Services Center Chapter 8.1 Admissions Policy and Procedures Whenever an individual under involuntary commitment as a mentally ill person is transferred to the chemical dependency program, a Voluntary Application for Treatment and Authorization for Disclosure must be signed for that program. The mental illness commitment is no longer valid once the Voluntary Application for Treatment is signed. Whenever an individual involuntarily committed to the Adult Chemical Dependency Program is transferred to a unit, a Voluntary Admission Agreement for Services shall be signed, if patient is competent to give informed consent, or emergency commitment proceedings initiated pursuant to SDCL 27A-10. The involuntary Chemical Dependency Commitment Order remains valid. Adolescents committed by the juvenile court may be transferred between programs pursuant to the court order. Enter legal status change in Health Information System with all transfers. Adolescents and adults admitted by signature of parent or guardian/DPOA may be transferred between programs with the consent of the parent or guardian/DPOA. The Admissions Office staff is responsible for entering legal status. changes. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.27 TRANSFER OF COMMITNIENT FROM MENTAL HEALTH VA OPERATED COMMUNITY BASED PROGRAM Policy: It shall be the policy of the that any mentally ill person who is under board?ordered treatment outside of the may, by authority of the board of mental illness of any county, be transferred to the on a bed availability basis. Purpose: To comply with existing state statute (SDCL 27A-11A-19). A hearing on an involuntarily committed patient must occur prior to transfer to as patient will be entering amore restricted environment. To provide mental health services to those in need of inpatient care. To identify necessary procedures involved with the transfer process. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Physicians 0 Admissions Clerks Medical Records Admissions Nurse 0 Co?Occurring Coordinator House Supervisor Procedures: Refer to this Chapter, Section entitled ?Pm-Admission Arrangements? of the Policy and Procedure Manual. Certified copy or original order by the mental illness board authorizing the transfer shall accompany the patient to the Center. If a certified copy of the order is not available at the time of admission, the Senior Secretary or designee will follow up the next business day for a certified copy, a copy of a certified order or duplicate original. The commitment order shall still be in effect and not expired. Check to see that the patient received the review hearings mandated by State Statute prior to authorizing transfer to this facility. Human Services Center Chapter 8.1 Admissions Policy and Procedures Advise Medical Records and Admissions Office that this is a transfer of commitment from a mental health center/V A facility/state operated community based program so that the legal status can be entered into the computer appropriately. Admissions Office shall enter original commitment date in the electronic health record for the purpose of scheduling further mental illness review hearings; . Last Revised: 10/01/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 was? .. Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.28 TRANSFER OF COMMITMENTS AND OUTPATIENT COMMITMENTS TO MENTAL HEALTH A OPERATED - CONIMUNITY-BASED MENTAL HEALTH PROGRAM Policy: It shall be the policy of the that any mentally ill person under board-ordered treatment at the may be transferred to the care of a community mental health center, VA Hospital or a community?based mental health program operated by the State or Purpose: To facilitate the least restrictive treatment environment (mental health centers/community? based mental health program). To facilitate the transfer of veterans to VA hospitals (if eligible for service). To comply with existing statutes. Responsible Parties: Treatment Team Assigned Social Worker 0 Admissions Officer Senior Secretary (Admissions Office) Medical Records Administrator Admissions Nurse Co-Occurring Coordinator House Supervisor Procedures: The Physician?s Assessment Form is completed by the indicating recommendations for an outpatient commitment. (Transfer pursuant to 10-9.1) Social Worker will determine if receiving facility is agreeable to accept transfer, date the transfer is to be implemented, and who the transfer arrangements were made with. (Transfer pursuant to Review hearing list to see if patient has a scheduled legal hearing in the near future. Review legal papers to identify which county initiated the commitment proceedings. Human Services Center Chapter 8.1 Admissions Policy and Procedures Admissions officer or designee prepares a letter authorizing the transfer of commitment for signature of the Administrator pursuant to or 27A-10-9.1. A copy of this letter shall be given to the patient, the chair of the mental illness board in the county of residence, and the chair of the mental illness board in the county where the patient is being placed (if different than residency). A copy of the letter is placed in the patient?s medical record. Attached to the original letter authorizing transfer to the mental health center/V A facility/community-based mental health program shall be a copy of the last Findings and Orders of Commitment. Copies of the Findings and Orders of commitment shall also be attached to the copy of the letter to the board chair where the patient shall be residing. If the patient is court ordered to take medication, a COpy' of the court order shall also be attached to the letter authorizing transfer of commitment. If during the course of treatment it is determined a transfer of commitment is recommended and an order for transfer of commitment was not received at the patient?s last mental illness hearing, an amended order can be requested. The Board Chair from the committing county is notified of the request to amend the court order. The assigned Social Worker shall be advised to obtain a general consent form from the patient authorizing the release of medical records. (Note: Records may be sent with or without patient's consent). Advise Admissions Senior Secretary or designee that this is a transfer of commitment to a mental health center/VA facility/cornmunity?based mental health program so that the appropriate legal status can be entered into the Health Information System. Last Revised: 07/0 1/ 16 Last Reviewed: 07/0 1/ 16 Next Review Date: 07/01/ 17 Chapter 8.1 - Human Services Center Admissions Policy and Procedures 8.1.29 INTER-INSTITUTIONAL TRANSFERS Policy: It shall be the policy of the that individuals residing in other state institutions under the care and control of the Department of Human Services and Department of Corrections may be transferred to the if clinically indicated, pursuant to statute, and on a bed availability basis. Purpose: To provide mental health services and chemical dependency treatment to residents of other state institutions under the Department of Human Services and the Department of Corrections. To comply with existing state statutes and To identify necessary procedures associated with the transfer process. Resraonsible Parties: 0 Admissions Officer Senior Secretary (Admissions Office) Medical Director Administrator Admitting Clerks Admitting Physicians/PA?C?s/CNP Medical Records Co?Occurring Coordinator House Supervisor Admissions Nurse Procedures: Transfers from South Dakota Developmental Center - Redfield Inquire as to the legal status of patient at Redfield. If committed to the South Dakota Developmental Center in Redfield or signed in by legal guardian, may be transferred to the as inter?institutional transfer (if guardian approves of transfer). If referral is a voluntary patient at Redfield, patient cannot be inter? institutionally transferred without consent. Patient, or guardian, must sign Voluntary Application for Hospitalization and Informed Consent forms. Human Services Center Chapter 8.1 Admissions Policy and Procedures Request copies of appropriate records for review by the Medical Director and Program Director for Adult Services. If recommendation is to approve the transfer, notify Administrator who also must approve the transfer. If transfer is approved, advise South Dakota Developmental Center in Redfield that the patient must remain on their census pending his return to Redfield. Advise Admission Office as to transfer date. Transfers from Department of Corrections If committed to the South Dakota Department of Corrections, an individual under the age of 21 can be transferred to as an Inter-institutional Transfer DOC . providing the Secretary from the Department of Corrections authorizes the transfer. Request a copy of the Transfer letter and Court Order from the Department of Corrections. Last Revised: 10/0 1/ 14 Last Reviewed: 07/01/16 Next. Review Date: 07/01/17 AR.8.1-61 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.30 REFERRAL FOR EVALUATION THROUGH THE CRIMINAL PROCEDURE Policy: It shall be the policy of the that individuals may be admitted/referred to the for examination regarding sanity, competency, need for treatment and dangerousness to others or property on a bed availability basis. As a courtesy to the court shall provide support to the counties by providing a maximum of three (3) evaluations per month. Purpose: To comply with existing state statutes. To identify necessary procedUres with the referral process. To provide mental health services to the court. Responsible Parties: - Administrator Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks - Medical Records - Co-Occurring Coordinator House Supervisor - Admissions Nurse Procedures: Refer to general policies applicable to all admissions in the pre-admission section. Notice of Mental Illness Defense Mental Examination whether the person was mentally ill or insane at the time of the offense charged. Mental competency to proceed Mental Examination whether the person is suffering from a mental disease or other disorder rendering him/her mentally incompetent to the extent that he/she is unable to understand the nature and consequences of the proceedings against him/her or to assist properly in his/her defense. Mental Examination and Report Before Hearing Prior to sentencing the court may order an examination to determine whether the person is suffering from a mental AR.8.1-62 Human Services Center Chapter 8.1 Admissions Policy and Procedures disease or defect as a result of which he/she is in need of custody for care or treatment in a suitable facility. Mental Examinations and Report Whether the person is suffering from a mental disease or defect as a result of which his release would create a substantial risk of bodily injury to another person or serious damage to property of another. For any of the above procedures, follow the steps below: Inquire as to the nature of the charges, whether the individual is bonded out and whether a formal plea has been entered. Request a copy of the police reports, indictment, the rap sheet, Grand Jury transcript, records, jail records, audio and video recordings, and any other information that would be of assistance to the physician. Request a certified copy of the Order for Examination. The examining Physician shall determine whether or not the referral can be admitted to an acute admission unit or to the Intensive Treatment Unit (ITU) (Cedar 2). Any patient charged with murder, manslaughter or escape from a secure facility will be admitted to ITU. Attending physician will determine whether the patient can be transferred to another unit once assessed. Flag the treatment unit chart indicating the legal involvement and notification. Last Revised: 07/16/15 Last Reviewed: - 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.31 REFERRALS FOR TREATMENT THROUGH THE CRIMINAL PROCEDURE Policy: It shall be the policy of the that individuals ordered to the by the court shall be admitted for treatment and care pursuant to statutory requirements and on a bed availability basis. Purpose: To comply with existing state statutes. To provide mental health services to those individuals involved with the legal system. To identify necessary procedures associated with admission and discharge of these referrals. Responsible Parties: Admissions Officer Senior Secretary (Admissions Office) Admission Clerks Medical Records Treatment 0 Administration Admissions Nurse Co?Occurring Coordinator House Supervisor Procedures: Refer to general policies applicable to all admissions in the pre-admission section. Mentally incompetent to proceed commitment Inquire as to the nature of the charges, type of security required and whether the individual is bonded out. Request a certified copy of the commitment order copies of the police reports, Findings of Fact; Conclusions of Law, and any other information that would be assistive to the t1eatment team Flag chart indicating legal involvement and notification. This commitment shall be limited to four months. Human Services Center Chapter 8.1 Admissions Policy and Procedures If the defendant has recovered to such an extent that he/she is able to understand the nature and consequences of the proceedings against him and to assist properly in his/her defense, shall file a certificate to that effect with the clerk of the court that ordered the commitment 1). Certificate initiated by the Admissions Officer, or designee, and co?signed by the attending Physician and Administrator. The certificate shall be notarized and mailed to the clerk of courts in the referring county. A report from the attending physician shall accompany the certificate if so ordered by the court. If after four months the defendant is still incompetent to proceed, the shall issue a certificate with accompanying report to the circuit court stating whether there is a substantial probability that within the next year the defendant will become . competent to proceed If, after hearing, the court finds there is- a reasonable likelihood that the defendant will become competent to proceed within the next year, it shall order the defendant committed to a facility fOr a period of time not to exceed one (1) year or until he/she becomes competent and a certificate of recovery is submitted to the court 14). If the court finds there is no reasonable likelihood that the defendant will become competent to proceed within one year, it shall review the defendant's condition to determine appropriate placement and order the defendant committed to an approved facility. If the one year expires without a certificate of recovery, shall notify the court for a review hearing. These cases are monitored by the Admissions Officer and Senior Secretary in the Admissions Office Not Guilty by Reason of Insanity When the jury has retumed a verdict acquitting the defendant upon the grounds of insanity, the court orders that the defendant be committed to the South Dakota Human Services Center until such time he/she is eligible for release pursuant to 26? 12. Refer to general policies applicable to all admissions in the pre-admission section. The chart is ?agged and patient is assigned in rotation once transport is arranged. Once the patient is found to be eligible for release from a Certificate is initiated by the Admissions Officer or designee. The Certificate is signed by the attending physician and Administrator and is then notarized. A report is completed by the attending physician and shall be submitted if so ordered by the court. Chapter 8.1 Human Services Center Admissions Policy and Procedures The court shall order immediate release or a hearing is scheduled to determine if the patient should be released. The Admissions Officer or designee keeps the treatment team apprised of the recommendations issued by the court. Guilty but Mentally Ill If the defendant is found guilty but mentally ill? the court shall impose any sentence which could be imposed upon a defendant pleading or found guilty of the same charge. If the defendant is sentenced to the state penitentiary, he/she shall undergo further examination and may be given treatment that is indicated. If treatment is available, it may be provided through the facilities under the jurisdiction of the Department of Human Services, including . The court must arrange for admission to Please refer to general policies applicable to all admissions in the pre?admission section. The Admissions Officer or designee notifies the court when treatment is completed. A report on the patient?s condition is completed by the attending physician and submitted to the Board of Pardons. The report shall contain clinical facts, diagnosis, course of treatment and prognosis. The patient is returned to the penitentiary after completion of treatment. Commitment?Finding?Provisional Sentence A defendant can be committed to the in lieu of being sentenced to imprisonment for suitable care and treatment. The Human Services Center shall hospitalize the defendant for the maximum time of the provisional sentence or until he/she is recovered pursuant to Refer to all general policies applicable to all admissions in the pre~adrnission section. The chart is flagged and the patient is assigned in rotation once transport is arranged. Once the patient is found to be eligible for release from a Certificate is initiated by the Admissions Officer or designee. The Certificate is signed by the attending physician and Administrator and is then notarized. A report is completed by the attending physician and is attached to the Certificate. The documents are mailed to the Clerk of Courts in the referring county if so ordered by the court. Copies of the documents are submitted as directed by the court order. Human Services Center Chapter 8.1 Admissions Policy and Procedures The court shall order immediate release or a hearing is scheduled to determine if the patient should be released. The Admissions Officer or designee keeps the treatment team apprised of the recommendations issued by the court. Last Revised: 07/01/16 Last Reviewed: 07/0 1/ 16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.32 JUVENILE COURT REFERRALS Policy: It shall be the policy of the that individuals ordered to the by the juvenile court system shall be admitted for evaluation/treatment pursuant to statutory requirements and on a bed availability basis. Purpose: To comply with existing State Statute. To provide mental health services to adolescents involved with the legal system. To identify necessary procedures associated with the admission of minors. Responsible Parties: - Admissions Officer Social Worker, Adolescent Program/Chemical Dependency Program Admissions Clerks Medical Records Treatment Teams 0 Senior Secretary (Admissions Office) Program Director, Adolescent Services Admissions Nurse Co?Occurring Coordinator House Supervisor Adolescent Admissions Coordinator Procedures: Minors may be court ordered to for evaluation, evaluation and treatment, or for treatment. Please refer to statutory authority in SDCL 26?7A?4l, (10), 26?806, 26?807 (6), 26?808. The Adolescent Admissions Coordinator and Program Director for Adolescent Services arrange for all admissions to their units. Minors may not be admitted to the adult units, unless emancipated. Suggest that referral be made direct, either to the Adolescent or Adolescent Chemical Dependency Program, whichever is appropriate. AR.8.lm68 Human Services Center Chapter 8.1 Admissions Policy and Procedures Obtain certified copy of the court order. Flag the chart as to legal involvement. Review all legal papers for completion and accuracy. Copies of Juvenile Code Orders are telefaxed or emailed to DSS Legal Counsel by the Admissions Senior Secretary. 'Last Revised: 07/01/16 . Last Reviewed: 07/01/16 ext Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.33 FEDERAL COURT REFERRALS Policy: It shall be the policy of the that Federal Court referrals be admitted to the pursuant to contract with the US. Bureau of Prisons and on a bed availability basis. Purpose: To provide mental health services to the Federal Courts. To provide mental health services to those individuals involved with the Federal Court system. To identify necessary procedures associated with the admission of Federal referrals. Responsible Parties: Admissions Officer 0 Administrator Admissions Clerks Medical Records Senior Secretary (Admissions Office) Business Office Admissions Nurse Co?Occurring Coordinator House Supervisor Medical Director Procedures: Refer to general policies applicable to all admissions in the pre-admission section. Referrals generally come from US. Marshall's Office, US. Attorney's Office, US. Probation Officers, defense attorneys and US. Bureau of Prisons. Identify status of legal involvement, security required and bonding status. Request copies of all appropriate information for review by staff. Consult with Administrator and Medical Director. If accepted, arrange admission date and time. If transfer is approved, the US. Marshall?s Office must authorize funding (check with Business Office for daily per diem). Human Services Center Chapter 8.1 Admissions Policy and Procedures Request certified copy of the Federal Court order. In some cases, the individual may be referred for voluntary admission. Flag chart indicating legal involvement and notification. All patients charged with murder, manslaughter or escape from a secure facility must be admitted to the Intensive Treatment Unit (ITU Cedar 2). The patient can be transferred to another unit once the attending physician makes the determination. Last Revised: 10/01/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 I Human Services Center Admissions Policy and Procedures 8.1.34 VOLUNTARY ADMISSIONS TO THE ALCOHOL AND DRUG ABUSE PROGRAMS (SDCL 34-20A) Policy: It shall be the policy of the that individuals may be admitted on a voluntary basis to the chemical dependency programs on a bed availability basis. Pumose: To provide appropriate treatment for individuals diagnosed with a chemical dependency. To identify necessary procedures associated with the admission process. Responsible Parties: Admitting Physicians/Counselors 0 Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Medical Records Chemical Dependency Supervisor Admissions Nurse Co?Occurring Coordinator Chemical Dependency Social Workers Procedures: Approval from the Division of Community Behavioral Health is received by Co?Occurring Coordinator or designee. Pertinent medical, and legal records are requested from the referral source. - Medical records are reviewed by Primary Care Physician, or Admissions Nurse to assess for medical stability. Once medically accepted, the referral source is notified of a bed date. I A Voluntary Application for Treatment and Authorization for Disclosure to the chemical dependency programs shall be signed at the time of admission. A $600 admission fee shall be due at the time of admission; unless other arrangements have been made with the Business Office. A voucher/letter authorizing payment by the county or some other governmental agency may be submitted. Flag treatment unit chart indicating legal involvement and notification, if verified through detainer or court order. Human Services Center Chapter 8.1 Admissions Policy and Procedures Once the patient submits a written request for release by completing the Voluntary Patient?s Notice of Termination form, he/she shall be discharged unless he/she meets the emergency criteria of the Mental Health code as set forth in 27A-10. If the Application for Treatment is made by a legal guardian, there must be proof of guardianship in the form of a court order. The Application for Treatment shall be signed by the guardian. Out?of?state referrals shall be discouraged, but can be reviewed for admission with administrative approval. Note: For all admissions to the chemical dependency programs, staff are to comply with the Federal regulations as set forth in the Federal Register, Department of HEW, Public Health Service, Confidentiality of Patient Records in Chemical Dependency Treatment Centers. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.35 INVOLUNTARY ALCOHO-LISM AND DRUG ABUSE COWITMENTS (SDCL 34-20A) Policy: It shall be the policy of the that individuals may be admitted to the chemical dependency programs when committed by the Circuit court pursuant to 34-20A on a bed availability basis. Purpose: To provide appropriate treatment for individuals diagnosed with a chemical dependency who refuse to accept treatment voluntarily. To maintain compliance with State Statute To identify necessary procedures associated with the admission process. Responsible Parties: Admitting Physicians/Counselors Admissions Officer Senior Secretary (Admissions Office) Admissions Clerks Medical Records Chemical Dependency Supervisor Admissions Nurse Co?Occurring Coordinator Chemical Dependency Social Worker Procedures . Approval from the Division of Community Behavioral Health is received by Co?Occurring Coordinator or designee. Pertinent medical, and legal records are requested from the referral source. Medical records are reviewed by Primary Care Physician, or Admissions Nurse to assess for medical stability. Once medically accepted, the referral source is notified of a bed date. A certified copy of the commitment order shall be Obtained prior to the patient?s arrival. A copy of the petition for commitment, stipulation, if applicable, and physician's report or Chemical Dependency Certificate shall be obtained prior to arrival. Patient has right to refuse assessment pursuant to Human Services Center I . Chapter 8.1 Admissions Policy and Procedures Commitment not to exceed 90 days unless recommitment as stated in SDCL Involuntary admissions must sign Authorization for Disclosure. Flag the chart indicating Involuntary commitment status. The charts shall be flagged by the Co?Occurring Coordinator or designee. Custody status criminal involvement will also be ?agged if verified with a court order or detainer. Length of stay shall be monitored by the treatment team so that the patient is either discharged by the end of 90 days, signs a voluntary application or is recommitted. The commitment may be transferred from Chemical Dependency Program to another accredited treatment program The commitment may be transferred from another accredited program to the Chemical Dependency Programs. A written authorization shall be obtained from the Administrator, or authorized designee of the facility to' which the person was committed, authorizing such transfer. CD program may refuse a request to accept the patient commitment to treatment (34-20A-79). The 90-days shall commence'from the date of admission to the and not the date of the order. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.36 INITIATION OF CHEMICAL DEPENDENCY COMMITMENT FOR AN ADULT INPATIEN AT P0_1icr; It shall be the policy of the according to SDCL the Administrator or any member of the treatment team may initiate a petition for commitment. The petition must allege the patient whose commitment is sought is an alcoholic or drug abuser who habitually lacks self?control to the use of alcoholic beverages or other drugs and that the patient has: Has threatened, attempted or in?icted physical harm on himself or herself or on another person and that unless committed is likely to in?ict harm to himself or herself or on another; or 2) Is incapacitated by the effects of alcohol and drugs; or 3) Is pregnant and abusing alcohol or drugs Pumose: To provide chemical dependency treatment deemed necessary pursuant to SDCL 70. Responsible Parties: 0 Admissions Officer 0 Physician . Unit Staff 0 Co?Occurring Coordinator or designee - Social Worker 0 Senior Secretary (Admissions Office) Eguipment: Application for Involuntary Commitment Civil Case Filing Statement (All forms can be found in the file cabinet located in the Co?Occurring Coordinator?s Office). Procedure: The Treatment Team recommends the initiation of filing for Involuntary Chemical Dependency Commitment (IVC-CD). The Co-Occurring Coordinator is contacted to provide the necessary forms. The petitioner (staff member or family) shall complete the Application for Involuntary Commitment and the Civil Case Filing Statement and file with the Yankton County Clerk of Courts during regular business hours. If the patient has already been committed to 90 Day MI pursuant to 27A-10.9.1 and 27A-10-9.2 the document can be filed with the MI Board Chair. Human Services Center Chapter 8.1 Admissions Policy and Procedures The Clerk of Courts or the MI Board Chair will then notify HSC, specifically the Petitioner, of the attorney appointed to represent them in this matter. Once the application is filed, the appointed attorney will have five (5) working days (excluding Saturdays, Sundays, and Holidays) to complete an investigative or probable cause report and draft a petition. Pursuant to 34-20A-72 the petition shall also be accompanied by a Certificate of a Licensed Physician or a licensed or certified Addiction counselor either of whom have examined the patient within TWO (2) days before the submission of the petition, unless the person refuses, and then this shall be documented in the petition. A physician or Addiction Counselor who is employed by HSC is not eligible to provide certification. 0 If the patient refuses to be examined by a Licensed Physician or a licensed or certified Addiction counselor, he or she will be given an opportunity to be examined by one appointed by the courts pursuant to SDCL 34-20A-76. The attorney will provide the patient with Notice of Rights, Petition, Certificate of Addiction Counselor or physician, and Investigative or probable cause report. The attorney may also provide the patient with a Stipulation Agreement. 0 If the patient chooses to sign the Stipulation Agreement this will then be forwarded to the judge or Ml Board Chair by the attorney for review and issuance of order for treatment. I If the patient declines to sign the Stipulation then a hearing must be held within 10 days of filing the petition. The hearing will then occur in Circuit Court in front of a judge or will be scheduled with the MI Board Chair. Testimony may be provided by the petitioner and the physician or counselor completing the certificate The judge or Ml Board Chair provides an order. If order is being obtained from Circuit Court the order will need to be filed with the Clerk of Courts and a certified copy will be forwarded by the attorney. Co-Occurring Coordinator will arrange for patient to transfer into an accredited treatment program once all legal documents have been obtained, approval from the Division of CBH has been obtained, and a bed is available. Origination Date: 01/30/08 Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.37 REFERRALS Policy: It shall be the policy of the that out?of-state referrals shall be referred to a treatment program in their own state of residence, unless emergency intervention is necessary or if the individual is transferred to South Dakota through the Interstate Compact on Mental Health. Purp? ose: To ensure that mental health services be made available primarily to residents of the State of South Dakota. To provide procedure for the admission of out?ofnstate residents who require emergency intervention or when referred through the Interstate Compact on Mental Health. Responsible Parties: Administrator Admissions Officer (Interstate Compact Coordinator) Senior Secretary (Admissions Office) Physicians and Admissions Clerks Medical Records House Supervisor Co-Occurring Coordinator House Supervisor Medical Director Procedures: Obtain information regarding patient's residency. Request records from sending facility pursuant to the guidelines of the Interstate Compact. Hospital Administrator and Medical Director are made aware of all Interstate Compact referrals. Request evaluation by community mental health center or other mental health professional to determine if inpatient hospitalization is necessary. If inpatient hospitalization is indicated, patient may be admitted to the either voluntary or under commitment. Human Services Center Chapter 8.1 Admissions PoliCy and Procedures Refer to this Chapter, Section entitled ?Pre-Adrnission Arrangements? of the Policy and Procedure Manual. Mandatory admission fee may be waived. (See SDCL Refer to this Chapter, Section entitled ?Interstate Compact Referrals? of the Policy and Procedure Manual to return patient to state of residence and for admitting referrals who are hospitalized in other states. Last Revised: 07/01/16 Last Reviewed: 07/01/ 16 Next Review Date: 07/01/ 17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.38 INTERSTATE COMPACT REFERRALS Policy: It shall be the policy of the that individuals may be transferred to and from the pursuant to the Interstate Compact on Mental Health and on a bed availability basis. South Dakota is a member of this compact. Purpose: To facilitate proper and expeditious treatment of the mentally ill by cooperative action of party states to the benefit of the patients, their families and Society irrespective of legal residence and citizenship status. Responsible Parties: - Administrator Treatment Team Admissions Officer (Interstate Compact Coordinator) Senior Secretary (Admissions Office) Administrator (Interstate Compact Administrator) Admissions Clerks Patient Services Office Co-Occurring Coordinator Admissions Nurse Procedures: Transfers to another state: The Admissions Officer shall monitor all ou?t?of?state admissions to determine appropriateness of interstate transfer. Any other referrals shall be made by the treatment team. Social Services shall obtain consent to transfer form and record release form signed by the patient. If the patient is not competent to give consent, pursue other avenues for obtaining consent including Health Care Consent pursuant to SDCL 34?1204 or temporary limited guardianship. Social Services shall contact patient?s family and advise as to the possible transfer, unless the patient objects to such notification. If patient has been committed, send Request for Approval of Transfer to the Board of Mental Illness in the county of residence or referring county (27A-6-5). Human Services Center Chapter 8.1 Admissions Policy and Procedures Complete application for transfer and enclose copies of clinical records, including copies of the legal papers, in duplicate. Make a listing of all records sent and file in the Medical Record chart. If the receiving state approves the transfer, arrangements shall be coordinated with Admissions Officer, the treatment team and Patient Services Office. The Hospital Administrator is made aware of the receiving state?s acceptance of transfer. The following documents shall be prepared by Admissions Office for the transfer: Letter of introduction (identifying staff escorts). Receipt of person (to be signed by staff of receiving state and returned to Copy of letter authorizing transfer. Copies of current medical records since the application was submitted. Transfers from other states: The application for transfer and accompanying information shall be received from the compact office in the referring state. If the applicant's family lives in South Dakota, the nearest mental health center shall be contacted to assess the home/family situation. Factors to be considered are: whether patient?s family has maintained contact with the patient in referring state, family's willingness to visit patient at the family's willingness to be involved with discharge planning, other benefits to be derived by transfer. A consent to transfer form and release of information form signed by the patient or guardian shall accompany the application for transfer. Information received shall be referred to the Interstate Compact Administrator, and HSC Administration for review and approval/denial. Chapter 8.1 Human Services Center Admissions Policy and Procedures If the transfer is approved, accompanying the letter authorizing the transfer shall be 3 Voluntary Admission Agreement that the patient or guardian shall sign, date, and have witnessed. This document shall accompany the patient at the time of transfer. It is understood that the transportation costs shall be at no expense to South Dakota. The transfer shall not be accepted if there are any criminal charges pending against the patient. Last Revised: 10/01/14 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.39 RETURNING PATIENTS FROM AUTHORIZED LEAVE Policy: It shall be the policy of that any patient committed by a county board of mental illness or voluntary patient deemed dangerous to self or others, who are on authorized leave, shall be returned to if notified that the patient?s condition has decompensated and immediate inpatient hospitalization is required. Purpose: To comply with existing state statute To identify necessary procedures to return the patient to the To provide appropriate treatment in an inpatient setting. Responsible Parties: Treatment Team Administrator Assigned Social Worker Admissions OffiCer Senior Secretary (Admissions Office) Admissions Clerks Admissions Nurse House Supervisor Co?Occurring Coordinator Procedures: If is notified that the patient?s mental condition has decompensated, the patient is refusing to return to the and law enforcement are hesitant to return the patient without authorization from the the Admissions Office shall be notified. The attending Physician shall be advised to write an order placing the patient on unauthorized leave. The Hospital Administrator shall be notified. The Admissions Office shall contact the Yankton County Sheriff?s Office requesting that a teletype message be sent to the sheriff?s office in the county where the patient is physically present. The message shall include the following: Name of the patient. Legal status of patient. 0 County of residence. AR.8.ln83 Chapter 8.1 Human Services Center Admissions Policy and Procedures Name of the attending Physician. Advise that patient has been placed on unauthorized leave. Advise that staff recommends that the patient be returned to the Location of the patient. If the sheriffs office in the county, where the patient is physically present, contacts the questioning the authority to return patient, cite SDCL 27A?4?l6. This statute provides the authority for law enforcement to return patients on unauthorized leave back to the Suggest thev contact their state?s attorney for confirmation. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.40 WRIT OF HABEAS CORPUS APPLICATIONS AND HEARINGS Policy: It shall be the policy of the that all patients found to be mentally ill by the board of mental illness and all persons confined or in any manner detained as mentally ill shall be entitled to the benefit of a writ of habeas corpus. Purpose; To comply with existing State Statute To identify necessary procedures for filing an application for writ of habeas corpus. To assist patients in the petitioning process. Responsible Parties: 1 DSS Legal Counsel Admissions Officer/designee Treatment Team Medical Records Co?Occurring Coordinator Administrator Procedures: If the patient is unable to retain an attorney and an application is completed with the Mental Health Advocacy Program for court appointed counsel, a copy of the application shall be provided to the Admissions Office by the Advocacy Program. A copy of the application is submitted to DSS Legal Counsel by the Admissions Officer or designee. The Court shall notify the patient and the Mental Health Advocacy Program as to whether or not eligibility for court?appointed counsel has been determined. If the Court determines that the patient is financially unable to obtain counsel, an attorney is appointed. Patient Advocacy shall notify the Admissions Office and provide the name of court- appointed counsel. A copy of the Notice of Court Appointed Counsel is submitted to DSS Legal Counsel. - Information pertaining to application for court appointed counsel and name of appointed attorney is entered in the Excel document titled Writs/Appeals located on the N: Drive. The appointed attorney shall bring a Court Order allowing access to the medical records. Chapter 8.1 Human Services Center Admissions Policy and Procedures If the attorney petitions for a hearing and legal documents are served on the Admissions Officer/designee shall make copies for the treatment unit chart. Copies shall be put in Medical Records. When has been advised of hearing date and time, the Admissions Office shall notify the attending Physician, the assigned Social Worker and the treatment team. The Admissions Officer or designee shall follow?up by getting a certified copy of the Court Order. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-86 Human Services Center I Chapter 8.1 Admissions Policy and Procedures 8.1.41 FLAGGIN RECORDS FOR NOTIFICATION Policy: It shall be the policy of the that all patients' charts and chemical dependency patients' charts shall have a colored ?ag inserted on the face sheet when appropriate legal authorities are to be notified and flagged when individuals are to be notified who have been threatened with bodily injury by the patient. Patient charts are also flagged for those patients which have legal involvement related to a criminal matter. Pumose: To inform Clinical staff that appropriate legal authorities shall be notified prior to patients? .on leave status, unauthorized leave status and prior to discharge. To inform clinical staff that individuals who have been threatened with bodily injury by the patient shall be notified prior to on leave status, unauthorized leave status and prior to discharge. Resnonsible Parties: Administrative Staff Admissions Officer Senior Secretary (Admissions Office) Assigned Social Worker Admissions Clerks Treatment Unit Personnel 0 Chemical Dependency Counselors and Staff Medical Records Admissions Nurse Co-Occurring Coordinator House Supervis0r Procedures: Administrative staff shall be notified of all high profile cases and those patients with serious charges, such as murder, manslaughter, or escape from a secure facility. Medical record files shall have a colored flag inserted on the face sheet when appropriate legal authorities are to be notified. Information shall be entered into the health information system in the Legal Status menu._ - Please refer to Chapter 1.2 (Administration), Section entitled ?Patients Requiring Notification of Authorities? of the Policy and Procedure Manual. AR.8.1-87 Chapter 8.1 I Human Services Center Admissions Policy and Procedures Criminal charges may be verified if a detainer or court order IS received. The chart 1s ?agged accordingly and info1mation is entered in the electronic health information legal status screen and the discharge alert is activated in the electronic health information system. If a detainer or court order is not received, the legal charges can be verified if the transporting law enforcement officer signs the Custody Document upon admission indicating the patient has criminal charges pending. Charges may also be verified by accessing the Odyssey Program, a software tool which allows for immediate access of a patient?s criminal record in the state of SD. The program does not provide information related to arrests on tribal reservations. Process for verifying charges and ?agging charts is as follows: 1. The patient presents to HSC with the transporting officer. The officer completes and signs the Custody Document form upon the patient?s arrival. The form is located in the Admissions Department behind the Security desk. 2. The registration staff shall place the original signed Custody Document in the chart under the legal section tab to alert the staff of pending criminal matters. 3. A copy of the Custody Document is provided to the Admissions Officer or designee if the patient has identified criminal matters pending. 4. The Admissions Officer or designee contacts the county sheriff?s department or count States Attorney?s Office in the identified county to verify the legal charges. 5. Once charges are verified an alert ?ag is prepared for the patient?s chart. The flag is routed to the unit to be placed on the Face Sheet of the patient?s medical record file. 6. The Admissions Officer or designee enters the charges into the electronic health information legal status screen. A discharge alert is activated in the electronic health information system. If the Custody Document is not signed or if it is believed the patient has pending criminal matters based on the referral information provided, the patient?s criminal history can be verified by accessing the Odyssey Program. The House Supervisor shall be contacted to access the information. If pending charges are identified the House Supervisor or designee completes an alert ?ag for the patient?s medical record file and enters the charges in the electronic health information legal status screen. A discharge alert is activated the electronic health information system. Medical records files of referrals shall be flagged if certain individuals are to be notified who have been threatened with bodily injury by the patient. If the Admissions Office is notified that the prospective patient has threatened another person with bodily injury, a ?ag shall be completed identifying the patient's name, date, why the notification is to be made and the name of the individual to be notified. Human Services Center Chapter 8.1 Admissions Policy and Procedures The ?ag is then sent to the treatment unit area for placement on the face sheet of the medical records file. If the treatment team discovers that during the patient's hospitalization the patient has threatened another person with bodily injury, the assigned Social Worker shall notify the Admissions Officer/designee so that a flag can be generated for the medical records file. If the individual who had been threatened with bodily injury advises the treatment team that such notification is not necessary, a note shall be placed on the flag and a note is placed in the patient?s electronic record by the Social Worker or chemical dependency staff documenting such notification. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 I Human Services Center Admissions Policy and Procedures 8.1.42 COORDINATION OF FORCED NIEDICATION HEARINGS Policy: It shall be the policy of the that Forced Medication hearings shall be coordinated by the Admissions Officer/designee in cooperation with DSS legal counsel and the attorney representing the patient. Purpose: To identify appropriate procedures associated with the hearing process. To comply with existing State Statute (SDCL and Responsible Parties: Admissions Officer Physician Senior Secretary (Admissions) DSS Legal Counsel 0 Medical Records Patient Services Co?Occurring Coordinator HSC Security Patient Services Treatment Team Procedures: Refer to Chapter 2.2 (Medical Staff), Sections entitled ?Emergency Use of Medication? and ?Forced Medications - Obtaining a Court Order for Involuntary Patients? of the Policy and Procedure Manual on Forced Medications. Medical Records shall provide the Admissions Office with a copy of the Treatment Plan: Involuntary Medication form, which is faxed to the hospital?s attorney, requesting a forced medication hearing. Patient?s name and date of referral shall be placed on file and entered into the Health Information System, Forced Medication Input screen by Medical Records staff. The cover letter signed by the physician, Consult and Treatment Plan: Involuntary Medication form is mailed to DSS Legal Counsel by Medical Records staff. AR.8.1-90 Human Services Center Chapter 8.1 Admissions Policy and Procedures The Admissions Officer prepares a colored flag for the chart alerting staff the Forced Medication Judicial Review has been filed with the court. DSS legal counsel shall advise the Admissions Officer as to the assignment of legal counsel. Obtain copies of all legal papers for file.- The appointed attorney shall bring a Court Order allowing access to medical records. Admissions Officer shall periodically give attorney status report during the interim as to whether or not patient is taking meds. DSS legal counsel shall advise as to date, time and place of hearing (if necessary). DSS legal division notifies the Admissions Officer or designee when the patient is to be served with the Notice of Hearing and Order of Appointment of Counsel. Documents are scanned and emailed to the Admissions Officer or designee. The documents are then given to the Security Officer along with an Affidavit of Service. The documents are served upon the patient by Security. Information is entered into the Health Information System, Forced Medication Input screen. The treatment team, Patient Services staff, Medical Records Supervisor are notified of the date, time and place of hearing. If the patient signs the stipulation prior to hearing, he/ she may be discharged prior to receipt of the Order to Medicate, providing the stipulation and order have been filed with the Court. The Admissions Officer or designee will contact DSS Legal Counsel to ensure the order has been signed and filed. DSS Legal Counsel will be informed of the patient?s discharge date and forwarding address. DSS Counsel will send the patient a receipt of admission of the Order to Medicate or have the sheriff in the residence county serve the document. The Order to Medicate document is placed in the patient?s chart. Information is entered into the Health Information System. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.43 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM HEALTH CARE DECISIONS Policy: It shall be the policy of the that any patient in need of surgery or any medical procedure requiring the signing of a consent form, who does not have a legal guardian or a durable power of attorney authorizing medical care, and who is not competent to give informed consent may receive such medical care pursuant to the consent requirements of - Chapter of the South Dakota Codified Laws and Chapter 1.2 (Administration), Section entitled ?Patient?s Self?Determination Act? of the Policy and Procedures Manual. If consent cannot be obtained pursuant to Chapter of the South Dakota Codified Laws, the court shall be petitioned for authorization to do the procedure. Surgical permits and other medical procedure hearings shall be coordinated by the Admissions Officer or designee. Purpose: To provide appropriate medical care for those patients who are not competent to give consent. To comply with existing state statute (34?1204 and To identify necessary procedures to obtain court authorization. Responsible Parties: 0 Attending Physician Medical Director 0 Admissions Officer Senior Secretary (Admissions Office) Specialty Clinic Nurse Assigned Social Worker Admissions Nurse Co-Occurring Coordinator 0 House Supervisor Patient Services Treatment Team Procedures: Referrals shall come from the attending Physician, Medical Director or Specialty Clinic. Attending Physician shall advise as to the urgency of the request so that a hearing date can be set as soon as possible. AR.8.1-92 Human Services Center Chapter 8.1 Admissions Policy and Procedures Petition is completed and notarized. The petition which includes the competency statement is forwarded to the Yankton County State's Attorney's Office or to the attorney office appointed by the Attorney General?s Office. The State's Attorney?s Office or office appointed by the Attorney'General?s Office shall notify the Admissions Officer/designee as to the date and time of the hearing. The treatment unit, attending physician, Specialty Clinic Nurse, Patient Services and Quality Management Director shall be notified of the date and time of the hearing. Obtain a certified copy of the court order. If the court grants authorization for the procedure, send cepy of the order to the treatment unit chart and flag the chart indicating the length of the commitment order. I The length of commitment shall be entered into the Health Information System. The chart is ?agged by the ECT Nurse indicating the length of the commitment. Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.44 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM ELECTRO-CONVULSIVE THERAPY Policy: It shall be the policy of the that no adult person may be subject to electro? convulsive therapy. (ECT) unless written informed consent is obtained from the patient or emergency treatment is ordered by the physician on a time limited basis or per court order. If the attending physician determines that the person is incapable of exercising informed consent, treatment may only be provided on an emergency basis or by order of the court Or board order. The court or mental illness board shall be petitioned for authorization to do the procedure. Electro-convulsive therapy hearings shall be coordinated by the Admissions Officer or designee. Pumose: To provide appropriate treatment for patients unable to give consent. To comply with existing state statutes I 3.14, and . Responsible Parties: Attending Physician Medical Director Admissions Officer Senior Secretary (Admissions Office) 0 Specialty Clinic Nurse Assigned Social Worker Admissions Nurse ECT RN Coordinator Co?Occurring Coordinator Treatment Team Procedure: Referrals shall come from the attending physician, Medical Director of Specialty Clinic. Petition is completed by the attending physician and is notarized. Human Services Center Chapter 8.1 Admissions Policy and Procedures The petition which includes a competency statement is forwarded to the Yankton County States Attorney?s Office, the attorney appointed by the Attorney General?s Office, or Yankton County Board Chair. The Admissions Officer is notified of the date and time of hearing by the States Attorney?s Office/designee or County Board Chair. The attending physician, assigned social worker, and ECT RN Coordinator, are notified of I the hearing date and time. A certified copy of the court order is placed in the patient?s chart. The chart is ?agged indicating the date of expiration of order. Origination Date: 08/29/05 . Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Chapter 8.1 Human Services Center Admissions Policy and Procedures 8.1.45 MENTAL ILLNESS HOLD PROCEDURE FOR ADULT CHEMICAL DEPENDENCY PATIENTS Policy: A Pine 1 patient may be placed on a mental illness hold for the following reasons: 1) The patient has requested to be released and meets criteria for a mental illness hold. 2) It is clinically indicated and the patient is not competent to give consent to voluntary hospitalization. Responsible Parties: Admissions Officer Unit Staff Admissions Senior Secretary Physician House Supervisor Admissions Nurse Co?Occurring Coordinator Procedure:? Documents needed for the hold include: Petition Hold Notice Qualified Mental Health Certificate Procedure to follow during regular business hours (Monday thru Friday 8:00am to 4:30pm) 1) The Unit RN consults with the regarding the patient?s condition. Unit staff contacts Admissions to obtain legal documents to initiate the hold. 2) The Unit RN serves the patient with a Hold Notice (Mental Illness Protective Custody Notice SDCL 3) The staff member having knowledge about the patient?s dangerousness completes the Petition (S elect the appropriate petition) and has it notarized or verified by affidavit. 4) The Yankton County Board Chair is notified of the Petition. (Calls to the Board Chair can be made at any time). The Board Chair will designate a QMHP at this time. Human Services Center Chapter 8.1 Admissions Policy and Procedures 5) 6) 7) 8) 9) The QMHP Certificate is to be completed by a or state endorsed QMHP employed by the Human Services Center. The treating cannot complete the QMHP Certificate. The Admissions staff is responsible to notify the QMHP of the required assessment. Upon completion of the Certificate (examination must be completed within 24 hours after the hold notice is served) the contents of the document is reviewed with the Yankton County Board Chair. If custody is to continue the Yankton County Board Chair issues a Verbal Order for Detention. The Admissions staff notifies the unit of the verbal order and enters the information in the Admission Log and electronic health record. The Unit RN contacts the attending physician for transfer orders authorizing the transfer to the acute unit. Unit staff will complete proper documentation per Medical Staff policy titled ?Transfers Within The patient is transferred from the Chemical Dependency Program to an Adult Unit. Check the Admission Rotation for the next available unit. 10) The unit staff will route the original Petition, Hold Notice and QMHP Certificate to the Admission staff. COpies of the documents are made for the chart by the Admission staff. 11) The Admissions staff enters legal status changes into the electronic health record and an updated Face Sheet is forwarded to the unit. Procedure to follow after hours (after 4:30pm, weekends and holidaysThe unit RN consults with the regarding the patient?s status. The House Supervisor is made aware by the unit RN of the need to, place the patient on a mental hold. Legal documents (Petition and Hold Notice) are obtained from the Admissions Department (Select the appropriate petition). The unit RN serves the patient with the hold notice (Mental Illness Protective Custody Notice SDCL The unit staff with first-hand knowledge of the patient?s dangerousness completes the petition and has it notarized or verified by affidavit. The House Supervisor contacts the Yankton County Board Chair immediately to review the contents of the Petition. AR.8.1-97 Chapter 8.1 Human Services Center Admissions Policy and Procedures 7) The Yankton County Board Chair designates the QMHP which will complete the Certificate (Pursuant to the QMHP is designated by the Board Chair and the QMHP cannot be the individual completing the petition or initiating the hold). The treating physician on Pine 1 cannot complete the QMHP Certificate. The Yankton County Board Chair is informed which is on call. 8) The QMHP Certificate. is completed by the designated QMHP and the certificate is submitted to the Yankton County Board Chair by the House Supervisor or Admissions staff. Once reviewed, the Yankton County Board Chair provides a Verbal Order for Detention. The call from the Board Chair is documented in the Admission Log as well as entered in the electronic health record. 9) The On Call Physician is contacted for transfer orders. The unit staff will complete proper documentation pertaining to Medical Staff policy titled ?Patient Transfers Within 10) The patient is transferred from the Adult Chemical Dependency Unit to an Adult Unit. Check the Admission Rotation for the next available unit. The Intensive Treatment Unit may be utilized if needed. 11) The original Petition, Hold Notice, QMHP Certificate are copied by the Admissions Clerk and copies are placed in the chart. The original documents are placed in the basket in Admissions for the Senior Secretary. The originals are forwarded to the Yankton County Board Chair the next business day. 12) The Admissions staff enters a legal status change in the electronic health record and a Face Sheet is forwarded to the unit. Origination Date: 05/06/04 Last Revised: 12/22/15 Last Reviewed: 07/01/16 I Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.46 NON-SURVEILLAN CE VIDEO AND AUDIO RECORDING PROCEDURE Policy: It shall be the policy of that non?surveillance Video and audio recordings shall require patient authorization or a court order pursuant to SDCL Purpose: To ensure patients are notified prior to non-surveillance Video and audio recording and authorization obtained, when required. Responsible Parties: 0 0 Health Information IRecords Specialist or designee - HSC Security 0 Admissions Officer I Admissions Clerk Procedure: Patient approval or a certified court order is required for all non?surveillance video and audio recording. The authorization to Video/Audio record must be signed prior to any recording and must be signed by the patient, parent, or legal guardian, if applicable. The will notify the Health Information/Records Specialist, Admissions Officer and/or HSC Security of the need to set up the recording equipment. The Admission Clerk presents the patient with the Authorization to Video/Audio recording form for signature (Form If the recording is court ordered the patient does not need to sign the authorization form. HSC Security, Health Information/Records Specialist and/or Admissions Officer will be responsible for video and audio equipment set up. Please refer to Dakota Security Operations Manual page 69 thru 147 for set up instructions. HSC Security will monitor recording equipment during the course of the patient interview and then disable the Audio Input Set Up upon completion of the interview. HSC Security notifies the Health Information/Records Specialist that the interview is completed. Chapter 8.1 - Human Services Center Admissions Policy and Procedures The Health Information/Records Specialist is responsible for saving the recorded segment to the EXE file and then exports the recorded information from the DVR to a DVD. Please refer to Dakota Operations Manual pages 172 thru 182 for exporting instructions. The DVD and Authorization Form shall remain at the South Dakota Human Services Center as part of the patient?s medical record pursuant to the South Dakota Human Services Center Medical Records Policy 8.4.6 Ownership, Access, Location and Removal of Patient Records. Pursuant to SDCL a mental health examination may be recorded upon court order and this recording shall be submitted to the court along with the physician?s report. Origination Date: 06/07/10 Last Revised: Last Reviewed: 07/01/16 Next Review Date: 07/01/17 AR.8.1-100 Human Services Center Chapter 8.1 Admissions Policy and Procedures 8.1.47 CLINICAL REVIEW OF NURSING FACILITY REFERRALS AND ASSISTED LIVING Policy: It shall be the policy of the to provide a consulting service to nursing and assisted living facilities caring for patients with behavioral needs. Purpose: To maintain nursing residents in the least restrictive environment. To provide nursing facilities with resources and interventions which will allow the resident to remain in their current setting. To support appropriate admissions to the South Dakota Human Services Center. Responsible Parties: 0 Medical Director Admissions Nurse House Supervisor Primary Medical Physician Geriatric Program Director Geriatric Social Worker Admissions Officer Co?Occurring Coordinator Nursing staff Therapeutic Recreational staff 0 I 0 Definitions: Clinical Team: 0 Primary Medical Physician assigned to the Geriatric Program 0 Medical Director - Geriatric Program Director 0 Geriatric Social Worker 0 Activity staff Intake Staff: 0 Admissions Nurse 0 House Supervisor Chapter 8.1 Human Services Center Admissions Policy and Procedures 0 Admission Officer 0 Co?Occurring Coordinator Procedure: The referral source contacts intake staff at HSC. The patient must be residing in a nursing facility. Intake information is gathered at the time of the phone call. At this time the intake staff determines whether the nursing facility has initiated a MI Hold. If not, the nursing facility is offered the option of a Clinical Review. If the nursing facility opts for this service proceed with the following process: 0 The intake staff provides the nursing facility/assisted living facility with a Clinical Summary Form. The Clinical Summary Form is emailed to the facility via secure email. 0 The nursing facility/assisted living facility is asked to thoroughly complete the form and fax it to the HSC Admission Nurse. 0 Nursing facility is informed that the Admission Nurse will get back to them within 24 to 48 hours (excluding weekends and holidays) with the Clinical Review team suggestions once the Clinical Summary Form is received. 0 Once the completed Clinical Summary Form is returned to HSC the Admission Nurse scans the document to the CliniCal Review Team. a The responses from the Clinical Review Team are reviewed by the Admission Nurse. Responses are summarized and entered in the call intake by the Admission Nurse. 0 The summarized suggestions offered by the Clinical Review Team are forwarded by the Admission Nurse to the nursing facility/assisted living facility via email or by fax within 24 to 48 hours of the receipt of the Clinical Summary Form. A call is placed by the Admission Nurse to the nursing facility/assisted living facility to ensure the information was received. - The nursing facility/assisted living facility are encouraged to call if they have any questions. a A follOw-up call is made by the Geriatric Social Worker to the nursing facility two weeks later to inquire about the patient?s status. I Origination Date: 07/24/14 Last Revised: 07/01/16 Last Reviewed: 07/01/16 Next Review Date: 07/01/17 Human Services Center Chapter 8.1 Admissions Policy and Procedures INDEX A ADMISSION OF EMANCIPATED MINORS (VOLUNTARY) 8.1?15 ADMISSION OF FIVE-DAY EMERGENCY HEARING PROCEDURES - ADULTS 8.1?17 ADMISSION OF INVOLUNTARY FORTY FIVE (45) DAY COMMITMENTS (MINOR) 8.1?26 ADMISSION OF INVOLUNTARY NINETY (90) DAY COMMITMENTS- ADULTS 8.1? 21 ADULT VOLUNTARY REFERRAL BY A LEGAL GUARDIAN, DURAB LE POWER OF ATTORNEY FOR HEALTHCARE OR NEXT OF KIN 8.1-11 CLINICAL REVIEW OF NURSING FACILITY REFERRALS AND ASSISTED LIVING 8.1?101 CONVERTING EMERGENCY COMMITMENTS TO VOLUNTARY STATUS PRIOR TO HEARING 8.1?30 CONVERTING VOLUNTARY PATIENT TO EMERGENCY STATUS (PATIENT DID NOT EXECUTE WRITTEN REQUEST FOR RELEASE) 8.1-29 CONVERTING VOLUNTARY PATIENT T0 EMERGENCY STATUS (PATIENT EXECUTED A WRITTEN REQUEST FOR RELEASE) 8.1?27 COORDINATING AND SCHEDULING MENTAL ILLNESS HEARINGS 8.1-35 COORDINATION OF FORCED MEDICATION HEARINGS . DEVELOPMENTAL DISABILITY HEARINGS 8.1-48 DISCHARGE OF AN EMERGENCY ADMISSION PRIOR TO A HEARING 8.1?32 . FEDERAL COURT REFERRALS - FLAGGING RECORDS FOR NOTIFICATION 8.1-87 DAY REVIEW HEARINGS 8.1?40 I INITIATION OF CHEMICAL DEPENDENCY COMMITMENT FOR AN ADULT INPATIENT AT 8.1-76 TRANSFERS 8.1?60 INTERSTATE COMPACT REFERRALS 8.1-80 INVOLUNTARY ALCOHOLISM AND DRUG ABUSE COMMITMENTS (SDCL 34" 20A) 8.1?74 JUVENILE COURT REFERRALS 8.1?68 Chapter 8.1 I Human Services Center Admissions Policy and Procedures I MEDICAL SCREENING 8.1?7 MENTAL ILLNESS HEARINGS FOR EMERGENCY ADMISSIONS - 8.1?22 MENTAL ILLNESS HOLD PROCEDURE FOR ADULT CHEMICAL DEPEN DEN CY PATIENTS 8.1?96 MISSION STATEMENT 8.1?3 MONITORING ADOLESCENT ADMISSIONS WHO REACH THE AGE OF MAJORITY 8.1-33 NATIVE AMERICAN REFERRALS TO THE ADOLESCENT TREATMENT PROGRAM WHO RESIDE ON RESERVATION OR TRUST LANDS OR WHOSE PARENTS RESIDE ON RESERVATION OR TRUST LANDS 8.1-52 NINETY (90) DAY REVIEW HEARINGS 8.142 NONSURVEILLANCE VIDEO AND AUDIO RECORDING PROCEDURE 81?99 0 . . OBJECTION BY MINOR OR GUARDIAN TO INPATIENT HOSPITALIZATION 8.1?37 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM ELECTRO- CONVULS IVE THERAPY 8.1-94 OBTAINING COURT ORDERS FOR AUTHORITY TO PERFORM HEALTH CARE DECISIONS 81?92 REFERRALS 81:78 ARRANGEMENTS . - 8 .1-4 REFERRAL FOR EVALUATION THROUGH THE CRIMINAL PROCEDURE 8.1?62 REFERRALS FOR TREATMENT THROUGH THE CRIMINAL PROCEDURE 8.1?64 RETURNING PATIENTS FROM AUTHORIZED LEAVE 81?83 SIX MONTH REVIEW HEARINGS 81?44 TRANSFER BETWEEN TREATMENT PROGRAMS AT 8.1?54 TRANSFER OF COMMITMENT FROM MENTAL HEALTH OPERATED COMMUNITY BASED PROGRAM 8.1?56 TRANSFER OF COMMITMENTS AND OUTPATIENT COMMITMENTS TO MENTAL HEALTH A STATE OPERATED MENTAL HEALTH PROGRAM 8.1?58 TRIBAL COURT COMMITMENT - 8.1?50 Human Services Center Chapter 8.1 Admissions Policy and Procedures VOLUNTARY ADMISSIONS TO THE ALCOHOL AND DRUG ABUSE PROGRAMS (SDCL 8.1-72 VOLUNTARY REFERRALS FOR CARE - ADULT 8.1?9 VOLUNTARY REFERRALS FOR CARE - MINOR 8. 1-13 . WRIT OF HABEAS CORPUS APPLICATIONS AND HEARINGS 8.1?85 REVIEW HEARING 8.1?46