Interfacility Transfer Policies – Other CA Counties


Behavioral Health transports occur from Ukiah Ambulance. Effective (8-2013) Black Talon Industries, Inc., along with other management groups also assists with and will respond to Behavioral Health and security needs in Mendocino.


Crisis staff on call should ask that the Emergency Room physician or the primary physician – if there is any reason that this individual should not be transported via county vehicle.

It is up to the Emergency Room physician or the primary physician in charge of the individual to decide what type of medical transportation is needed for a safe medical transfer of the individual. Crisis staff will need the physician‘s direction on the transport status (via ambulance, EMT, non-medical transport, private car, etc.)

Upon the physician‘s determination, he/she will write an order in the chart and will complete the EMTALA paperwork which will have the information about the type of transportation method.

  • If the physician states that the individual cannot be transported via county vehicle then the hospital completes the transportation loop as hospitals are under strict laws around medical transportation and Crisis staff would not be able to help.
  • If the physician states that the individual can be transported via county vehicle, please call transportation and arrange for the individual to be transported to the receiving psychiatric facility.

The agency that transported the individual to the Queen of the Valley Hospital Emergency Department (QVMCED) will stay with the individual or contract with private security until the individual has been medically evaluated.

The agency that transported the individual to the QVMCED will be responsible for transporting the individual to the appropriate care provider.

If an individual is brought to the Emergency Response Team-ERT Unit and is then determined to be in need of a medical screening examination, in most instances, Emergency Response Team staff or private security will be responsible for transporting the individual to the QVMCED for the medical screening examination.

Law Enforcement will be responsible to transport the individual to the QVMCED for the medical screening examination if Emergency Response Team or Law Enforcement staff feels the individual presents a critical level of risk potential.


Current mental health consumers or other individuals in a crisis situation are to be transported for emergency hospitalization only. This service is to be provided by the current transportation contractor. When medically necessary, it‘s permissible to make use of the local ambulance service for the transporting of individuals for hospitalization. Under NO circumstances should an individual on a 5150 transport themselves or be transported by anyone other than the current transportation contractor.

  • Crisis worker determines that transportation is necessary.
  • Crisis worker notifies current transportation contractor that transport is necessary; identifies mental health consumer and their location for pick up.
  • Crisis worker includes all necessary paperwork for admission to the psychiatric facility.
  • Crisis worker notifies receiving facility that consumer is being transported.

Response time to Trinity County General Hospital will be no more than 30 minutes.

Always use a caged car.

Individuals are to be checked by the Sheriff‘s Deputy or the Emergency Room team, which includes the crisis worker, for sharp weapons or contraband before being transferred to the psychiatric facility. No individual is to be transferred on a detention without this search.

While in the Emergency Room, individuals should be issued disposable slippers and the individual‘s shoes should be placed in a bag held by the driver and given to the psychiatric facility upon arrival. Other personal items, such as watches, jewelry, and belts, must be removed as a safety precaution to avoid individual self-harming during transport or transfer.

If the individual is an extreme elopement risk, the Emergency Room staff may consider issuing a gown to the individual to discourage the individual from leaving the hospital. This is the doctor‘s decision.

Individuals should be asked to use the restroom before leaving for their psychiatric placement. The individual should be accompanied to the restroom and never left alone. If the individual needs to use the restroom, the driver must escort the individual, and then stand by the door until the individual exits. If the driver is the same gender as the individual, it is appropriate to accompany the individual into the bathroom and stand by the stall door.

While at the rest stop using the restroom, the individual may be given a cigarette if the driver is confident the individual will cooperate in returning to the vehicle. If the driver is in doubt about the individual‘s ability to return to the vehicle after using the restroom or smoking a cigarette, it would be better to avoid such stops.

Driver will get a copy of the medical clearance, 5150 (copy legally equivalent to original), and clinical report to take to the hospital. The crisis worker will supply this document.

If there is a highway emergency, use the cell phone and dial 911 for help.

Upon arrival at the psychiatric facility, the driver will use the cell phone to notify the psychiatric facility staff that the Trinity County Transport has arrived. If possible, do not leave the individual alone in the car or allow the individual to get out of the car. The driver should wait in the car with the individual until after the psychiatric facility staff has arrived to assist with the transition into the facility. There will be psychiatric facilities that do not provide this service, and in this situation, drivers will need to walk the individual to the door of the facility.

If the individual somehow escapes, let them go and immediately call 911. Describe the problem and then call TCBHS or the crisis worker or Manager-on-Call to obtain further instruction.

An Incident Report should be generated for any unusual event or activity that occurred on the transport/transfer, signed, and forwarded to the supervisor of the program.


Transfer documentation shall be completed by the Emergency Room ward clerk, attending nurse and attending physician.

  • The attending physician shall complete his/her portion of the Memorandum of Transfer, along with a prescription for the ambulance.
  • The attending nurse shall complete his/her appropriate portion of the Memorandum of Transfer.
  • Once a facility has accepted the individual, Emergency Room staff shall arrange for transportation to the accepting hospital. If the individual is conserved, Crisis staff will arrange for transportation.
  • Crisis staff shall notify the Emergency Room staff if they believe that the individual is potentially assaultive or an elopement risk. It is the responsibility of the Emergency Room staff to manage staff and individual safety issues.
  • Crisis staff may leave the Emergency Room as soon as:
    • A psychiatric facility has accepted the individual, and
    • Emergency Room staff have been informed of the placement, and
    • All relevant documentation has been completed.

It is the responsibility of the Emergency Room staff to conclude the transfer of the individual, including completion and distribution of the transfer paperwork; accompanying the individual to the ambulance; and notifying the accepting facility of the individual‘s estimated time of arrival.