|
Madera |
THIS INFORMATION CAN CHANGE–For accuracy—please check with each County The definition of “medically cleared”, as defined by Madera County, includes tests, screenings, and clinical observations that allow a medical professional to conclude that a individual is medically stable, does not require further inpatient acute care hospitalization, and is physically suitable for transfer for further psychiatric care (either on an inpatient or outpatient basis). |
| Modoc |
Modoc Medical Center (MMC) Emergency Room staff (doctors/nurses/other ancillary staff) will conduct an investigation/assessment to determine if the individual is in need of medical attention due to a physical condition. Blood alcohol and/or drug testing will be ordered as signs/symptoms indicate. MMC Emergency Room doctor will assess the individual for medical clearance. Medical clearance = The individual has been examined by a physician who has determined the individual has no physical condition (or has completed ALL treatment for a physical condition) which would prevent transfer/transport to a mental health facility or discharge except for the mental health assessment/evaluation. |
| Mono |
Local law enforcement may transport a detained individual directly to a Psychiatric Health Facility, designated Acute Psychiatric Hospital, or inpatient psychiatric unit in a General Acute Care Hospital. However, the reality of gaining admission to these facilities, and the risks inherent in the long distance transport of such individuals, warrant the management of acute psychiatric problems by Mental Health staff in cooperation with medical personnel at Mammoth Hospital‘s Emergency Department, with law enforcement standing by as needed to ensure the safety of all concerned. Additionally, many psychiatric facilities require doctor-to-doctor transfer of patients. Thus, the physician from the Emergency Department may be discussing the case with a psychiatrist from the psychiatric facility. Given the above, it shall be Mono County‘s policy to first transport all individuals detained on a 5150 to the Emergency Department of Mammoth Hospital for a: Pre-Admission Assessment. Such an assessment shall include both a mental health evaluation and a physical examination. If there is no other payor source, Mental Health shall pay Mammoth Hospital for Emergency Department visits resulting in an acute psychiatric hospitalization under WIC 5150. According to contractual agreement, medical staff of Mammoth Hospital‘s Emergency Department shall complete a medical assessment, including indicated laboratory studies, to assist in diagnosis and formulation of a treatment plan for detainees. If the Emergency Department physician concurs with a plan for transfer to inpatient psychiatric care, s/he will support the plan with appropriate medical orders for ambulance transportation and will communicate with the physician at the psychiatric facility to facilitate a doctor-to-doctor transfer if such is required by the receiving facility. Most acute psychiatric facilities require that their admissions be medically cleared before they will accept a potential patient. If a detainee requires acute medical care prior to transport to an acute psychiatric unit, Mammoth Hospital staff shall provide medical care as needed to stabilize the individual sufficiently for transfer if such stabilization is possible. It will be the discretion of the Emergency Department physician regarding the disposition of each individual case from a medical perspective. |
| Napa |
The following factors will be considered in making a determination as to the necessity for a medical screening:
If Emergency response Team-ERT staff on behalf of an admitting psychiatrist at a psychiatric facility requests, the Medical Center Emergency Room will medically screen the individual including testing for drugs and alcohol to the extent allowable by law. If a psychiatric facility requests additional medical testing they must contact and consult a Physician. |
| Sutter-Yuba |
Individuals in need of immediate medical attention and involuntary psychiatric hospitalization must be medically treated and cleared prior to admission to the psychiatric facility. The WIC 5150 application shall remain in force until such time as the individual is transferred to Sutter-Yuba Mental Health Services‘ Psychiatric Emergency Services (PES) for evaluation, or a peace officer relinquishes custody of the individual. |
| Trinity |
Medical Screening: Part of the screening process is to determine if the referring behavior/condition is the result of some cause other than a mental health disorder. In every case appropriate laboratory tests shall be conducted first to insure that the individual‘s presenting symptoms are not due to chemical or medical causes. It is the responsibility of medical staff to screen for possible medical/chemical conditions and to report this information to the Trinity County Behavioral Health (TCBHS) staff. Medical Clearance: A second part of the medical evaluation involves obtaining medical clearance. A written document, signed by a Physician and the TCBHS, the Brief Assessment must accompany the individual to the psychiatric facility documenting medical clearance on all hospitalizations. Generally, a psychiatric facility will not accept an individual requiring more medical care than can be managed on an outpatient basis. Unfortunately, there is no uniform standard for medical clearance. Per County policy, The facility can only admit individuals who meet the following:
The following are allowed refusals for admittance: eating disorders; major detoxification procedures; medical issues such as dialysis, colostomy care, complex dietary needs, indwelling catheter, blindness; inability to ambulate or transfer to chair or wheelchair bound; level of dangerous to self or others. If the Crisis Worker believes that the individual is under the influence of alcohol, legal or illegal drugs, and that the referring conditions are a result of these chemicals and not the result of a mental health disorder, then the Crisis Worker is to discuss this with the Emergency Room physician and explore options other than a psychiatric inpatient unit. If there is an agreement with the Emergency Room physician that the individual is both under the influence and is a danger to self or others and/or is gravely disabled due to a mental health disorder, then TCBHS staff should discuss the condition of the consumer with the various 5150 facilities. Determine under what conditions they would admit the individual. Communicate to the Emergency Room physician. Facilities vary with their willingness to admit individuals under the influence. ORGANIC DISORDERS: dementia, delirium, amnesia and other cognitive disorders are excluded diagnoses for Specialty Mental Health Services. Persons with mental retardation may or may not have a co-diagnosis which meets criteria for specialty mental health services.
Always perform a Mini Mental Status Exam when there is memory impairment, confusion and disorientation.
|
