Commitment transporting revamped
BY WILLIAM F. WEST
Tuesday, August 13, 2019
NASHVILLE — A plan was recently approved by Nash County for Nash UNC Health Care police to assist the sheriff’s office and other law enforcement agencies in the county in transporting involuntary commitment patients.
The Nash County Board of Commissioners signed off on the document to comply with revisions in state law to take effect at the start of October.
Involuntary commitment is the process requiring emergency medical care for a person’s behavioral health condition. News accounts said the state law was updated due to concerns about a flood of people with mental health crises ending up in hospital emergency departments.
The Nash County document states Nash UNC Health Care police, the sheriff’s office and other law enforcement in the county are going to have the power to take an involuntary commitment patient to the first exam location.
That location would be the hospital’s emergency department, with the transport to be within 24 hours of a custody order issued by the judicial or health care systems.
And Nash UNC Health Care police will have the power to help take the patient to locations such as Coastal Plain Hospital, Medical Bed Tower or the Women’s Center.
The document was approved at the board’s Aug. 5 regular meeting.
Allison Manning-Williams, who directs in-patient psychiatry for Nash UNC Health Care, told the board a patient is presented at the emergency department for a first screening and needs to be placed in a facility for psychiatric treatment.
Manning-Williams noted while Coastal Plain is one such facility, there are many facilities outside Nash County, with examples being Cherry Hospital in Wayne County and Holly Hill Hospital in Raleigh.
Manning-Williams said the revised state law is going to ask for the patient to be transported within six hours of the finding of an in-patient facility for the patient to receive treatment.
Manning-Williams told the commissioners the document would allow the hospital to put the patient first because he or she needs to be taken out of the emergency department to receive proper treatment.
Additionally, she said the document would free up beds in the emergency department and keep the law enforcement in Nash County answering calls in the county.
“So it’s a partnership between us both,” she said.
Board Chairman Robbie Davis asked Manning-Williams whether Nash UNC Health Care has a way of getting reimbursed for any of this.
Manning-Williams said not at the moment, but she said she and her team have reached out to County Manager Zee Lamb to start discussing finances. She also emphasized the revised state law requires counties come up with transportation agreements regarding involuntary commitment cases.
“But of course, the ultimate goal is the patient needs to be treated where the patient needs to be,” Manning-Williams said.
“Understood,” Davis said.
Commissioner Wayne Outlaw wanted to know whether the hospital is going to be adding any staff.
“Potentially we may,” Manning-Williams said.
Manning-Williams said the hospital has a small group of what the hospital considers to be physical medicine and rehabilitation employees to be tapped to help support the process.
She also said the hospital is going to use company police staff.
Outlaw said while the document is going to keep county deputies working law enforcement in the county, Nash UNC Health Care staff would be taken away from their responsibilities, meaning there would be additional costs.
Manning-Williams acknowledged this, but she said, “It is working together to take care of the task at hand.”
“So we feel if we work together, you do have a bigger pool of employees if you put the sheriff’s department and our police together,” she said. “Currently, we have actually lost some in-patient beds waiting for transportation. So we do feel like this joint venture is the right thing to do for the patient.”
Lamb told the Telegram that in the past, county deputies were responsible for the transports in involuntary commitment cases.
The N.C. Healthcare Association’s website said state law about involuntary commitment had not been updated in decades, leaving the law unclear and subject to abuse.