Involuntary Psychiatric Hospitalization

Document Sample
Involuntary Psychiatric Hospitalization Powered By Docstoc
					Involuntary Psychiatric

     Information for Petitioners,
Family Members and Concerned Others

             Prepared by Emergency Services staff
                 at the Woodburn Center for
                  Community Mental Health

             October 2011
            Fairfax-Falls Church Community Services Board
               Woodburn Center for Community Mental Health
                           Emergency Services
                           3340 Woodburn Road
                           Annandale, VA 22003
                     703-573-5679, TTY 703-207-7737

This publication can be made available in alternative format upon request. Please call 703-
573-5679, TTY 703-207-7737, and allow a reasonable period of time for preparation of the
The psychiatric hospitalization of a person against his or her will is a treatment option that
is pursued only when all less restrictive treatment options have been exhausted or deemed

Taking away an individual’s personal freedom, even with the good intention of providing
mental health treatment, is such a serious step that the Virginia legislature has established strict
requirements that must be met before a person can be involuntarily hospitalized.

Involuntary hospitalization occurs only when a person’s psychiatric condition causes a situation
where there is a substantial likelihood that the person, in the near future, will “cause serious
physical harm” to self or others, or will “suffer serious harm” due to lack of capacity to protect self or
to provide for their basic human needs.

The process starts with the issuance of a Temporary Detention Order (TDO) and the scheduling of
a Commitment Hearing. The involuntary hospitalization of adults is done in accordance with the
Code of Virginia, sections 37.2-809 through 37.2-826, as amended.

What is a Temporary Detention                             a mental health clinician who is employed by
Order (TDO)?                                              the Fairfax-Falls Church Community Services
A TDO is a court order issued by a Magistrate*            Board (CSB) and is certified to conduct TDO
that requires an individual to be held in a               evaluations.
psychiatric facility for a period of 1 to 5 days          The purpose of the Certified Prescreener’s
until a commitment hearing is held. How long              assessment is to determine whether the
the person is hospitalized before the hearing             individual meets the TDO criteria specified in
occurs depends upon when the TDO is issued                the statute. Based on the results, the Certified
and whether there is an intervening weekend or            Prescreener will then recommend or not
legal holiday. Magistrates are available to issue         recommend that the individual be involuntarily
a TDO every day of the year, 24 hours a day.              hospitalized under a TDO.
When is a TDO issued?                                     If a TDO is issued, the results of the assessment
A TDO is issued in response to a request by a             are documented in a Preadmission Screening
“Petitioner” and, except in rare circumstances,           report (“prescreening”) that is sent to the
only after completion of an in-person                     hospital and is admitted into evidence at the
assessment within the preceding 72 hours                  commitment hearing. Prior to issuance of the
by a “Certified Prescreener.” The Petitioner,             TDO, the Certified Prescreener is required to
defined by the law as “any responsible person”            ascertain the insurance status of the individual
or “treating physician,” is the person who is             and determine the facility where he/she will be
requesting involuntary hospitalization of the             hospitalized. The Certified Prescreener is also
individual. The Certified Prescreener must be             required to inform the petitioner and the “on-

* Often a resident's first contact with Virginia’s Judicial System is through the Office of the Magistrate. The
magistrate provides an independent, unbiased review of complaints of criminal conduct brought to the
office by law enforcement or the public. Among a magistrate’s many duties are processes such as issuing
arrest warrants, search warrants, subpoenas, and temporary detention orders. Magistrates can conduct
hearings in person or by videoconference, and are available around the clock at two locations in Fairfax
Fairfax Adult Detention Center                            Mount Vernon Governmental Center
10520 Judicial Drive                                      2511 Parkers Lane
Fairfax, VA 22030                                         Alexandria, VA 22306
703-246-2178 , TTY 711                                    703-780-8580, TTY 711

                                                                                                        Page 1
site treating physician” if hospitalization under     Hospital. Since all commitment hearings are
a TDO is not being recommended.                       held at Inova Fairfax Hospital, an admission
                                                      there is beneficial because the individual will
What criteria have to be met for the                  not have to be transported by a police officer
TDO to be issued?                                     from another hospital to the commitment
To issue the TDO, the Magistrate, based on all        hearing. In the event that the person cannot be
the evidence readily available, must decide that      admitted to Inova Fairfax Hospital, alternative
the individual:                                       arrangements will be made at other hospitals
                                                      in Fairfax County (primarily Inova Mount
1. Has a mental illness and that there exists a
                                                      Vernon Hospital, Dominion Hospital or the
   substantial likelihood that, as a result of that
                                                      Northern Virginia Mental Health Institute). The
   mental illness, the person will, in the near
                                                      Petitioner is always given information about
                                                      where the individual is admitted.
   a. cause serious physical harm to himself
      or others as evidenced by recent                In the back of this pamphlet you will find a
      behavior causing, attempting, or                list of the names and addresses of the local
      threatening harm and other relevant             hospitals and a space where you can record the
      information, if any, or                         name and address of the hospital where the
                                                      person has been admitted.
   b. suffer serious harm due to his lack of
      capacity to protect himself from harm
      or to provide for his basic human needs,
                                                      When does the commitment
      and                                             hearing occur?
                                                      Commitment hearings are held in the
2. Is in need of hospitalization or treatment,        Psychiatric Unit (4th floor) at Inova Fairfax
   and                                                Hospital, 3300 Gallows Road, Falls Church,
3. Is unwilling to volunteer or incapable             Virginia, 703-776-3491. They are scheduled to
   of volunteering for hospitalization or             begin at 7 a.m. The Certified Prescreener who
   treatment.                                         recommended issuance of the TDO will give the
                                                      Petitioner the date and location of the hearing.
Defining “serious physical harm,” “serious            That information can also be obtained by
harm” and “basic human needs” is a matter             contacting the hospital where the individual has
for each Magistrate and Certified Prescreener.        been admitted or by contacting the Emergency
Typically, they look for evidence that the            Service at the Woodburn Center for Community
individual is engaging in behavior that could         Mental Health (703-573-5679; TTY 703-207-
result in physical injury, disability or death, or    7737). In the back of this pamphlet you will find
could result in physical harm because they are        a space where you can record the location, date
not caring for themselves or providing for their      and time of the hearing.
food, clothing or shelter.
                                                      Commitment hearings are held in a meeting
How does the individual get safely                    room. When you arrive at the psychiatric unit,
to the hospital?                                      let the staff know that you are there to attend
Once the TDO is issued, a police officer will         the hearing and they will show you to a waiting
serve the TDO, take the individual into custody,      room. You will be notified when to go to the
and transport him/her to the hospital. During         hearing room. Usually, several hearings are
transportation to the hospital, police officers       scheduled on any given day and there is no way
usually place the person in handcuffs.                of knowing in advance which case will be heard
                                                      first. When many cases have to be heard, you
Where is the individual                               may be at the hospital for several hours. It is
hospitalized?                                         absolutely essential that the Petitioner
An attempt will be made to have the individual        and any witnesses be present when the
admitted to the psychiatric unit at Inova Fairfax     case is called. If the Petitioner and/

Page 2
or witnesses are not present, the TDO                 the individual will, in the near future, (1)
will be dismissed and the person will be              cause serious physical harm to self or others,
released from the hospital. The Virginia              or (2) suffer serious harm due to his/her lack
laws of evidence and procedure apply to the           of capacity to protect self from harm or to
commitment hearing, even though it takes place        provide for his/her basic human needs. The
in a hospital and not in a courtroom.                 Independent Evaluator will also provide clinical
                                                      opinions about what type of treatment the
Who attends the commitment                            person needs and whether or not that treatment
hearing?                                              should be ordered by the court.
Those attending the commitment hearing
include: the individual, his/her court-               What is the role of the Petitioner?
appointed Attorney, a Special Justice, a Deputy       The Petitioner is the person who requested that
Sheriff (who provides security), an Independent       the individual be involuntarily hospitalized and
Evaluator, a CSB representative, the Petitioner       is an essential part of the TDO process. A TDO
and any witnesses who are attending the               cannot be issued without a Petitioner.
hearing to testify.                                   Petitioners are often family members or friends
                                                      but can be other mental health professionals or
What is the role of the Special                       concerned individuals.
Justice?                                              According to the Virginia Code, the Petitioner
The Special Justice conducts the hearing and          is “entitled” to attend the hearing and to “testify
determines the final outcome of the hearing.          and present evidence.” It also indicates that the
                                                      Petitioner is “encouraged” but “not required”
What is the role of the court-                        to testify at the hearing and that the “person
appointed attorney?                                   whose involuntary admission is sought should
The court-appointed attorney, at State expense,       not be released solely because the Petitioner
represents the individual at the hearing.             fails to attend or testify at the hearing.” But the
Under Virginia law, the attorney is required          presence and testimony of the Petitioner at the
to “represent the wishes of his client.”              hearing is a practical necessity. If the Petitioner
This means that if the individual wants to be         and/or witness are not present to provide first-
discharged from the hospital, the attorney            hand evidence about the individual’s behavior
will challenge the opinion and testimony of           – especially those behaviors and verbal threats
those who think he/she should remain in the           that have resulted in, or could result in, physical
hospital. Before the hearing, the attorney will       harm – there is the strong possibility that the
probably obtain information by interviewing           TDO will be dismissed at the hearing due to
the individual, the Petitioner, the Certified         insufficient evidence. When that happens, the
Prescreener, the Independent Evaluator and            individual will be free to leave the hospital.
any witnesses, and by reviewing relevant
treatment records and reports.                        As the petitioner, you will be asked to complete
                                                      and sign a “Petition for Certification for
What is the role of the Independent                   Involuntary Admission for Treatment” court
Evaluator?                                            form. On this form you will be required to
In Fairfax County, the Independent Evaluator          provide specific information about why you
is usually a Clinical Psychologist, skilled in        are asking to have a TDO issued. The form will
the diagnosis and treatment of mental illness.        be notarized by the CSB Emergency Service
Before the hearing, the Independent Evaluator         clinician and be sent to the Court.
conducts an evaluation of the individual in
                                                      Petitioners are permitted to hire an attorney,
order to provide an “expert clinical opinion”
                                                      at their own expense, to represent them at the
about whether the individual has a mental
                                                      hearing. While not required, this is very useful
illness and whether there is a substantial
                                                      as the attorney is able to elicit testimony which
likelihood that, as a result of the mental illness,

                                                                                                 Page 3
is admissible at the hearing, provide legal advice   and verbal threats about which you have
and suggestions, and respond to legal issues         personal and direct knowledge. This includes
that may be raised at the hearing.                   recent statements made by the individual
                                                     directly to you or that you have personally
As the Petitioner, you are strongly encouraged       heard the individual make to others and any
to bring other witnesses to the hearing so           documents recently written by the individual
they can provide supporting testimony. You           that you have obtained. Remember to include
and your witnesses should be available to the        evidence related to the individual’s refusal to
Independent Evaluator prior to the hearing           seek or cooperate with voluntary psychiatric
to provide information about why you sought          treatment.
the TDO. You are also encouraged to bring
to the hearing any relevant physical evidence        If you are the Petitioner and do not have first-
(for example, weapons, photographs, audio            hand evidence, then it is absolutely essential
recordings, letters, documents, etc.) that           that you bring witnesses who do have such
supports your testimony. If you bring any            information. While there are exceptions,
type of weapon as physical evidence,                 Virginia law essentially does not allow the
please inform the Deputy Sheriff before              Petitioner or witnesses to testify about what
the hearing begins. Do not hesitate to               someone else told them or about behavior
ask questions of the Special Justice, the            they have not personally seen or heard.
Independent Evaluator and the Attorney if you        Such evidence is rarely admissible because
do not understand something that is occurring        it is considered “hearsay” under the laws of
at the hearing.                                      evidence.

What type of testimony should be                     What type of evidence does the
provided?                                            Special Justice consider?
The testimony of the Petitioner should provide       According to the Virginia Code, the Special
first-hand information about what the                Justice, in addition to his “observations” of
individual has done or said that puts him/           the individual, should consider the following
her at risk for causing serious physical harm        evidence when making his decision about the
to self or others or at risk for suffering serious   outcome of the hearing:
harm because he/she is not protecting self from      •   the recommendations of any treating
harm or providing for his/her basic human                or examining physician or psychologist
needs. When you testify, it is important to focus        licensed in Virginia, if available,
on the individual’s recent behavior that you
have personally witnessed and on recent              •   any past actions of the person,
statements or verbal threats made by the             •   any past mental health treatment of the
individual that you have personally heard.               person,
What is considered “recent” varies among the         •   any examiner’s certification,
Special Justices, but may encompass anything
                                                     •   any health records available,
from the past few days to the past few weeks.
                                                     •   the preadmission screening report, and
When testifying, try to be as direct and             •   any other relevant evidence that may have
precise as possible and provide as may                   been admitted.
details as you can. You will probably not be
able to simply express your opinion or concern
                                                     What happens at the hearing?
that the individual will suffer or cause physical
                                                     At the start of the hearing, the participants
harm. The individual’s attorney will probably
                                                     will be asked to identify themselves and
object to such testimony since only an “expert
                                                     be sworn in if they are going to provide
witness” may offer an “opinion.” Rather,
                                                     testimony. The Special Justice will then
testimony should focus on facts and specific
                                                     advise the individual of his/her legal rights
examples of the individual’s recent behavior

Page 4
and inform the individual of his/her right to           dismissed, the individual is free to leave the
apply for voluntary admission to inpatient              hospital and is under no legal obligation to
treatment. According to the Virginia Code,              receive any type of psychiatric treatment.
the Special Justice must allow the individual           Dismissal of the petition does not prevent
an opportunity for voluntary admission and              the individual from voluntarily staying in
must decide if the individual is willing and            the hospital if he/she agrees to remain in
capable of seeking voluntary hospitalization.           the hospital and is accepted for admission.
If it is decided that the individual is willing to   •	 Court-Mandated Admission (CMA) –
accept a voluntary admission and is capable             According to the Virginia Code, the Special
of making that choice, the Special Justice will         Justice “shall afford” the individual “an
require the individual to be hospitalized as a          opportunity for voluntary admission” if
Court Mandated Admission (CMA). When that               the individual is determined by the Special
happens, no testimony is taken and the hearing          Justice to be “willing and capable of seeking
is concluded. The Petitioner can disagree with          voluntary admission.” This is referred to as
(object to) the decision to allow an admission          a Court-Mandated Admission (CMA). When
under a CMA and ask that a formal hearing               the Special Justice permits the individual
be held to determine if the individual should           to be a CMA, the individual is required to
be committed. The Special Justice can agree             accept a “minimum period of treatment.”
with the objection and hear testimony or can            According to the Virginia Code, the
disagree and allow the CMA to occur.                    individual is required to stay in the hospital
A formal commitment hearing is held and                 for a minimum of 72 hours and, after
testimony is taken only if the individual               that period, is required to give 48 hours
refuses voluntary hospitalization or is found           notice of their desire to leave the hospital.
incapable of making that decision, or if the            The individual is required to remain in the
Special Justice agrees with the Petitioner’s            hospital during that 48 hour period unless
objection to allowing a voluntary admission.            discharged by the hospital. This effectively
The Special Justice will then hear the testimony        means that the individual would remain in
of the Petitioner and any other witnesses and           the hospital for a minimum	of	five	days	
decide on the disposition. During the hearing,          after the hearing, unless discharged
the individual is not required to testify but           sooner. When the individual is permitted
may choose to do so. At the conclusion of the           to stay in the hospital as a CMA, a
hearing, the individual will be either committed        commitment cannot be ordered. In Fairfax
to inpatient treatment or ordered into                  County, approximately 50% of all TDO cases
Mandatory Outpatient Treatment, or the TDO              result in a CMA.
will be dismissed. A voluntary admission under       •	 Commitment – When the Special Justice
a CMA is no longer an option.                           orders a commitment, the individual is
                                                        under a court order to be involuntarily
What are the possible hearing                           admitted to the hospital and is required to
outcomes?                                               remain in the hospital for a maximum
The possible outcomes of the hearing process            period of 30 days, unless discharged
include the following:                                  sooner. To be committed, the Special Justice
                                                        must find, by clear and convincing evidence,
•	 Dismissal of the Petition – If the Special           that:
   Justice decides that a technical error               (1) The individual has a mental illness and
   occurred during the issuance of the TDO,                 there is a substantial likelihood that, as
   he may dismiss the petition for involuntary              a result of mental illness, the individual
   hospitalization. The petition can also be                will, in the near future, (a) cause serious
   dismissed if the Special Justice decides                 physical harm to himself or others as
   that the evidence is not strong enough to                evidenced by recent behavior causing,
   order a commitment. When the petition is

                                                                                               Page 5
         attempting, or threatening harm and            (2) The less restrictive alternatives to
         other relevant information, if any, or             involuntary inpatient treatment have
         (b) suffer serious harm due to his lack            been investigated and are deemed
         of capacity to protect himself from harm           appropriate; and
         or to provide for his basic human needs,       (3) The individual (a) has sufficient capacity
         and                                                to understand the stipulations of his
   (2) The alternatives to involuntary inpatient            treatment, (b) expresses an interest
       treatment have been investigated and                 in living in the community and agrees
       deemed unsuitable and there is no less               to abide by his treatment plan, and
       restrictive alternative to involuntary               (c) is deemed to have the capacity to
       inpatient treatment.                                 comply with the treatment plan and
   Individuals under commitment can be                      understand and adhere to conditions
   discharged from the hospital without further             and requirements of the treatment and
   involvement of the court or he/she can be                services; and
   “re-committed.” A re-commitment occurs               (4) The ordered treatment can be delivered
   when another TDO is issued prior to the                  on an outpatient basis by the CSB or
   expiration of the original commitment order              designated provider.
   and a second commitment hearing is held.          When an individual is ordered to participate
   If the individual is “re-committed” at that       in MOT, his/her compliance with treatment
   hearing, the duration of the commitment is        is monitored by the CSB where the individual
   a maximum of 180 days.                            resides. Failure of the individual to adhere to
   An individual can appeal a commitment or          the terms of the outpatient treatment could
   recommitment order to the Circuit Court.          result in a revocation of the MOT and an order
   The appeal must be filed within 10 days of        for commitment to a hospital. Before the MOT
   the court order.                                  expires, it can be continued for a period not to
•	 Mandatory Outpatient Treatment                    exceed 180 days or it can be rescinded.
   (MOT) – The Special Justice can order             The MOT order can also be appealed to the
   the individual to participate in a period of      Circuit Court. The appeal must be filed within
   outpatient treatment. This is referred to as      10 days of the court order.
   Mandatory Outpatient Treatment (MOT).
   The duration of the MOT is determined             Can a person be placed on MOT if
   by the Special Justice based on the
   recommendations of the CSB but cannot
                                                     committed to a period of inpatient
   exceed 90 days. When MOT is ordered,              treatment?
   the patient is released from the hospital. To     At the time that the person is committed at
   order MOT, the Special Justice must find, by      the hearing, the Special Justice may authorize
   clear and convincing evidence, that:              the treating physician to place the person on a
                                                     period of MOT when they are discharged from
   (1) The individual has a mental illness and       the hospital. This is less formally referred to
       there exists a substantial likelihood that,   as a “step-down” MOT. The length of time that
       as a result of mental illness, the person     the “step-down” MOT is in place can not exceed
       will, in the near future, (a) cause serious   the duration of treatment specified in the
       physical harm to himself or others as         commitment order. For example, if the person
       evidenced by recent behavior causing,         was committed for 30 days and they were being
       attempting, or threatening harm and           discharged after 10 days, the “step-down” MOT
       other relevant information, if any, or        would be in place for only 20 days.
       (b) suffer serious harm due to his lack
       of capacity to protect himself from harm      To authorize the “step-down” MOT, the Special
       or to provide for his basic human needs;      Justice must find by “clear and convincing
       and                                           evidence” that:

Page 6
1. The person has a history of lack of                  stipulations of their treatment,
   compliance with treatment for mental              4. Has expressed an interest in living in the
   illness that at least twice within the past          community and has agreed to abide by their
   36 months has resulted in the person                 discharge plan,
   being subject to an order for involuntary
   admission;                                        5. Is deemed to have the capacity to comply
                                                        with the discharge plan and understand and
2. In view of the person’s treatment history            adhere to conditions and requirements of
   and current behavior, the person is in               the treatment and services, and
   need of mandatory outpatient treatment
   following inpatient treatment in order to         6. The ordered treatment can be delivered on
   prevent a relapse or deterioration that              an outpatient basis by the CSB or designated
   would be likely to result in the person              provider.
   meeting the criteria for involuntary              It must also be determined that the treatment
   inpatient treatment;                              services are actually available in the community
3. As a result of mental illness, the person         and the providers of those services have actually
   is unlikely to voluntarily participate in         agreed to deliver the services.
   outpatient treatment unless the court             Finally, if a person is placed on “step-down”
   enters an order authorizing discharge to          MOT, his/her compliance with the discharge
   mandatory outpatient treatment following          plan is monitored by the CSB where the
   inpatient treatment; and                          individual resides. Failure of the individual to
4. The person is likely to benefit from              adhere to the terms of the discharge plan could
   mandatory outpatient treatment.                   result in a revocation of the “step-down” MOT
The assessment conducted by the Independent          and an order for commitment to a hospital.
Evaluator must also include a clinical opinion       Also, before the “step-down” MOT expires, it
about whether the person meets the criteria for      could be continued for a period not to exceed
a “step-down” MOT.                                   180 days or it could be rescinded.

Prior to discharging the person to MOT, a            What happens after the hearing?
discharge plan must be developed by the              What happens after the hearing is determined
treating physician and the hospital staff in         by two factors: the disposition reached at the
conjunction with the CSB and the person.             hearing and which hospital the individual had
The plan must be submitted to the Court for          been admitted to under the TDO.
approval, incorporated into the commitment
order, and provided to the person. The person        An individual who had been admitted to Inova
should not be discharged to MOT if he/she            Fairfax Hospital under the TDO is free to leave
meets the criteria for involuntary commitment.       the hospital if the TDO was dismissed or if he/
In addition, the treating physician, based on his    she was placed on MOT at the hearing. If the
professional judgment, must determine that the       individual was allowed to voluntarily remain
person:                                              in the hospital as a CMA or was committed
                                                     to inpatient treatment at the hearing, he/she
1. In view of their treatment history and            must remain at Inova Fairfax Hospital until a
   current behavior, no longer needs inpatient       determination about which hospital where he/
   hospitalization,                                  she will stay has been made.
2. Requires mandatory outpatient treatment at
   the time of discharge to prevent relapse or       An individual who had been admitted under
   deterioration of their condition that would       the TDO to a hospital other than Inova Fairfax
   likely result in their meeting the criteria for   Hospital is free to leave Inova Fairfax Hospital
   involuntary inpatient treatment,                  (the site of the hearing), if the TDO was
                                                     dismissed or if he/she was placed on MOT at
3. Has sufficient capacity to understand the         the hearing. If the individual was allowed to

                                                                                               Page 7
voluntarily remain in the hospital as a CMA or       the third-party payor. Uninsured individuals
was committed to inpatient treatment at the          are usually referred for hospitalization to the
hearing, he/she must be returned by a police         Northern Virginia Mental Health Institute, a
officer to the hospital where he/she had been        state facility, where the cost of treatment is
admitted until a determination about which           determined by the person’s income level and
hospital where he/she will stay has been made.       ability to pay. If space is not available there,
                                                     the individual may be admitted to a private
How is the hospital determination                    facility using a state fund that covers the cost
made?                                                of the hospitalization. Concerns about the cost
The staff of the Emergency Service at the            of treatment and the payment for treatment
Woodburn Center for Community Mental                 should be directed to a hospital social worker.
Health identifies the hospital where the
individual who has been committed to inpatient       Does a TDO affect the person’s
treatment will be admitted. The individual           right to own firearms?
may be able to stay at the hospital where            Under the Virginia Code, simply being
they were admitted under the TDO or may              hospitalized under a TDO does not remove the
have to be transferred to another facility. The      right of the individual to own firearms. Whether
determination is primarily based on health           or not that right is removed depends on what
insurance coverage, bed availability, and            happens at the commitment hearing. The right
whether or not a particular hospital will accept     is not lost if the TDO is dismissed. However,
the individual for admission. All attempts will      if the outcome of the hearing is anything other
be made to have the individual hospitalized at       than dismissal, (for example, the individual
a local psychiatric facility in Fairfax County.      is voluntarily hospitalized under a CMA, or
When an individual has to be transferred to          is committed to inpatient treatment, or is
another hospital, he/she is transported by a         ordered into MOT) the individual loses their
Deputy Sheriff.                                      right to “purchase, possess, or transport
                                                     a	firearm.” It then becomes illegal for the
Who is responsible for the cost of                   individual to “purchase, possess or transport
treatment?                                           a firearm,” a violation of which is considered a
During the Detention period, the cost of             Class 1 misdemeanor. After their release from
all treatment provided while the individual is       the CMA, the commitment, or the MOT, the
hospitalized under the TDO is the responsibility     individual can “petition” (ask) the General
of the individual (or parent/legal guardian          District Court to restore their right.
in the case of a minor). When the individual
is covered by private health insurance,
Medicare, or Medicaid, the hospital can seek
reimbursement from the third-party payor. In
cases where the individual is not covered by a
third-party payor and is demonstrably unable to
pay the cost of treatment, the hospital can ask
for reimbursement from the Commonwealth of
Virginia’s indigent patient fund.

After the Commitment Hearing, the cost
of all treatment is also the responsibility of the
individual even when he or she is committed
or hospitalized as a CMA. When the individual
is covered by insurance, he/she is admitted to
a facility that accepts his/her insurance and
the hospital will seek reimbursement from

Page 8
If you have further questions…
Please call CSB Emergency Services (24 hours a day) or the Mobile Crisis Unit (8 a.m. until
midnight) at the Woodburn Center for Community Mental Health 703-573-5679, TTY 703-207-

Local Psychiatric Facilities                                 Admitting Hospital
Inova Fairfax Hospital                           Name/Address:
3300 Gallows Road, 4th Floor
Falls Church, VA 22042

Dominion Hospital
2960 Sleepy Hollow Road
Falls Church, VA 22044                           Phone:

Inova Mount Vernon Hospital
2501 Parkers Lane, 3rd Floor (Unit 3A)
Alexandria, VA 22306
                                                          Commitment Hearing
Northern Virginia Mental Health Institute
3302 Gallows Road
Falls Church, VA 22042




                                                                                        Page 9

Shared By: