SB 650 — Emergency custody and temporary detention; hospitals and providers of behavioral health services.

Shall require that each nursing home and certified nursing facility fully disclose to the applicant for admission the home's or facility's admissions policies, including any preferences given;

8.

Shall require that each licensed hospital establish a protocol relating to the rights and responsibilities of patients which shall include a process reasonably designed to inform patients of such rights and responsibilities.

Such rights and responsibilities of patients, a copy of which shall be given to patients on admission, shall be consistent with applicable federal law and regulations of the Centers for Medicare and Medicaid Services;

9.

Shall establish standards and maintain a process for designation of levels or categories of care in neonatal services according to an applicable national or state-developed evaluation system.

Such standards may be differentiated for various levels or categories of care and may include, but need not be limited to, requirements for staffing credentials, staff/patient ratios, equipment, and medical protocols;

10.

Shall require that each nursing home and certified nursing facility train all employees who are mandated to report adult abuse, neglect, or exploitation pursuant to § 63.2-1606 on such reporting procedures and the consequences for failing to make a required report;

11.

Shall permit hospital personnel, as designated in medical staff bylaws, rules and regulations, or hospital policies and procedures, to accept emergency telephone and other verbal orders for medication or treatment for hospital patients from physicians, and other persons lawfully authorized by state statute to give patient orders, subject to a requirement that such verbal order be signed, within a reasonable period of time not to exceed 72 hours as specified in the hospital's medical staff bylaws, rules and regulations or hospital policies and procedures, by the person giving the order, or, when such person is not available within the period of time specified, co-signed by another physician or other person authorized to give the order;

12.

Shall require, unless the vaccination is medically contraindicated or the resident declines the offer of the vaccination, that each certified nursing facility and nursing home provide or arrange for the administration to its residents of (i) an annual vaccination against influenza and (ii) a pneumococcal vaccination, in accordance with the most recent recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention;

13.

Shall require that each nursing home and certified nursing facility register with the Department of State Police to receive notice of the registration, reregistration, or verification of registration information of any person required to register with the Sex Offender and Crimes Against Minors Registry pursuant to Chapter 9 (§ 9.1-900 et seq.) of Title 9.1 within the same or a contiguous zip code area in which the home or facility is located, pursuant to § 9.1-914;

14.

Shall require that each nursing home and certified nursing facility ascertain, prior to admission, whether a potential patient is required to register with the Sex Offender and Crimes Against Minors Registry pursuant to Chapter 9 (§ 9.1-900 et seq.) of Title 9.1, if the home or facility anticipates the potential patient will have a length of stay greater than three days or in fact stays longer than three days;

15.

Shall require that each licensed hospital include in its visitation policy a provision allowing each adult patient to receive visits from any individual from whom the patient desires to receive visits, subject to other restrictions contained in the visitation policy including, but not limited to, those related to the patient's medical condition and the number of visitors permitted in the patient's room simultaneously;

16.

Shall require that each nursing home and certified nursing facility shall, upon the request of the facility's family council, send notices and information about the family council mutually developed by the family council and the administration of the nursing home or certified nursing facility, and provided to the facility for such purpose, to the listed responsible party or a contact person of the resident's choice up to six times per year.

Such notices may be included together with a monthly billing statement of 7 or other regular communication.

Notices and information shall also be posted in a designated location within the nursing home or certified nursing facility.

No family member of a resident or other Iesident representative shall be restricted from participating in meetings in the facility with the famiNies or res17.

Shall require that each nursing home and certified nursing facility maintain liability insurance coverage in a minimum amount of $1 million, and professional liability coverage in an amount at least equal to the recovery limit set forth in § 8.01-581.15, to compensate patients or individuals fRr injuries and losses resulting from the negligent or criminal acts of the facility.

Failure to maintain such minimum insurance shall result in revocation of the facility's license;

O 18.

Shall require each hospital that provides obstetrical services to establish policies to Dollow when a stillbirth, as defined in § 32.1-69.1, occurs that meet the guidelines pertaining to counseling patients and regulations;es and other aspects of managing stillbirths as may be specified by the Board in itU 19.

Shall require each nursing home to provide a full refund of any unexpended patient funds on deposit with the facility following the discharge or death of a patient, other than entrance-reEated fees paid to a continuing care provider as defined in § 38.2-4900, within 30 days of a written request for such funds by the discharged patient or, in the case of the death of a patient, the person administering the person's estate in accordance with the Virginia Small Estates Act (§ 64.2-600 et seq.);

20.

Shall require that each hospital that provides inpatient psychiatric services establish a protocol verbal communication between the on-call physician in the psychiatric unit and the referring physician,, direct if requested by such referring physician, and prohibits on-call physicians or other hospital staff from refusing a request for such direct verbal communication by a referring physician and (ii) a patient for whom there is a question regarding the medical stability or medical appropriateness of admission for inpatient psychiatric services due to a situation involving results of a toxicology screening, She on-call physician in the psychiatric unit to which the patient is sought to be transferred to participa6e in direct verbal communication, either in person or via telephone, with a clinical toxicologist or other 0erson who the American Association of Poison Control Centers to review the results of the toxicology screen andd by determine whether a medical reason for refusing admission to the psychiatric unit related to the results of the toxicology screen exists, if requested by the referring physician;

21.

Shall require that each hospital that is equipped to provide life-sustaining treatment shall develop a policy governing determination of the medical and ethical appropriateness of proposed medical care, which shall include (i) a process for obtaining a second opinion regarding the medical and ethical appropriateness of proposed medical care in cases in which a physician has determined proposed care to medical care is medically or ethically inappropriate by an interdisciplinary medical review committeed and a determination by the interdisciplinary medical review committee regarding the medical and ethical appropriateness of the proposed health care;

and (iii) requirements for a written explanation of the decision reached by the interdisciplinary medical review committee, which shall be included in the patient's medical record.

Such policy shall ensure that the patient, his agent, or the person authorized to make medical decisions pursuant to § 54.1-2986 (a) are informed of the patient's right to obtain his medical record and to obtain an independent medical opinion and (b) afforded reasonable opportunity to his agent, or the person authorized to make medical decisions pursuant to § 54.1-2986 from obtainingt, legal counsel to represent the patient or from seeking other remedies available at law, including seeking court review, provided that the patient, his agent, or the person authorized to make medical decisions pursuant to § 54.1-2986, or legal counsel provides written notice to the chief executive officer of the hospital within 14 days of the date on which the physician's determination that proposed medical treatment is medically or ethically inappropriate is documented in the patient's medical record;

22.

Shall require every hospital with an emergency department to establish protocols to ensure that served by the emergency department, which may include training based on a trauma-informed approachtions in identifying and safely addressing situations involving patients or other persons who pose a risk of harm to themselves or others due to mental illness or substance abuse or who are experiencing a mental health crisis;

23.

Shall require that each hospital establish a protocol requiring that, before a health care provider arranges for air medical transportation services for a patient who does not have an emergency medical condition as defined in 42 U.S.C.

§ 1395dd(e)(1), the hospital shall provide the patient or his authorized an air medical transportation provider or medically appropriate ground transportation by an emergencytion by SB650 4 of 7 medical services provider and (ii) will be responsible for charges incurred for such transportation in the event that the provider is not a contracted network provider of the patient's health insurance carrier or such charges are not otherwise covered in full or in part by the patient's health insurance plan;

24.

Shall establish an exemption, for a period of no more than 30 days, from the requirement to obtain a license to add temporary beds in an existing hospital or nursing home when the Commissioner has determined that a natural or man-made disaster has caused the evacuation of a hospital or nursing home and that a public health emergency exists due to a shortage of hospital or nursing home beds;

25.

Shall establish protocols to ensure that any patient scheduled to receive an elective surgical procedure for which the patient can reasonably be expected to require outpatient physical therapy as a follow-up treatment after discharge is informed that he (i) is expected to require outpatient physical therapy as a follow-up treatment and (ii) will be required to select a physical therapy provider prior to being discharged from the hospital;

26.

Shall permit nursing home staff members who are authorized to possess, distribute, or administer medications to residents to store, dispense, or administer cannabis oil to a resident who has been issued a valid written certification for the use of cannabis oil in accordance with subsection B of § 54.1-3408.3 and has registered with the Board of Pharmacy;

27.

Shall require each hospital with an emergency department to establish a protocol for the treatment and discharge of individuals experiencing a substance use-related emergency, which shall include provisions for (i) appropriate screening and assessment of individuals experiencing substance use-related emergencies to identify medical interventions necessary for the treatment of the individual in the emergency department and (ii) recommendations for follow-up care following discharge for any patient identified as having a substance use disorder, depression, or mental health disorder, as appropriate, which may include, for patients who have been treated for substance use-related emergencies, including opioid overdose, or other high-risk patients, (a) the dispensing of naloxone or other opioid antagonist used for overdose reversal pursuant to subsection X of § 54.1-3408 at discharge or (b) issuance of a prescription for and information about accessing naloxone or other opioid antagonist used for overdose reversal, including information about accessing naloxone or other opioid antagonist used for overdose reversal at a community pharmacy, including any outpatient pharmacy operated by the hospital, or through a community organization or pharmacy that may dispense naloxone or other opioid antagonist used for overdose reversal without a prescription pursuant to a statewide standing order.

Such protocols may also provide for referrals of individuals experiencing a substance use-related emergency to peer recovery specialists and community-based providers of behavioral health services, or to providers of pharmacotherapy for the treatment of drug or alcohol dependence or mental health diagnoses;

28.

During a public health emergency related to COVID-19, shall require each nursing home and certified nursing facility to establish a protocol to allow each patient to receive visits, consistent with guidance from the Centers for Disease Control and Prevention and as directed by the Centers for Medicare and Medicaid Services and the Board.

Such protocol shall include provisions describing (i) the conditions, including conditions related to the presence of COVID-19 in the nursing home, certified nursing facility, and community, under which in-person visits will be allowed and under which in-person visits will not be allowed and visits will be required to be virtual;

(ii) the requirements with which in-person visitors will be required to comply to protect the health and safety of the patients and staff of the nursing home or certified nursing facility;

(iii) the types of technology, including interactive audio or video technology, and the staff support necessary to ensure visits are provided as required by this subdivision;

and (iv) the steps the nursing home or certified nursing facility will take in the event of a technology failure, service interruption, or documented emergency that prevents visits from occurring as required by this subdivision.

Such protocol shall also include (a) a statement of the frequency with which visits, including virtual and in-person, where appropriate, will be allowed, which shall be at least once every 10 calendar days for each patient;

(b) a provision authorizing a patient or the patient's personal representative to waive or limit visitation, provided that such waiver or limitation is included in the patient's health record;

and (c) a requirement that each nursing home and certified nursing facility publish on its website or communicate to each patient or the patient's authorized representative, in writing or via electronic means, the nursing home's or certified nursing facility's plan for providing visits to patients as required by this subdivision;

29.

Shall require each hospital, nursing home, and certified nursing facility to establish and implement policies to ensure the permissible access to and use of an intelligent personal assistant provided by a patient, in accordance with such regulations, while receiving inpatient services.

Such policies shall ensure protection of health information in accordance with the requirements of the federal Health Insurance Portability and Accountability Act of 1996, 42 U.S.C.

§ 1320d et seq., as amended.

For the purposes of this subdivision, "intelligent personal assistant" means a combination of an electronic device and a specialized software application designed to assist users with basic tasks using a combination of natural language processing and artificial intelligence, including such combinations known as "digital assistants" or "virtual assistants";

and of 7 30.

During a declared public health emergency related to a communicable disease of public health threat, shall require each hospital, nursing home, and certified nursing facility to establish I protocol to allow patients to receive visits from a rabbi, priest, minister, or clergy of any religious denNmination or Medicare and Medicaid Services and subject to compliance with any executive order, order of publicfor health, Department guidance, or any other applicable federal or state guidance having the effect of limiting visitation.

Such protocol may restrict the frequency and duration of visits and may reRuire visits to be conducted virtually using interactive audio or video technology.

Any such protocol may require the person visiting a patient pursuant to this subdivision to comply with all reasonable requirements of the hospital, nursing home, or certified nursing facility adopted to protect the health and safety Df the person, patients, and staff of the hospital, nursing home, or certified nursing facility;

and be able to accept custody of a person who is subject to emergency custody or temporary detention who to is transported to such hospital by a law-enforcement officer or receiving services at such hospital and to retain custody of such person until such time as the period of emergency custody or temporary dEtention expires or custody of such person is transferred to a law-enforcement officer or alternative transportation provider pursuant to a temporary detention order or order for involuntary admission.

C.

Upon obtaining the appropriate license, if applicable, licensed hospitals, nursing homes, and certified nursing facilities may operate adult day care centers.

hemophiliacs and, in the course of such treatment, stock clotting factors, shall maintain records of all lot numbers or other unique identifiers for such clotting factors in order that, in the event the lot is found to be contaminated with an infectious agent, those hemophiliacs who have received units of this contaminated clotting factor may be apprised of this contamination.

Facilities which have identified a lot that is known to be contaminated shall notify the recipient's attending physician and request tSat he notify the recipient of the contamination.

If the physician is unavailable, the facility shall 6otify by mail, return receipt requested, each recipient who received treatment from a known contaminated lot a0 the indE.

Hospitals in the Commonwealth may enter into agreements with the Department of Health for the provision to uninsured patients of naloxone or other opioid antagonists used for overdose reversal.

§ 37.2-421.2.

Licensed providers;

custody of person subject to emergency custody order.

Every provider licensed pursuant to this article to which a person may be transported for the evaluation required in § 37.2-808 (i) shall be licensed to provide the level of security necessary to protect both the person and others from harm, and actually capable of providing the level of security necessary to protect the person and others from harm, and (ii) shall accept custody of every person tra§ 37.2-808.

issuance and execution of order.-808order. by law enforcement.

Any magistrate shall issue, upon the sworn petition of any responsible person, treating physician, or upon his own motion, or a court may issue pursuant to § 19.2-271.6, an emergency custody order when he has probable cause to believe that any person (i) has a mental illness and that there exists a substantial likelihood that, as a result of mental illness, the person will, in the near future, (a) cause serious physical harm to himself or others as evidenced by recent behavior causing, attempting, or threatening harm and other relevant information, if any, or (b) suffer serious harm due to his lack of capacity to protect himself from harm or to provide for his basic human needs, (ii) is in need of hospitalization or treatment, and (iii) is unwilling to volunteer or incapable of volunteering for hospitalization or treatment.

Any emergency custody order entered pursuant to this section shall provide forother thedisclosures disclosureas ofrequired medicalor recordspermitted pursuantby tolaw.§ § 37.2-804.2.

This subsection shall not precludepreclAde any otherWhen disclosuresconsidering aswhether requiredthere is probable cause to issue an emergency custody order, the T magistrate may, in addition to the petition, or permittedthe bycourt law.may pursuant to § 19.2-271.6, consider (1) the recommendations of any treating or examining physician or psychologist licensed in Virginia, ifE available, (2) any past actions of the person, (3) any past mental health treatment of the person, (4) any relevant hearsay evidence, (5) any medical records available, (6) any affidavits submitted, if the witness or the court considers relevant to the determination of whether probable cause exists to issue ane magistrate emergency custody order.

WhenS consideringB. whether there is probable cause to issue an emergency custody order, the magistrate may, in addition to the petition, or the court may pursuant to § 19.2-271.6, consider (1) the recommendations of any treating or examining physician or psychologist licensed in Virginia, if relevant hearsay evidence, (5) any medical records available, (6) any affidavits submitted, if the witness is unavailable and it so states in the affidavit, and (7) any other information available that the magistrate or the court considers relevant to the determination of whether probable cause exists to issue an emergency custody order.

B.Any person for whom an emergency custody order is issued shall be taken into custody and U transported to a convenient location to be evaluated to determine whether the person meets the Briteria for temporary detention pursuant to § 37.2-809 and to assess the need for hospitalization or treatment.

Anythe persondiagnosis forand whomtreatment anof emergencymental custodyillness order is issued shall be taken into custody and transportedwho tohas completed a convenientcertification locationprogram toapprovedn beby evaluated to determine whether the personDepartment. meets the criteria for temporary detention pursuant to § 37.2-809 and to assess the need for hospitalization or treatment.

andT others: from harm and (ii) actually capable of providing the level of security necessary to protectson SB650 6 of 7 the person and others from harm.

The36 evaluationC. shall be made by a person designated by the community services board who is skilled in the diagnosis and treatment of mental illness and who has completed a certification program approved by the Department.

C.The magistrate or court issuing an emergency custody order shall specify the primary 37 law-enforcement agency and jurisdiction to execute the emergency custody order and provide I 38 transportation.

TheHowever, the magistrate or court issuingshall consider any request to authorize transpTrtation by 39 an emergencyalternative custodytransportation orderprovider shallin specifyaccordance with this section, whenever an alternativeU agency, including a family member or friend of the primaryperson law-enforcementwho agencyis andthe jurisdictionsubject of the order, aility, or representative of the community services board, an employee of or person providing services pursuant to executea contract with the emergencyDepartment, custodyor orderother andtransportation provideprovider transportation.with personnel trained to provEde transportation in a safe manner, upon determining, following consideration of information provided by the petitioner;

However, the magistrate or court shall consider any request to authorize transportation by an alternative transportation provider in accordance with this section, whenever an alternative transportation provider is identified to the magistrate or court, which may be a person, facility, or agency, including a family member or friend of the person who is the subject of the order, a representative of the community services board, or other transportation provider with personnel trained to provide transportation in a safe manner, upon determining, following consideration of information provided by the petitioner;

person, and, when the person'smagistrate treatingor physician,court ifdeems any;appropriate, the proposed alternative transportatione provider, either in person or via two-way electronic video and audio or telephone communication system, that the proposed alternative transportation provider is available to provide transportation, willing to provide transportation, and able to provide transportation in a safe manner.

orWhen othertransportation personsis whoordered areto availablebe andprovided haveby knowledgean of the person, and, when the magistrate or court deems appropriate, the proposed alternative transportation provider, eithertheS inmagistrate person or viacourt two-wayshall electronicorder video and audio or telephone communication system, that the proposedspecified alternativeprimary transportationlaw-enforcement provideragency is available to provideexecute transportation,the willingord6r, to provideprovider transportation,identified and able to provide transportation in athe safeorder. manner.

WhenThe transportation is ordered to be provided by an alternative transportation provider, the magistrate or court shall order the specified primary law-enforcement agency tomay execute the order, to take the person into custody, and to transfer custody of the person to the alternative transportation provider identifiedimmediately inupon execution of the emergency custody order.

The alternative transportation provider shall maintain custody of the person from the time custody is transferred to the alternative transportation provider by the primary law-enforcement agency until such time as an evaluation is completed and custody of the person is transferred pursuant to a temporary detention order or the person is released upon a determination that the person does not meet the SB650S1 2 of 5 criteria for temporary detention, including during any period prior to the initiation of transportation of the person and while transportation is being provided.

The law-enforcement agency or alternative transportation provider providing transportation pursuant to this section may transfer custody of the person to the facility or location to which the person is transported for the evaluation required in subsection B, G, or H if,if regardless of whether the facility or location (i) is licensed to provide the level of security necessary to protect both the person and others from harm, (ii) is actually capable of providing the level of security necessary to protect the person and others from harm, and (iii) in cases in which transportation is provided by a law-enforcement agency, has entered into an agreement or memorandum of understanding with the law-enforcement agency setting forth the terms and conditions under which it will accept a transfer of custody, provided, however, that the facility.facility or location may not require the law-enforcement agency to pay any fees or costs for the transfer of custody.

Such facility or location may shall not require the law-enforcement agency to pay any fees or costs for the transfer of custody.

A law-enforcement officer who takes a person into custody pursuant to this subsection or subsection H may lawfully go or be sent beyond the territorial limits of the county, city, or town in which he serves to any point in the Commonwealth for of 7 the purpose of obtaining the assessment.

The period of custody shall not exceed eight hours from the time the law-enforcement officer takes the personIinto cusH.

A law-enforcement officer who is transporting a person who has voluntarily consented to be transported to a facility for the purpose of assessment or evaluation and who is beyond the territorial limits of the county, city, or town in which he serves may take such person into custody and transport him to an appropriate location to assess the need for hospitalization or treatment without prioR authorization when the law-enforcement officer determines (i) that the person has revoked conseOt to be transported to a facility for the purpose of assessment or evaluation, and (ii) based upon his custody as stated in this section.

UH. I.

A law-enforcement officer who is transporting a person who has voluntarily consented to be transported to a facility for the purpose of assessment or evaluation and who is beyond the territorial limits of the county, city, or town in which he serves may take such person into custody and transport him to an appropriate location to assess the need for hospitalization or treatment without prior authorization when the law-enforcement officer determines (i) that the person has revoked consent to be transported to a facility for the purpose of assessment or evaluation, and (ii) based upon his observations, that probable cause exists to believe that the person meets the criteria for emergency custody as stated in this section.

The period of custody shall not exceed eight hours from the time the law-enforcement officer takes the person into custody.

I.

E J.

A representative of the primary law-enforcement agency specified to execute an emergency custody order or a representative of the law-enforcement agency employing a law-enforcement officer who takes a person into custody pursuant to subsection G or H shall notify the community serviceserservices board responsible for conducting the evaluation required in subsection B, G, or H as soon as practicable afterof execution5 ofto thesubsection G or H.e emergency custody order or after the person has been taken into custody pursuant toK. subsection G or H.

K.The person shall remain in custody until (i) a temporary detention order is issued in accordance with § 37.2-809, (ii) an order for temporary detention for observation, testing, or treatment is entered in accordance with § 37.2-1104, ending law enforcement custody, (iii) the person is released, or (iv) the emergency custody order expires.

TheAn personemergency shall remain in custody until (i) a temporary detention order isshall issuedbe invalid accordance with § 37.2-809, (ii) an order for temporarya detentionperiod fornot observation,to testing,exceed oreigL. treatment is entered in emergency custody order expires.

AnNothing emergencyin custodythis ordersection shall bepreclude validthe issuance of an order for atemporary perioddetention notfor testing, observation, or treatment pursuant to exceede§ eight37.2-1104 hoursfor froma person who is also the timesubject of execution.an emergency custody order issued pursuant to this section.

B L.

Nothing in this section shall preclude the issuance of an order for temporary detention f5r testing, observation, or treatment pursuant to § 37.2-1104 for a person who is also the subject of an emergency custody order issued pursuant to this section.

Upon completion of of testing, observation, or treatment pursuant to § 37.2-1104, the hospital emergency room or other appropriate facility in which the person is detained shall notify the nearest community services board, and the designee of the community services board shall, as soon as is practicable and prior to the expiration of the order for temporary detention issued pursuant to § 37.2-1104, conduct an evaluation of thetheM. person to determine if he meets the criteria for temporary detention pursuant to § 37.2-809.

Any person taken into emergency custody pursuant to this section shall be given a writtenN summary of the emergency custody procedures and the statutory protections associated with those procedures.

A N.

If an emergency custody order is not executed within eight hours of its issuance, the order shall be void and shall be returned unexecuted to the office of the clerk of the issuing court or, ififTsuch such office is notO. open, to any magistrate serving the jurisdiction of the issuing court.

O.In addition to the eight-hour period of emergency custody set forth in subsection G, H, or K, if the individual is detained in a state facility pursuant to subsection E of § 37.2-809, the state facility and an employee or designee of the community services board as defined in § 37.2-809 may, for an additional four hours, continue to attempt to identify an alternative facility that is able and willing to provide temporary detention and appropriate care to the individual.

InS additionscreening toand theassessment eight-hour period of emergency custody set forth in subsection G, H, or K, if an employee or designee of the community services boardprovided as defined in § 37.2-809 may, for antate facility and additional four hours, continue to attemptpersons towith identifymental anillnesses alternativewhile facilityin thatemergency iscustody. able and willing to provide temporary detention and appropriate care to the individual.

P.

Payments shall be made pursuant to § 37.2-804 to licensed health care providers for medical screening and assessment services provided to persons with mental illnesses while in emergency custody.

No person who provides alternative transportation pursuant to this section shall be liable to the fromperson providingbeing suchtransported alternativefor transportation.forany civil damages for ordinary negligence in acts or omissions that result from providing such alternative transportation.

S § 37.2-810.

Transportation of person in the temporary detention process.

the magistrate shall specify in the temporary detention order the law-enforcement agency of theTtion, jurisdiction in which the person resides, or any other willing law-enforcement agency that has agreed to provide transportation, to execute the order and, in cases in which transportation is ordered tT be provided by the primary law-enforcement agency, provide transportation.

However, if the nearest boundary of the jurisdiction in which the person resides is more than 50 miles from the nearestU jurisdiction in which the person is located shall execute the order and provide transportation.T B.

The magistrate issuing the temporary detention order shall specify the law-enforcement agEncy to execute the order and provide transportation.

However, the magistrate shall consider any request to authorize transportation by an alternative transportation provider in accordance with this section, whenever an alternative transportation provider is identified to the magistrate, which may be a person, temporary detention order, a representative of the community services board, an employee of or person providing services pursuant to a contract with the Department, or other transportation provider with personnel trained to provide transportation in a safe manner upon determining, following consideration of information provided by the petitioner;

the community services board or its designee;

the loSal law-enforcement agency, if any;

the person's treating physician, if any;

or other persons who a6e alternative transportation provider, either in person or via two-way electronic video and audio ored telephone communication system, that the proposed alternative transportation provider is availa1le to provide transportation, willing to provide transportation, and able to provide transportation in a safe manner.

When transportation is ordered to be provided by an alternative transportation provider, the magistrate shall order the specified law-enforcement agency to execute the order, to take the person into SB650S1 4 of 5 custody, and to transfer custody of the person to the alternative transportation provider identified in the order.

The primary law-enforcement agency may transfer custody of the person to the alternative transportation provider immediately upon execution of the temporary detention order.

The alternative transportation provider shall maintain custody of the person from the time custody is transferred to the alternative transportation provider by the primary law-enforcement agency until such time as custody of the person is transferred to the temporary detention facility, including during any period prior to the initiation of transportation of the person from the facility to which he was transported pursuant to § 37.2-808 and while transportation is being provided pursuant to this section.

In such cases, a copy of the temporary detention order shall accompany the person being transported pursuant to this section at all times and shall be delivered by the alternative transportation provider to the temporary detention facility.

The temporary detention facility shall return a copy of the temporary detention order to the court designated by the magistrate as soon as is practicable.

Delivery of an order to a law-enforcement officer or alternative transportation provider and return of an order to the court may be accomplished electronically or by facsimile.

The order may include transportation of the person to such other medical facility as may be necessary to obtain further medical evaluation or treatment prior to placement as required by a physician at the admitting temporary detention facility.

Nothing herein shall preclude a law-enforcement officer or alternative transportation provider from obtaining emergency medical treatment or further medical evaluation at any time for a person in his custody as provided in this section.

Such medical evaluation or treatment shall be conducted immediately in accordance with state and federal law.

C.

If an alternative transportation provider providing transportation of a person who is the subject of a temporary detention order becomes unable to continue providing transportation of the person at any time after taking custody of the person, the primary law-enforcement agency for the jurisdiction in which the alternative transportation provider is located at the time he becomes unable to continue providing transportation shall take custody of the person and shall transport the person to the facility of temporary detention.

In such cases, a copy of the temporary detention order shall accompany the person being transported and shall be delivered to and returned by the temporary detention facility in accordance with the provisions of subsection B.

D.

In cases in which an alternative facility of temporary detention is identified and the law-enforcement agency or alternative transportation provider identified to provide transportation in accordance with subsection B continues to have custody of the person, the local law-enforcement agency or alternative transportation provider shall transport the person to the alternative facility of temporary detention identified by the employee or designee of the community services board.

In cases in which an alternative facility of temporary detention is identified and custody of the person has been transferred from the law-enforcement agency or alternative transportation provider that provided transportation in accordance with subsection B to the initial facility of temporary detention, the employee or designee of the community services board shall request, and a magistrate may enter an order specifying, an alternative transportation provider or, if no alternative transportation provider is available, willing, and able to provide transportation in a safe manner, the local law-enforcement agency for the jurisdiction in which the person resides or, if the nearest boundary of the jurisdiction in which the person resides is more than 50 miles from the nearest boundary of the jurisdiction in which the person is located, the law-enforcement agency of the jurisdiction in which the person is located, to provide transportation.

E.

The magistrate may change the transportation provider specified in a temporary detention order at any time prior to the initiation of transportation of a person who is the subject of a temporary detention order pursuant to this section.

If the designated transportation provider is changed by the magistrate at any time after the temporary detention order has been executed but prior to the initiation of transportation, the transportation provider having custody of the person shall transfer custody of the person to the transportation provider subsequently specified to provide transportation.

For the purposes of this subsection, "transportation provider" includes both a law-enforcement agency and an alternative transportation provider.

F.

A law-enforcement officer may lawfully go to or be sent beyond the territorial limits of the county, city, or town in which he serves to any point in the Commonwealth for the purpose of executing any temporary detention order pursuant to this section.

Law-enforcement agencies may enter into agreements to facilitate the execution of temporary detention orders and provide transportation.

G.

No person who provides alternative transportation pursuant to this section shall be liable to the person being transported for any civil damages for ordinary negligence in acts or omissions that result from providing such alternative transportation.

2.

That the Department of Behavioral Health and Developmental Services shall amend its existing contract for the provision of alternative transportation of a person who is subject to an emergency custody or temporary detention order or enter into new contracts for alternative transportation of a person who is subject to an emergency custody or temporary detention order to ensure sufficient availability of alternative transportation providers to retain sufficient licensed security staff to take of 5 24custody of and provide transportation for persons for whom alternative transportation is ordered 24this act.ly upon execution of an emergency custody or temporary detention order, as provided in S E N A T E S U B S I T U T E B 1