Regulation detail

18 V.S.A. ch. 179

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18 V.S.A. ch. 179 changed

Admission procedures (emergency examination)

Jurisdiction: VT Agency: Vermont General Assembly
PRTF (100%) PSYCH_FACILITY (100%)
Plain-English summary

Vermont's Chapter 179 establishes admission procedures for designated psychiatric hospitals and psychiatric residential treatment facilities for youth (PRTFs), covering voluntary admissions, emergency examination processes, and involuntary holds. Facility operators must follow specific application and certification requirements for emergency admissions, ensure timely psychiatric evaluation (within 24 hours of initial certification), and provide patients with notice of rights, dignity in treatment, and communication access. Transportation of patients to and from these facilities must minimize trauma and use the least restrictive means necessary.

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The Vermont Statutes Online

The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE
: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.

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Title 
18
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Chapter 
179
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Title 
18
: 
 Health

Chapter 
179
: 
 Admission Procedures

§ 7501. Authority to receive patients

The head of a hospital that has been officially designated by the Commissioner may
 receive therein for observation, diagnosis, care, and treatment any individual whose
 admission is sought on proper application. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968.)

§ 7502. Control and treatment of patients

A person admitted to a hospital shall be subject to the control and treatment of the
 head of the hospital and the Board until his or her condition warrants his or her
 release, or until he or she has been lawfully removed or otherwise discharged. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968.)

§ 7503. Application for voluntary admission

(a) Any person 14 years of age or over may apply for voluntary admission to a designated
 hospital or psychiatric residential treatment facility for youth for examination and
 treatment.

(b) Before the person may be admitted as a voluntary patient, the person shall give consent
 in writing on a form adopted by the Department. The consent shall include a representation
 that:

(1) the person understands that treatment will involve inpatient status or residence at
 a psychiatric residential treatment facility for youth;

(2) the person desires to be admitted to a hospital or a psychiatric residential treatment
 facility for youth, respectively;

(3) the person consents to admission voluntarily, without any coercion or duress; and

(4) the person understands that inpatient treatment or residence at a psychiatric residential
 treatment facility for youth may be on a locked unit, and a requested discharge may
 be deferred if the treating physician determines that the person is a person in need
 of treatment pursuant to section 7101 of this title.

(c) If the person is under 14 years of age, the person may be admitted as a voluntary
 patient if the person consents to admission, as provided in subsection (b) of this
 section, and if a parent or guardian makes written application. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968; amended 1977, No. 252 (Adj. Sess.), § 6; 2021, No. 30, § 1; 2023, No. 137 (Adj. Sess.), § 9, eff. July 1, 2024.)

§ 7504. Application and certificate for emergency examination

(a) Upon written application by an interested party made under the pains and penalties
 of perjury and accompanied by a certificate by a licensed physician who is not the
 applicant, a person shall be held for admission to a hospital for an emergency examination
 to determine if he or she is a person in need of treatment. The application and certificate
 shall set forth the facts and circumstances that constitute the need for an emergency
 examination and that show that the person is a person in need of treatment.

(b) The application and certificate shall be authority for transporting the person to
 a hospital for an emergency examination, as provided in section 7511 of this title.

(c) For the purposes of admission of an individual to a designated hospital for care and
 treatment under this section, a head of a hospital, as provided in subsection (a)
 of this section, may include a person designated in writing by the head of the hospital
 to discharge the authority granted in this section. A designated person must be an
 official hospital administrator, supervisory personnel, or a licensed physician on
 duty on the hospital premises other than the certifying physician under subsection
 (a) of this section. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968; amended 1969, No. 33, § 2, eff. April 1, 1969; 1973, No. 107, § 4; 1977, No. 252 (Adj. Sess.), § 7; 2003, No. 122 (Adj. Sess.), § 141f; 2013, No. 192 (Adj. Sess.), § 5, eff. Nov. 1, 2014.)

§ 7505. Warrant and certificate for emergency examination

(a) In emergency circumstances where certification by a licensed physician is not available
 without serious and unreasonable delay, and when personal observation of the conduct
 of a person constitutes reasonable grounds to believe that the person is a person
 in need of treatment, and the person presents an immediate risk of serious injury
 to self or others if not restrained, a law enforcement officer or mental health professional
 may make an application, not accompanied by a physician’s certificate, to any Superior
 judge for a warrant for an emergency examination. The application shall be based on
 facts personally observed by the mental health professional or the law enforcement
 officer or shall be supported by a statement of facts under penalty of perjury by
 a person who personally observed the facts that form the basis of the application.

(b)(1) The law enforcement officer may take the person into temporary custody if the law
 enforcement officer has probable cause to believe that the person poses a risk of
 harm to self or others. The law enforcement officer or a mental health professional
 shall apply to the court for the warrant without delay while the person is in temporary
 custody. The law enforcement officer, or a mental health professional if clinically
 appropriate, may then transport the person if the law enforcement officer or mental
 health professional conducting the transport has probable cause to believe that the
 person poses a risk of harm to self or others.

(2) Transports conducted pursuant to this subsection shall provide individuals with the
 same protections as provided to individuals in the custody of the Commissioner who
 are transported pursuant to section 7511 of this title.

(c) If the judge is satisfied that a physician’s certificate is not available without
 serious and unreasonable delay, and that probable cause exists to believe that the
 person is in need of an emergency examination, the judge may order the person to submit
 to an evaluation by a licensed physician for that purpose.

(d)(1) If necessary, the court may order the law enforcement officer to transport the person
 to a hospital for an evaluation by a licensed physician to determine if the person
 should be certified for an emergency examination.

(2) Transports conducted pursuant to this subsection shall provide individuals with the
 same protections as provided to individuals in the custody of the Commissioner who
 are transported pursuant to section 7511 of this title.

(e) Authority to transport a person pursuant to this section shall expire if the person
 is not taken into custody and transported within 72 hours after a warrant is issued
 by a Superior judge.

(f) A person transported pursuant to subsection (d) of this section shall be evaluated
 as soon as possible after arrival at the hospital. If after evaluation the licensed
 physician determines that the person is a person in need of treatment, the licensed
 physician shall issue an initial certificate that sets forth the facts and circumstances
 constituting the need for an emergency examination and showing that the person is
 a person in need of treatment. Once the licensed physician has issued the initial
 certificate, the person shall be held for an emergency examination in accordance with
 section 7508 of this title. If the licensed physician does not certify that the person is a person in need of
 treatment, the licensed physician shall immediately discharge the person and cause
 the person to be returned to the place from which the person was taken, or to such
 place as the person reasonably directs. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968; amended 1977, No. 252 (Adj. Sess.), § 8; 2013, No. 192 (Adj. Sess.), § 6, eff. Nov. 1, 2014; 2023, No. 25, § 1, eff. July 1, 2023.)

§§ 7506, 7507. Repealed. 1977, No. 252 (Adj. Sess.), § 36.

§ 7508. Emergency examination and second certification

(a) When an initial certification is issued for an emergency examination of a person in
 accordance with section 7504 or subsection 7505(e) of this title, he or she shall be examined and certified by a psychiatrist as soon as practicable,
 but not later than 24 hours after initial certification.

(b) If the person is held for admission on an application and physician’s certificate,
 the examining psychiatrist shall not be the same physician who signed the certificate.

(c) If the psychiatrist does not issue a second certification stating that the person
 is a person in need of treatment, he or she shall immediately discharge or release
 the person and cause him or her to be returned to the place from which he or she was
 taken or to such place as the person reasonably directs.

(d) If the psychiatrist does issue a second certification that the person is a person
 in need of treatment, the person may continue to be held for an additional 72 hours,
 at which time the person shall be discharged or released, unless within that period:

(1) the person has accepted voluntary admission under section 7503 of this title; or

(2) an application for involuntary treatment is filed with the appropriate court under
 section 7612 of this title, in which case the patient shall continue to be held pending the court’s finding
 of probable cause on the application.

(e)(1)(A) A person shall be deemed to be in the temporary custody of the Commissioner when the
 first of the following occurs:

(i) a physician files an initial certification for the person while the person is in a
 hospital; or

(ii) a person is certified by a psychiatrist to be a person in need of treatment during
 an emergency examination.

(B) Temporary custody under this subsection shall continue until the court issues an order
 pursuant to subsection 7617(b) of this title or the person is discharged or released.

(2) The Commissioner shall make every effort to ensure that a person held for an emergency
 examination pending a hospital admission is receiving temporary care and treatment
 that:

(A) uses the least restrictive manner necessary to protect the safety of both the person
 and the public;

(B) respects the privacy of the person and other patients; and

(C) prevents physical and psychological trauma.

(3) All persons admitted or held for admission shall receive a notice of rights as provided
 for in section 7701 of this title, which shall include contact information for Vermont Legal Aid, the Office of the
 Mental Health Care Ombudsman, and the mental health patient representative. The Department
 of Mental Health shall develop and regularly update informational material on available
 peer-run support services, which shall be provided to all persons admitted or held
 for admission.

(4) A person held for an emergency examination may be admitted to an appropriate hospital
 at any time. (Added 1977, No. 252 (Adj. Sess.), § 15; amended 2013, No. 192 (Adj. Sess.), § 7, eff. Nov. 1, 2014.)

§ 7509. Treatment; right of access

(a) Upon admission to a hospital, secure residential recovery facility, or psychiatric
 residential treatment facility for youth pursuant to section 7503, 7508, 7617, or 7624 of this title, the person shall be treated with dignity and respect and shall be given such medical
 and psychiatric treatment as is indicated.

(b) All persons admitted or held for admission shall be given the opportunity, subject
 to reasonable limitations, to communicate with others, including visits by a peer
 or other support person designated by the person, presence of the support person at
 all treatment team meetings the person is entitled to attend, the reasonable use of
 a telephone, and the reasonable use of electronic mail and the internet.

(c) The person shall be requested to furnish the names of persons that the person may
 want notified of the person’s hospitalization or residence and kept informed of the
 person’s status. The head of the hospital shall see that such persons are notified
 of the status of the person, how the person may be contacted and visited, and how
 they may obtain information concerning the person. (Added 1977, No. 252 (Adj. Sess.), § 16; amended 1997, No. 114 (Adj. Sess.), § 1a; 2013, No. 192 (Adj. Sess.), § 8; 2023, No. 137 (Adj. Sess.), § 9a, eff. July 1, 2024.)

§ 7510. Preliminary hearing

(a) Within five days after a person is admitted to a designated hospital for emergency
 examination, he or she may request the Superior Court to conduct a preliminary hearing
 to determine whether there is probable cause to believe that he or she was a person
 in need of treatment at the time of his or her admission.

(b) The court shall conduct the hearing within three working days after the filing of
 the request. The court shall cause timely notice of the preliminary hearing to be
 given to the patient or the patient’s attorney, the hospital, and the attorney for
 the applicant.

(c) The individual has the right to be present and represented by legal counsel at the
 preliminary hearing.

(d) If probable cause to believe that the individual was a person in need of treatment
 at the time of his or her admission is established at the preliminary hearing, the
 individual shall be ordered held for further proceedings in accordance with the law.
 If probable cause is not established, the individual shall be ordered discharged from
 the hospital and the court shall order him or her returned to the place from which
 he or she was transported or to his or her home.

(e) Upon a showing of need, the court may grant a reasonable continuance to either the
 patient’s attorney or the attorney for the State. (Added 1977, No. 252 (Adj. Sess.), § 17; amended 2009, No. 154 (Adj. Sess.), § 238; 2019, No. 167 (Adj. Sess.), § 20, eff. Oct. 7, 2020; 2023, No. 6, § 201, eff. July 1, 2023.)

§ 7511. Transportation

(a) The Commissioner shall ensure that all reasonable and appropriate measures consistent
 with public safety are made to transport or escort a person subject to this chapter
 to and from any hospital, secure residential recovery facility, or psychiatric residential
 treatment facility for youth under the jurisdiction of the Commissioner in any manner
 that:

(1) prevents physical and psychological trauma;

(2) respects the privacy of the individual; and

(3) represents the least restrictive means necessary for the safety of the patient.

(b) The Commissioner shall have the authority to designate the professionals or law enforcement
 officers who may authorize the method of transport of patients under the Commissioner’s
 care and custody.

(c) When a professional or law enforcement officer designated pursuant to subsection (b)
 of this section decides an individual is in need of secure transport with mechanical
 restraints, the reasons for such determination shall be documented in writing.

(d) It is the policy of the State of Vermont that mechanical restraints are not routinely
 used on persons subject to this chapter unless circumstances dictate that such methods
 are necessary. A law enforcement vehicle shall have soft restraints available for
 use as a first option, and mechanical restraints shall not be used as a substitute
 for soft restraints if the soft restraints are otherwise deemed adequate for safety. (Added 2003, No. 122 (Adj. Sess.), § 141e; amended 2005, No. 180 (Adj. Sess.), § 2; 2007, No. 15, § 14; 2011, No. 79 (Adj. Sess.), § 24, eff. April 4, 2012; 2023, No. 25, § 2, eff. July 1, 2023; 2023, No. 137 (Adj. Sess.), § 9b, eff. July 1, 2024.)

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