The Vermont Statutes Online

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.)