Effective: 09-12-23
Supersedes: 06-22-20
Purpose: Provide a mechanism for dispatching ambulances to section 12 (non-voluntary committal) patients and compliance with Massachusetts General Law Chapter 123 Section 12 A and transportation of Patients already admitted to a psychiatric facility who require movement to another facility for treatment or services unavailable at the psychiatric facility in compliance with Massachusetts General Law Chapter 104 Section 27.
Policy: Dispatchers must follow the below procedure for proper dispatching and validation of the section 12 patient and/or the patient who is already in a psychiatric facility utilizing the BB-303 Form.
Definition(s):
Section-12 refers to a legal document that states the individual is a threat to self, threat to others, or lacks capacity. It may be issued by law enforcement, the Court, Physician, Psychiatrist, Nurse Practitioner, or Mental Health Practitioner.
A Section-12 allows for patient restraint but only if necessary for the safety of the person being transported or of others who are likely to come into contact with him or her.
Following M.G.L. 123: Mental Health, a properly completed Section 12 form will be honored for patient transports. This includes the appropriate signature and date fields which have no expiration.
Form BB-303 is a legal document that authorizes the transportation of a patient who is already a patient of a psychiatric facility to another facility for services not available at the psychiatric facility, including the return of said patient.
Procedure:
Section 12s originating from a private residence or business
These cases will be treated as a street emergency and an ambulance must be immediately dispatched (on a priority) only when the circumstances warrant such a response. Patient information from the requesting Police agency will determine such a response. Caution must be used at all times, with scene safety and patient care made a priority. A copy of the section 12 must either be faxed to our communication center by the requesting agency or presented to the ambulance crew at the place of pickup. In the latter case, a copy of the section 12 must be attached to the patient care report. Crews shall be notified by radio not to enter a scene unless secured and declared safe by the responding police agency. In certain cases, a Section 12 will be issued by a Police Officer or Mental Health Professional on-scene who may request transport to a non-acute care facility such as the Bournewood Hospital. Non-acute care facilities or institutions must verbally accept the patient before Brewster and EasCare Ambulance Service will transport to their facility. If the receiving facility does not verbally accept the patient before transport, advise the issuing authority to change the patient’s destination to an acute care hospital with emergency services.
Section 12s originating from a Medical Facility.
These patients are considered to be in a secure environment and therefore, an emergency ambulance response is not warranted. The ambulance crew must be instructed to verify that the section 12 is valid (see below) and a copy must be attached to their patient care report.
A valid Section 12 document must meet the following criteria:
· It must be issued and completed by a Police Officer, Judge, Qualified Psychiatric Nurse, Mental Health Clinical Specialist, Physician, Nurse Practitioner, or Licensed Psychologist
· The patient’s name or other means of identification must appear in the appropriate space (Jane or John Doe is an acceptable name if the patient is identified by a licensed professional or Police Officer).
· The destination and gender must be entered
· Social security # and address is not required
· One of the criteria necessitating the section 12 must be entered
· The name and signature of the issuing authority must be entered
· The date the document was signed must appear.
FORM BB-303
· Used for patients who are already under the care and treatment of a psychiatric facility.
· Transportation to and/or from is for treatment or services not available at the psychiatric facility including court appearances, evaluation at medical facilities or offices, or admission to another psychiatric facility.
· Authorization /signature of the said form must be by an authorized physician OR staff member at the initiating facility.
· This form may be used for transport over State line if the state is part of the Interstate Compact on Mental Health which includes; NH, ME, RI, CT, and NY.
Additional Information:
In an emergency setting if the patient is suicidal, homicidal or experiencing suicidal/homicidal ideations, or is lacking the capacity to understand the risks and benefits of medical treatment and transport the ambulance on scene should transport the patient to the closest appropriate facility. If doubt is present, the crew should contact on-line Medical Control for guidance and direction. Remember to document fully such events and conversations thoroughly on the PCR.