Cat Patteson, BA, QMHPCat Patteson, BA, QMHPBHH Inpatient Adult and BHH Inpatient Adult and

Child/Adolescent ServicesChild/Adolescent ServicesCare Mgmt/Clinical Social Work Asst.Care Mgmt/Clinical Social Work Asst.

The MD/DO fills out an “Affidavit and Petition

for Involuntary Commitment” form as well as the first “Examination and Recommendation” form.

Have the Affidavit notarized. Call the magistrate to let them know you will

be faxing petition papers and obtain any special instructions they may request.

Petitioning an Existing Patient

Notarized

Fax the paperwork to the magistrate. Ensure the “Findings and Custody Order” is delivered

by law enforcement within 24 hours. If it is not the petition expires at that time. Ensure “Section A” of the Custody order is appropriately filled out by law enforcement.

Send original IVC paperwork to the Clerk of Court. Place IVC paperwork delivered by law enforcement in shadow chart.

The patient may be held in the ED up to 7 days waiting to be transported to a “24 hour mental health facility” (such as BHH, CRH, ADATC etc.).

If the patient waits in the ED longer than 7 days the petition has expired.

Petitioning an Existing Patient cont’d

Forms: Affidavit

Forms: Involuntary Commitment

Forms: Custody

Place all IVC documents in shadow chart. If a patient is admitted under IVC it is imperative

to check if they have had a first “Examination and Recommendation” form filled out. If a patient was transferred from Monarch or

another provider they may have had this completed.

If a patient was petitioned by a family member, law enforcement, or another layperson they will need to have the first “Examination and Recommendation” form completed by a MD/DO within 24 hours of the petition being filed.

Patients Admitted Under IVC

Once a patient is under IVC a Physician must

create an order to discontinue the patient’s IVC. This might be done by discharging them to their home or allowing them to sign voluntary.

A patient under IVC cannot sign for voluntary consent for admission to BHH without a Physician order.

Miscellaneous

Physician Order

Needed

Example 1

A 24 yo patient presents to the Emergency Department via Sheriff. The patient was petitioned by his mother an hour before hand. What needs to be completed?

Scenarios

A first “Examination and Recommendation” form by a MD/DO.

Example 2

An adult presents to the ED feeling unsafe. The patient states they want to leave in order to end their life. The Physician decides to place the patient under IVC. The physician fills out the “Affidavit and Petition for Involuntary Commitment” and a first “Examination and Recommendation” form. What happens next?

Scenarios

The affidavit must be notarized and both forms front and back must be faxed to the appropriate magistrate. The “Findings and Custody Order” will be delivered within 24 hours by law enforcement.

NC General Statues 122C-261. & 122C-263. UNC School of Governance

http://www.sog.unc.edu/node/858

References