EMTALA Basics
The Emergency Medical Treatment & Labor Act (EMTALA) was passed by the U.S. Congress in 1986 to ensure public access to emergency services, regardless of ability to pay. The basic tenets of EMTALA are:
- Hospitals that offer emergency services are obligated to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual’s ability to pay, citizenship, or legal status.
- Hospitals are then required to provide stabilizing treatment for patients with EMCs.
- If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.
Legal Definitions and Security Procedures for Psychiatric Emergencies
| TERM | DEFINITION | SECURITY PROCEDURE |
| Detainment | A status issued by a physician providing emergency medical services in any department of RRUCLA Medical Center or Emergency Department, for the involuntary detention of a person who is judged to be a danger to himself or herself (DTS), and/or a danger to others (DTO), and/or gravely disabled1 (GD) as the result of a mental illness. Detainment is initially valid for up to 8 hours, and can be extended for up to 24 hours. | Patient shall be detained involuntarily to prevent elopement, and harm to self or others. |
| 72-Hour Hold | A legal status issued by a peace officer, or LPS-designated2 psychiatrist or mental health professional, that permits involuntary detention of a person judged to be DTS, DTO, or GD, as the result of a mental illness. Valid for up to 72 hours for the purposes of evaluation and treatment in a designated facility. Common synonyms: “Hold,” 5150, 5585 (under 18), involuntary hold, psychiatric hold, mental health hold. | Patient shall be detained involuntarily to prevent elopement, and harm to self or others. |
| 14-Day Hold | A legal status issued by an LPS-designated psychiatrist or mental health professional that permits involuntary detention of a person judged to be DTS, DTO, or GD, as the result of a mental illness. A 14-day hold is placed after a 72-hour hold and is valid for up to 14 days. | Patient shall be detained involuntarily to prevent elopement, and harm to self or others. |
| LPS Conservatorship | A court-ordered legal status for a person determined to be gravely disabled. Specific court-ordered “powers” may authorize the conservator to place the patient (conservatee) in a locked acute care psychiatric hospital, and thereby authorizes involuntary detention in the RRUCLA-ED. Additional powers may authorize treatment with psychotropic medications. The court-issued conservatorship papers must be physically present and valid (not expired). | Patient shall be detained involuntarily to prevent elopement, and harm to self or others. |
| Voluntary | A status for a patient, whereby he/she may not be detained forcefully or against his/her will. | Patient shall not be detained involuntarily, unless reassess and determined to meet above involuntary criteria. |