RD435 - Report on Information on the Civil Commitment Process (Item 282.C)


Executive Summary:
Item 282.C of the 2009 Appropriation Act states:

“The Secretary of Health and Human Resources, in consultation with the Executive Secretary of the Supreme Court, shall develop a reporting system to collect relevant information on emergency custody orders (ECOs), involuntary commitment orders (TDOs), and mental health commitment hearings by fiscal year. The data shall include, but not be limited to, the number of ECOs, TDOs, and commitment hearings that occur each year by locality, and the estimated cost, duration, location, and disposition of each proceeding. The information collected shall comply with all relevant state and federal health privacy laws and shall not include any personal identifiable information. The data collected shall be reported to the Governor, the Chairmen of the Senate Finance and House Appropriations Committees, and the Supreme Court by November 1, 2008, and each year thereafter.”

This report describes the activities of the Department of Behavioral Health and Developmental Services (Department) on behalf of the Secretary of Health and Human Resources (HHR) and with the Office of the Executive Secretary of the Supreme Court of Virginia (OES) in response to this budget item.

While the scarcity of usable data about the civil commitment process has improved somewhat since noted last year in the Department’s Report Document 216 (2008), the lack of systematic data continues to make it difficult to project fiscal impacts for implementing the statutory changes in the involuntary commitment process. (*1) As Report Document 216 noted, along with this lack of usable data, another complication in gathering data about the civil commitment process is the high degree of variability with which it is implemented or administered across the state. For example, while the concept of an emergency custody order (ECO) may appear to be fairly clear and uncomplicated, the manner in which statutory provisions for ECOs are implemented varies considerably across Virginia. In some localities, few if any ECOs are issued by magistrates; instead, law enforcement officials take individuals into custody, as authorized by the statute, but there is no paper order issued by a magistrate. While there is no comprehensive information about the prevalence of this practice, most individuals familiar with the process indicate there could be thousands of ECOs executed by law enforcement officials each year. It would be impossible to obtain information about the estimated cost, duration, location, or disposition of those paperless ECOs. Similarly, the manner in which temporary detention orders are issued and executed varies greatly, particularly regarding duration and location, and the availability of documentation about those TDOs also varies widely across the state. Finally, the location and scheduling of commitment hearings varies considerably across the state.

In the absence of complete and systematic data, this report includes the data that is available. The report also contains a discussion of how more consistent statewide data will be gathered for FY 2010.
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(*1) Report on the Allocation of Funds in Item 316.KK of the 2008 Appropriation Act, September 1, 2008, page 4.