SD9 - Assessment of Virginia’s Emergency Evaluators Qualifications, Training and Oversight (SB261, 2014)


Executive Summary:
This study was conducted pursuant to Senate Bill 261 (Chapter 364, 2014 Acts of Assembly) and House Bill 1216 (Chapter 292, 2014 Acts of Assembly). These identical bills required the Department of Behavioral Health and Developmental Services (DBHDS) to study the qualifications of community services board (CSB) designees authorized by the Code of Virginia to perform evaluations (*1) of individuals who are subject to emergency custody orders and to report its findings and recommendations. Specifically these bills state:

"…that the Department of Behavioral Health and Developmental Services shall review requirements related to qualifications, training and oversight of individuals designated by community services boards to perform evaluations of individuals taken into custody pursuant to an emergency custody order and to make recommendations for increasing such qualifications, training and oversight, in order to protect the safety and well-being of individuals who are subject to emergency custody orders and the public. The Department shall report its findings to the Governor and the General Assembly by December 1, 2014."

DBHDS used three separate data collection approaches to complete the study. These included: (1) a survey of characteristics of the current workforce of CSB evaluators (*2), (2) a survey of Virginia stakeholders involved in the emergency custody and involuntary admission process, and (3) a review of selected other states’ requirements for individuals who perform similar evaluations as part of the involuntary commitment treatment process in those states.

On the basis of these data, DBHDS determined that the qualifications, training and oversight of CSB evaluators should be strengthened. These evaluations are demanding and complicated to the individuals in crisis and their family members. In addition, the process often involves many other individuals and entities, such as emergency departments, law enforcement agencies, court officials, and public and private hospitals. The evaluations must also incorporate complex and, at times, contradictory clinical information. Individuals are extraordinarily vulnerable during a psychiatric crisis and therefore must be evaluated and treated by professionals who are qualified to provide appropriate treatment for individuals in crisis.

In order to strengthen the CSB evaluator workforce, DBHDS recommends:

• Creating an enhanced certification program for CSB evaluators to become “Certified Crisis Intervention Specialists” to reflect the complex and multifaceted responsibilities of providing emergency evaluations.

• Commencing a five year transition period (2015 - 2020) after which all individuals performing these evaluations will need to meet the enhanced certification requirements as proposed.
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(*1) “Individuals designated by community services boards to perform evaluations”, in this context, do not include independent examiners, who are designated by the district court judge or special justice.
(*2) The term “CSB evaluators” will be used in this report to describe the individuals currently designated by community services boards (CSBs) to perform the face-to-face clinical evaluations of persons in crisis, who may be in emergency custody or who may need involuntary temporary detention or other emergency treatment.