BAKER ACT TRAINING

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BAKER ACT TRAINING

• Laura Gailey, LMHC

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• Should I Take Their Rights Away?

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Voluntary Admissions

• Adults
• Must have a mental illness
• Must be competent to provide express and informed
  consent
• Minors
• Must have a mental illness.
• Guardian applies for express and informed consent
  for minors admission

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Express and Informed ConsentWhat does that mean?

• Client is able to make knowing and willful
  decisions
• There has been no element of force, fraud,
  deceit, duress or coercion.
• Judgment is not affected by mental illness

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Voluntary Criteria

• You have reason to believe the person has a
  mental illness (wanting to die due to end stage
  illness is not criteria for admission).
• Without care or treatment, the person is likely
  to suffer from neglect to self care and such
  neglect poses a real and present threat of
  substantial harm to ones well-being
• There is substantial likelihood that without
  treatment, in the near future person will cause
  serious bodily harm to self or others, as
  evidenced by recent behavior
• Client is willing to sign self in voluntary
• Client is competent to sign self in voluntary
• Client must also sign Right to Request Discharge
  form

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Who can sign in a person on a Voluntary?

• Has a minimum of a bachelor degree in a health
  related field
• Registered Nurse
• Physician
• Most agencies will not allow an outsider to
  sign a person in voluntarily

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Involuntary Criteria

• Reason to believe person has a mental illness and
  because of mental illness, person has refused or
  is unable to determine whether examination is
  necessary (wanting to die due to end stage
  illness is not criteria for admission).
• and either
• Without care or treatment, is likely to suffer
  from neglect or refuse to care for self, and such
  neglect or refusal poses a real and present
  threat of substantial harm to ones well-being
  and it is not apparent that such harm may be
  avoided through the help of willing family
  members, friends, or the provision of other
  services or
• There is substantial likelihood that without
  treatment will cause in the near future serious
  bodily harm to self or others, as evidenced by
  recent behavior.

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Who Can Baker Act?

• Licensed professionals
• LMHC
• LCSW
• LMFT
• MD
• ARNP
• Law Enforcement

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Referring to Lakeside/Aspire

• Paperwork required
• Baker Act
• 3102 (if coming from a hospital)
• Labs
• Presenting problem (Medical and Psychiatric)
• Current vitals signs
• Medications (what the client is taking and what
  the hospital/Doctor has administered)
• Insurance Precertification
• Face Sheet (demographics)

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I am going to baker act, now what

• From an area hospital
• Contact your psych intake department or transfer
  coordinator
• From a Private Office Setting
• Call your local law enforcement agency, request a
  CIT officer.
• Provide the officer with the original baker act
  form.
• The officer will bring the client to a receiving
  center.

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Lakeside/Aspire Contact Information

• Contact Information
• Liaison 407-875-3700 ext 5038
• 24/7 availability
• Fax [phone]

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Central Florida Baker Act Receiving Facilities

• Central Receiving Center
• Lakeside Behavioral Healthcare
• Florida Hospital
• University Behavioral Center
• Central Florida Behavioral Hospital
• Seminole CMHC/CSU
• South Seminole Hospital
• Park Place Behavioral Health
• Circles of Care
• Wuesthoff Medical Center
• Public Receiving Facility

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Exclusionary Criteria

• The following conditions ALONE are not
  appropriate for an admission to a crisis unit per
  FL Statute.
• Pervasive Developmental Disability
• Antisocial Personality Disorder
• Mental Retardation
• Dementia
• Alzheimers
• Homeless Seeking Shelter
• No DSM-IV diagnostic criteria
• Absence of immediate risk of harm to self or
  others due to a psychiatric illness or absence
  of risk of not being able to care for self due to
  psychiatric illness

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Exclusionary Criteria

• Exclusionary for Inpatient Units or lengthy stay
  at CRC.
• Acute medical condition that would prohibit
  treatment of the psychiatric condition
• Patients in need of the following
• Continuous oxygen
• Continuous monitoring
• Cardiac monitoring
• Continuous medically ordered bed rest
• Traction
• Continuous skilled nursing care
• Complex Dressings
• Blood transfusions, IVs, Catheters, etc
• Methadone Maintenance (client can remain at CRC
  for less than 4 hours if a transfer to the CFDFL
  will occur and the client remains medically
  stable).

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Exclusionary Criteria

• Uncontrolled or Unmanageable Seizure Disorders
• Substance toxicity or severe withdrawal that
  cannot be safely treated with standard detox
  protocols. (Cocaine, Benzo, PCP, Morphine,
  Heroin).

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Exclusionary Criteria

• BAL of .3 or above
• Clients with a BAL below .3 can be transferred
  from an ED to Lakeside as long as the following
  conditions have been met
• The client must be able to walk and talk. The
  client cannot be so intoxicated that they are
  stumbling, have an unsteady gait or have slurred
  speech.
• The hospital must show that the clients BAL is
  decreasing, by having at least two BAL checks
  completed to show this is decreasing, unless the
  client has been in the ED for a minimum of 10
  hours (Then a 2nd BAL is not needed).
• The client must have stable vital signs as
  evidenced by checking vitals every 30 minutes for
  a two-hour period.
• If withdrawal symptoms are present, a client can
  only be accepted after a detox protocol has been
  initiated at the hospital.
• Clients with other serious medical conditions in
  addition to intoxication will be decided on a
  case-by-case basis.

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Exclusionary Criteria

• Suggestions
• Obtain a copy of your Receiving Facilitys
  Exclusionary Criteria
• If in doubt, you could contact EMTs to evaluate
  the medical condition.
• Call your local Receiving Facility case by case
  to determine if the client should be sent to the
  ER first.

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Forms

• All baker act forms can be found on the DFC
  website at
• http//www.myflfamilies.com/service-programs/menta
  l-health/baker-act-forms

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Forms

• Voluntary - CF - MH 3040 Feb. 2005 Application
  for Voluntary Admission (Receiving Facility) This
  form may be altered
• Baker Act - CF - MH 3052b Sept. 2006 Certificate
  of Professional Initiating Involuntary
  Examination This form may not be altered
• Ex Parte - CF - MH 3001 Jan. 1998 Ex Parte Order
  for Involuntary Examination

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Suggestions Final Thoughts

• Find out who your local Receiving Facility is and
  their contact information
• Find out of your communicate has CIT Trained
  Officers
• Build a Relationship with the Receiving Facility
  and the Officers that patrol your area.
• Take this decision seriously.
• Consider if your decision will keep you up at
  night or not.

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Questions?