Patient advocacy organizations have accused VA Loma Linda (Calif.) Health Care System of violating patient civil liberties by placing some veterans on involuntary psychiatric holds as a precondition for their transportation to a hospital, the Press-Telegram reported Oct. 8.
An Aug. 28, 2022, email discussing the policy stated that veterans arriving at the ambulatory care center for voluntary hospitalization should be placed on a 5150 hold — involuntary hold — to ensure they are transported safely by ambulance to the emergency department for evaluation.
"If you are transporting a veteran without a hold either using VA staffed transportation methods or ambulance, the veteran can request to leave at any moment," VA Loma Linda Associate Chief of Staff Michael Potoczniak, PhD, wrote in the email. "If you would be concerned about the patient if they did not arrive at the agreed upon location (the Emergency Department or a community psychiatric facility), the safest method is to place the hold for the purposes of transport."
It is illegal to use a 5150 hold for anything other than evaluation, assessment and crisis intervention for individuals deemed dangerous to others or themselves, or who are unable to provide the basic needs or unwilling or unable to accept voluntary treatment, Rebecca Basson, lead patients rights attorney for the Law Foundation of Silicon Valley, told the news outlet.
One mental health provider who asked not to be identified added that "a 5150 can't be used as a transportation voucher."
Anthony Hwang, PhD, the hospital's behavioral health inpatient supervisor, said in a memo obtained by the Press-Telegram that "true" voluntary admissions can be considered, but if there were concerns about a veteran changing their mind about voluntary hospitalization, a 5150 is "absolutely appropriate."
"A lot can happen between here and the Emergency Department," Dr. Hwang said. "We have had patients become agitated, exit vehicles unsafely, leave the premises, harm others. … If we are unable to safely transport our veterans, we may lose our ability to write 5150s."
The U.S. House Committee on Veterans Affairs is investigating this and other complaints about VA Loma Linda.