(Minor revision. Replaces memo 3.01-2 of December 16, 2002.)

The following are the general procedures and guidelines for transporting clients on involuntary hold, and clients with other urgent transportation needs.

911 should be called in the event that the client is posing a serious physical threat to self or others, is not cooperative, and is likely to require physical restraint while being transported. Combative or agitated clients need to be transported by the police, for everyone's safety. However, SFPD should not be called to transport 5150 clients who are cooperative and agreeable to going to the hospital, and are not agitated nor combative. The CBHS driver or MV Transportation, described below, should be used to transport cooperative 5150 clients.

911 should also be called in the event that the client has a medical emergency.

Available Mon - Fri, 10 AM - 7 PM (last trip completed by 7 PM), phone- 206-8125, or pager- 303-0435:

There is one CBHS driver available to transport clients on involuntary hold to:

Psychiatric Emergency Services (PES), or

to pre-arranged psychiatric hospitalization within San Francisco, or

to 24-hour aftercare facilities after hospitalization (i.e., long-term care facilities, SF Mental Health Rehabilitation Facility, residential treatment, transitional residential treatment, and residential care facilities).

Minors being transported on an involuntary hold by the CBHS driver need to be accompanied by another adult.

MV Transportation can be utilized to transport clients to psychiatric facilities whenever 1) the CBHS Driver is not available, and/or 2) for out-of-town trips and 3) for weekend trips.. The CBHS Driver should be the first option for in-town trips, and MV should be resorted to for in-town trips only when the CBHS Driver is unavailable.

Programs that are pre-authorized can call MV directly to arrange transport. All other programs must call the CBHS AOD at pager # 739-3539, or the MV contract monitor (Edwin Batongbacal at 415-255-3446), to obtain approval to use MV transportation.

MV transport is restricted to clients who are being transported to in- or out-of county psychiatric hospitalization, or who are being moved to 24-hour aftercare treatment from a psychiatric hospitalization; and, who are non-combative. MV will be used primarily (but not exclusively) to transport clients to out-of-county placements for continuing 24-hour treatment services from hospital psychiatric wards which contract with the San Francisco Mental Health Plan. An appointment with MV should be made as soon as a discharge date is known, but no less than 24 hours in advance.

Any exceptional use of MV (such as for clients who are not on a psychiatric hold, or for transports other than to PES/psychiatric hospitalizations and other than to 24-hour aftercare facilities) must be approved by the CBHS AOD at pager # 739-3539, or by the MV contract monitor, Edwin Batongbacal, at (415) 255-3446. MV cannot be used to return clients to their homes, or to take them to medical appointments, unless specifically approved by the CBHS AOD or the MV contract monitor for exceptional circumstances.

The MV vehicles are equipped with wheelchair and restraint straps; they cannot transport clients on a gurney. When necessary, a female escort can be arranged.

MV’s hours of operation are 9 AM to 12 Midnight, 7 days a week. The last call that can be made to MV to schedule local trips within city limits is 11 PM. For trips outside of San Francisco, the last call that can be made is 10 PM.

When scheduling a pick-up, provide the following information to the MV dispatcher:

Client's name, your name, clinic name, clinic's phone number, location for pick-up, destination, appointment time, Is client on 5150? Need a wheelchair? Need an escort?

Ambulances should be used for transporting clients only after other means of transportation have been considered and have been ruled out.

The determination of responsibility for payment for ambulance services depends upon a variety of factors including the client's insurance, the diagnosis, and the location of the person calling for ambulance services. The attached table of “Payment/Authorization of Ambulance Transportation Services” outlines the responsibility for payment of ambulance services.

Susie Reichert (255-3495) may be contacted for assistance with interpreting the attached table. The table indicates when prior authorization is necessary.

The Mobile Crisis Treatment Team and Comprehensive Child Crisis perform psychiatric evaluations and treatment. They are NOT client transport services.

The Office of Self Help will provide prearranged transportation for clients who cannot utilize or have no other means to get to medical appointments or other mental health related activities in the county. Services are available Monday through Friday, 12:00 PM to 4:00 PM (last pick-up at 3:30 PM).

Programs which have discretionary purchase-of-service funds for clients have found it helpful to purchase Municipal Railway bus tokens and taxi scripts in advance for clients who appropriately need and can utilize these modes of transportation. However, it is not appropriate to send individuals on an involuntary hold to the hospital utilizing these modes of transportation.

Contact Person: Sidney Lam, Assistant Director, Adult Services, 255-3446.

• Administrative Manual Holders
• Assistant Clinical Directors
• Program Directors
• Psychiatric Emergency Services
• Medivan Transportation (MV)
• Mobile Crisis
• Comprehensive Child Crisis

CBHS policies and procedures are distributed by the Quality Management Section, Policy Distribution Coordinator.