ECO/TDO Flashcards
(116 cards)
1
Q
ECO/TDO: Successive Orders? Extensions?
A
NO consecutive orders if executed. NO extensions on time limits.
2
Q
What Virginia Code sections generally cover adult and juvenile mental health orders handled by magistrates?
A
Adults: Title § 37.2
Juveniles/Minors: Title § 16.1
3
Q
Are successive (back-to-back) ECOs or TDOs permitted?
A
No. An executed ECO or TDO cannot be immediately followed by another one for the same episode.
look into the exception?
4
Q
Can ECOs or TDOs be extended beyond their time limits?
A
NO. Extensions are not permitted.
5
Q
What is the primary purpose of an Adult Mental Health ECO?
A
To take a person into temporary custody for transportation to receive a mental health evaluation by a qualified professional.
6
Q
Is issuing an Adult Mental Health ECO mandatory or discretionary for a magistrate if the criteria are met?
A
SHALL Issue (Mandatory)
7
Q
Who can initiate the process for an Adult Mental Health ECO?
A
- Petition by designated “Responsible Persons” (e.g., family, caregiver)
- Community Services Board (CSB)/Behavioral Health Authority
- Law Enforcement Officer (LEO)
- Treating physician
- Any other reliable person (at magistrate’s discretion)
- Magistrate’s own motion (based on information brought to them)
8
Q
What factors determine if a petitioner (not otherwise designated) is “reliable” for an Adult ECO?
A
Magistrate’s discretion, considering: maturity, education, experience, judgment, powers of observation and discernment, credibility.
9
Q
What are the 5 general requirements for issuing an Adult Mental Health ECO?
A
- Person is in the magistrate’s region (or last known location).
- Person is believed to have a mental illness or substance use disorder.
- There’s a substantial likelihood in the near future of serious harm (active or passive).
- Hospitalization or treatment is believed necessary.
- Person is unable or unwilling to volunteer for evaluation/treatment.
10
Q
Define “mental illness” for ECO purposes.
A
A broad definition: a disorder of thought, mood, emotion, perception, etc. An official diagnosis is not required.
11
Q
Explain the “substantial likelihood of serious harm” requirement for an Adult ECO (Active vs. Passive).
A
Active: Causing serious physical harm to self (suicide, cutting) or others (threats, violence).
Passive: Suffering serious harm due to inability to protect self (neglecting hygiene leading to infection, not eating/drinking).
12
Q
What factors MUST a magistrate consider when deciding on an Adult ECO?
A
The circumstances leading to the request, including: observed behavior, recommendations from licensed professionals, past mental health history, available medical records, affidavits, relevant hearsay, any other available information. (Crucial to understand why petitioner is concerned).
13
Q
What happens immediately after an Adult Mental Health ECO is issued?
A
Law enforcement takes the person into custody and transports them to a “convenient” location (often an ER) for evaluation
14
Q
Which law enforcement agency typically executes an Adult Mental Health ECO?
A
The LE agency where the person is currently located. City/County/Town police are preferred over the Sheriff’s office if available. (NOT private or campus police, unless specific agreement exists).
15
Q
A
16
Q
Can LEO go outside their jurisdiction to execute an Adult ECO?
A
Yes
17
Q
Can a magistrate order an emergency medical exam or treatment before the mental health evaluation under an Adult ECO?
A
Yes. “Treatment” implies immediate medical care; “Exam” implies medical clearance for a psych facility.
18
Q
What is the time limit to execute (serve and take into custody) an Adult Mental Health ECO?
A
8 hours from issuance. NO EXTENSIONS.
19
Q
Can another Adult Mental Health ECO be issued if the first one was already executed?
A
No.
20
Q
Is issuing an Adult Mental Health TDO mandatory or discretionary if the criteria are met?
A
MUST Issue (Mandatory).
21
Q
What is required before an Adult Mental Health TDO can be issued?
A
A qualified professional must have completed an evaluation (within the last 72 hours), recommending inpatient treatment.
22
Q
Is an ECO always required before an Adult Mental Health TDO?
A
No. An evaluation could have occurred through other means (e.g., LEO-initiated custody, voluntary admission followed by status chan
23
Q
What are the 5 general requirements for issuing an Adult Mental Health TDO?
A
- Evaluation completed (within 72 hrs, unless dangerous to perform).
- Person is in the magistrate’s region.
- Person has a mental illness or substance use disorder.
- Substantial likelihood of serious harm (active or passive) in near future.
- Inpatient hospitalization/treatment is necessary.
- Person is unable or unwilling to consent voluntarily.
24
Q
Who designates the facility for an Adult Mental Health TDO?
A
The Community Services Board (CSB). State hospitals must accept the patient.
25
What if the evaluator recommends against a TDO, but the petitioner still wants one?
The magistrate MUST allow the petitioner to be heard again immediately and can still issue the TDO based on the petitioner's information, overriding the evaluator's recommendation.
26
How long is a sworn petition for an Adult TDO valid?
96 hours
27
How long is the evaluation supporting an Adult TDO valid?
72 hours.
28
What is the time limit to execute an Adult Mental Health TDO?
24 hours from issuance.
29
What happens if an Adult TDO is not executed within 24 hours?
It expires, but a new TDO may be issued if the original petition is still valid (within 96 hours of petition filing). However, a new evaluation may be required if the previous one is over 72 hours old.
30
How long does custody typically last after an Adult Mental Health TDO is executed?
Approximately 72 hours, until the commitment hearing.
31
When is the commitment hearing held after an Adult TDO?
Within 72 hours of TDO execution (often the next business day if weekend/holiday).
32
Can a consecutive Adult TDO be issued if the first one was executed?
No
33
Is issuing a Juvenile Mental Health ECO/TDO mandatory or discretionary if the criteria are met?
MUST Issue (Mandatory)
34
Can magistrates issue medical orders (Medical ECO/TDO) for juveniles?
NO
35
Who can initiate a Juvenile Mental Health ECO/TDO?
Parent, doctor, responsible adult (if parent unable), or magistrate's own motion.
36
What are the specific criteria for a Juvenile Mental Health ECO/TDO (Mental Illness resulting in...)?
1) Serious danger to self/others likely to result in severe/irremediable injury; OR
2) Serious deterioration in ability to care for self (developmentally appropriate); OR
3) Needs and will benefit from proposed "compulsory" treatment.
37
Is the minor's unwillingness/inability to consent a required finding for a Juvenile ECO/TDO?
No. Consent is irrelevant for minors in this context.
38
What conditions are explicitly not sufficient on their own for a Juvenile mental health order?
Intellectual disability, head injury, learning disability, seizure disorder.
39
What is the duration of custody under a Juvenile ECO?
8 hours (same as adult).
40
Is an evaluation absolutely required for a Juvenile TDO?
YES. A phone call is not sufficient; a formal evaluation must occur.
41
Whose input MUST a magistrate consider for a Juvenile TDO?
The recommendations of any treating physician AND the parent.
42
When is the commitment hearing held after a Juvenile TDO?
Within 96 hours of TDO execution (longer than adult), or next business day if weekend/holiday.
43
What is the venue for Juvenile Mental Health proceedings?
* Where the minor resides; OR
* Where the minor is located when proceedings are commenced.
## Footnote
(Note: Unlike adults, not just anywhere the emergency occurred).
44
Which LE agency transports for a Juvenile or Adult ECO?
The LE agency where the person is physically located when the ECO is issued. (50-mile rule does NOT apply to ECOs).
45
Explain the 50-Mile Rule for TDO transport.
Measure the distance "as the crow flies" between the closest points of the political subdivision of the person's residence and the political subdivision where they are currently located.
* If 50 miles or LESS: Use the LE agency of the person's *residence*.
* If MORE than 50 miles: Use the LE agency where the person is *currently located.*
46
Does the 50-mile rule apply to Transport Orders for facility transfers?
Yes. The magistrate designates the LE agency using the 50-mile rule
47
If a town has its own police department within a county, which LE agency is considered for the 50-mile rule?
The town police department (use the smallest applicable political subdivision with its own LE).
48
Can someone other than Law Enforcement provide transport under a TDO?
Yes, this is "Alternate Transportation" (kinder, gentler). The magistrate can consider this if presented but doesn't have to order it.
49
Who can provide alternate transportation for a TDO?
Family member, CSB staff, medical transport provider, or any other third party deemed *available, willing*, and *able* to provide safe transport.
50
What is the time requirement for alternate transport providers for an Adult TDO?
They must be able to take custody within 6 hours of notification.
51
Does Law Enforcement still have a role if alternate transportation is approved?
Yes. LEO must still formally execute the TDO (serve the papers/establish legal custody) and then transfer custody and paperwork to the approved alternate transporter.
52
When is a Transport Order used?
When a person is already admitted under a TDO, and the CSB identifies an "alternate treatment facility" requiring transfer.
53
Who prepares the Transport Order? Who designates the LE agency?
CSB prepares the order. The Magistrate designates the LE agency using the 50-mile rule.
54
Is a *new* TDO needed for a facility transfer via Transport Order
No
55
Does the Jail Inmate Mental Health TDO apply to state prisons?
No, only local/regional jails
56
Can a magistrate issue an ECO for a jail inmate?
No, only a TDO (they are already in custody).
57
Is issuing a Jail Inmate Mental Health TDO mandatory or discretionary?
MAY issue (Discretionary, but strong expectation to issue if criteria met).
58
What are the criteria for a Jail Inmate Mental Health TDO?
Meets standard TDO criteria (mental illness, danger/deterioration, needs treatment, unable/unwilling) AND the inmate's treatment needs *exceed the jail's capability.*
59
Who must petition for a Jail Inmate Mental Health TDO?
Sheriff or designated jail staff ONLY. (Cannot be CSB or magistrate's own motion).
60
What is the maximum initial hospitalization period under a Jail Inmate TDO?
30 days.
61
Does Mandatory Outpatient Treatment (MOT) apply to juveniles?
No
62
When might a magistrate issue an order related to MOT?
When a person under court-ordered MOT fails to comply and either:
(1) deteriorates meeting ECO/TDO criteria
OR
(2) fails to appear for a court-ordered examination related to their non-compliance.
63
Can a magistrate issue a standard ECO/TDO for someone on MOT?
Yes, if they meet the criteria due to deterioration. Non-compliance alone is not sufficient grounds.
64
When MUST a magistrate issue an "MOT Capias" (Transport and Mandatory Examination Order)?
When ALL are true:
1. Court ordered MOT.
2. CSB reports non-compliance.
3. Court orders an examination due to non-compliance.
4. Person fails to appear for the court-ordered exam.
5. The court is *not available *to issue the capias itself.
65
What does the MOT Capias authorize?
Short-term LE custody (up to 8 hours) solely to transport the person to the mandatory examination. No bail.
66
Which LE agency is designated for an MOT Capias?
The primary LE agency in the jurisdiction where the person resides.
67
What type of order(s) can a magistrate issue for a conditionally released acquittee under exigent circumstances?
ECO and potentially a subsequent TDO.
68
What is the standard for issuing an ECO for a conditionally released acquittee?
Probable cause (based on petition, own motion, or LEO info) to believe the acquittee violated release conditions, is no longer suitable for conditional release, AND requires emergency evaluation for potential hospitalization.
69
How long does an ECO for a conditionally released acquittee last?
Up to 8 hours, or until a TDO is issued or the person is released.
70
What type of order can a magistrate issue for a conditionally released SVP who violates conditions?
ECO only. (Concurrent authority with the court).
71
Is issuing an SVP ECO mandatory or discretionary?
MAY issue (Discretionary, but need a very good reason not to if criteria met).
72
What are the requirements for an SVP ECO?
1. Petition (or own motion) finding:
2. Person is in the region.
3. Person is an adjudicated SVP.
4. Person has violated conditions of release.
73
Who evaluates someone under an SVP ECO and where?
A specially designated evaluator conducts the exam at a secure facility (like the local jail).
74
How long does an SVP ECO remain in effect?
Until the Circuit Court hearing. The person remains in custody until then
75
Who must be notified upon issuance of an SVP ECO?
Circuit Court, Commonwealth's Attorney (CA), Attorney General (AG), and the relevant department (likely Dept. of Corrections or Behavioral Health)
76
Is issuing a Adult Medical ECO mandatory or discretionary?
MAY issue (Discretionary).
77
What is the purpose of a Medical ECO?
Temporary custody (up to 4 hours) to transport an adult to an ER for medical evaluation when they are incapable of consenting due to a medical condition and refusing transport.
78
What are the key requirements for a Medical ECO?
1. Dire need for eval to prevent imminent/irreversible harm.
2. No authorized person available to consent.
3. Person incapable of informed decision due to illness/injury.
4. Person refused/resisted transport for evaluation.
5. Person unlikely to regain capacity within time needed for eval.
79
Who must the magistrate hear from to issue a Medical ECO?
A licensed physician. Not a PA.
80
How long does a Medical ECO last?
Maximum 4 hours custody for evaluation. Expires if capacity regained.
81
What is needed if *treatment* (not just eval) is required after a Medical ECO?
A Medical TDO.
82
Is issuing a Standard Medical TDO mandatory or discretionary? Who has primary authority?
MAY issue (Discretionary). The Court has primary authority; magistrate has concurrent authority (try court first if available).
83
What does a Standard Medical TDO authorize? How long does it last?
Authorizes observation, testing, AND treatment for up to 24 hours. Order expires in 24 hours. NO extensions.
84
What are the key requirements for a Standard Medical TDO?
1. Adult incapable of making/communicating informed decision (due to physical/mental condition or intoxicant).
2. Medical standard requires observation/testing/treatment within 24 hours to prevent injury, death, disability, or other harm.
85
What must the requesting licensed physician provide evidence of?
Attempted to obtain consent AND that the medical standard of care requires intervention within 24 hours.
86
Can a Standard Medical TDO be issued while someone is under a Mental Health ECO? What effect does it have?
Yes. Issuing the Medical TDO terminates the Law Enforcement custody under the mental health ECO. (The ECO itself may or may not be technically void, but custody transfers).
87
Can a Mental Health TDO follow a Medical TDO used to address the incapacitating medical issue?
Yes, this is not considered a prohibited successive order.
88
Is issuing an Intoxication Medical TDO mandatory or discretionary?
Notes state: "Doesn't say if must or may." (Likely MAY issue, consistent with other medical TDOs).
89
What must be caused by intoxication for this specific TDO?
BOTH the person's mental or physical condition AND the need for treatment must result from intoxicati
90
Who must request an Intoxication Medical TDO?
A licensed physician.
91
What are the requirements for an Intoxication Medical TDO?
1. Regional authority.
2. Physician attempted consent.
3. Condition results from intoxication.
4. Requires testing/observation/treatment for the condition.
5. Medical standard requires intervention within 24 hours to prevent harm (potentially including harm to others, though physician confirmation is rare).
92
How long does the Intoxication Medical TDO authorize treatment?
24 hours.
93
Who must authorize continued treatment beyond the initial 24 hours for intoxication?
COURT ONLY, even if the court is closed.
94
Is issuing a Medical TDO for a state/local inmate mandatory or discretionary? Who has primary authority?
SHALL Issue (Mandatory) if criteria met. Court has primary authority; magistrate has concurrent authority.
95
What are the requirements for an Inmate Medical TDO?
1. In region, in local jail OR state (DOC) facility.
2. Physical or mental condition prevents informed consent.
3. Medical standard requires treatment within **12 hours** prevent death, disability, or serious irreversible condition (higher standard, shorter timeframe than standard Medical TDO).
96
97
Who provides the medical evidence for an Inmate Medical TDO?
Licensed physician, psychologist, or psychiatrist who attempted to obtain consent. Broader.
98
What is the relationship between an Adult Mental Health ECO and a TDO?
An ECO's purpose is to facilitate an evaluation. While an ECO often precedes a TDO, it is not a strict prerequisite. A TDO can be issued if a qualifying evaluation has already occurred through other means (e.g., LEO-initiated custody, voluntary patient seeking discharge but meets TDO criteria).
99
What is the significance of "unable or unwilling to consent" for Adult ECO/TDOs, especially regarding capacity?
This requires assessing if the person has the mental capacity to make an informed decision about treatment/evaluation. Simply agreeing or disagreeing doesn't equal capacity. Someone might sign voluntary forms without truly understanding (as noted with the schizophrenic patient example), making the involuntary process (with its reviews) necessary despite apparent "consent." Conversely, having capacity means their refusal must be respected unless ECO/TDO criteria are met.
100
Explain the distinction between "Unique to Magistrates" and "Concurrent Authority" for these orders
Unique to Magistrates" (like Adult/Juv Mental Health ECOs, Medical ECOs) means these specific emergency processes are primarily initiated and issued by magistrates. "Concurrent Authority" (like Medical TDOs, SVP ECOs) means both magistrates and courts can issue such orders, but there might be a preference ("Court first") or specific circumstances dictating magistrate involvement (e.g., court unavailable for MOT Capias).
101
Who performs the evaluation initiated by an ECO or required for a TDO?
A qualified mental health professional certified to perform such evaluations (often associated with the local Community Services Board - CSB). For SVPs, it must be a specially designated evaluator.
102
What is the overarching goal of these emergency magistrate orders (ECOs/TDOs)?
These orders are for emergency situations requiring immediate evaluation, stabilization, and short-term detention for safety or urgent treatment when a person cannot or will not consent. They are not final commitment orders; those require subsequent court hearings.
103
Time and Authority: Adult ECO
**Authority**: Unique to Magistrates; SHALL issue if criteria met.
**Time**: Execute within 8 hours; Custody under ECO lasts up to 8 hours (or until TDO/release); No extensions.
104
Time and Authority: LEO Initiated Custody
**Authority**: LEO initiated based on probable cause (no magistrate order initially).
**Time**: Custody lasts up to 8 hours (or until TDO/release); No extensions.
105
Time and Authority: Adult Mental Health TDO
**Authority**: Unique to Magistrates; MUST issue if criteria met.
**Time**: Petition valid 96 hours; Eval valid 72 hours; Execute TDO within 24 hours; Custody lasts ~72 hours until hearing; Hearing within 72 hours of execution.
106
Time and Authority: Juvenile ECO
**Authority**: Unique to Magistrates; MUST issue if criteria met.
**Time**: Execute within 8 hours; Custody lasts up to 8 hours
107
Time and Authority: Juvenile TDO
**Authority**: Unique to Magistrates; MUST issue if criteria met.
**Time**: Hearing within 96 hours of execution
108
Time and Authority: Medical ECO
**Authority**: Unique to Magistrates; MAY issue.
**Time**: Custody/evaluation lasts up to 4 hours.
109
Time and Authority: Standard Medical TDO
**Authority**: Concurrent (Court first); MAY issue.
**Time**: Authorizes intervention for up to 24 hours; expires in 24 hours. Medical need within 24 hours.
110
Time and Authority: Intoxication Medical TDO
**Authority**: Concurrent; SHALL/MAY unclear (likely MAY).
**Time**: Authorizes intervention for up to 24 hours. Medical need within 24 hours. Continued Tx requires COURT order.
111
Time and Authority: Inmate Medical TDO
**Authority**: Concurrent (Court first); SHALL issue.
**Time**: Medical need within 12 hours.
112
Time and Authority: MOT Capias
**Authority**: Magistrate MUST issue if *court unavailable.*
**Time**: Custody for exam up to **8 hours**
113
Time and Authority: Acquittee ECO
**Authority**: Magistrate authority.
**Time**: Custody lasts up to **8** hours.
114
Time and Authority: SVP ECO
**Authority**: Concurrent; MAY issue.
**Time**: Effective until Circuit Court hearing.
115
Time and Authority: Alternate Transport (Adult TDO)
Time: Must be able to take custody within **6 hours.**
116
Time and Authority: Jail Inmate TDO
Time: Max initial hospitalization 30 days.
