Union Democrat staff

Tuolumne County leaders this week ratified policies regarding how county mental-health and law enforcement agencies, ambulance operators and Sonora Regional Medical Center staff should deal with psychiatric patients who could be dangerous to themselves or others.

The policies adopted by the Board of Supervisors on Tuesday come almost a year after a critical grand jury review of procedures, and nearly three years after a Sonora woman, dropped off by sheriff's deputies at Sonora Regional for a 72-hour psychiatric hold, walked away and was later found dead.

Marlo Chadwick's family sued the hospital in a civil case that was quietly settled earlier this month.

The adopted policies deal directly with so-called "5150" patients. The number refers to a section of state law allowing 72-hour detention of people who are a danger to themselves or others.

Chadwick, who died in July 2011, was such a case.

In Tuolumne County, 5150s are typically picked up by Sonora police officers or county sheriff's deputies and taken to Sonora Regional, where they are evaluated by a doctor and then wait to be picked up by a contracted mental hospital outside the county.

Tuolumne County hasn't had a mental holding facility since Tuolumne General Hospital and its psychiatric ward closed in 2009, and Sonora Regional has no means of legally holding people against their will.

As a result, patients can walk away, as Chadwick did, sometimes unnoticed.

Among the key provisions in Tuesday's agreement:

• 5150 cases taken to the Sonora Regional emergency room by a law enforcement officer will be given priority over others in the ER who are not in life-or-death situations or critically ill. The procedures also set a goal of evaluating a patient within 60 minutes. Patients have in the past left the hospital after lengthy stretches of waiting.

• A law enforcement officer may stay with a patient at the hospital until transferred if possible. Officers are legally allowed to hold such patients against their will, unlike hospital staff.

For the complete story, see the April 17, 2014, edition of The Union Democrat.