Patient Administration - Army Publishing Directorate - U.S. Army

authorities, to the sponsor or NOK. When a nonmilitary patient with a psychiatric condition requires further hospitalization,
the MTF commander will contact the sponsor or NOK to ascertain whether the relative wishes to assume the
custody and responsibility for the patient’s care. The relative will be advised of all factors which render acceptance of
the patient inadvisable and of the responsibility in the care of such patient. The relative who accepts responsibility for
the patient will present an affidavit declaring his/her willingness to assume responsibility for the patient.
(1) When transfer to the NOK is inappropriate, the MTF commander will contact proper authorities of the State of
legal or current residence to obtain authorization to transfer the patient to State custody.
(2) To aid the State authorities in reaching a timely decision they should be provided—
(a) The patient’s diagnosis.
(b) The date of onset of the condition.
(c) History of previous hospitalization for mental illness.
(d) Residence.
(e) Place and date of birth.
(f) Name and address of the NOK.
(3) Commitment proceedings or laws for involuntary hospitalization vary among the States. Army MTF personnel
must be thoroughly familiar with local requirements for emergency involuntary admission to or retention in local
civilian facilities designated for the care of psychiatric patients.
5–24. Evacuation of military spouses from overseas areas to the United States
When a hospitalized military spouse is evacuated from an overseas area to an MTF in the United States and is
accompanied by a child or children but not by the military sponsor, plans will be made for the care of the children
while the parent is hospitalized. The overseas MTF commander will ensure that plans for the child or children are
coordinated with the social worker at the receiving MTF before the Family departs from the overseas area.
Chapter 6
Patients in Special Circumstances
6–1. General
This chapter prescribes procedures for preparing and maintaining records pertaining to VSI and SI patients, deceased
persons, and patients in certain special categories (SPECAT). It also contains authority for the MTF commander to
order autopsies. Notifications required under this chapter are exempt from reports control under provisions of AR 335-
15.
6–2. Very seriously ill, seriously ill, SPECAT, (not SI) hospital care required, and (not SI) hospital care
not required
a. Definitions. Definitions will be applied literally because international agreements require furnishing information
to certain foreign nations concerning VSI and SI patients. The action taken by these nations depends upon which
category the patient is placed. (See para 4-7.) VSI, SI, and SPECAT patients will be recorded as part of the DA Form
3821 (Report of Administrative Officer of the Day). DA Form 3821 is available on the APD Web site (www.apd.army.
mil/).
(1) A patient is VSI when the illness is of such severity that life is imminently endangered.
(2) A patient is SI when the illness is of such severity that there is cause for immediate concern, but there is no
imminent danger to life.
(3) A patient is SPECAT when one of the following conditions exist:
(a) Has a severe injury, such as loss of sight or limb.
(b) Has a permanent and unsightly disfigurement of a portion of the body normally exposed to view.
(c) Has an incurable and fatal disease and has limited life expectancy.
(d) Has an established psychiatric condition.
(e) May require extensive medical treatment and hospitalization.
(f) Has been released from the Service under the provisions of AR 635-40 for a psychiatric condition.
(g) Is paralyzed.
(4) A patient is classified (Not SI) hospital care required and (Not SI) hospital care not required by the hospital
commander/physician and reported to the CAC. (Not SI patients are of special interest to the CAC (for example, hostile
injuries, multiple or mass casualty (MASCAL) events) (AR 600-8-1). Not SI patient information is provided to the
CAC by the patient administrator upon request as it is available.
b. Records (for use in noncombat areas).
(1) DA Form 2984 (Very Seriously Ill/Seriously Ill/Special Category Patient Report). When a medical officer
AR 40–400 27 January 2010
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