Committee advances substitute to let successful freestanding psychiatric ED model operate without on‑site physician when guardrails exist

RICHMOND — A substitute to SB738 won subcommittee approval on Monday, preserving a narrowly tailored model that permits certain freestanding psychiatric emergency departments to operate without a full‑time, on‑site physician when several guardrails — including written transfer agreements with hospitals, EMS protocols, co‑location standards and video consultative services — are in place.

Sen. Jordan, sponsor of the substitute, said the change stems from successful local experience at Riverside, where a freestanding psychiatric emergency department has served thousands of patients since late 2023 with very few transfers for direct medical care. Riverside officials said 13,000 patients have been treated at their facility since opening and that only a small fraction — they described 19 patients in one period — required emergent medical transfer.

Supporters including hospital associations told the subcommittee the substitute preserves patient safety while removing an onerous staffing requirement that has hindered the model’s replication. Stacy Johnson, hospital president at Riverside Mental Health and Recovery Center, described protocols and local EMS coordination designed to keep patients safe.

Opponents, including the Virginia College of Emergency Physicians represented by Amy Perrin Savard, said emergency departments need 24/7 physician presence for walk‑in emergencies and urged caution even with narrow substitutes.

The committee adopted the substitute and reported the bill, with sponsors emphasizing the intent to expand a successful, narrowly tailored model across the state if safety metrics hold.

What happens next: The substitute was reported out of subcommittee; the bill will go on for further legislative consideration.