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• - Portsmouth City Council approved the casino development proposal with a casino developer Tuesday. The City Council approved the proposal with Rush Street Gaming, headquartered in.
• (WAVY) — It’s a good bet that casino gaming is coming to Hampton Roads. Preliminary results show that Norfolk and Portsmouth residents voted in favor of a referendum that would.

Virginia is one of the last states in the nation to legalize casino gambling. In 2019 the state legislation approved five cities as locations to build casino resorts.

Four of these cities selected a casino proposal from the plans submitted by applicants, and final approval was granted by local voters in the Nov 2020 election. The fifth city, Richmond, delayed their casino process by one year.

Tribal Casinos
Virginia remains a state with no Indian gaming casinos, however, two of the state-licenced casinos will be developed and operated by Native American gaming companies.

Virginia's First Casinos

Five cities have been authorized by legislation to host casinos. Four cities have approved a casino referendum - Bristol, Danville, Norfolk and Portsmouth. These four casino are entering a development stage in early 2021.The fifth casino designated for Richmond will follow by one year.

Virginia casinos will operate under state licenses issued by the Virginia Lottery Board. None of the casinos will operate under the U.S. Indian Gaming Regulatory Act, however, two of Virginia's first four casinos will be operated by Native American tribes.

• The Norfolk Resort & Casino is owned and operated by the Pamunkey Indian Tribe.

• Hard Rock Casino in Bristol is operated by Hard Rock International, which is owned by the Seminole Tribe of Florida.

Projected Casino Opening Dates

Virginia's first four casinos will start construction in 2021 and open to the public in late 2022 and early 2023. The Richmond casino will follow a year later.

Virginia's Casino Gaming Laws

In March 2019 a new casino gaming law was passed by the state general assembly and signed by the governor. In the Nov. 2020 election voters approved construction of casinos in the four cities of Bristol, Danville, Norfolk and Portsmouth.

'Casino Gaming'
Virginia law defines casino gaming as follows:

'... baccarat, blackjack, twenty-one, poker, craps, dice, slot machines, sports betting, roulette wheels, Klondike tables, punchboards, faro layouts, keno layouts, numbers tickets, push cards, jar tickets, pull tabs, online gaming, and any other activity that is authorized by the Board as a wagering game or device under Chapter 41 (§ 58.1-4100 et seq.).

Source: http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+SB1126ER

News Headlines

Virginia Sports Betting began Jan 1January 7, 2021 - January 1st was the beginning date for legalized sports betting in Virginia. The first online sportsbooks are expected to launch later this month just in time for Super Bowl LV on February 7th. A maximum of 12 operators... Read moreRichmond casino will be selected from three proposalsDecember 29, 2020 - Voters in Richmond, Virginia will decide in a Nov 2021 election whether to approve or reject a casino for their city. The casino proposed on the ballot will be selected by the Richmond City Council... Read moreRichmond casino timeline through 2023December 7, 2020 - Richmond is starting the year-long process to select a casino applicant for development of a casino resort within its city. Richmond was one of five cities authorized by the Virginia General Assembly to build a casino... Read moreTimeline for opening new Virginia CasinosNovember 29, 2020 - he Virginia Lottery Board has begun the long process towards licensing and opening the first Vegas-style casinos in Virgnia after voters in Bristol, Danville, Norfolk, and Portsmouth approved casino referendums... Read more Headlines continued...

Approved Casinos

Virginia legislation allows casino gambling in five cities: Danville, Bristol, Portsmouth, Norfolk and Richmond. Richmond residents will vote later on a ballot measure to approve a casino. The other four cities voted approvals on Nov. 3, 2020.

BRISTOL, VIRGINIA
HARD ROCK CASINO BRISTOL
This $150M casino proposal would build a 90,000-square-foot casino, a live concert venue, and a 600-1000 room hotel.

DANVILLE, VIRGINIA
CAESARS VIRGINIA
The Danville City Council members voted unanimously Jan 3 to support the state legislators effort to allow casino gambling in Danville.

NORFOLK, VIRGINIA
NORFOLK RESORT & CASINO
The Pamunkey Indian Tribe is proposing a $700M casino and hotel be built on the Norfolk waterfront next to the minor league baseball stadium. An option to buy the land for $10M has been signed with the city.

PORTSMOUTH, VIRGINIA
RIVERS CASINO PORTSMOUTH
The Portsmouth casino would be built on the Elizabeth River near the marina on property once occupied by a Holiday Inn.

RICHMOND, VIRGINIA
RICHMOND CASINO - Future
The city of Richmond has started the process of selecting a casino operator and location by summer 2021. Voter approval will be Nov. 2021.

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News Articles

Virginia Sports Betting began Jan 1

January 7, 2021

January 1st was the beginning date for legalized sports betting in Virginia. The first online sportsbooks are expected to launch later this month just in time for Super Bowl LV on February 7th.

Last July the Virginia General Assembly authorized the Virginia Lottery to license and oversee all sportsbook operations in the state. A maximum of 12 licenses is authorized, and nearly two dozen applications have been received. It is expected that four licenses will be issued to the recent voter-approved casinos: Caesars Virginia in Danville, Hard Rock Casino in Bristol, Pamunkey Tribe's Resort & Casino in Norfolk and Rivers Casino in Portsmouth. The other eight will likely be issued to established operators such as DraftKings, FanDuel, BetRivers, and others. One may be held for the future Richmond Casino.

Sports betting in Virginia is expected to generate $400 million in annual revenues. The state will collect 15% of the revenue as taxes.

Back Full Page >Virginia Casinos Updates 2021

Timeline for opening new Virginia Casinos

November 29, 2020

The Virginia Lottery Board has begun the long process towards licensing and opening the first Vegas-style casinos in Virginia. Those casinos will be Hard Rock Casino Bristol in Bristol, Caesars Virginia in Danville, Norfolk Resort & Casino in Norfolk and Rivers Casino Portsmouth in Portsmouth.

Here is the expected timeline from today until the first casinos open:

November 2020
Virginia Lottery attorneys have begun preparing casino gaming regulations soon after November 3 when Bristol, Danville, Norfolk, and Portsmouth approved casino referendums for their cities.

February 2021
The Virginia Lottery Board will see a draft version of the regulations in February 2021. A final version is expected to be approved by April 2021.

April 2021
Kevin Hall, Executive Director of the Virginia Lottery, anticipates 'to begin accepting the first casino applications shortly after the initial regs take effect in April.' All casino applicants will undergo an extensive criminal and financial background investigation that could take up to a year.

Spring-Summer 2021
The first casino operator licenses will be issued in the spring or summer of 2022.

Spring 2022
The first new casinos are expected to open in Virginia.

Temporary Casinos
Hard Rock Bristol proposed a temporary casino while its main casino is under construction, however, this is unlikely because a temporary casino follows the same licensing provisions and procedures as a permanent casino.

Back Full Page >Virginia Casinos Updates 2021

Virginia voters approve casinos in four cities

November 5, 2020

Local voters in Bristol, Danville, Norfolk and Portsmouth approved local referendums to build casinos in their respective cities. Votes were 2 to 1 in favor of these casinos.

Bristol Casino
HARD ROCK CASINO BRISTOL
This $400 million casino and hotel project that will be built on the site of the former Bristol Mall. The plan includes a 90,000-square-foot casino, a live concert venue, and a 600-1000 room hotel.

Danville Casino
CAESARS VIRGINIA
This $400 million casino and hotel project will be built at the former site of Dan River Mills' Schoolfield Division. It includes a casino, restaurants, 2,500-seat live entertainment center, conference space, and a 300-room hotel with spa.

Norfolk Casino
NORFOLK RESORT & CASINO
The Pamunkey Indian Tribe plans a $500 milliion casino and hotel on the Norfolk waterfront next to the minor league baseball stadium. The project includes a casino with 3,000 slot machines, 150 table games and a 300-room hotel.

Portsmouth Casino
RIVERS CASINO PORTSMOUTH
This $300 million casino and hotel project will be built on the Elizabeth River near the marina on property of the former Holiday Inn. It features 400,000 square feet of gaming and entertainment including a 3,000-seat entertainment center and a 4-star hotel.

Back Full Page >Virginia Casinos Updates 2021

VA Govenor amends and returns casino bill to legislature

April 12, 2020

Governor Ralph Northam supports the expansion of gaming in Virginia, however, he did not sign the gaming bill sent to him by the legislature. Instead he amended the bill and returned it to the legislature to reconsider.

The key provision amended by the governor was the distribution of gaming revenues received by the state. Instead of designating the income to the Virginia General Fund as prescribed in the bill, the governor wants two-thirds sent to state education programs.

The General Assembly will now reconvene on the issue to complete the bill. If the governor's changes are approved, the bill becomes law. If rejected or no action is taken, the governor will make the final decision by either signing or vetoing the bill.

Back Full Page >Virginia Casinos Updates 2021

Virginia moves to legalize casinos, sports betting

March 13, 2020

This week the Virginia General Assembly gave its final approvals to a major expansion in state gambling by passing two bills to legalize casinos and sports betting.

SPORTS BETTING BILL

Online sports betting will be legalized for professional sports and college sports excluding Virginia schools. These may become available by end of year.

Permits to operate a sports betting website or app will be limited to 12. This limit does not apply to the casinos or major sport teams in Virginia. Professional teams like the Washington Redskins and others based in the state can also build brick-and-mortar sportsbooks in Virginia-based stadiums.

Sports betting will not be included in the 'skill games' betting machines that are widely available in convenience stores, truck stops and restaurants.

CASINO BILL

Casinos will be built in Bristol, Danville, Richmond, Norfolk and Portsmouth if approved by local voters. Referendums on each casino and its location will be held later this year.

Pamunkey Indian Tribe plan to build casinos in Richmond and Norfolk.

'After centuries of disenfranchisement and social injustices, the Pamunkey Tribe is on the verge of ensuring the long-term success of the Tribe. Its plans to build two resorts with casinos will allow the Tribe to provide needed programs and services to its members. It will be a great partner for Norfolk and Richmond.'

Pamunkey spokesman Jay Smith

NEXT STEP

Both bills are noW waiting for Gov. Ralph Northam's for signature.

Back Full Page >Virginia Casinos Updates 2021

Virginia governor remains noncommittal on casino legislation

January 17, 2020

Gov. Ralph Northam said he is open to the idea of casino legalization in Virginia, but has not taken a position on Bill SB1126, which must be reenacted by both the House and the Senate in this session. If passed, the governor will make the final decision on whether to sign the legislation into law and legalize casino gambling in the state.

Bill SB1126 was introduced in the 2019 legislative session. It has been amended by both houses and must be reenacted in the 2020 Session of the General Assembly.

The bill will authorize casino gambling in a limited number of cities. The Virginia Lottery Board will license and regulate the casinos. City residents must vote to approve these casinos.

For a full summary of the bill and its amendments, visit SB 1126 Lottery Board; regulation of casino gaming, penalties, report.

Back Full Page >Virginia Casinos Updates 2021

2020 Preview: Virginia Casino Legalization?

January 7, 2020

One of the hot topics for the Virginia legislature in 2020 will be casino gambling. Virginia is currently one of nine states that prohibit casinos.

In March 2019 a casino law was passed by the state general assembly and signed by the governor that will give local voters an opportunity this year to approve or disapprove casinos in five proposed cities: Bristol, Danville, Richmond, Norfolk and Portsmouth.

The legislature also directed a study by the Joint Legislative Audit and Review Commission (JLARC) to determine the impact of casinos on these communities. The results of the JLARC's report were these:

• Casinos would generate $260 million a year in new state gaming taxes.

• Casinos would create 5,000 new jobs.

• A northern Virginia casino would generate an additional $155 million in state gaming taxes, and create an additional 3,200 jobs.

The Virginia general assembly is caonsidering bill SB1126 in the 2020 session for the next step towards the legalization of casinos. If passed and if residents approve a local casino referendum later this year, the first Virginia casino will open after 12-18 months of construction.

For details on the cities with current casino proposals, read these pages:

Back Full Page >Virginia Casinos Updates 2021

Virginia Gov Signs Casino Gambling Bill

March 26, 2019

Governor Ralph Northam signed Senate Bill 1126 into law Friday in an essential step toward authorizing casino gambling in Virginia. The bill had passed the Senate 30-10 and the House 64-33.

The new law is not the final authorization needed to build casinos. The final authorization can only be granted by voters in a November 2020 referendum ballot.

There are additional steps defined between now and the referendum that will be the responsibility of the Lottery Board. This law authorizes the Lottery Board to regulate all casino gaming and provides a framework for the Board to follow in drafting its policies, rules and procedures.

SB 1126 SUMMARY: 'Lottery Board; regulation of casino gaming, penalties'

• Casino gaming will be regulated by the Virginia Lottery Board.

• Casino gaming will only operate in five cities: Bristol, Danville, Portsmouth, Richmond and Norfolk.

• City residents must approve the casino by referendum.

• The Joint Legislative Audit and Review Commission (JLARC) will research casino gaming laws in other states and submit a report before December 1, 2019.

• Referenda must be held after the JLARC report and before January 1, 2021.

• After the Lottery Board drafts its gaming regulations, the 2020 Session of the General Assembly must re-enact the bill.

• The Lottery Board cannot issue casino licenses prior to July 1, 2020.

Casino Gaming, Sports Betting and Online Gambling

This law specifies the following definition of casino gaming, which implies the legalization of sports betting and online gambling.

'Casino gaming' means baccarat, blackjack, twenty-one, poker, craps, dice, slot machines, sports betting, roulette wheels, Klondike tables, punchboards, faro layouts, keno layouts, numbers tickets, push cards, jar tickets, pull tabs, online gaming, and any other activity that is authorized by the Board as a wagering game or device under Chapter 41 (§ 58.1-4100 et seq.).

Back Full Page >Virginia Casinos Updates 2021

Virginia General Assembly Passes Casino Bill

February 24, 2019

The General Assembly voted today to legalize casino gambling in Virginia and grant regulation authority to the Virginia Lottery Board.

The bill passed the Senate 30-10 and the House 64-33. To become law it requires the signature of the governor and a voter referendum to authorize an amendment to the state constitution.

Under the provisions of the bill the Virginia Lottery Board would develop rules and regulations for casino gambling and procedures for licensing casino applicants. The regulations must be completed and approved before June 30, 2020. Casino licenses will be issued after July 1, 2020.

The bill specifies five cities where casinos can be built: Bristol, Danville, Portsmouth and either Norfolk or Richmond. Residents must vote to approve or disapprove the casino planned for their city. Referenda must be passed before Jan. 1, 2021.

The state would tax each casino 13 to 15 percent of the annual adjusted gross revenue.

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First Virginia Casino Bill Passes Senate Committee

Danville, Bristol, Portsmouth, Norfolk and Richmond Selected for Casinos

January 21, 2019

The Senate Committee on General Laws and Technology voted 9-3-1 to pass Senate Bill 1126, the first major step taken to legalize casinos in Virginia.

The bill allows five cities to hold referendums this fall to determine whether voter approve or disapprove of casino projects in their cities. The five cities are Danville, Bristol, Portsmouth, Norfolk and Richmond. Casino licenses would be issued beginning July 1, 2020.

The Pamunkey Indian Tribe can apply for a federally approved casino but has announced its interest in pursuing a commercial casino license with the state. '... we believe that if the Commonwealth is ready to authorize gaming, our project should be part of it,' said Robert Gray, Pamunkey Indian Tribe Chief. Possible sites for the Pamunkey casino are Norfolk and Richmond.

Under the term of the Bill, the state would receive 10% of gross revenues from each licensed casino. Half would go to cities where casinos are located and the remainder would stay with the state for public school construction and the general fund.

Back Full Page >Virginia Casinos Updates 2021

Virginia tribes celebrate federal recognition

October 05, 2018

On Wednesday a celebration was held by members of seven Virginia Indian tribes over the federal government granting formal recognition.

Representatives and officials from the Nation Park Service, Virginia governor's office, senate offices, and Secretary of the Interior Ryan Zinke, U.S. Rep. Rob Wittman were in attendance.

The federal recognition allows the tribes to apply for federal services and funding.

For decades these tribes have attempted to obtain their federal recognition. They include the Chickahominy, Chickahominy Eastern Division, Rappahannock, Pamunkey, Nansemond, Upper Mattaponi, and the Monacan tribes.

The first Virginia tribe to receive federal recognition was the Pamunkey Tribe in January 2016. The tribe has plans to develop a $700 million casino on land approved by the Bureau of Indian Affairs.

Back Full Page >Virginia Casinos Updates 2021

A politician from Virginia is pushing for a Portsmouth casino

August 26, 2012

A bill has been submitted by Sen. Louise Lucas. It will be available for the next session of the General Assembly. The decision behind the new gaming bill was related to a visit to Maryland. The senator was impressed by the success of their two month old casino. Maryland earns 67 percent of the gaming revenue.

Portsmouth is the proposed area for the new casino. She believes that area would help retain casino goers from going to another state to gamble.

Currently the state is having a difficult time finding ways to raise funds for the various programs. Residents of the state are against highway tolls and raising taxes. Lucas believes that casino gaming may be a solution to help pay for education and infrastructure.

Back Full Page >Virginia Casinos Updates 2021

News Headlines Continued

2020 Election: Virginia voters approve casinos in four citiesNovember 5, 2020 - Local voters in Bristol, Danville, Norfolk and Portsmouth approved local referendums to build casinos in their respective cities. Votes were 2 to 1 in favor of these casinos.... Read more 2020 Election: Norfolk voters approve Pamunkey Tribe casino planNovember 6, 2020 - On Tuesday the voters in Norfolk approved a plan by the Pamunkey Indian Tribe to build a $500M resort & casino on the Elizabeth River waterfront near Harbor Park.... Read more 2020 Election: Danville voters approve Caesars Virginia casino planNovember 5, 2020 - The proposed $400M Caesars Virginia was approved by Danville voters this week. The project includes a casino, a 2,500-seat entertainment venue and a 300-room hotel.... Read more 2020 Election: Portsmouth voters approve Rivers Casino planNovember 5, 2020 - The $300M Rivers Casino Portsmouth was approved by Portsmouth voters this week. The project includes a casino, a 3,000-seat entertainment venue and a hotel. The location is... Read more2020 Election: Hard Rock Casino in Bristol, VA is approved by votersNovember 4, 2020 - Voters in Bristol, Virginia yesterday approved a ballot referendum to build a $400 million Hard Rock Hotel & Casino at the former Bristol Mall. The vote was 71% in favor.... Read more Hard Rock Bristol plans temporary casino during main constructionNovember 2, 2020

Hampton Casino Va

- If the Hard Rock Hotel and Casino planned for Bristol, Virginia is approved by voters tomorrow, Hard Rock will build a temporary casino to operate until construction is finished on... Read more Hard Rock Bristol forecasts employment opportunitiesOctober 22, 2020 - As the Nov. 3 election approaches, a job information event supporting the proposed Hard Rock Casino in Bristol was held by executives of Hard Rock International and Bristol's Chamber... Read more Pamunkey Tribe selects development team for Norfolk casinoOctober 21, 2020 - Last week the Pamunkey Tribe announced the hiring of a two-company development team for their proposed Norfolk Resort Casino. HKS Architects designed AT&T Stadium Dallas... Read more Pamunkey Tribe makes final push for Norfolk casinoOctober 20, 2020 - As the Nov. 3 election nears the Pamunkey Indian Tribe is making a final push for voter approval to build a casino near Harbor Park. The casino is supported by the Yes Norfolk Committee... Read more Bristol Hard Rock Hotel & Casino Preview VideoSeptember 22, 2020 - Developers of the planned Bristol Hard Rock Hotel & Casino in Bristol, Virginia discuss the features and amenities designed for the property.... Read more Bristol Hard Rock Hotel & Casino unveils new 3D modelSeptember 22, 2020 - A 3D model of the planned Hard Rock Bristol Hotel and Casino in Bristol went on public display last Thursday at the former Bristol Mall. The model shows the casino, entertainment venue... Read more TV ads seeks voter support for Hard Rock BristolSeptember 11, 2020 - The 'Vote Yes For Bristol' campaign launched its first TV ads this week in a major effort to win voter approval in the Nov. 3 election to build the Hard Rock Hotel & Casino in Bristol, Virginia.... Read moreNorfolk Resort Casino voter campaign is launchedSeptember 7, 2020 - The 'All In Norfolk' campaign to gather voter support for the Norfolk Resort Casino is officially underway. The Norfolk casino requires voter approval in the Nov. 3, 2020 election for construction... Read more Hard Rock Casino Bristol receives local business supportSeptember 6, 2020 - A coalition of Bristol businesses has announced support for the Hard Rock Casino project and the 'Vote Yes For Bristol' ballot referendum. The coalition is named 'Small Businesses for Bristol'... Read moreHard Rock Bristol Nov 3 election ballot updateJuly 21, 2020 - The Bristol City Council unanimously approved a resolution last week seeking to add a voter referendum on the Hard Rock Casino plan for Bristol on the ballot for the upcoming Nov 3 general election.... Read moreHard Rock Bristol plan is pre-certified by VA Lottery BoardJuly 17, 2020 - The Virginia Lottery Board has OK'd plans for the proposed Hard Rock Casino in Bristol. The board's action paves the way for a Nov 3 ballot referendum to allow Bristol residents to approve... Read more Hard Rock Bristol will build a temporary casinoJuly 4, 2020 - Hard Rock Bristol will apply for a gaming license to operate a temporary casino inside the former Bristol Mall adjacent to the future site of the permanent Hard Rock Casino Bristol.... Read more Hard Rock Casino Bristol is approved by City CouncilMay 26, 2020 - The City Council of Bristol, Virginia voted 5-0 to approve the casino proposal from Hard Rock International. Next steps are approval by the Virginia Lottery Board followed by voter approval on... Read moreVA Govenor amends and returns casino bill to legislatureApril 12, 2020 - Gov. Northam supports gambling in Virginia, however, he did not sign the gaming bill sent to him by the legislature. Instead he amended and returned it to the legislature to reconsider.... Read moreVirginia moves to legalize casinos, sports bettingMarch 13, 2020 - This week the Virginia General Assembly gave its final approvals to a major expansion in state gambling by passing bills to legalize sports betting and build casinos in Richmond, Norfolk, Portsmouth,... Read morePamunkey Indian Tribe proposes $350M Richmond casino resortJanuary 23, 2020 - The Pamunkey tribe have announced plans to build a $350 million Indian gaming casino in South Richmond. The project includes a 275-room hotel, spa, pool and fitness center... Read morePamunkey tribe and Norfolk sign casino agreementsJanuary 16, 2020 - The Pamunkey Tribe and the City of Norfolk signed two agreements advance the tribe's plan to build a $700 million casino on the Elizabeth River.... Read more

Casino To Open In Hampton Va Restaurants

Virginia governor remains noncommittal on casino legislationJanuary 17, 2020 - Gov. Ralph Northam has stated he is open to the idea of casino legalization, but has not taken a position on Bill SB1126 which will be debated and amended in this year's legislature... Read moreCherokee propose casino in southwestern VirginiaJanuary 15, 2020 - The Eastern Band of Cherokee Indians (EBCI) last week announced plans for building a casino, hotel, indoor water park and outdoor concert venue on a 350-acre tract known as The Pinnacle.... Read more2020 Preview: Virginia Casino Legalization?January 7, 2020 - Casinos are prohibited in Virginia, however legislation passed last year may open the door to legalization of casinos. A study shows casino gambling will add 5,000 jobs and $260M in state taxes... Read more Virginia Casino News Archive ...

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HAMPTON NOTES

Latest News

Face-to-Face Appointment Update

QUESTION:
When will we reopen our face-to-face services?

ANSWER:
We have been actively planning our phased approach for reopening face-to-face services that were put on hold to prevent the spread of COVID-19 in the early stages of the pandemic. Due to the increased cases of COVID-19 in Hampton Roads, our facilities are not ready to resume face-to-face services just yet.
Reopening criteria that align with VA, federal, state, and the White House must be met before reintroducing selected services, such as a decline in COVID-19 for 14 days. Unfortunately, we are not there in our region yet.
Once we have met the reopening criteria, we will start reopening services in a phased approach.
In the meantime, we are actively learning and watching other VA facilities that are reopening sooner. Facility leadership will continue to keep Veterans informed about when it is safe for the facility to begin expanding care. Safe care is our mission and our continuing commitment to every Veteran every time.
We encourage our Veterans to call the call center or email their primary care team via secure messaging on MyHealtheVet to schedule a telehealth appointment to review their needs.

UPDATE*** COVID-19 Screening and Manditory Masking:

• All individuals that enter any VA facility are required to wear a face mask, and will be pre-screened for COVID19. To include Veterans, employees, visitors, volunteers, and contractors.
• No entry of anyone who is ill with seasonal flu or COVID-19 symptoms, including: fever, shortness of breath, coughing.
• Individuals suspect of COVID19 will be redirected to a secondary screening outside the facility to determine the next clinical steps

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