So the cops came, Alex and Drea spent hours and hours at the ER in Rockville. They arrived at noon and spent hours waiting, then filling out paper work, then a psychiatric evaluation, and finally a recommendation for her to get acute care and then longer-term residential.
I finally thought we had success until they told us there were no beds available in treatment facilities in the area. Well, of the facilities who took her insurance.
Only place in the area that accepted her insurance, had a bed available and it was located in Hagerstown, Maryland–2 hours away… They would have an ambulance ready to take sister and Drea up to Hagerstown, but they probably wouldn’t get there until 1 or 2 in the morning. Alex didn’t have a car, didn’t have cash (or a way of getting cash) and would be stranded. Hagerstown. She also didn’t even have a jacket for the increasingly cold night.
I called the Hagerstown clinic and they told me that they don’t have a waiting room and she would be kicked out after Drea was admitted.
God, this story is already long, but to shorten it some:
I called the Hagerstown clinic screaming that they would have two patients they would be dealing with and not one if my sister went. She would be pulling an all-nighter (for the second or third night in a row after all she went through with Drea earlier in the week and with her own illness on Thursday night)
Hagerstown called Rockville to sort out the fact that my sister, with pulmonary hypertension, was in no condition to commute to Hagerstown and then spend the night OUTSIDE of the hospital. freezing without her coat, tired and sick 
Finally, Rockville called me and after yelling, screaming, and crying, I got them to cancel the ambulance, allow niece to stay overnight (with my sister) and then figure out where to go next.
Turns out that by screaming and getting them to wait until the next day, a bed opened up across the street from Rockville hospital!
Relief. Now I wait to see how this week turns out in acute care. If Drea is on good behaviour and doesn’t seem out of control, they may send her home. If she gets worse or shows signs of deep disturbance, they may send her to residential.
She’s been under acute hospital care at least 4 times since November and it seems to be getting worse and worse. I pray that they find residential to be her next step so the cycle ends.