(a) CSU staff members, trained in accordance with §306.83(h)
- (i) of this subchapter (relating to Staff Training), must conduct
the intake and admission process in accordance with Texas Health and
Safety Code §572.0025(e) and §572.0025(h)(3).
(b) Voluntary admission into a CSU may be requested
by:
(1) an individual 16 years of age or older, in accordance
with Texas Health and Safety Code §572.001;
(2) the parent, managing conservator, or guardian of
an individual younger than 18 years of age, in accordance with Texas
Health and Safety Code §572.001 or Texas Family Code Chapter
35A;
(3) the adult caregiver of an individual, who has obtained
an order under Texas Family Code Chapter 35A when the individual is
younger than 18 years of age; or
(4) an individual with capacity to consent.
(c) A request for admission must be made in accordance
with Texas Health and Safety Code §572.001 and must:
(1) be in writing and signed by the individual, and
the individual's parent, adult caregiver, or LAR; and
(2) include a statement that the individual:
(A) has capacity to consent to the administration of
psychoactive medication, administered in accordance with Texas Health
and Safety Code §576.025;
(B) agrees to voluntarily remain in the CSU until discharge;
and
(C) consents to diagnosis, observation, care and treatment
until the earlier of one of the following occurrences:
(i) the discharge of the individual; or
(ii) the individual leaves the CSU after a request
for discharge is made, in accordance with Texas Health and Safety
Code §572.004.
(d) Voluntary admission occurs only if:
(1) a request for admission is made in accordance with
subsection (c) of this section;
(2) the individual receives pre-admission screening
and assessment, in accordance with the CSU's written policies and
procedures, to determine if a physician admission examination is required:
(A) if the pre-admission screening and assessment is
conducted by a physician, the physician may conduct the pre-admission
screening and assessment as part of the physician admission examination
referenced in §306.53(d) of this division (relating to Pre-admission
Screening and Assessment); and
(B) if the QMHP-CS or LPHA conducting pre-admission
screening and assessment determines:
(i) the individual does not need a physician admission
examination, then the CSU may not admit the individual and must refer
the individual to alternative services, as appropriate and available,
including LMHA, LBHA, or LIDDA crisis services; or
(ii) the individual does need a physician-admission
examination, a physician must conduct an admission examination of
the individual before CSU admission;
(3) a physician in accordance with Texas Health and
Safety Code §572.0025 (f):
(A) conducts either in person or through telemedicine
medical services, or consults with a physician who conducted, a physical
assessment and psychiatric admission examination within 72 hours before
or 24 hours after admission, as described in §306.53 of this
division (relating to Pre-Admission Screening and Assessment), and
may not delegate the examination to a non-physician; and
(B) provides an admission order;
(i) in writing and signed by the issuing physician;
or
(ii) if the order is provided orally or, if the electronic
order is unsigned, an original signed order must be provided to the
facility within 24 hours;
(4) the administrator or administrator's designee has
signed a written statement agreeing to admit the individual, in accordance
with Texas Health and Safety Code §572.0025; and
(5) a CSU staff member, trained in accordance with §306.83(i)
of this subchapter, completes intake procedures in accordance with
Texas Health and Safety Code §572.0025(e) and §572.0025(h)(3),
that includes:
(A) obtaining relevant information about the individual,
including information about finances, insurance benefits, and advance
directives;
(B) explaining, orally and in writing, the individual's
rights in a language and format easily understandable to the individual,
or the individual's LAR or adult caregiver, as applicable;
(C) explaining, orally and in writing, the CSU's services
and treatment as they relate to the individual;
(D) informing the individual, orally and in writing,
of the existence, telephone number, and address of the protection
and advocacy system established in Texas;
(E) informing the individual of the availability of
information and assistance from the Ombudsman by contacting the Ombudsman
at 1-800-252-8154 or online at hhs.texas.gov/ombudsman, and the Health
Facility Licensing complaints line at 1-888-973-0022; and
(F) determining whether the individual comprehends
the information provided in accordance with subparagraphs (B) - (E)
of this paragraph.
(e) An individual who is admitted to a CSU before the
physical assessment and psychiatric admission examination is conducted
must be discharged by the physician immediately if the physician conducting
the physical assessment and psychiatric examination of the individual
determines the individual does not meet the clinical standards to
receive inpatient mental health services, in accordance with Texas
Health and Safety Code §572.0025(f-1).
(f) A CSU that discharges an individual under the circumstances
described in (e) of this section may not bill the individual or the
individual's third-party payor for the temporary admission of the
individual to the CSU, in accordance with Texas Health and Safety
Code §572.0025(f-2).
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