(a) Criteria for involuntary admission under order
of emergency detention. In accordance with Texas Health and Safety
Code §573.021, a CSU administrator may accept an individual for
a preliminary examination who is:
(1) apprehended, and transported to the CSU by a peace
officer, in accordance with Texas Health and Safety Code §573.001(a)
and §573.005; or
(2) an adult who is transported to the CSU by the individual's
family member or LAR in accordance with Texas Health and Safety Code §573.003.
(b) Preliminary examination under order of emergency
detention. A physician must conduct an individual's preliminary examination
in accordance with Texas Health and Safety Code §573.021 and
as described in §306.53(d) of this division (relating to Pre-admission
Screening and Assessment). The individual's preliminary examination
must:
(1) occur as soon as possible, but no later than 12
hours after:
(A) the individual is apprehended by the peace officer;
or
(B) the individual's LAR transports the individual
to the CSU for emergency detention; and
(2) include:
(A) an assessment for medical stability; and
(B) a psychiatric examination to determine if the individual
meets the criteria described in the emergency detention requirements
listed in subsection (c) of this section.
(c) Requirements for emergency detention. When clinically
indicated, a CSU physician may initiate an emergency detention proceeding
in accordance with Texas Health and Safety Code §572.004(d).
A CSU physician may admit an individual for emergency detention in
accordance with Texas Health and Safety Code §573.022(a)(2),
only if:
(1) a physician determines from the preliminary examination
that:
(A) the individual has a mental illness;
(B) the individual evidences a substantial risk of
serious harm to self or others;
(C) the described risk of harm is imminent unless the
individual is immediately detained; and
(D) emergency detention is the least restrictive means
by which the necessary detention may be accomplished;
(2) a physician makes a written statement, in accordance
with Texas Health and Safety Code §573.022 that:
(A) documents the determination described in paragraph
(1) of this subsection; and
(B) describes:
(i) the nature of the individual's mental illness or
SED;
(ii) the specific risk of harm to self or others the
individual evidences, demonstrated either by behavior or evidence
of severe emotional distress;
(iii) the deterioration of mental condition to the
extent that the individual cannot remain at liberty; and
(iv) the detailed information on which the physician
based the determination described in paragraph (1) of this subsection;
(3) the physician writes an order admitting the individual
for emergency detention based on the determination described in paragraph
(1) of this subsection; and
(4) the individual meets the CSU's admission criteria,
as required by §306.51 of this division (relating to Admission
Criteria).
(d) Release of an individual from emergency detention.
(1) A CSU administrator, or administrator's designee,
must release an individual accepted for a preliminary examination
if:
(A) a preliminary examination of the individual has
not been conducted within 12 hours, in accordance with Texas Health
and Safety Code §573.021; or
(B) the individual is not admitted to the CSU under
order of emergency detention on completion of the preliminary examination
in accordance with Texas Health and Safety Code §573.023(a).
(2) A CSU administrator, or administrator's designee,
must release an individual determined ineligible for admission under
emergency detention in accordance with the requirements in Texas Health
and Safety Code §576.007. Before releasing an individual, the
CSU must:
(A) make a reasonable effort to notify the individual's
LAR, if applicable, and any other person authorized by the individual
of the individual's release;
(B) document the individual's refusal of notification
in the individual's medical record, if applicable; and
(C) coordinate with the individual, the individual's
LAR, if applicable, or the apprehending county to arrange the individual's
transportation after release, in accordance with Texas Health and
Safety Code §573.024(a) - (d), to:
(i) the location of the individual's apprehension;
(ii) the individual's residence in this state; or
(iii) another suitable location identified by the individual
or LAR, if applicable.
(e) Intake under Emergency Detention. A CSU staff member,
trained in accordance with §306.83(h) - (i) of this subchapter
(relating to Staff Training), must:
(1) conduct the intake of an individual as soon as
possible, but no later than 24 hours after the time an individual
is apprehended for emergency detention, as described in §306.55
of this division (relating to Voluntary Admission Criteria and Intake
Process; and
(2) advise the individuals of their rights and determine
whether the individual comprehends the rights for individuals apprehended,
detained, or transported for emergency detention provided in accordance
with Texas Health and Safety Code §573.025 and consent rights
and information described in §306.51 and §306.55 of this
division, and if the staff member determines that the individual:
(A) comprehends the information, the CSU must document
in the individual's medical record the reasons for such determination;
or
(B) does not comprehend the information, the staff
member must:
(i) repeat the explanation to the individual daily
within 24-hour intervals until the individual demonstrates comprehension
of the information or is discharged, whichever occurs first; and
(ii) document in the individual's medical record the
individual's response to each explanation and whether the individual
demonstrated comprehension of the information.
(f) Criteria for involuntary admission under an order
of protective custody.
(1) When clinically indicated, a CSU physician may
initiate an application to request an order of protective custody
of an individual in accordance with Texas Health and Safety Code §574.021.
(2) A CSU physician may admit an individual under an
order of protective custody only if a court has issued a protective
custody order in accordance with Texas Health and Safety Code §574.022.
(g) Intake under order of protective custody.
(1) A CSU staff member trained in accordance with §306.83(h)
- (i) of this subchapter:
(A) must conduct an intake of an individual, as described
in §306.55(d)(5)(A) - (D) and §306.55(d)(5)(F) of this division,
as soon as possible, but no later than 24 hours after the time an
individual is accepted for protective custody; and
(B) advise the individual of their rights in accordance
with Texas Health and Safety Code §573.0025 and determine whether
the individual comprehends the rights and consent information described
in §306.51 of this division and §306.55(d)(5) of this division.
(2) If the CSU staff member determines that the individual:
(A) comprehends the information, the staff member must
document in the individual's medical record the reasons for such determination;
or
(B) does not comprehend the information, the staff
member must:
(i) repeat the explanation to the individual daily
until the individual demonstrates comprehension of the information
or is discharged, whichever occurs first; and
(ii) document in the individual's medical record the
individual's response to each explanation and whether the individual
demonstrated comprehension of the information.
(3) A CSU staff member is not required to conduct another
intake if the intake was conducted when the individual was admitted,
or within 24 hours before the issuance of the order of protective
custody.
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