(a) Acceptance for preliminary examination. In accordance
with Texas Health and Safety Code §573.021 and §573.022,
a hospital shall accept for a preliminary examination:
(1) an individual who has been transported to a hospital
by peace officer or emergency medical services personnel in accordance
with Texas Health and Safety Code §573.001 or §573.012;
or
(2) an individual who is at least 18 years of age or
older and who has been transported to the hospital by the individual's
guardian of the person in accordance with Texas Health and Safety
Code §573.003.
(b) Preliminary examination.
(1) A physician shall examine the person as soon as
possible within 12 hours after the time the person is apprehended
by the peace officer or transported for emergency detention by the
person's guardian, in accordance with Texas Health and Safety Code §573.021.
(2) The preliminary examination shall include:
(A) an assessment for medical stability; and
(B) a psychiatric examination to determine if the individual
meets the criteria described in subsection (c)(1) of this section.
(c) Requirements for emergency detention. A hospital
may admit a prospective patient for emergency detention only if:
(1) in accordance with Texas Health and Safety Code §573.022(a)(2),
a physician determines from the preliminary examination that:
(A) the prospective patient has a mental illness;
(B) the prospective patient evidences a substantial
risk of serious harm to self or others;
(C) the described risk of harm is imminent unless the
prospective patient is immediately detained; and
(D) emergency detention is the least restrictive means
by which the necessary detention may be accomplished;
(2) in accordance with Texas Health and Safety Code §573.022(a)(3),
a physician makes a written statement:
(A) documenting the determination described in paragraph
(1) of this subsection; and
(B) describing:
(i) the nature of the prospective patient's mental
illness;
(ii) the risk of harm the individual evidences, demonstrated
either by the prospective patient's behavior or by evidence of severe
emotional distress and deterioration in the prospective patient's
mental condition to the extent that the prospective patient may harm
themselves or another; and
(iii) the detailed information on which the physician
based the determination described in paragraph (1) of this subsection;
(3) based on the determination described in paragraph
(1) of this subsection, the physician issues an order admitting the
prospective patient for emergency detention; and
(4) the prospective patient meets the hospital's admission
criteria, as required by §568.21 of this subchapter (relating
to Admission Criteria).
(d) Release.
(1) A hospital shall release a prospective patient
accepted for a preliminary examination if:
(A) a preliminary examination of the prospective patient
has not been conducted within the time frame described in subsection
(b)(1) of this section; or
(B) in accordance with Texas Health and Safety Code §573.023(a),
the prospective patient is not admitted for emergency detention in
accordance with subsection (c) of this section on completion of the
preliminary examination.
(2) In accordance with Texas Health and Safety Code §576.007,
before releasing a prospective patient who is at least 18 years of
age or older, a hospital shall make a reasonable effort to notify
the prospective patient's family of the release if the prospective
patient grants permission for the notification.
(3) Before releasing a patient who is younger than
18 years of age, a hospital shall notify the patient's legally authorized
representative (LAR) or the LAR's designee of the release.
(4) Upon release, the hospital may release a minor
younger than 18 years of age only to the minor's LAR or the LAR's
designee.
(5) In accordance with Texas Health and Safety Code §573.021(b),
a person accepted for a preliminary examination may be detained in
custody for not longer than 48 hours after the person was presented
to the facility, unless a written order for protective custody is
obtained. If the 48-hour period ends on a Saturday, Sunday, legal
holiday, or before 4:00 PM on the first succeeding business day, the
person may be detained until 4:00 PM on the first succeeding business
day. If the 48-hour period ends at a different time, the person may
be detained only until 4:00 PM on the day the 48-hour period ends.
(e) Intake. A hospital shall conduct an intake process
as soon as possible, but not later than 24 hours after the time a
patient is admitted for emergency detention.
(1) The intake process shall include:
(A) obtaining, as much as possible, relevant information
about the patient, including information about finances, insurance
benefits and advance directives; and
(B) explaining to the patient and their LAR, when applicable,
orally and in writing, the patient's rights described in 25 TAC Chapter
404, Subchapter E (concerning Rights of Persons Receiving Mental Health
Services), including:
(i) the hospital's services and treatment as they relate
to the patient; and
(ii) the existence, purpose, telephone number, and
address of the protection and advocacy system of the state of Texas,
as required by Texas Health and Safety Code §576.008.
(2) The hospital shall determine whether the patient
comprehends the information provided in accordance with paragraph
(1)(B) of this subsection. If the hospital determines that the patient
comprehends the information, the hospital shall document in the patient's
medical record the reasons for such determination. If the hospital
determines that the patient does not comprehend the information, the
hospital shall:
(A) repeat the explanation to the patient at reasonable
intervals until the patient demonstrates comprehension of the information
or is discharged, whichever occurs first; and
(B) document in the patient's medical record the patient's
response to each explanation and whether the patient demonstrated
comprehension of the information.
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