| (a) With the exceptions of Waco Center for Youth, a
maximum-security unit, and an adolescent forensic unit, an SMHF or
facility with a CPB may admit an individual, who has been assessed
by an LMHA or LBHA and recommended for inpatient admission, only if
the individual has a mental illness and, as a result of the mental
illness:
(1) presents a substantial risk of serious harm to
self or others; or
(2) evidences a substantial risk of mental or physical
deterioration.
(b) An individual's admission to an SMHF or facility
with a CPB may not occur if the individual:
(1) requires specialized care that is not available
at the SMHF or facility with a CPB; or
(2) has a physical medical condition that is unstable
and could reasonably require inpatient medical treatment for the condition.
(c) If an individual arrives at an SMHF or facility
with a CPB for mental health services, and the individual was not
screened or referred by an LMHA or LBHA as described in §306.163
of this subchapter (relating to Most Appropriate and Available Treatment
Options):
(1) the SMHF or facility with a CPB notifies the designated
LMHA or LBHA that the individual has presented for services at the
SMHF or facility with a CPB; and
(2) the SMHF or facility with a CPB physician determines
if the individual has an emergency medical condition and the physician
decides whether the facility has the capability to treat the emergency
medical condition.
(A) If the SMHF or facility with a CPB has the capability
to treat the emergency medical condition, the facility admits the
individual as required by the Emergency Medical Treatment and Active
Labor Act (EMTALA) (42 USC §1395dd).
(B) If the SMHF or facility with a CPB does not have
the capability to treat the emergency medical condition in accordance
with EMTALA, the facility provides evaluation and treatment within
its capability to stabilize the individual and arranges for the individual
to be transferred to a hospital that has the capability to treat the
emergency medical condition.
(d) If an LMHA or LBHA authorized an individual's admission
to an SMHF or a facility with a CPB and the facility determines that
the individual does not meet inpatient criteria for admission, the
facility contacts the designated LMHA or LBHA to coordinate alternate
outpatient community services. The designated LMHA or LBHA must contact
the individual within 24 hours after being notified that the individual
does not meet inpatient admission criteria.
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