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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 306BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER DMENTAL HEALTH SERVICES--ADMISSION, CONTINUITY, AND DISCHARGE
DIVISION 3ADMISSION TO A STATE MENTAL HEALTH FACILITY OR A FACILITY WITH A CONTRACTED PSYCHIATRIC BED--PROVIDER RESPONSIBILITIES
RULE §306.176Admission Criteria for a Facility with a Contracted Psychiatric Bed Authorized by an LMHA or LBHA or for a State Mental Health Facility for Emergency Detention

(a) Acceptance for preliminary examination. In accordance with Texas Health and Safety Code §573.021 and §573.022, an SMHF or facility with a CPB accepts for a preliminary examination:

  (1) an individual, of any age, who has been apprehended and transported to the SMHF or facility with a CPB by a peace officer or emergency medical services personnel in accordance with Texas Health and Safety Code §573.001 or §573.012; or

  (2) an adult who has been transported to the SMHF or facility with a CPB by the adult's guardian in accordance with Texas Health and Safety Code §573.003.

(b) Preliminary examination.

  (1) A physician conducts a preliminary examination of an individual as soon as possible but not more than 12 hours after the individual is transported to the SMHF or facility with a CPB for emergency detention.

  (2) The preliminary examination consists of:

    (A) an assessment for medical stability; and

    (B) a psychiatric examination, including a substance use assessment if indicated, to determine if the individual meets the criteria described in subsection (c)(1) of this section.

(c) Requirements for emergency detention. The SMHF or facility with a CPB admits an individual for emergency detention if:

  (1) in accordance with Texas Health and Safety Code §573.022(a)(2), 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 himself 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) in accordance with Texas Health and Safety Code §573.022(a)(3), a physician makes a written statement documenting the determination described in paragraph (1) of this subsection and describing:

    (A) the nature of the individual's mental illness;

    (B) the risk of harm the individual evidences, demonstrated either by the individual's behavior or by evidence of severe emotional distress and deterioration in the individual's mental condition to the extent that the individual cannot remain at liberty; and

    (C) the detailed information on which the physician based the determination;

  (3) the physician issues and signs a written order admitting the individual for emergency detention; and

  (4) the individual meets the admission criteria of the SMHF or facility with a CPB.

(d) Release.

  (1) The SMHF or facility with a CPB releases the individual accepted for a preliminary examination if:

    (A) a preliminary examination of the individual has not been conducted within 12 hours after the individual is apprehended and transported to the facility by the peace officer or transported for emergency detention; or

    (B) in accordance with Texas Health and Safety Code §573.023(a), the individual is not admitted for emergency detention on completion of the preliminary examination.

  (2) If the SMHF or facility with a CPB does not admit the individual on an emergency detention, 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 of being notified that the individual does not meet inpatient admission criteria to coordinate alternate outpatient community services.

  (3) In accordance with Texas Health and Safety Code §576.007(a), if an individual who is an adult is not admitted on emergency detention, the SMHF or facility with a CPB makes a reasonable effort to notify the individual's family, or any other person providing support as authorized by the individual, and LAR, if any, before he or she is released.

(e) Intake assessment. An assessment professional for an SMHF or facility with a CPB conducts an intake assessment as soon as possible, but not later than 24 hours after an individual is admitted for emergency detention. The intake assessment includes:

  (1) obtaining relevant information about the individual, including:

    (A) psychiatric and medical history;

    (B) social history;

    (C) symptomology;

    (D) support systems;

    (E) finances;

    (F) third-party coverage or insurance benefits; and

    (G) advance directives;

  (2) explaining, orally and in writing, the individual's rights described in 25 TAC Chapter 404, Subchapter E (relating to Rights of Persons Receiving Mental Health Services);

  (3) explaining, orally and in writing, the SMHF's or facility with a CPB's services and treatment as they relate to the individual;

  (4) explaining, orally and in writing, the existence, purpose, telephone number, and address of the protection and advocacy system established in Texas, pursuant to Texas Health and Safety Code §576.008; and

  (5) explaining, orally and in writing, the individual trust fund account, charges for services, and the financial responsibility form.


Source Note: The provisions of this §306.176 adopted to be effective May 20, 2020, 45 TexReg 3301

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