Current through Reg. 49, No. 38; September 20, 2024
(a) All persons voluntarily admitted to
inpatient services for treatment of mental illness or chemical dependency or
the person who requested admission on the individual's behalf have the right to
request discharge. Any such person expressing a request for release shall be
given an explanation of the process for requesting release and afforded the
opportunity to request release in writing.
(1) When a written request for release is
presented to any direct care staff of the department facility, community
center, or psychiatric hospital, it should be signed, dated, and timed by the
individual or a person legally responsible for the individual.
(2) If an individual informs a person
associated with or employed by the department facility, community center, or
psychiatric hospital of the individual's desire to leave, the employee or
person shall, as soon as possible, assist the individual in creating the
written request and present it to the individual to sign, date, and time.
Without regard to whether the individual agrees to sign paperwork requesting
discharge from services, the request will be documented and processed by staff.
The refusal or inability of the individual to sign the request for discharge
will be documented on the unsigned written request.
(3) All written or prepared requests for
discharge will be timed, dated, and signed by the staff member, who shall
provide information to the individual that pursuant to law, during the ensuing
period of up to 24 hours, the individual will be observed and evaluated to
determine the clinical appropriateness of seeking an involuntary commitment to
services. The form and format for requesting release and the information to be
provided may be prescribed by the department.
(b) All persons voluntarily admitted to
inpatient services for treatment of mental illness or chemical dependency have
the right to be discharged within four hours of a request for release unless
the individual's treating physician (or another physician if the treating
physician is not available) determines that there is cause to believe that the
individual might meet the criteria for court-ordered mental health services or
emergency detention.
(1) Each such person
detained beyond four hours has the right to be examined in person by a
physician and assessed for discharge readiness within 24 hours of the filing of
a request for release, with results of the assessment and recommendation
resulting documented in the medical record and disclosed to the individual. All
such persons have the right not to be detained beyond the completion of the
in-person examination unless:
(A) the person
who filed the request for release files a written withdrawal of the request or
asks a staff member to withdraw the request (the staff member must put the
request in writing);
(B) the person
served, in the physician's clinical judgment, meets the criteria for
involuntary commitment outlined in the Texas Health and Safety Code, §
573.022,
and an application for court-ordered mental health services,
chemical-dependency services or emergency detention will be filed and an order
obtained not later than 4 p.m. on the next succeeding business day after the
date on which the examination occurs and the individual is detained under the
provisions of the relevant statute; or
(C) the person receiving inpatient treatment
for chemical dependency is a minor admitted with the consent of the parent,
guardian, or conservator, and the individual who gave that consent objects in
writing to the release of the minor after consultation with personnel of the
department facility, community center, or psychiatric hospital.
(2) If extremely hazardous weather
conditions exist or a disaster occurs, the physician may request the judge of a
court that has jurisdiction to extend the period under which the individual may
be detained. The judge or a magistrate appointed by the judge may, by written
order made each day, extend the period during which the individual may be
detained until 4 p.m. on the first succeeding business day.
(c) All persons voluntarily
admitted to inpatient services for treatment of mental illness or chemical
dependency have the right not to have an application for court-ordered mental
health or chemical dependency services filed while receiving voluntary services
unless, in the opinion of the physician responsible for the individual's
treatment, the individual meets the criteria for court-ordered services as
outlined in the Texas Health and Safety Code, §
573.022,
and either:
(1) requests discharge;
(2) is absent without
authorization;
(3) is unable to
consent to appropriate and necessary psychiatric or chemical dependency
treatment; or
(4) refuses to
consent to necessary and appropriate treatment recommended by the physician
responsible for the individual's treatment and the physician completes a
certificate of medical examination for medical illness that, in addition to the
information required by the Texas Health and Safety Code, §
574.011,
includes the opinion of the physician that:
(A) there is no reasonable alternative to the
treatment recommended by the physician; and
(B) the individual will not benefit from
continued inpatient care without the recommended treatment.
(d) Each of these
persons has the right to be informed by the physician of the intent to file an
application for court-ordered mental health services based on the criteria
outlined in subsection (c) of this section.
(e) Each of these person has the right to be
free from threatening or coercive representations of actions that will result
if the individual requests to leave a department facility, community center, or
psychiatric hospital against medical advice, including representations that:
(1) the individual will be subject to an
involuntary commitment proceeding or subsequent emergency detention unless that
representation is made by a physician or on the written instruction of a
physician who has evaluated the individual within 48 hours prior to the
representation;
(2) the
individual's insurance company will refuse to pay all or any portion of the
medical expenses previously incurred; or
(3) the person will be reported to an
enforcement or regulatory agency (i.e., Department of Protective and Regulatory
Services) merely because the person refuses to follow a treatment
recommendation. However, this does not preclude reminding the individual of the
consequences of requesting release as relate to any agreements the individual
entered into as a condition of treatment, i.e., treatment as a condition of
parole.
