Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 415 - PROVIDER CLINICAL RESPONSIBILITIES-MENTAL HEALTH SERVICES
Subchapter G - DETERMINATION OF MANIFEST DANGEROUSNESS
Section 415.310 - Procedures and Requirements Specific to the DSHS Dangerousness Review Board
Universal Citation: 25 TX Admin Code ยง 415.310
Current through Reg. 49, No. 38; September 20, 2024
The DSHS Dangerousness Review Board must convene at least once every month in accordance with this section.
(1) Schedule of hearings. The DSHS Dangerousness Review Board chair, in consultation with the MSU/SAU CEO, is responsible for scheduling hearings in accordance with this paragraph.
(A) Initial hearing.
(i) A hearing for an individual committed to
the MSU/SAU under the Texas Code of Criminal Procedure must be scheduled to
occur on such a date so as to ensure the individual, if determined not
manifestly dangerous, will be transferred from the MSU/SAU within 60 days after
arrival at the MSU/SAU, as required by the Texas Code of Criminal Procedure,
Article 46B.105 or 46C.260.
(ii) A
hearing for an individual transferred to the MSU/SAU from a facility must be
scheduled within 60 days after transfer.
(B) Regularly scheduled hearing(s). If an
individual is determined manifestly dangerous at the initial hearing, then
another hearing must be scheduled no later than six months after the initial
hearing. If the individual continues to be determined manifestly dangerous,
then another hearing must be scheduled no later than every six months after the
previous hearing for as long as the individual remains at the
MSU/SAU.
(C) Hearings scheduled
upon request.
(i) If, between regularly
scheduled hearings, an individual's treating physician or treatment team
determines that there has been sufficient change in the individual's condition
to indicate that the individual may no longer be manifestly dangerous, then the
physician or team will request that a hearing be scheduled. The request must be
in writing, submitted to the MSU/SAU CEO, and include the individual's name,
the reason(s) for the request, and supporting documentation.
(I) If the MSU/SAU CEO concurs with the
request, then a hearing must be scheduled for the next convening date of the
board that will enable adequate notice as described in paragraph (3) of this
section.
(II) If the MSU/SAU CEO
does not concur with the request, then the CEO will notify the physician or
team that the request has been denied.
(ii) If, between regularly scheduled
hearings, an independent evaluator (as defined) determines that there is
sufficient evidence that the individual may no longer be manifestly dangerous,
then the individual or LAR may request that a hearing be scheduled. The request
must be in writing, submitted to the MSU/SAU CEO, and include the individual's
name, the reason(s) for the request, and supporting documentation.
(I) If the MSU/SAU CEO concurs with the
request, then a hearing must be scheduled for the next convening date of the
board that will enable adequate notice as described in paragraph (3) of this
section.
(II) If the MSU/SAU CEO
does not concur with the request, then the CEO will notify the individual or
LAR that the request has been denied.
(2) Convening the board. The chair will convene the review board by impaneling review board members for each hearing that is scheduled for the convening date in accordance with § 415.305(e) of this title (relating to Procedures and Requirements for All Review Boards). If the chair does not select him/herself to serve as one of the five members for a hearing, then the chair will appoint one of the five impaneled members to act as chair for the hearing.
(3) Notice and statement(s). The MSU/SAU CEO will provide notice of a hearing and receive statement(s) in accordance with this paragraph.
(A) Notice. At least 10 days before the
hearing, the MSU/SAU CEO will complete the Notice of Hearing by DSHS
Dangerousness Review Board, referenced in §
415.314
of this title (relating to Notice of Hearing Forms), and deliver it to the
individual and LAR, if any, for signature.
(i) The MSU/SAU CEO must ensure that the
content of the notice is communicated in a language and format likely to be
understandable to the recipient(s) and initiating a discussion with the
individual and LAR regarding the right to be represented by a spokesperson. If
the individual or LAR requests a spokesperson, then the CEO will assist him/her
with identifying and securing a spokesperson. If an individual who lacks
capacity does not request a spokesperson, then the CEO will make a reasonable
effort to identify and secure a spokesperson. If the CEO is unable to secure a
spokesperson, then the facility rights protection officer will serve as the
individual's spokesperson to ensure the individual's rights are protected
during the hearing.
(ii) The
MSU/SAU CEO will provide a copy of the signed notice to the individual, LAR,
and spokesperson(s) and will file a copy of the signed notice in the
individual's medical record.
(B) Statement(s). At least 10 days before the
hearing, the MSU/SAU CEO will provide the individual and LAR with an
opportunity to submit a statement concerning the possible manifest
dangerousness of the individual. The CEO will offer assistance to the
individual or LAR in preparing a statement, and will provide assistance if
requested. The individual or LAR may decline to submit a statement.
(4) Hearing documentation.
(A) At least seven days before the hearing
the MSU/SAU CEO will ensure the following documentation is distributed to each
review board member impaneled for the hearing, the individual, LAR, and
spokesperson(s):
(i) a written summary,
prepared by the individual's MSU/SAU treatment team, of all pertinent
background information, including:
(I) a
legal history, including current legal status;
(II) a clinical history and assessments,
including identified strengths that may contribute to success in
treatment;
(III) a chronology of
aggressive behaviors with emphasis upon those that have occurred since the last
admission;
(IV) the treatment
interventions used to address the aggressive behaviors and behavioral responses
of the individual to the interventions;
(V) an assessment of risk for manifest
dangerousness, including the results of any applicable standardized assessment
tools; and
(VI) a description of
the behavior or incident that resulted in the individual's transfer or
commitment to the MSU/SAU;
(ii) statement(s) from the individual and
LAR, as described in paragraph (3)(B) of this section, if submitted;
(iii) if an independent evaluator requested
the hearing, the request, including the reason(s) for the request and the
supporting documentation; and
(iv)
any other pertinent information considered appropriate by the individual's
MSU/SAU treatment team.
(B) Any additional relevant documentation
that becomes available after the hearing documentation has been distributed
shall be submitted to the MSU/SAU CEO. The CEO will ensure the chair receives a
copy of the additional documentation as soon as possible before the
hearing.
(C) With the approval of
the chair, the individual or LAR may agree to receive the hearing documentation
less than seven days before the hearing.
(5) Preparing for possible transfer from the MSU/SAU. At least seven days prior to the hearing, the MSU/SAU CEO must ensure:
(A) that a copy of the hearing documentation
(referenced in paragraph (4)(A) of this section), is sent to the receiving
facility CEO; and
(B) that the
individual's MSU/SAU treating physician consults with a physician at the
identified receiving facility regarding the individual's characteristics,
including those with implications for risk management, to facilitate the
development of an appropriate risk management plan by the receiving
facility.
(6) Hearing, deliberations, and determination. The chair will ensure the hearing, deliberations, and determination are conducted in accordance with §415.305(g) -
(i) of this title
(relating to Procedures and Requirements for All Review Boards).
(7) Action taken upon determination.
(A) Notification. Within 24
hours after the DSHS Dangerousness Review Board's determination, the MSU/SAU
CEO will provide written notification to the individual, LAR, and
spokesperson(s) of:
(i) the review board's
determination; and
(ii) the right
of the individual or LAR to request that the MSU/SAU CEO refer the matter to
the commissioner and the procedures for requesting a referral as described in
§
415.311
of this title (relating to Disagreement with DSHS Dangerousness Review Board
Determination and Referral to Commissioner) if the individual or LAR disagrees
with the determination.
(B) Determined manifestly dangerous. If the
DSHS Dangerousness Review Board determines that an individual is manifestly
dangerous, then the individual will remain at the MSU/SAU. A subsequent hearing
will be scheduled for the individual in accordance with paragraph (1) of this
section.
(C) Determined not
manifestly dangerous. If the DSHS Dangerousness Review Board determines that an
individual is not manifestly dangerous, then the MSU/SAU CEO will:
(i) notify the receiving facility CEO of the
determination; and
(ii) ensure
compliance with §
415.312
of this title (relating to Transferring an Individual from the
MSU/SAU).
(D) New
hearing. The DSHS Dangerousness Review Board may conduct a new hearing at any
time upon request by the MSU/SAU CEO or upon its own motion. The new hearing
must be conducted in accordance with paragraphs (2) - (6) of this
section.
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