Current through Reg. 49, No. 38; September 20, 2024
(a) CSU staff members, trained in accordance
with §306.83(h) - (i) of this subchapter (relating to Staff Training),
must conduct the intake and admission process in accordance with Texas Health
and Safety Code §
572.0025(e)
and §
572.0025(h)(3).
(b) Voluntary admission into a CSU may be
requested by:
(1) an individual 16 years of
age or older, in accordance with Texas Health and Safety Code §
572.001;
(2) the parent, managing conservator, or
guardian of an individual younger than 18 years of age, in accordance with
Texas Health and Safety Code §
572.001
or Texas Family Code Chapter 35A;
(3) the adult caregiver of an individual, who
has obtained an order under Texas Family Code Chapter 35A when the individual
is younger than 18 years of age; or
(4) an individual with capacity to
consent.
(c) A request
for admission must be made in accordance with Texas Health and Safety Code
§
572.001
and must:
(1) be in writing and signed by the
individual, and the individual's parent, adult caregiver, or LAR; and
(2) include a statement that the individual:
(A) has capacity to consent to the
administration of psychoactive medication, administered in accordance with
Texas Health and Safety Code §
576.025;
(B) agrees to voluntarily remain in the CSU
until discharge; and
(C) consents
to diagnosis, observation, care and treatment until the earlier of one of the
following occurrences:
(i) the discharge of
the individual; or
(ii) the
individual leaves the CSU after a request for discharge is made, in accordance
with Texas Health and Safety Code §
572.004.
(d)
Voluntary admission occurs only if:
(1) a
request for admission is made in accordance with subsection (c) of this
section;
(2) the individual
receives pre-admission screening and assessment, in accordance with the CSU's
written policies and procedures, to determine if a physician admission
examination is required:
(A) if the
pre-admission screening and assessment is conducted by a physician, the
physician may conduct the pre-admission screening and assessment as part of the
physician admission examination referenced in §306.53(d) of this division
(relating to Pre-admission Screening and Assessment); and
(B) if the QMHP-CS or LPHA conducting
pre-admission screening and assessment determines:
(i) the individual does not need a physician
admission examination, then the CSU may not admit the individual and must refer
the individual to alternative services, as appropriate and available, including
LMHA, LBHA, or LIDDA crisis services; or
(ii) the individual does need a
physician-admission examination, a physician must conduct an admission
examination of the individual before CSU admission;
(3) a physician in accordance with
Texas Health and Safety Code §
572.0025(f):
(A) conducts either in person or through
telemedicine medical services, or consults with a physician who conducted, a
physical assessment and psychiatric admission examination within 72 hours
before or 24 hours after admission, as described in §306.53 of this
division (relating to Pre-Admission Screening and Assessment), and may not
delegate the examination to a non-physician; and
(B) provides an admission order;
(i) in writing and signed by the issuing
physician; or
(ii) if the order is
provided orally or, if the electronic order is unsigned, an original signed
order must be provided to the facility within 24 hours;
(4) the administrator or
administrator's designee has signed a written statement agreeing to admit the
individual, in accordance with Texas Health and Safety Code §
572.0025;
and
(5) a CSU staff member, trained
in accordance with § 306.83(i) of this subchapter, completes intake
procedures in accordance with Texas Health and Safety Code §
572.0025(e)
and §
572.0025(h)(3),
that includes:
(A) obtaining relevant
information about the individual, including information about finances,
insurance benefits, and advance directives;
(B) explaining, orally and in writing, the
individual's rights in a language and format easily understandable to the
individual, or the individual's LAR or adult caregiver, as
applicable;
(C) explaining, orally
and in writing, the CSU's services and treatment as they relate to the
individual;
(D) informing the
individual, orally and in writing, of the existence, telephone number, and
address of the protection and advocacy system established in Texas;
(E) informing the individual of the
availability of information and assistance from the Ombudsman by contacting the
Ombudsman at 1-800-252-8154 or online at hhs.texas.gov/ombudsman, and the
Health Facility Licensing complaints line at 1-888-973-0022; and
(F) determining whether the individual
comprehends the information provided in accordance with subparagraphs (B) - (E)
of this paragraph.
(e) An individual who is admitted to a CSU
before the physical assessment and psychiatric admission examination is
conducted must be discharged by the physician immediately if the physician
conducting the physical assessment and psychiatric examination of the
individual determines the individual does not meet the clinical standards to
receive inpatient mental health services, in accordance with Texas Health and
Safety Code §
572.0025(f-1).
(f) A CSU that discharges an individual under
the circumstances described in (e) of this section may not bill the individual
or the individual's third-party payor for the temporary admission of the
individual to the CSU, in accordance with Texas Health and Safety Code §
572.0025(f-2).
