Current through Reg. 49, No. 38; September 20, 2024
(a) A CSU staff member must provide an
individual crisis stabilization services under the direction of a physician and
in accordance with the individual's recovery or treatment plan and the service
requirements. Such treatment includes medical services and nursing services
described in §306.61 of this division (relating to Crisis Stabilization
Unit Medical Services) and §306.63 of this division (relating to Crisis
Stabilization Unit Nursing Services).
(b) Nursing staff must develop and implement
an initial or preliminary nursing care plan within the first 24 hours after
admission. This plan must be based on the findings of the initial comprehensive
nursing assessment and any pre-admission assessment information that is
available at the time of admission.
(c) The IDT must collaborate in developing
the individual's recovery or treatment plan based on the findings of:
(1) the individual's physical examination
identified in §306.63 of this division;
(2) the individual's psychiatric evaluation
identified in §306.61 of this division;
(3) the individual's initial comprehensive
nursing assessment identified in §306.63 of this division;
(4) an assessment of the individual's risk of
harm to self or others, identified in § 306.53 of this subchapter
(relating to Pre-Admission Screening and Assessment); and
(5) the psychosocial assessment identified in
§ 306.53 of this subchapter.
(d) The recovery or treatment plan must
contain:
(1) a list of all the individual's
diagnoses with notation as to which diagnoses will be treated at the CSU,
including:
(A) at least one mental illness or
SED diagnosis according to the current edition of the Diagnostic and
Statistical Manual of Mental Disorders;
(B) any substance use disorder diagnosis
according to the current edition of the Diagnostic and Statistical Manual of
Mental Disorders; and
(C) any
non-psychiatric conditions;
(2) a description of all treatment
interventions intended to address the individual's condition, including:
(A) all medications prescribed and the
symptoms each medication is intended to address;
(B) psychosocial rehabilitative services;
(C) counseling or psychotherapies;
and
(D) peer specialist services,
as available, and in accordance with 1 TAC §
354.3013(relating
to Services Provided);
(3) a documented level of monitoring assigned
to the individual by the physician, or physician-delegated PA or APRN;
(4) an identification of
additional assessments and evaluations to be conducted, including:
(A) risk of harm to self or others;
(B) history of trauma; and
(C) emerging health issues;
(5) a description of
any potential barriers to the individual's discharge; and
(6) a description of any medical or nursing
services.
(e) A member
of the IDT reviews the recovery or treatment plan and evaluates its
effectiveness:
(1) at least 72 hours after
being implemented; or
(2) any time
there is a change in the individual's condition based on:
(A) a medical re-evaluation described in
§306.61 of this division;
(B)
a nursing reassessment described in §306.63 of this division;
(C) a request by the individual, or the
individual's LAR or adult caregiver, as applicable; or
(D) receiving information regarding
recommended services and supports needed by the individual after discharge.
(f) A member
of the IDT discusses all revisions with the individual, and the individual's
adult caregiver or LAR, as necessary, to obtain feedback and agreement from the
individual, and the individual's LAR or adult caregiver, as applicable, before
implementing the individual's revised recovery or treatment plan.
