Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM
Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, DISCHARGE, AND CONTINUITY OF CARE
Division 2 - SCREENING AND ASSESSMENT FOR CRISIS SERVICES AND ADMISSION INTO LOCAL MENTAL HEALTH AUTHORITY OR LOCAL BEHAVIORAL HEALTH AUTHORITY SERVICES
Section 306.163 - Most Appropriate and Available Treatment Options
Universal Citation: 26 TX Admin Code § 306.163
Current through Reg. 50, No. 13; March 28, 2025
(a) Recommendation for treatment. The designated LMHA or LBHA is responsible for recommending the most appropriate and available treatment alternative for an individual in need of mental health or SUD services.
(b) Inpatient services.
(1) Before an LMHA or LBHA refers
an individual for inpatient services, the LMHA or LBHA must screen and assess
the individual to determine if the individual requires inpatient
services.
(2) If the screening and
assessment indicates the individual requires inpatient services and inpatient
services are the least restrictive and most appropriate setting available, the
LMHA or LBHA must refer the individual:
(A) to
a state hospital or CPB, if the LMHA or LBHA determines that the individual
meets the criteria for admission; or
(B) to an LMHA or LBHA network provider of
inpatient services.
(3)
If the individual is identified in the applicable HHSC automation system as
having an ID or a DD, the LMHA or LBHA must inform the designated LIDDA that
the individual has been referred for inpatient services.
(4) If the LMHA, LBHA, or LMHA or
LBHA-network provider refers the individual for inpatient services, the LMHA or
LBHA must communicate necessary information to the contracted inpatient
provider before or at the time of admission, including the individual's:
(A) identifying information, including
address;
(B) legal status, for
example regarding guardianship, charges pending, or custody, as
applicable;
(C) pertinent medical
and medication information, including known disabilities;
(D) behavioral information, including
information regarding COPSD;
(E)
other pertinent treatment information;
(F) finances, third-party coverage, and other
benefits, if known; and
(G) advance
directive.
(5) If an
LMHA or LBHA, other than the individual's designated LMHA or LBHA, refers the
individual for inpatient services, the state hospital or CPB must notify the
individual's designated LMHA or LBHA of the referral for inpatient services by
the end of the next business day.
(6) The designated LMHA or LBHA must assign a
CoC liaison to an individual admitted to a state hospital, a CPB, or an LMHA or
LBHA inpatient services network provider.
(7) If the individual has an ID or a DD, the
designated LIDDA must assign a continuity of care worker to the
individual.
(8) The LMHA or LBHA
CoC liaison, and LIDDA continuity of care worker as applicable, are responsible
for the facilitation of the individual's continuity of services.
(9) The LMHA or LBHA is responsible for
continuity of care and must plan to the greatest extent possible for the
successful transition of individuals who are determined by a state hospital or
CPB to be clinically appropriate for discharge from these facilities to a
community setting in accordance with Texas Health and Safety Code §
534.0535.
(c) Community-based crisis treatment options.
(1) An LMHA or LBHA
must ensure the provision of crisis services to an individual experiencing a
crisis while the individual is in its local service area.
(2) An individual in need of a higher level
of care, but not requiring inpatient services, has the option, as available,
for admission to other services such as a diversion center, crisis respite
unit, crisis residential unit, extended observation unit, or crisis
stabilization unit.
(d) LMHA or LBHA Services.
(1) If an LMHA or LBHA
admits an individual to LMHA or LBHA services, the LMHA or LBHA must ensure the
provision of services in the least restrictive and most appropriate setting
available.
(2) The LMHA or LBHA
must assign, to an individual receiving services, a staff member who is
responsible for coordinating the individual's services.
(e) Court Ordered Treatment. The LMHA or LBHA must provide services to an individual ordered by a court to participate in outpatient mental health services or competency restoration services, if available, when the court identifies the LMHA or LBHA as being responsible for those services.
(f) Referral to alternate provider.
(1) If an individual
requests a referral to an alternate provider, and there is not a court order to
receive services from the LMHA or LBHA, the LMHA or LBHA must make a referral
to an alternate provider in accordance with the individual's request.
(2) If an individual has third-party
coverage, but the coverage will not pay for needed services because the
designated LMHA or LBHA does not have a provider in its network that is
approved by the third-party coverage, the designated LMHA or LBHA must comply
with §
301.111(c)(2) of
this title (relating to Determination of Ability to Pay).
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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