Current through Reg. 50, No. 13; March 28, 2025
(a) Request for
voluntary admission.
(1) In accordance with
Texas Health and Safety Code §
572.001, a
request for voluntary admission of an individual with a mental illness may only
be made by:
(A) the individual, if the
individual is at least 16 years of age or older;
(B) an LAR who meets the criteria described
in paragraph (4)(A)(i) or (iii) of this subsection, if the individual is
younger than 18 years of age; or
(C) an LAR who meets the criteria described
in paragraph (4)(A)(ii) of this subsection, if the admission is sought pursuant
to the provisions of Texas Health and Safety Code §
572.001(c-1)
- (c-4).
(2) In
accordance with Texas Health and Safety Code §
572.001(b) and
(e), a request for admission must:
(A) be in writing and signed by the
individual or LAR making the request; and
(B) include a statement that the individual
or LAR making the request:
(i) agrees that the
individual will remain in the state hospital or CPB until the individual's
discharge; and
(ii) consents to
diagnosis, observation, care, and treatment of the individual until:
(I) the discharge of the individual;
or
(II) the individual is entitled
to leave the state hospital or CPB, in accordance with Texas Health and Safety
Code §
572.004, after
a request for discharge is made.
(3) The consent given under paragraph
(2)(B)(ii) of this subsection does not waive an individual's rights described
in:
(A) Chapter 320, Subchapter A of this
title (relating to Rights of Individuals Receiving Mental Health
Services);
(B) Chapter 307,
Subchapter I of this title (relating to Electroconvulsive Therapy
(ECT));
(C) Chapter 320, Subchapter
B of this title (relating to Consent to Treatment with Psychoactive
Medication--Mental Health Services); and
(D) Chapter 320, Subchapter C of this title
(relating to Interventions in Mental Health Services).
(4) An LAR is a person authorized by state
law to act on behalf of an individual for the purposes of:
(A) admission, transfer, or discharge that
includes:
(i) a parent, non-DFPS managing
conservator, or guardian;
(ii) a
representative of DFPS for a minor under DFPS conservatorship pursuant to Texas
Health and Safety Code §
572.001
(c-2) - (c-4); or
(iii) a person authorized by a district court
under Texas Family Code Chapter 35A to consent for the temporary admission of a
minor; or
(B) consent on
behalf of an individual regarding a matter described in this subchapter other
than admission, transfer, or discharge that includes:
(i) persons described in subparagraph (A) of
this paragraph;
(ii) a person
eligible to consent to treatment for a minor under Texas Family Code §
32.001(a);
and
(iii) an agent acting under a
Medical Power of Attorney under Texas Health and Safety Code Chapter 166 or a
Declaration for Mental Health Treatment under Texas Civil Practice and Remedies
Code Chapter 137.
(b) Failure to meet admission criteria. If a
physician of a state hospital or CPB determines that an individual does not
meet admission criteria and that community resources may appropriately serve
the individual, the facility must contact the LMHA, LBHA, or LIDDA to discuss
the availability and appropriateness of community-based services for the
individual. The LMHA, LBHA, or LIDDA must:
(1)
contact the individual and LAR, if applicable, no later than 24 hours after the
LMHA, LBHA, or LIDDA is notified of the failure to meet the admission criteria;
and
(2) provide referrals and
referral follow-up for ongoing services as clinically indicated to address the
individual's mental health needs and SUD needs.
(c) Examination.
(1) A physician must conduct an examination
on an individual requesting voluntary admission in accordance with this
subsection.
(2) In accordance with
Texas Health and Safety Code §
572.0025(f)(1)(A),
a physician must conduct a physical and psychiatric examination, either in
person or through audiovisual or other telecommunications technology within 72
hours before voluntary admission or 24 hours after voluntary admission, that
includes:
(A) an assessment for medical
stability;
(B) a psychiatric
examination; and
(C) if indicated,
an assessment for a SUD.
(3) In accordance with Texas Health and
Safety Code §
572.0025(f)(1);
the physician may not delegate the examination to a non-physician.
(d) Meets admission criteria. If,
after examination, a physician determines that an individual meets the
admission criteria of a state hospital or CPB, the state hospital or CPB must
admit the individual.
(e) To meet
the needs of an individual who does not meet admission criteria to a state
hospital or CPB, an LMHA or LBHA, as applicable, must:
(1) provide community mental health services
and supportive services to the individual; or
(2) refer the individual or LAR to community
mental health services and supportive services.
(f) Capacity to consent.
(1) If a physician determines that an
individual whose consent is necessary for a voluntary admission does not have
the capacity to consent to diagnosis, observation, care, and treatment, the
state hospital or CPB may not voluntarily admit the individual.
(2) When appropriate, the state hospital or
CPB may initiate an emergency detention proceeding in accordance with Texas
Health and Safety Code Chapter 573 or file an application for court-ordered
inpatient mental health services in accordance with Texas Health and Safety
Code Chapter 574.
(g)
Intake assessment. Before voluntary admission of an individual, in accordance
with Texas Health and Safety Code §
572.0025(b),
an assessment professional for a state hospital or CPB, must conduct an intake
assessment with the individual and LAR, if applicable, to:
(1) obtain relevant information about the
individual, including:
(A) psychiatric and
medical history;
(F) third-party coverage or insurance
benefits; and
(2) explain,
orally and in writing, the individual's rights described in Chapter 320,
Subchapter A of this title;
(3)
explain, orally and in writing, the state hospital's or CPB's services and
treatment as the services and treatment relate to the individual;
(4) explain, orally and in writing, the
existence, purpose, telephone number, and address of the protection and
advocacy system established in Texas, pursuant to Texas Health and Safety Code
§
576.008;
and
(5) explain, orally and in
writing, the individual trust fund account, charges for services, and the
financial responsibility form.
(h) Requirements for voluntary admission.
(1) An individual or LAR must make a request
for admission in accordance with subsection (a) of this section;
(2) a physician must:
(A) in accordance with Texas Health and
Safety Code §
572.0025(f)(1):
(i) conduct an examination in accordance with
subsection (c) of this section within 72 hours before the admission or 24 hours
after the admission; or
(ii)
consult with a physician who has conducted an examination in accordance with
subsection (c) of this section within 72 hours before the admission or 24 hours
after the admission;
(B)
determine that the individual meets the admission criteria of the state
hospital or CPB and that admission is clinically justified; and
(C) issue an order admitting the
individual;
(3) in
accordance with Texas Health and Safety Code §
572.0025(f)(2),
the administrator or designee of the state hospital or CPB must sign a written
statement agreeing to admit the individual; and
(4) in accordance with Texas Health and
Safety Code §
572.0026, the
state hospital or CPB must have available space for the individual.
(i) Documentation of admission
order. In accordance with Texas Health and Safety Code §
572.0025(f)(1),
the order described in subsection (h)(2)(C) of this section is issued:
(1) in writing and signed by the issuing
physician; or
(2) orally or
electronically if, within 24 hours after its issuance, the state hospital or
CPB has a written order signed by the issuing physician.
(j) Periodic evaluation. To determine the
need for continued inpatient treatment, a physician or physician's designee
must evaluate and document justification for continued stay for an individual
voluntarily receiving acute inpatient treatment as often as clinically
indicated, but no less than once a week.
