Current through Reg. 49, No. 38; September 20, 2024
(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) the LAR if:
(i) the individual is younger than 18 years
of age; and
(ii) the LAR is
described by § 306.153(36)(A)(i) or (iii) of this subchapter (relating to
Definitions); or
(C) the
LAR, if the LAR is described by § 306.153(36)(A)(ii), and 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 LAR or
individual making the request; and
(B) include a statement that the LAR or
individual making the request:
(i) agrees
that the individual remains in the SMHF or facility with a 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 SMHF or facility with a 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) 25 TAC Chapter 404, Subchapter E
(relating to Rights of Persons Receiving Mental Health Services);
(B) 25 TAC Chapter 405, Subchapter E
(relating to Electroconvulsive Therapy (ECT));
(C) 25 TAC Chapter 414, Subchapter I
(relating to Consent to Treatment with Psychoactive Medication--Mental Health
Services); and
(D) 25 TAC Chapter
415, Subchapter F (relating to Interventions in Mental Health
Services).
(b)
Failure to meet admission criteria. If the physician of an SMHF or facility
with a CPB determines that an individual does not meet admission criteria and
that community resources may appropriately serve the individual, the facility
contacts the LMHA or LBHA to discuss the availability and appropriateness of
community-based services for the individual to receive. The LMHA or LBHA must
contact the individual, the individual's family or any other person providing
support as authorized by the individual, and LAR, if any, no later than 24
hours after the LMHA or LBHA is notified of the failure to meet the admission
criteria.
(c) Examination.
(1) A physician must conduct an examination
on each 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 conducts a physical and psychiatric examination, either in person
or through the use of audiovisual or other telecommunications technology within
72 hours before voluntary admission or 24 hours after voluntary admission for
the following:
(A) an assessment for medical
stability; and
(B) a psychiatric
examination, and, if indicated, a substance use assessment.
(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, the physician determines that the individual meets admission
criteria of the SMHF or facility with a CPB, the SMHF or facility with a CPB
admits the individual.
(e) Does not
meet admission criteria. If, after the examination, the physician determines
that the individual does not meet the admission criteria of the SMHF or
facility with a CPB, the SMHF or the facility with a CPB contacts the
designated LMHA or LBHA to coordinate alternate outpatient community services
as clinically indicated.
(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 SMHF or the facility with a CPB may not voluntarily
admit the individual.
(2) When
appropriate, the SMHF or the facility with a CPB initiates an emergency
detention proceeding in accordance with Texas Health and Safety Code, Chapter
573, or files an application for court-ordered inpatient mental health services
in accordance with Texas Health and Safety Code Chapter 574.
(g) Intake assessment. In
accordance with Texas Health and Safety Code §
572.0025(b),
an assessment professional for an SMHF or facility with a CPB, before voluntary
admission of an individual, conducts an intake assessment for:
(1) obtaining relevant information about the
individual, including:
(A) psychiatric and
medical history;
(B) social
history;
(C)
symptomology;
(D) support
systems;
(E) finances;
(F) third-party coverage or insurance
benefits; and
(G) advance
directives;
(2)
explaining, orally and in writing, the individual's rights described in 25 TAC
Chapter 404, Subchapter E;
(3)
explaining, orally and in writing, the SMHF's or facility with a CPB's services
and treatment as they relate to the individual;
(4) explaining, 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) explaining, orally and in
writing, the individual trust fund account, charges for services, and the
financial responsibility form.
(h) Requirements for voluntary admission. An
SMHF or facility with a CPB may voluntarily admit an individual only if:
(1) a request for admission is made in
accordance with subsection (a) of this section;
(2) a physician has:
(A) in accordance with Texas Health and
Safety Code §
572.0025(f)(1):
(i) conducted an examination in accordance
with subsection (c) of this section within 72 hours before the admission or 24
hours after the admission; or
(ii)
has consulted 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) determined that the individual meets the
admission criteria of the SMHF or facility with a CPB and that admission is
clinically justified; and
(C)
issued an order admitting the individual; and
(3) in accordance with Texas Health and
Safety Code §
572.0025(f)(2),
the administrator or designee of the SMHF or facility with a CPB has signed a
written statement agreeing to admit 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 SMHF or facility
with a 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.
