Current through Reg. 49, No. 38; September 20, 2024
(a) An SMHF or facility with a CPB must
discharge an individual voluntarily receiving treatment if the administrator or
designee of the SMHF or facility with a CPB concludes that the individual can
no longer benefit from inpatient services based on the physician's
determination, as delineated in Division 5 of this subchapter (relating to
Discharge and Absences from a State Mental Health Facility or Facility with a
Contracted Psychiatric Bed).
(b) If
a written request for discharge is made by an individual voluntarily receiving
treatment or the individual's LAR:
(1) the
SMHF or facility with a CPB must discharge the individual in accordance with
Texas Health and Safety Code §
572.004;
and
(2) the individual or
individual's LAR signs, dates, and documents the time on the discharge
request.
(c) In
accordance with Texas Health and Safety Code §
572.004, if an
individual informs a staff member of an SMHF or facility with a CPB of the
individual's desire to leave the SMHF or facility with a CPB, the SMHF or
facility with a CPB must:
(1) as soon as
possible, assist the individual in creating the written request and obtaining
the necessary signature; and
(2)
within four hours after a written request is made known to the SMHF or facility
with a CPB, notify:
(A) the treating
physician; or
(B) another physician
who is an SMHF or facility with a CPB staff member, if the treating physician
is not available during that time period.
(d) Results of physician notification
required by subsection (c)(3) of this section.
(1) In accordance with Texas Health and
Safety Code §
572.004(c) and
(d):
(A) an
SMHF or facility with a CPB, based on a physician's determination, must
discharge an individual within the four-hour time period described in
subsection (c)(2) of this section; or
(B) if the physician who is notified in
accordance with subsection (c)(2) of this section has reasonable cause to
believe that the individual may meet the criteria for court-ordered inpatient
mental health services or emergency detention, the physician must examine the
individual as soon as possible, but no later than 24 hours, after the request
for discharge is made known to the SMHF or facility with a CPB.
(2) Reasonable cause to believe
that the individual may meet the criteria for court-ordered inpatient mental
health services or emergency detention.
(A)
If a physician does not examine an individual who may meet the criteria for
court-ordered inpatient mental health services or emergency detention within 24
hours after the request for discharge is made known to the SMHF or the facility
with a CPB, the facility must discharge the individual.
(B) If a physician, in accordance with Texas
Health and Safety Code §
572.004(d),
examines the individual as described in paragraph (1)(B) of this subsection and
determines that the individual does not meet the criteria for court-ordered
inpatient mental health services or emergency detention, the SMHF or the
facility with a CPB discharges the individual upon completion of the
examination.
(C) If a physician, in
accordance with Texas Health and Safety Code §
572.004(d),
examines the individual as described in paragraph (1)(B) of this subsection and
determines that the individual meets the criteria for court-ordered inpatient
mental health services or emergency detention, the SMHF or the facility with a
CPB, by 4:00 p.m. on the next business day:
(i) if the SMHF or facility with a CPB
intends to detain the individual, to file an application and obtain a court
order for further detention of the individual in accordance with Texas Health
and Safety Code §
572.004(d),
the physician:
(I) files an application for
court-ordered inpatient mental health services or emergency detention and
obtains a court order for further detention of the individual;
(II) notifies the individual of such
intention; and
(III) documents in
the individual's record the reasons for the decision to detain the individual;
or
(ii) discharges the
individual.
(e) In accordance with Texas Health and
Safety Code §
572.004(i),
after a written request from a minor individual admitted under §
306.175(a)(1)(B) of this subchapter (relating to Voluntary Admission Criteria
for a Facility with a Contracted Psychiatric Bed Authorized by an LMHA or LBHA
or for a State Mental Health Facility), the SMHF or facility with a CPB must:
(1) notify the minor's parent, managing
conservator, or guardian of the request and:
(A) if the minor's parent, managing
conservator, or guardian objects to the discharge, the minor continues
treatment as a patient receiving voluntary treatment; or
(B) if the minor's parent, managing
conservator, or guardian does not object to the discharge, the minor individual
is discharged; and
(2)
document the request in the minor's record.
(f) In accordance with Texas Health and
Safety Code §
572.004(f)(1),
an SMHF or facility with a CPB is not required to complete the requirements
described in this section if the individual makes a written statement
withdrawing the request for discharge.
