Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 904 - CONTINUITY OF SERVICES-STATE FACILITIES
Subchapter B - ADMISSION AND COMMITMENT
Section 904.25 - Criteria for Commitment, Commitment for Residential Services Without an Interdisciplinary Team Recommendation, and Regular Voluntary Admission of an Adult to a Residential Care Facility Under the PIDA
Universal Citation: 26 TX Admin Code § 904.25
Current through Reg. 50, No. 13; March 28, 2025
(a) In accordance with THSC §§593.003, 593.052, and 593.041, except as provided by subsection (b) of this section, an adult may be committed to a residential care facility for residential services only if:
(1) the adult
is determined to have an intellectual disability in accordance with §
304.401 of this title (relating to
Conducting a Determination of Intellectual Disability);
(2) the adult, because of an intellectual
disability:
(A) represents a substantial risk
of physical impairment or injury to self or others; or
(B) is unable to provide for and is not
providing for the adult's most basic personal physical
needs;
(3) the adult
cannot be adequately and appropriately habilitated in an available, less
restrictive setting, as demonstrated by documentation that alternative settings
have been identified, evaluated, and determined to be unavailable or unable to
meet the adult's identified needs;
(4) the residential care facility provides
habilitative services, care, training, and treatment appropriate to the adult's
needs; and
(5) a report by an IDT
recommending the placement has been completed in accordance with §
904.43 of this subchapter
(relating to LIDDA IDT Recommendation Concerning the Commitment of an Adult or
a Minor or the Regular Voluntary Admission of an Adult to a Residential Care
Facility Under the PIDA) during the six months preceding the date of the
commitment hearing; and
(6) the
court determines beyond a reasonable doubt that the adult meets the
requirements of subsection (d) of this section and paragraphs (1), (2)(A) or
(2)(B), (3), and (4) of this subsection.
(b) In accordance with THSC §§593.003, 593.041, 593.0511, and 593.052, an adult may be committed to a residential care facility for residential services without an IDT recommendation only if:
(1) the adult is
determined to have an intellectual disability in accordance with §
304.401 of this title;
(2) the guardian of the adult petitions the
court to issue a commitment order and shows, because of an intellectual
disability, the adult:
(A) represents a
substantial risk of physical impairment or injury to self or others;
or
(B) is unable to provide for and
is not providing for the adult's most basic personal physical
needs;
(3) the adult
cannot be adequately and appropriately habilitated in an available, less
restrictive setting, as demonstrated by documentation that alternative settings
have been identified, evaluated, and determined to be unavailable or unable to
meet the adult's identified needs;
(4) the residential care facility provides
habilitative services, care, training, and treatment appropriate for the
adult's needs; and
(5) the court
determines beyond a reasonable doubt that the adult meets the requirements of
subsection (d) of this section and paragraphs (1), (2)(A) or (2)(B), (3), and
(4) of this subsection.
(c) An adult with the capacity to give legally adequate consent may be admitted to a residential care facility under a regular voluntary admission for residential services only if:
(1) in accordance with THSC
§§593.003, 593.013, and 593.026:
(A)
the adult has been determined to have an intellectual disability in accordance
with §
304.401 of this title;
(B) a report by a LIDDA's IDT recommending
the placement has been completed in accordance with §
904.43 of this subchapter during
the six months preceding the request for admission;
(C) HHSC determines space is available in a
residential care facility; and
(D)
the facility director determines that the residential care facility provides
services that meet the needs of the adult; and
(2) the IDT report referenced in paragraph
(1)(B) of this subsection includes the following findings:
(A) because of an intellectual disability,
the adult:
(i) represents a substantial risk
of physical impairment or injury to self or others; or
(ii) is unable to provide for and is not
providing for the adult's most basic personal physical needs;
(B) the adult cannot be adequately
and appropriately habilitated in an available, less restrictive setting, as
demonstrated by documentation that alternative settings have been identified,
evaluated, and determined to be unavailable or unable to meet the adult's
identified needs; and
(C) the
residential care facility provides habilitative services, care, training, and
treatment appropriate for the adult's needs.
(d) An adult represents a substantial risk of physical impairment or injury to self or others or is unable to provide for and is not providing for the adult's most basic personal physical needs, as referenced in subsections (a)(2),(b)(2)(A), and (c)(2)(A) of this section, if:
(1) the adult's IQ is four or more standard
deviations below the mean, (i.e., in the severe or profound range of
intellectual disability); or
(2)
the adult's ICAP service level equals:
(A) 1,
2, 3, or 4; or
(B) 5 or 6 and the
adult:
(i) has extraordinary medical needs
that would require direct nursing treatment for at least 180 minutes per week
if the adult's caregiver were not providing such treatment; or
(ii) exhibits incidents of dangerous behavior
that would require intensive staff intervention and resources to prevent
serious physical injury to the adult or others if the adult's caregiver were
not managing such incidents.
(e) In accordance with THSC §593.056, a party to a commitment proceeding under subsections (a) or (b) of this section has the right to appeal the judgment to the appropriate court of appeals.
(1) The Texas Rules of Civil Procedure apply
to an appeal under this section.
(2) An appeal under this section shall be
given a preference setting.
(3) The
county court may grant a stay of commitment pending the outcome of the
appeal.
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