This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:45 GMT
(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).