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TITLE 26 - HEALTH AND HUMAN SERVICES
PART 1 - HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER D - MENTAL HEALTH SERVICES--ADMISSION, DISCHARGE, AND CONTINUITY OF CARE
SECTION/RULE §306.176 - Admission Criteria for a State Hospital or a Facility with a Contracted Psychiatric Bed for Emergency Detention
Chapter Review Date 07/23/2024

(a) Acceptance for preliminary examination. In accordance with Texas Health and Safety Code §573.021 and §573.022, a state hospital or CPB must accept for a preliminary examination: (1) an individual, of any age, who has been apprehended and transported to the state hospital or CPB by a peace officer or by emergency medical services personnel in accordance with Texas Health and Safety Code §573.001 or §573.012; or (2) an adult who has been transported to the state hospital or CPB by the adult's guardian in accordance with Texas Health and Safety Code §573.003. (b) Preliminary examination. (1) A physician must conduct a preliminary examination of an individual as soon as possible but not more than 12 hours after the individual is transported to the state hospital or CPB for emergency detention. (2) The preliminary examination must consist of: (A) an assessment for medical stability; and (B) a psychiatric examination, including a substance use assessment if indicated, to determine if the individual meets the criteria described in subsection (c)(1) of this section. (c) Requirements for emergency detention. The state hospital or CPB may admit an individual for emergency detention if: (1) in accordance with Texas Health and Safety Code §573.022(a)(2), a physician determines from the preliminary examination that: (A) the individual has a mental illness; (B) the individual evidences a substantial risk of serious harm to himself or others; (C) the described risk of harm is imminent unless the individual is immediately detained; and (D) emergency detention is the least restrictive means by which the necessary detention may be accomplished; (2) in accordance with Texas Health and Safety Code §573.022(a)(3), a physician must make a written statement documenting the determination described in paragraph (1) of this subsection and describing: (A) the nature of the individual's mental illness; (B) the risk of harm the individual evidences, demonstrated either by the individual's behavior or by evidence of severe emotional distress and deterioration in the individual's mental condition to the extent that the individual cannot remain at liberty; and (C) the detailed information on which the physician based the determination; (3) the physician issues and signs a written order admitting the individual for emergency detention; and (4) the individual meets the admission criteria of the state hospital or CPB. (d) Release. (1) The state hospital or CPB must release the individual accepted for a preliminary examination if: (A) a preliminary examination of the individual has not been conducted within 12 hours after the individual is apprehended and transported to the facility by the peace officer or transported for emergency detention; or (B) in accordance with Texas Health and Safety Code §573.023(a), the individual is not admitted for emergency detention on completion of the preliminary examination. (2) If the state hospital or CPB does not admit the individual on an emergency detention in accordance with Texas Health and Safety Code Chapter 573, the facility must contact the designated LMHA or LBHA to provide referrals and referral follow-up for ongoing services as clinically indicated to address the individual's mental health needs. (A) The LMHA or LBHA in the individual's county of residence must contact the individual within 24 hours of being notified that the individual does not meet emergency detention criteria. (B) The LMHA or LBHA must provide referrals and referral follow-up for ongoing services as clinically indicated to address the individual's mental health needs, as applicable, when the individual does not meet admission criteria to a state hospital or CPB. (3) In accordance with Texas Health and Safety Code §576.007(a), if an individual who is an adult is not admitted on emergency detention, the state hospital or CPB must make a reasonable effort to notify the individual's family, or any other person providing support as authorized by the individual and LAR, if applicable, before the individual is released. (e) Intake assessment. An assessment professional for a state hospital or CPB must conduct an intake assessment as soon as possible, but not later than 24 hours after an individual is admitted for emergency detention. All documents related to the intake assessment must be provided to the individual or LAR and include: (1) a request for relevant information about the individual, such as: (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; and(2) a written and oral explanation of:(A) the individual's rights described in Chapter 320, Subchapter A of this title(relating to Rights of Individuals Receiving Mental Health Services); (B) the state hospital's or CPB's services and treatment as the services and treatment relate to the individual; (C) 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 (D) the individual's trust fund account, charges for services, and the financial responsibility form.

Source Note: The provisions of this §306.176 adopted to be effective May 20, 2020, 45 TexReg 3301; amended to be effective February 23, 2025, 50 TexReg 997.

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