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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 §306.203 - Discharge of an Individual Voluntarily Receiving Inpatient Treatment
Chapter Review Date 07/23/2024

(a) A state hospital or CPB must discharge an individual voluntarily receiving treatment if the administrator or designee of the state hospital or 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 Hospital or a Facility with a Contracted Psychiatric Bed). (b) If an individual voluntarily receiving treatment or LAR makes a written request for discharge: (1) the state hospital or CPB must discharge the individual in accordance with Texas Health and Safety Code §572.004; and (2) the individual or LAR must sign, date, and document 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 a state hospital or CPB of the individual's desire to leave the state hospital or CPB, the state hospital or CPB must: (1) as soon as possible, assist the individual in documenting the written request and obtaining the necessary signature; and (2) within four hours after a written request is made known to the state hospital or CPB, notify: (A) the treating physician; or (B) another physician who is a state hospital or CPB staff member, if the treating physician is not available during that period. (d) Results of physician notification required by subsection (c)(2) of this section. (1) In accordance with Texas Health and Safety Code §572.004(c) and (d): (A) a state hospital or CPB, based on a physician's determination, must discharge an individual within the four-hour 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 state hospital or 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 state hospital or 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 state hospital or CPB must discharge 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 state hospital or CPB, by 4:00 p.m. on the next business day, must: (i) if the state hospital or CPB intends to detain the individual, require the physician or designee, in accordance with Texas Health and Safety Code §572.004(d), to: (I) file an application for court-ordered inpatient mental health services or emergency detention and obtains a court order for further detention of the individual; (II) notify the individual and LAR, if applicable, of such intention; and (III) document in the individual's record the reasons for the decision to detain the individual; or (ii) discharge 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 State Hospital or a Facility with a Contracted Psychiatric Bed, the state hospital or 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 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 released to the minor's LAR; and (2) document the request in the minor's record. (f) In accordance with Texas Health and Safety Code §572.004(f)(1), a state hospital or CPB is not required to complete the requirements described in this section if the individual documents and signs a written statement withdrawing the request for discharge.

Source Note: The provisions of this §306.203 adopted to be effective May 20, 2020, 45 TexReg 3301; amended to be effective February 23, 2025, 50 TexReg 997.

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