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§411.461: Voluntary Admission

(a) Request for voluntary admission.

(1) In accordance with Texas Health and Safety Code, §572.001(a) and (c), a request for voluntary admission of a prospective patient may only be made by:

(A) the prospective patient, if:

(i) he or she is 16 years of age or older; or

(ii) he or she is younger than 16 years of age and is or has been married; or

(B) the parent, managing conservator, or guardian of the prospective patient, if the prospective patient is younger than 18 years of age and is not and has not been married, except that a guardian or managing conservator acting as an employee or agent of the state or a political subdivision of the state may request admission of the prospective patient only with the prospective patient's consent.

(2) In accordance with Texas Health and Safety Code, §572.001(b) and (e), a request for admission shall:

(A) be in writing and signed by the individual making the request; and

(B) include a statement that the individual making the request:

(i) agrees that the prospective patient will remain in the hospital until discharged; and

(ii) consents to diagnosis, observation, care and treatment of the prospective patient until the earlier of one of the following occurrences:

(I) the discharge of the prospective patient; or

(II) the prospective patient is entitled to leave the hospital, in accordance with Texas Health and Safety Code, §572.004, after a request for discharge is made.

(3) The consent given under paragraph (2)(B)(ii) of this subsection does not waive a patient's rights described in the rules listed under §411.454(g) of this title (relating to General Provisions).

(b) Capacity to consent. If a prospective patient does not have the capacity to consent to diagnosis, observation, care and treatment, as determined by a physician, then the hospital may not admit the prospective patient on a voluntary basis. When appropriate, the hospital may initiate an emergency detention proceeding in accordance with Texas Health and Safety Code, Chapter 573, or file an application for court-ordered inpatient mental health services in accordance with Texas Health and Safety Code, Chapter 574.

(c) Pre-admission screening.

(1) Prior to voluntary admission of a prospective patient, a PASP shall conduct a pre-admission screening of the prospective patient.

(2) If the PASP determines that the prospective patient does not need an admission examination, the hospital may not admit the prospective patient and shall refer the prospective patient to alternative services. If the PASP determines that the prospective patient needs an admission examination, a physician shall conduct an admission examination of the prospective patient.

(3) If the pre-admission screening is conducted by a physician, the physician may conduct the pre-admission screening as part of the admission examination referenced in subsection (d)(2)(A) of this section.

(d) Requirements for voluntary admission. A hospital may voluntarily admit a prospective patient only if:

(1) a request for admission is made is accordance with subsection (a) of this section;

(2) a physician has:

(A) in accordance with Texas Health and Safety Code, §572.0025(f)(1), conducted, within 72 hours prior to admission, or has consulted with a physician who has conducted, within 72 hours prior to admission, an admission examination in accordance with subsection (f) of this section; and

(B) issued an order admitting the prospective patient;

(3) the prospective patient meets the hospital's admission criteria; and

(4) in accordance with Texas Health and Safety Code, §572.0025(f)(2), the administrator or administrator's designee has signed a written statement agreeing to admit the prospective patient.

(e) Intake. In accordance with Texas Health and Safety Code §572.0025(b), a hospital shall, prior to voluntary admission of a prospective patient, conduct an intake process, that includes:

(1) obtaining relevant information about the prospective patient, including information about finances, insurance benefits and advance directives; and

(2) explaining, orally and in writing, the prospective patient's rights described in Chapter 404, Subchapter E of this title (concerning Rights of Persons Receiving Mental Health Services), including:

(A) the hospital's services and treatment as they relate to the prospective patient; and

(B) the existence, purpose, telephone number, and address of the protection and advocacy system established in Texas, which is Advocacy, Inc., as required by Texas Health and Safety Code, §576.008.

(f) Admission examination.

(1) The admission examination referenced in subsection (d)(2)(A) of this section shall be conducted by a physician and include a physical and psychiatric examination conducted in the physical presence of the patient or by using audiovisual telecommunications.

(2) The physical examination may consist of an assessment for medical stability.

(3) The physician may not delegate conducting the admission examination to a non-physician.

(g) Documentation of admission order. In accordance with Texas Health and Safety Code §572.0025(f)(1), the order described in subsection (d)(2)(B) of this section shall be:

(1) issued in writing and signed by the issuing physician; or

(2) issued orally or electronically if, within 24 hours after its issuance, the hospital has a written order signed by the issuing physician.

Comments

Source Note: The provisions of this §411.461 adopted to be effective January 1, 2004, 28 TexReg 11294