(a) With the exceptions of Waco Center for Youth, a maximum-security unit, and an adolescent forensic unit, an SMHF or facility with a CPB may admit an individual, who has been assessed by an LMHA or LBHA and recommended for inpatient admission, only if the individual has a mental illness and, as a result of the mental illness:
  (1) presents a substantial risk of serious harm to self or others; or
  (2) evidences a substantial risk of mental or physical deterioration.
(b) An individual's admission to an SMHF or facility with a CPB may not occur if the individual:
  (1) requires specialized care that is not available at the SMHF or facility with a CPB; or
  (2) has a physical medical condition that is unstable and could reasonably require inpatient medical treatment for the condition.
(c) If an individual arrives at an SMHF or facility with a CPB for mental health services, and the individual was not screened or referred by an LMHA or LBHA as described in §306.163 of this subchapter (relating to Most Appropriate and Available Treatment Options):
  (1) the SMHF or facility with a CPB notifies the designated LMHA or LBHA that the individual has presented for services at the SMHF or facility with a CPB; and
  (2) the SMHF or facility with a CPB physician determines if the individual has an emergency medical condition and the physician decides whether the facility has the capability to treat the emergency medical condition.
    (A) If the SMHF or facility with a CPB has the capability to treat the emergency medical condition, the facility admits the individual as required by the Emergency Medical Treatment and Active Labor Act (EMTALA) (42 USC §1395dd).
    (B) If the SMHF or facility with a CPB does not have the capability to treat the emergency medical condition in accordance with EMTALA, the facility provides evaluation and treatment within its capability to stabilize the individual and arranges for the individual to be transferred to a hospital that has the capability to treat the emergency medical condition.
(d) If an LMHA or LBHA authorized an individual's admission to an SMHF or a facility with a CPB and the facility determines that the individual does not meet inpatient criteria for admission, the facility contacts the designated LMHA or LBHA to coordinate alternate outpatient community services. The designated LMHA or LBHA must contact the individual within 24 hours after being notified that the individual does not meet inpatient admission criteria.

Source Note: The provisions of this §306.171 adopted to be effective May 20, 2020, 45 TexReg 3301