(a) An SMHF or facility with a CPB must discharge an individual voluntarily receiving treatment if the administrator or designee of the SMHF or facility with a 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 Mental Health Facility or Facility with a Contracted Psychiatric Bed).
(b) If a written request for discharge is made by an individual voluntarily receiving treatment or the individual's LAR:
  (1) the SMHF or facility with a CPB must discharge the individual in accordance with Texas Health and Safety Code §572.004; and
  (2) the individual or individual's LAR signs, dates, and documents 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 an SMHF or facility with a CPB of the individual's desire to leave the SMHF or facility with a CPB, the SMHF or facility with a CPB must:
  (1) as soon as possible, assist the individual in creating the written request and obtaining the necessary signature; and
  (2) within four hours after a written request is made known to the SMHF or facility with a CPB, notify:
    (A) the treating physician; or
    (B) another physician who is an SMHF or facility with a CPB staff member, if the treating physician is not available during that time period.
(d) Results of physician notification required by subsection (c)(3) of this section.
  (1) In accordance with Texas Health and Safety Code §572.004(c) and (d):
    (A) an SMHF or facility with a CPB, based on a physician's determination, must discharge an individual within the four-hour time 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 SMHF or facility with a 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 SMHF or the facility with a 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 SMHF or the facility with a CPB discharges 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 SMHF or the facility with a CPB, by 4:00 p.m. on the next business day:
      (i) if the SMHF or facility with a CPB intends to detain the individual, to file an application and obtain a court order for further detention of the individual in accordance with Texas Health and Safety Code §572.004(d), the physician:
        (I) files an application for court-ordered inpatient mental health services or emergency detention and obtains a court order for further detention of the individual;
        (II) notifies the individual of such intention; and
        (III) documents in the individual's record the reasons for the decision to detain the individual; or
      (ii) discharges 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 Facility with a Contracted Psychiatric Bed Authorized by an LMHA or LBHA or for a State Mental Health Facility), the SMHF or facility with a 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 treatment as a patient 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
  (2) document the request in the minor's record.
(f) In accordance with Texas Health and Safety Code §572.004(f)(1), an SMHF or facility with a CPB is not required to complete the requirements described in this section if the individual makes 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