(a) CSU staff members, trained in accordance with §306.83(h) - (i) of this subchapter (relating to Staff Training), must conduct the intake and admission process in accordance with Texas Health and Safety Code §572.0025(e) and §572.0025(h)(3).
(b) Voluntary admission into a CSU may be requested by:
  (1) an individual 16 years of age or older, in accordance with Texas Health and Safety Code §572.001;
  (2) the parent, managing conservator, or guardian of an individual younger than 18 years of age, in accordance with Texas Health and Safety Code §572.001 or Texas Family Code Chapter 35A;
  (3) the adult caregiver of an individual, who has obtained an order under Texas Family Code Chapter 35A when the individual is younger than 18 years of age; or
  (4) an individual with capacity to consent.
(c) A request for admission must be made in accordance with Texas Health and Safety Code §572.001 and must:
  (1) be in writing and signed by the individual, and the individual's parent, adult caregiver, or LAR; and
  (2) include a statement that the individual:
    (A) has capacity to consent to the administration of psychoactive medication, administered in accordance with Texas Health and Safety Code §576.025;
    (B) agrees to voluntarily remain in the CSU until discharge; and
    (C) consents to diagnosis, observation, care and treatment until the earlier of one of the following occurrences:
      (i) the discharge of the individual; or
      (ii) the individual leaves the CSU after a request for discharge is made, in accordance with Texas Health and Safety Code §572.004.
(d) Voluntary admission occurs only if:
  (1) a request for admission is made in accordance with subsection (c) of this section;
  (2) the individual receives pre-admission screening and assessment, in accordance with the CSU's written policies and procedures, to determine if a physician admission examination is required:
    (A) if the pre-admission screening and assessment is conducted by a physician, the physician may conduct the pre-admission screening and assessment as part of the physician admission examination referenced in §306.53(d) of this division (relating to Pre-admission Screening and Assessment); and
    (B) if the QMHP-CS or LPHA conducting pre-admission screening and assessment determines:
      (i) the individual does not need a physician admission examination, then the CSU may not admit the individual and must refer the individual to alternative services, as appropriate and available, including LMHA, LBHA, or LIDDA crisis services; or
      (ii) the individual does need a physician-admission examination, a physician must conduct an admission examination of the individual before CSU admission;
  (3) a physician in accordance with Texas Health and Safety Code §572.0025 (f):
    (A) conducts either in person or through telemedicine medical services, or consults with a physician who conducted, a physical assessment and psychiatric admission examination within 72 hours before or 24 hours after admission, as described in §306.53 of this division (relating to Pre-Admission Screening and Assessment), and may not delegate the examination to a non-physician; and
    (B) provides an admission order;
      (i) in writing and signed by the issuing physician; or
      (ii) if the order is provided orally or, if the electronic order is unsigned, an original signed order must be provided to the facility within 24 hours;
  (4) the administrator or administrator's designee has signed a written statement agreeing to admit the individual, in accordance with Texas Health and Safety Code §572.0025; and
  (5) a CSU staff member, trained in accordance with §306.83(i) of this subchapter, completes intake procedures in accordance with Texas Health and Safety Code §572.0025(e) and §572.0025(h)(3), that includes:
    (A) obtaining relevant information about the individual, including information about finances, insurance benefits, and advance directives;
    (B) explaining, orally and in writing, the individual's rights in a language and format easily understandable to the individual, or the individual's LAR or adult caregiver, as applicable;
    (C) explaining, orally and in writing, the CSU's services and treatment as they relate to the individual;
    (D) informing the individual, orally and in writing, of the existence, telephone number, and address of the protection and advocacy system established in Texas;
    (E) informing the individual of the availability of information and assistance from the Ombudsman by contacting the Ombudsman at 1-800-252-8154 or online at hhs.texas.gov/ombudsman, and the Health Facility Licensing complaints line at 1-888-973-0022; and
    (F) determining whether the individual comprehends the information provided in accordance with subparagraphs (B) - (E) of this paragraph.
(e) An individual who is admitted to a CSU before the physical assessment and psychiatric admission examination is conducted must be discharged by the physician immediately if the physician conducting the physical assessment and psychiatric examination of the individual determines the individual does not meet the clinical standards to receive inpatient mental health services, in accordance with Texas Health and Safety Code §572.0025(f-1).
(f) A CSU that discharges an individual under the circumstances described in (e) of this section may not bill the individual or the individual's third-party payor for the temporary admission of the individual to the CSU, in accordance with Texas Health and Safety Code §572.0025(f-2).

Source Note: The provisions of this §306.55 adopted to be effective May 27, 2021, 46 TexReg 3257