(a) In accordance with THSC, §593.021, only the following persons may apply for admission to a state MR facility for emergency services:
  (1) the individual seeking admission; or
  (2) the LAR of an individual.
(b) If the MRA determines that an individual meets the criteria for emergency admission under §2.261 of this subchapter (relating to Criteria for Emergency Admission of an Adult or a Minor to a State MR Facility Under the PMRA), the MRA must retain a copy of the application packet, as described in §2.265(h) of this subchapter (relating to MRA Referral of an Applicant to a State MR Facility) and send the original application packet to the admission coordinator of the state MR facility.
(c) DADS will determine when a vacancy exists in a state MR facility and which individuals are appropriate to fill the vacancy, based on the information in the application packets.
(d) Upon notification from DADS that an appropriate vacancy in a state MR facility is available, the MRA will contact each individual identified by DADS as appropriate to fill the vacancy and will:
  (1) determine whether the individual is still seeking emergency admission to a state MR facility;
  (2) update the information in the individual's application packet, including ensuring that the assessments reflect the individual's current level of functioning; and
  (3) determine whether the individual would accept the proposed emergency admission to the state MR facility.
(e) The state MR facility will offer emergency admission to one of those individuals identified by DADS as appropriate to fill the vacancy and who the MRA has determined would accept the proposed emergency admission to the state MR facility.
(f) Prior to admission of the individual, the MRA must:
  (1) negotiate the terms of the Emergency Admission/Discharge Agreement with the parties and prepare the agreement;
  (2) send a copy of the completed Emergency Admission/Discharge Agreement to the individual or LAR, the state MR facility, and the Department of Aging and Disability Services, Provider Services Division, State Mental Retardation Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030; and
  (3) develop a service coordination plan to accomplish the expected outcomes identified in the Emergency Admission/Discharge Agreement.
(g) If the individual is under 22 years of age, the Emergency Admission/Discharge Agreement must incorporate elements of the individual's permanency plan, as appropriate, and specify that the individual is to be admitted for no longer than six months to receive emergency services in the state MR facility.
(h) The Emergency Admission/Discharge Agreement must be approved by the commissioner or designee prior to the admission of the individual by the state MR facility.
(i) If the Emergency Admission/Discharge Agreement is approved by the commissioner or designee and the individual is admitted, the state MR facility will, at the time of admission:
  (1) complete a physical examination of the individual and issue orders addressing the applicant's medication, treatment, and diet needs; and
  (2) develop a plan of services and supports to be provided while the individual is a resident.
(j) Within 30 calendar days after the individual is admitted, the state MR facility will arrange for:
  (1) a DMR to be conducted in accordance with §5.155 of this title (relating to Determination of Mental Retardation (DMR)); and
  (2) an IDT at the state MR facility to make findings and recommendations in accordance with the process described for an MRA IDT in §2.264 of this subchapter (relating to MRA IDT Recommendation Concerning the Commitment of an Adult or a Minor or the Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA).
(k) The terms of the Emergency Admission/Discharge Agreement, including the date of discharge, may not be amended unless the MRA obtains approval from the commissioner or designee.
(l) The individual will be discharged by the state MR facility under the terms of the Emergency Admission/Discharge Agreement.
(m) If DADS determines that the terms of the Emergency Admission/Discharge Agreement cannot be met, the MRA may initiate commitment proceedings under the PMRA.

Source Note: The provisions of this §904.53 adopted to be effective January 1, 2001, 25 TexReg 12746; amended to be effective March 31, 2002, 27 TexReg 2445; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective September 1, 2006, 31 TexReg 6783; transferred effective September 1, 2023, as published in the August 11, 2023, issue of the Texas Register, 48 TexReg 4397