Section 306.65 - Crisis Stabilization Services and Recovery or Treatment Planning(a) A CSU staff member must provide an individual crisis stabilization services under the direction of a physician and in accordance with the individual's recovery or treatment plan and the service requirements. Such treatment includes medical services and nursing services described in §306.61 of this division (relating to Crisis Stabilization Unit Medical Services) and §306.63 of this division (relating to Crisis Stabilization Unit Nursing Services). (b) Nursing staff must develop and implement an initial or preliminary nursing care plan within the first 24 hours after admission. This plan must be based on the findings of the initial comprehensive nursing assessment and any pre-admission assessment information that is available at the time of admission. (c) The IDT must collaborate in developing the individual's recovery or treatment plan based on the findings of: (1) the individual's physical examination identified in §306.63 of this division; (2) the individual's psychiatric evaluation identified in §306.61 of this division; (3) the individual's initial comprehensive nursing assessment identified in §306.63 of this division; (4) an assessment of the individual's risk of harm to self or others, identified in § 306.53 of this subchapter (relating to Pre-Admission Screening and Assessment); and (5) the psychosocial assessment identified in § 306.53 of this subchapter. (d) The recovery or treatment plan must contain: (1) a list of all the individual's diagnoses with notation as to which diagnoses will be treated at the CSU, including: (A) at least one mental illness or SED diagnosis according to the current edition of the Diagnostic and Statistical Manual of Mental Disorders; (B) any substance use disorder diagnosis according to the current edition of the Diagnostic and Statistical Manual of Mental Disorders; and (C) any non-psychiatric conditions; (2) a description of all treatment interventions intended to address the individual's condition, including: (A) all medications prescribed and the symptoms each medication is intended to address; (B) psychosocial rehabilitative services; (C) counseling or psychotherapies; and (D) peer specialist services, as available, and in accordance with 1 TAC § 354.3013(relating to Services Provided); (3) a documented level of monitoring assigned to the individual by the physician, or physician-delegated PA or APRN; (4) an identification of additional assessments and evaluations to be conducted, including: (A) risk of harm to self or others; (B) history of trauma; and (C) emerging health issues; (5) a description of any potential barriers to the individual's discharge; and (6) a description of any medical or nursing services. (e) A member of the IDT reviews the recovery or treatment plan and evaluates its effectiveness: (1) at least 72 hours after being implemented; or (2) any time there is a change in the individual's condition based on: (A) a medical re-evaluation described in §306.61 of this division; (B) a nursing reassessment described in §306.63 of this division; (C) a request by the individual, or the individual's LAR or adult caregiver, as applicable; or (D) receiving information regarding recommended services and supports needed by the individual after discharge. (f) A member of the IDT discusses all revisions with the individual, and the individual's adult caregiver or LAR, as necessary, to obtain feedback and agreement from the individual, and the individual's LAR or adult caregiver, as applicable, before implementing the individual's revised recovery or treatment plan.26 Tex. Admin. Code § 306.65
Adopted by Texas Register, Volume 46, Number 21, May 21, 2021, TexReg 3270, eff. 5/27/2021