SECTION 904.25. Criteria for Commitment and Regular Voluntary Admission of an Adult to a State MR Facility Under the PMRA

(a) In accordance with THSC, §§593.003, 593.052, and 593.041, an adult may be committed to a state MR facility for residential services only if:

(1) the adult is determined to have mental retardation in accordance with §415.155 of this title (relating to Determination of Mental Retardation (DMR));

(2) the adult, because of mental retardation:

(A) represents a substantial risk of physical impairment or injury to self or others; or

(B) is unable to provide for and is not providing for the adult's most basic personal physical needs;

(3) the adult cannot be adequately and appropriately habilitated in an available, less restrictive setting;

(4) the state MR facility provides habilitative services, care, training, and treatment appropriate to the adult's needs; and

(5) a report by an IDT recommending the placement has been completed in accordance with §412.264 of this title (relating to 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) during the six months preceding the date of the commitment hearing.

(b) An adult with the capacity to give legally adequate consent may be admitted to a state MR facility under a regular voluntary admission for residential services only if:

(1) in accordance with THSC, §§593.003, 593.013, and 593.026:

(A) the adult has been determined to have mental retardation in accordance with §415.155 of this title (relating to Determination of Mental Retardation (DMR));

(B) a report by an MRA's IDT recommending the placement has been completed in accordance with §412.264 of this title (relating to 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) during the six months preceding the request for admission;

(C) the department determines space is available in a state MR facility; and

(D) the facility superintendent determines that the state MR facility provides services that meet the needs of the adult; and

(2) the IDT report referenced in paragraph (1)(B) of this subsection includes the following findings:

(A) because of mental retardation, the adult:

(i) represents a substantial risk of physical impairment or injury to self or others; or

(ii) is unable to provide for and is not providing for the adult's most basic personal physical needs;

(B) the adult cannot be adequately and appropriately habilitated in an available, less restrictive setting; and

(C) the state MR facility provides habilitative services, care training and treatment appropriate to the adult's needs.

(c) An adult represents a substantial risk of physical impairment or injury to self or others or is unable to provide for and is not providing for the adult's most basic personal physical needs, as referenced in subsection (a)(2) and (b)(2)(A) of this section, if:

(1) the adult's IQ is four or more standard deviations below the mean, (i.e., in the severe or profound range of mental retardation);

(2) the adult's ICAP service level equals:

(A) 1, 2, 3, or 4; or

(B) 5 or 6 and the adult:

(i) has extraordinary medical needs that would require direct nursing treatment for at least 180 minutes per week if the adult's caregiver were not providing such treatment; or

(ii) exhibits incidents of dangerous behavior that would require intensive staff intervention and resources to prevent serious physical injury to the adult or others if the adult's caregiver were not managing such incidents; or

(3) the adult meets other objective measures as determined by the department.

Source Note: The provisions of this §904.25 adopted to be effective January 1, 2001, 25 TexReg 12746; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective September 1, 2023, as published in the August 11, 2023, issue of the Texas Register, 48 TexReg 4397