SECTION 3.8013. Discharge Criteria for Inpatient Rehabilitation/Treatment (Hospital or 24-hour Residential) Services

The patient is no longer considered eligible for inpatient rehabilitation/treatment (hospital or 24-hour residential) services for any particular episode when the patient meets the conditions of any one paragraph out of paragraphs (1)-(4) of this section.

(1) Diagnosis. The patient no longer meets the diagnostic criteria as addressed in §3.8011(1) of this title (relating to Admission Criteria for Inpatient Rehabilitation/Treatment (Hospital or 24-hour Residential) Services).

(2) Psychiatric illness or medical complication. The patient must meet the conditions of subparagraph (A) or (B) of this paragraph, as follows:

(A) documentation that a psychiatric or medical condition should be treated in another setting; or

(B) documentation that a psychiatric or medical condition which is interfering with alcohol/drug recovery is not being treated.

(3) Chemical dependency rehabilitation/treatment. The patient must meet all conditions under at least one subparagraph out of subparagraphs (A)-(C) of this paragraph.

(A) Patient displays behaviors which demonstrate that the patient:

(i) is medically stable;

(ii) recognizes or identifies with the severity of chemical substance use;

(iii) has insight into the patient's defeating relationship with alcohol/drugs;

(iv) is applying the essential coping skills necessary to maintain sobriety either in a self-help fellowship and/or with post-treatment supportive care.

(B) The provider and patient have developed an individualized aftercare plan to help the patient maintain the gains made during active treatment.

(C) In the case of adolescents, the family or adult significant other refuses to participate in treatment (if the discharge plan is to return to the original setting), unless the attending provider can document that the adolescent is making progress toward established treatment goals and can demonstrate that active efforts are being made to involve the family or adult significant other in treatment.

(4) Behavioral factors. The patient must meet the conditions under subparagraphs (A) and (B) of this paragraph.

(A) Patient is consistently uncooperative, to the degree that no further progress is likely to occur.

(B) Greater intensity of service or transfer to another treatment provider would not have a positive impact on the problem.

Source Note: The provisions of this §3.8013 adopted to be effective August 28, 1991, 16 TexReg 4403