1. (1) If a service recipient requires evaluation for emergency involuntary admission to a state- owned or operated treatment resource under T.C.A. § 33-6-404 and cannot be examined by a mandatory pre-screening agent within two (2) hours of the request to examine the person, a physician or psychologist may perform the evaluation and provide a certificate of need. The physician or psychologist then has the following responsibilities:

   1. (a) Maintain compliance with requirements for physician under T.C.A. § 33-1-101(15) or psychologist under T.C.A. § 33-6-427(a).
   2. (b) Pre-screen the service recipient for emergency involuntary admission under T.C.A. § 33-6-404.
   3. (c) Determine, if possible, whether the service recipient has executed a durable power of attorney for health care or a declaration for mental health treatment and comply to the extent possible.
   4. (d) Determine, if possible, whether the service recipient is under a mandatory outpatient treatment obligation from an inpatient provider.
   5. (e) Before completing a certificate of need, make a determination, in consultation with a crisis response service that serves the county where the service recipient is being evaluated, that all available and appropriate less drastic alternatives to placement in a hospital or treatment resource are unsuitable to meet the needs of the person and EMERGENCY INVOLUNTARY ADMISSIONS document the consultation. A face-to-face consultation with the crisis response service is not required.
   6. (f) Complete a certificate of need for any service recipient assessed as eligible for emergency involuntary admission under T.C.A. § 33-6-404.
   7. (g) Determine and document level of security required and mode of transportation to the admitting hospital for service recipients eligible for emergency involuntary admission under T.C.A. § 33-6-404.
   8. (h) For service recipients not eligible for emergency involuntary admission, notify a crisis response service that serves the county where the service recipient resides or is receiving services of the need for follow-up. Provide necessary information and document this notification.

   9. (i) When a service recipient is referred for emergency involuntary admission or alternative services, provide at least the following information to the treatment resource:

      1. 1. The certificate of need for emergency involuntary admission;
      2. 2. Acknowledgement and copy, where possible, of a durable power of attorney for health care or a declaration for mental health treatment;
      3. 3. Existence of mandatory outpatient treatment obligation, if applicable, and discharging facility, if known;
      4. 4. Name of person at referring service provider;
      5. 5. Any known medical condition(s);
      6. 6. Current or recent prescription and/or over-the-counter medication(s), if any;
      7. 7. Current or recent use of alcohol and/or other substance use, if any;
      8. 8. Name of current or most recent community mental health provider, if known; and
      9. 9. Recommendations for services and/or supports following discharge.

Authority: T.C.A. §§ 4-4-103, 4-5-202, 4-5-204, 33-1-301, 33-1-303, 33-1-305, 33-6-102, 33-6-104, 33-6- 402, 33-6-403, 33-6-404, 33-6-406, and 33-6-427. Administrative History: Original rule filed November 7, 2003; effective January 21, 2004.