• CRU Admission Criteria
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CRU ADMISSION CRITERIA:

 Uninsured voluntary adult patients and residents of County, AND

 Validated principal DSM-IV Axis I or Axis II diagnosis
      GAF<50, AND

 Capacity to make a decision to enter into voluntary treatment, AND

 Capacity to perform self medication, AND ONE OF THE FOLLOWING:

	Loss of ability to perform activities of daily living due to moderate impairment in judgment, poor impulse control, or moderate impairment in cognitive perceptual abilities arising from: Acute psychiatric condition or dual disorder condition Acute exacerbation of chronic psychiatric condition Significant decrease in functioning in several activities of daily living as measured against baseline function over the preceding year.
	Danger to self as evidenced by: Specific plan to harm self with high lethality and/or lack of means and ambivalence in intention with desire to seek treatment, or Moderate to significant violent/homicidal ideation accompanied by a rejection or lack of available social/therapeutic support, and Absence of significant violent attack within 72 hours
	Danger to others as evidenced by: Specific plan to take a life threatening action with high lethality and availability of means but ambivalence in intention with desire to seek treatment; or Mild to moderate suicidality accompanied by rejection or lack of available social therapeutic support (24 hours)
	Danger to property where such danger includes: Specific plan to take destructive action that may result in life threatening situation with high lethality and availability of means to take such action
	A high risk for placing self or others at risk for significant harm through impulsive behavior or exercising poor judgment as evidenced by: A documented pattern of ongoing and recent impulsive behavior that puts self or others at risk, or Documented evidence of a plan to behave in a manner that will place self or others at significant risk and documented evidence of a lack of ability to control one’s behavior to avoid enacting such a plan.
	Consumer has deteriorated to level of disorganization and dysfunction that they cannot cooperate with outpatient care or treatment plan.
In addition two or more of the following are present: :
	Unable to currently participate in treatment without intervention to stabilize/organize and initiate an outpatient treatment plan, or
	Regression or further decompensation is very likely without this level of care at this time, or
	Moderate impairment in communication or judgment that can resolve with intensive interventions leading to a safe return to the community, or
	Severe multiple psychosocial stressors which prevent the individual from being able to participate in some or all activities of daily living, or
	Affective or behavioral liability which may resolve quickly with intensive interventions.
If substance abuse, intoxication, or dependence diagnosis all three of the following must be present:
	Signs and symptoms do not pose a severe immediate medical threat to the patient, and
	Signs and symptoms of such severity to request short term nursing/medical monitoring, and
	Relapse potential immediate without this level of intervention.
REFERRAL PROCEDURE:
Coming from MHMRA clinic during business hours:
1.	Call Mende Snodgress (713-970-7433) for bed availability and clearance. In her absence, call Debbie Zebot (713-970-7412).
2.	Clinic doctor must complete a doctor to doctor with Dr. Maria Garza (713-970-7518) or her designee. In her absence, call Dr. Avrim Fishkind (713-970-4606).
3.	All relevant assessments, progress notes, laboratory work-ups or other important clinical information must accompany the consumer or be faxed to CRU.
4.	If medication is required, a 14-day supply more of medication must accompany the consumer supplied by the clinic pharmacy.
Community referrals during business hours and after business hours:
1.	Call Mende Snodgress (713) 970-7433) to determine if bed is available.
2.	If applicable, treating doctor must complete a doctor to doctor with Dr. Maria Garza (713-970-7518) or her designee. In her absence, call Dr. Avrim Fishkind (713-970-4606). If physician is unavailable in the CRU or the transferring facility, admission must be authorized by a licensed mental health professional (call Mende Snodgress, 713-970-7433). If medical problems are suspected, Dr. Garza or her designee must authorize the admission. Should Dr. Garza be unavailable, call Dr. Avrim Fishkind.
3.	All relevant assessments, progress notes, laboratory work-ups or other important clinical information must accompany the consumer.