| (a) Medical Referral. If a staff member believes any resident to be in need of immediate medical attention or if a resident requests treatment, the resident shall be referred for medical services. (b) Medical Release. Documentation of consent for medical treatment received in accordance with Texas Family Code Section 32.001, shall be maintained in applicable resident files. (c) Medication. In accordance with Texas Human Resources Code Section 142.005, the juvenile board shall adopt a policy concerning the administration of medication to residents. The policy shall include which facility employees are authorized to administer medication to residents. (d) Suicidal Youth. (1) Prevention Plan. (A) Each facility shall have a written suicide prevention plan developed in consultation with a mental health professional that addresses the following components: (i) definitions of high risk and moderate risk suicidal behavior; (ii) screening methodology to assess a resident's risk of suicide upon admission and upon any indication a resident previously screened may now be at moderate or high risk for suicidal behavior; (iii) communication among facility staff, mental health professionals, the resident, and the resident's parent or guardian including communication regarding observations or indications a resident previously screened may now be at moderate or high risk for suicidal behavior; (iv) level of supervision for residents assigned to moderate or high risk for suicidal behavior; (v) policy and procedure for intervening in suicide attempts; (vi) reporting of resident suicides and attempted suicides in accordance with any applicable state law, administrative standard, or local policy or ordinance; (vii) training on the contents and implementation of the suicide prevention plan; (viii) housing of residents assigned to moderate or high risk of suicidal behavior including the removal from the resident's presence any dangerous objects; and (ix) mortality reviews designed to review the facility's compliance and possible needed revisions to the suicide prevention plan following a resident's suicide. (B) All short-term juvenile detention officers shall be trained annually in the implementation of the suicide prevention plan. (C) Review. (i) The suicide prevention plan shall be reviewed on an annual basis in consultation with a mental health professional. (ii) The suicide prevention plan shall be included in the facility administrator's review of the facility's policies and procedures in accordance with §351.2(d)(1) of this chapter. (2) Level of Supervision. (A) Moderate Risk for Suicidal Behavior. During non-program hours, or any time a resident classified as a moderate risk for suicidal behavior is confined or restricted from the general population: (i) The resident shall be visually checked by a short-term juvenile detention officer at staggered intervals not to exceed every 10 minutes. (ii) The short-term juvenile detention officer shall document each visual observation made with the time of the observation and a general description of the resident's behavior. (B) High Risk for Suicidal Behavior. (i) Supervision. During non-program hours, or any time a resident classified as high risk for suicidal behavior is confined or restricted from the general population: (I) the resident shall be under the continuous, uninterrupted visual supervision of a short-term juvenile detention officer; and (II) the short-term juvenile detention officer shall document physical observations of a high risk resident at staggered intervals of no less than every 30 minutes. (ii) Required Documentation. The following documentation shall be maintained for high-risk residents and shall be posted where it is immediately accessible to the short-term juvenile detention officer providing supervision to the high risk resident: (I) the date and time the resident was classified as high risk; (II) who classified the resident as high risk; (III) a description of the resident's behavior that caused the resident's classification as high risk; (IV) who has been assigned to supervise the resident; (V) the location for the resident's supervision; (VI) the date and time the resident was reclassified as no longer being high risk; and (VII) the name of the mental health professional who reclassified the resident as no longer being high risk. (C) A short-term juvenile detention officer assigned to work in a facility's primary control room may not provide supervision under paragraph (2)(A) or (2)(B) of this subsection. (D) Video and audio monitoring devices shall not substitute for supervision by a short-term juvenile detention officer under paragraph 2(A) or (2)(B) of this subsection. (3) Mental Health Referral. (A) The facility shall refer a resident classified as exhibiting a high risk for suicidal behavior to a mental health professional as defined by §351.1(10)(A), (B), (E), (F) and (G) of this chapter within 24 hours from the time the resident is classified as a high risk for suicidal behavior. (B) The facility shall maintain written documentation that the referral under subparagraph (A) of this paragraph was made. The documentation shall include: (i) who notified the mental health professional or mental health agency; (ii) the date and time of the notification; (iii) the method of notification; and (iv) a brief description of the response provided by the mental health professional or mental health agency. (C) Prior to being removed from a high risk for suicidal behavior designation/classification, a mental health professional as defined by section §351.1(10)(A) (B) (E) (F) and (G) of this chapter shall conduct an assessment of the resident's suicide risk and issue a written recommendation which addresses the following: (i) the need to re-classify the resident's suicide risk level; (ii) the need for intervention strategies and/or services during the resident's period of incarceration within the facility; and (iii) the need for additional assessment(s). (D) The mental health professional's written recommendation shall be maintained in the resident's record. (E) Only the facility administrator or their designee may remove a resident from being designated/classified as being a high risk for suicidal behavior paragraph (2)(B) of this section. |
