| (a) Purpose. The purpose of this rule is to establish
the process by which youth committed to the Texas Juvenile Justice
Department (TJJD) are assessed and treated for specialized treatment
needs. The purpose of all provisions in this rule is to promote successful
youth reentry and reduce risk to the community by addressing individual
specialized treatment needs through programs that are designed to
reduce risk to reoffend.
(b) Definitions. Except as indicated in this subsection,
see §380.8501 of this chapter for definitions of terms used in
this rule.
(1) Intensive Treatment Program--a high-intensity treatment
program designed to address youth with a high need for specialized
treatment. Treatment is generally delivered in specialized groups
by licensed or appropriately trained staff.
(2) Psycho-educational Program--a low-intensity program
delivered by appropriately trained staff that is designed to address
youth with a low need for specialized treatment.
(3) Sex Offense--a reportable adjudication as defined
in Article 62.001 of the Texas Code of Criminal Procedure.
(4) Mental Health Professional--see definition in §380.9187
of this chapter.
(5) Moderate-Intensity Treatment Program--a program
designed to address youth with a moderate need for specialized treatment.
Treatment is generally delivered in specialized groups by licensed
or appropriately trained staff.
(c) General Provisions.
(1) Youth with one or more specialized needs will have
these needs addressed while under TJJD jurisdiction. Youth may have
specialized needs addressed while in a high- or medium-restriction
facility or on parole status.
(2) If a youth cannot be provided the type(s) of specialized
program designated in this rule for the youth's assessed need level,
the youth will be provided with the most appropriate alternate form
of intervention for that treatment need.
(d) Treatment Planning.
(1) Upon admission to TJJD, comprehensive assessments
are conducted to determine if a youth has any specialized treatment
needs and to identify the type of specialized program that is best
suited to address those needs. For each youth assessed as having a
specialized treatment need, an initial plan documenting all specialized
treatment needs and recommended programs is developed as soon as possible.
(2) In addition to the initial plan, a comprehensive
plan is developed for each youth with specialized treatment needs.
The comprehensive plan must:
(A) include individually tailored statements regarding
treatment goals and objectives;
(B) include the tentative sequence and start dates
for each specialized program;
(C) be developed with input from the youth; and
(D) be documented in the youth's individual case plan.
(3) The sequence and start dates for specialized programs
are based on individual youth needs, facility schedules, and program
openings, with consideration given to the youth's minimum length of
stay or minimum period of confinement.
(4) The comprehensive specialized treatment plan is
reviewed, reevaluated, and modified in accordance with rules for the
review and modification of the individual case plan, as set forth
in §380.8701 of this chapter. The plan is also modified following
each reassessment of a youth's specialized treatment needs.
(5) Specialized treatment needs may be reassessed at
any time during a youth's stay in TJJD.
(e) Specialized Treatment Needs. The areas of specialized
treatment need are set forth in paragraphs (1) - (6) of this subsection,
with each area given priority for placement and treatment based on
urgency of need.
(1) Medical. Each youth is provided comprehensive medical
and dental examinations. Based on the results of these examinations,
each youth is assigned a need level for medical or dental services.
Non-compliance with treatment may cause any youth to be designated
as higher need than the underlying condition would typically warrant.
(A) High Need--includes youth who require medical,
surgical, or dental services of an intense/acute nature. The youth
has a serious acute condition, experiences an exacerbation of a chronic
medical or dental condition, sustains a serious injury, and/or may
require hospitalization. The youth's condition is unstable or unpredictable,
and recovery requires 24-hour nursing care or supervision beyond the
scope of normal infirmary services. The youth's medical needs, until
resolved, take precedence over other therapeutic interventions and
temporarily prevent active participation in programming.
(B) Moderate Need--includes youth who are diagnosed
with a medical or dental condition that is moderate to serious in
severity and that may require frequent access to clinical and/or hospital
services for symptom exacerbation.
(C) Low Need--includes youth who are diagnosed with
a condition that is mild to moderate in severity and does not require
ongoing treatment or monitoring. The youth may be temporarily restricted
from an activity due to an accident, injury, or illness of mild to
moderate severity.
(D) None--includes youth with no medical or dental
diagnosis requiring ongoing attention.
(2) Mental Health. The mental health needs assessment
is provided by mental health staff through comprehensive psychological
and/or psychiatric evaluation using the most current edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM). Based
on this assessment, each youth is assigned a need level for mental
health treatment services.
(A) High Need - Level 1.
(i) This level of treatment need includes youth who:
(I) are diagnosed with a mental disorder. As a result
of the disorder, there is disorganized, bizarre, and/or grossly inappropriate
behavior in one or more of the following areas: social or interpersonal
interactions, educational or vocational participation, or the ability
to manage daily living requirements;
(II) have an assessment of adaptive functioning that
is consistent with the level of impairment noted;
(III) cannot meaningfully participate in programming
until the underlying disorder is stabilized; and/or
(IV) are an imminent danger to themselves or others
as a result of the mental disorder.
(ii) This level of impairment is not the result of
a conduct disorder, oppositional defiant disorder, or similar impulse
control/behavioral disorders and is not the result of intoxication
or withdrawal from drugs.
(iii) Youth with this level of impairment require a
protective environment during this phase of the disorder and are treated
at an agency-operated crisis stabilization unit or a psychiatric hospital
with psychiatric care as the highest priority.
(B) High Need - Level 2.
(i) This level of treatment need includes youth who:
(I) are diagnosed with a mental disorder. As a result
of the disorder, there is moderate to severe impairment in one or
more of the following areas: social or interpersonal interaction,
educational or vocational participation, or the ability to manage
daily living requirements despite receiving psychiatric care and clinical
support services;
(II) have an assessment of adaptive functioning that
is consistent with the level of impairment noted; and/or
(III) are having a difficult time maintaining stability
and program participation despite receiving psychiatric services and
local clinical support.
(ii) This level of impairment is not the result of
a conduct disorder, oppositional defiant disorder, or similar impulse
control/behavioral disorders and is not the result of intoxication
or withdrawal from drugs.
(iii) Youth with this level of treatment need are placed
in an intensive mental health treatment program with structured interventions
and enhanced clinical support services in addition to regular psychiatric
services.
(C) Moderate Need.
(i) This level of treatment need includes youth who:
(I) are diagnosed with a mental disorder. As a result
of the disorder, behavior is mildly impaired by signs and symptoms
of the mental disorder in one or more of the following areas: social
or interpersonal interaction, educational or vocational participation,
or ability to manage daily living requirements with regular psychiatric
care and/or psychological intervention;
(II) have an assessment of adaptive functioning that
is consistent with the level of impairment noted; and/or
Cont'd... |
