| (a) Purpose. The purpose of this rule is to establish
criteria and a process for admitting youth who are experiencing a
psychiatric crisis into a crisis stabilization unit (CSU) operated
by the Texas Juvenile Justice Department (TJJD).
(b) Definitions.
(1) Designated Mental Health Professional--has the
meaning assigned by §380.9187 of this title.
(2) Psychiatric Provider--has the meaning assigned
by §380.9187 of this title.
(c) References.
(1) For due process procedures for mental health status
reviews, see §380.9571 of this title.
(2) For emergency mental health placements, see §380.8771
of this title.
(d) Admissions.
(1) Admission Criteria. A youth may be admitted to
a CSU only when the following criteria are met:
(A) the youth demonstrates serious dysfunction in behavior,
judgment, thinking, or mood; and
(B) the dysfunction is the result of a current neurological
deficit, emotional disturbance, and/or psychiatric disorder (e.g.,
psychosis, major affective disorder, organic disorder, or anxiety
disorder) and the dysfunction is not the result of a primary conduct
disorder or antisocial personality disorder; and
(C) the youth:
(i) presents a risk of serious harm to self or others;
or
(ii) if not treated, will continue to suffer severe
and abnormal mental, emotional, or physical distress and will continue
to experience deterioration in his/her ability to function independently,
as evidenced by the youth's inability to attend to basic needs, such
as food, health, personal hygiene, or safety; and
(D) a CSU is the least restrictive intervention that
is appropriate and available to safely and effectively meet the treatment
needs and to control the dysfunctional behavior.
(2) Referral Documents. The referral must include a
current psychiatric evaluation from a psychiatric provider and a psychological
evaluation approved by the designated mental health professional,
unless the referral is due to an emergency mental health placement
under §380.8771 of this title.
(3) 96-Hour Admission Review Process. A mental health
status review hearing must be held for each youth within 96 hours
after arrival at the unit. If the 96-hour period ends on a Saturday,
Sunday, or official holiday, the hearing must be held on the next
workday. The hearing is held to determine whether criteria for unit
admission have been met.
(A) If the youth does not meet criteria for admission,
he/she is not retained in the CSU. Youth who are not admitted are
returned to the referring program/location.
(B) If the youth meets criteria for admission, he/she
is retained and treated in the CSU.
(C) If the youth's treatment needs and appropriateness
for admission cannot be determined during the hearing, the youth may
be temporarily admitted to the CSU for diagnostic and assessment purposes
for up to 45 days from the date of arrival.
(i) A youth may be temporarily admitted for diagnostic
and assessment purposes only if the hearing manager determines:
(I) the youth exhibits evidence of psychiatric dysfunction;
(II) the youth has recently engaged in behavior that
presents a danger to self or others or has demonstrated a chronic
failure to progress in his/her prior programming;
(III) the youth is in need of comprehensive psychiatric
and psychological evaluation in a specialized setting; and
(IV) the CSU is the least restrictive setting in which
to effectively accomplish this evaluation.
(ii) Before the end of the 45-day diagnostic and assessment
period, the CSU staff must:
(I) hold a mental health status review hearing to seek
admission to CSU; or
(II) transfer the youth out of CSU if a hearing is
not held or if the youth is not admitted to CSU.
(e) Program Requirements.
(1) The program focus is on stabilization of the psychiatric
dysfunction.
(2) Services are provided in a self-contained unit.
(3) An individualized treatment program, including
treatment goals and objectives, is developed for and with each youth.
(4) The treatment team reviews the youth's progress
weekly.
(5) The youth must be transferred out of the CSU within
90 days after the admission hearing unless an extension is granted.
(f) Extensions.
(1) Extension Criteria. An extension may be granted
beyond 90 days only if:
(A) the youth continues to meet admission criteria
and the youth's treatment plan has been implemented appropriately;
or
(B) the youth has symptoms of mental illness and continued
treatment in the CSU is deemed to be in the youth's best interest.
(2) Due Process Requirements for Extensions.
(A) The due process required to determine whether extension
criteria have been met is a mental health status review hearing. A
youth on parole status, as defined in §380.9550 of this title,
will remain on parole status.
(B) If an extension is recommended, the mental health
status review hearing must be held:
(i) approximately 75 days but no later than 90 days
after the last mental health status review hearing; or
(ii) within two workdays after the youth returns to
the unit if he/she is in a state hospital at the time the hearing
is required.
(C) Multiple extensions may be granted by following
procedures in this subsection.
(3) Release and Transition Options.
(A) The extension of time to treat the psychiatric
dysfunction must be terminated when placement in a CSU is no longer
needed for the primary purpose of treatment of the dysfunction, as
determined by a majority vote of the youth's treatment team.
(B) Following termination of the extension, future
placement decisions, including the youth's return to his/her home
parole placement, are made in accordance with other applicable policies
and procedures.
(C) No youth may be discharged from TJJD jurisdiction
directly from a CSU unless TJJD's jurisdiction ends by statute.
|
| Source Note: The provisions of this §380.8767 adopted to be effective June 24, 1997, 22 TexReg 5765; amended to be effective January 31, 2001, 26 TexReg 765; amended to be effective July 31, 2001, 26 TexReg 4876; amended to be effective April 15, 2002, 27 TexReg 2830; amended to be effective September 21, 2005, 30 TexReg 5955; amended to be effective September 1, 2009, 34 TexReg 5551; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended to be effective December 1, 2014, 39 TexReg 9257 |
