| (a) Purpose. This rule provides guidelines for using
psychopharmacotherapy as part of an established treatment plan for
Texas Juvenile Justice Department (TJJD) youth exhibiting symptoms
of mental illness, mental disorder, or emotional distress.
(b) General Provisions. Under no circumstances are
tranquilizers, psychostimulants, or other psychotropic medications
administered:
(1) for discipline, security, or control purposes;
(2) for experimental research; or
(3) as a sleep aid (unless sleep disturbance is related
to a primary mental health diagnosis).
(c) Prescribing Psychotropic Medication.
(1) TJJD strives to ensure that prescribing psychotropic
medication is a collaborative effort among the psychiatric provider,
the youth, and the parent/guardian when feasible. All discussions
and/or notifications to the youth and/or the parent/guardian regarding
treatment objectives, medication disadvantages, available alternatives,
consequences of not following the recommended treatment plan, and
potential medication side effects are documented in the youth's medical
record. During the intake and assessment process, the psychiatric
provider may continue the medication after reviewing the youth's medical
record and/or conducting a psychiatric evaluation. Indication for
the psychopharmacotherapy must be documented in the youth's medical
record.
(2) Psychotropic medication may be prescribed only
as part of an established treatment plan after a youth has received
nursing, medical, and mental health screenings and evaluations. A
previously prescribed medication may be continued upon TJJD admission
or transfer to promote continuity of care in accordance with subsection(c)(1)
of this section.
(3) Psychotropic medication is prescribed only to a
youth who exhibits symptoms that meet criteria in the current Diagnostic
and Statistical Manual for a psychiatric disorder.
(4) The schedule and dosage of prescribed psychotropic
medication are consistent with established community standards of
care and nationally accepted practice guidelines. If the schedule
and dosage differ from these standards or guidelines, the psychiatric
provider must clearly document his/her rationale.
(5) Standing orders will not be utilized for prescribing
psychotropic medication. The use of standing orders shall comply with
applicable state regulations.
(6) Psychotropic medication is prescribed in accordance
with disease management guidelines and the formulary adopted for use
by TJJD and the University of Texas Medical Branch-Correctional Managed
Care (UTMB). The guidelines and formulary are developed and revised
as needed by the TJJD/UTMB Pharmacy and Therapeutics Committee, consisting
of psychiatrists, pharmacists, nurses, the TJJD medical director,
and the UTMB mental health directors.
(d) Psychotropic Medication Administration.
(1) Psychotropic medication is administered orally
unless specific contraindications have been documented.
(2) Psychotropic medication may not be administered
against the will of a youth except in a psychiatric emergency as specified
in §380.9192of this title.
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| Source Note: The provisions of this §380.9191 adopted to be effective December 31, 1996, 21 TexReg 12185; amended to be effective February 20, 1998, 23 TexReg 1115; amended to be effective July 31, 2001, 26 TexReg 4728; amended to be effective September 19, 2011, 36 TexReg 5943; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended to be effective April 15, 2015, 40 TexReg 1976 |
