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RULE §163.40Substance Abuse Treatment

(a) Definitions. These words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise.

  (1) "Admission" is the administrative process and procedure performed to accept an offender into a treatment program or facility.

  (2) "Aftercare" is the counseling and community based support services that are designed to provide continued support for treatment delivered in a residential or outpatient program.

  (3) "Aftercare Caseloads" is the supervision of and support services for offenders who have completed a substance abuse treatment program.

  (4) "Assessment" is a process conducted by a qualified credentialed counselor or counselor intern trained to administer a structured interview to determine the nature and extent of an offender's chemical abuse, dependency, or addiction, and to assist in making an appropriate referral. Other criminogenic risks and needs will be assessed and incorporated into the individual treatment plan.

  (5) "Best Practices" are evidence based substance abuse treatment programs that address concepts such as criminogenic risks and needs, responsivity, and cognitive behavioral treatment, and programs that possess the following hallmarks:

    (A) Validated treatment assessments that include criminogenic risks and need factors;

    (B) A treatment regimen that focuses on changing criminogenic risks and needs, behaviors, and thinking patterns;

    (C) A treatment regimen that includes a specific, cognitive behavioral program that has been recognized in professional criminal justice journals;

    (D) Responsivity in addressing offenders' needs and employment of qualified staff; and

    (E) Measurable outcomes to reduce substance abuse, dependency, or addiction as well as other criminogenic risks and needs.

  (6) "Chemical Dependency" is a substance related disorder as defined in the most recent published edition of the Diagnostic and Statistical Manual of Mental Disorders.

  (7) "Continuum of Care" is a system that provides for the uninterrupted provision of essential services from initial assessment through completion of treatment.

  (8) "Counseling" is face-to-face interaction between offenders and counselors to help offenders identify, understand, and resolve personal issues and problems related to their substance abuse or chemical dependency. Counseling may take place in groups or in individual meetings.

  (9) "Counselor" is a graduate or counselor intern working towards licensure that would certify the individual to be a qualified credentialed counselor.

  (10) "Counselor Intern" (CI) is a person seeking a license as a chemical dependency counselor who is registered with the Texas Department of State Health Services (DSHS) and pursuing a course of training in chemical dependency counseling at a registered clinical training institute or under the supervision of a certified supervisor.

  (11) "Criminogenic Risk and Needs" are dynamic risk factors that are directly related to crime production, such as antisocial peers; antisocial beliefs, values, and attitudes; substance abuse, dependency, or addiction; anger or hostility; poor self-management skills; inadequate social skills; poor attitude toward work or school; and poor family dynamics.

  (12) "Detoxification" is chemical dependency treatment designed to systematically reduce the amount of alcohol and other toxic chemicals in an offender's body, manage withdrawal symptoms, and encourage the offender to continue ongoing treatment for chemical dependency.

  (13) "Direct Care Staff" is staff responsible for providing treatment, care, supervision, or other direct client services that involve face-to-face contact with an offender.

  (14) "Discharge" is formal documented termination of services.

  (15) "Discharge Summary" is a written report of the offender's progress and participation while in treatment, including a discharge plan that provides an aftercare or supervision plan designed to sustain progress for offenders successfully completing treatment.

  (16) "Education" is instruction; a planned, structured presentation of information that is related to substance abuse or chemical dependency. Education is not considered counseling.

  (17) "Emergency" is a situation requiring immediate attention and action to treat or prevent physical or emotional harm or illness.

  (18) "Evaluation" is a process conducted by a community supervision officer (CSO) trained to administer the Texas Department of Criminal Justice Community Justice Assistance Division (TDCJ CJAD) Substance Abuse Evaluation instrument to determine the nature and extent of an offender's chemical abuse, dependency, or addiction to assist in making an appropriate referral. Other criminogenic risks and needs will be assessed and incorporated into the individual treatment plan.

  (19) "Facility" is the physical location of the treatment program operated by, for, or with funding from the TDCJ CJAD. Some locations may be secured facilities for inpatient treatment; other programs may be offered at locations as outpatient treatment.

  (20) "Graduate" is an individual who has successfully completed, or been exempted from, supervised work experience and who is still registered with the DSHS as a CI, as defined by the DSHS.

  (21) "Grievance" is a formal complaint limited to matters affecting the complaining offender personally and limited to matters that the facility or program has the authority to remedy.

  (22) "Intake" is the process of gathering information to determine if an offender is eligible and appropriate for services as well as providing information to the offender about a program's services and rules.

  (23) "Intensive Outpatient Treatment" is an outpatient treatment program that delivers no less than six hours per week of chemical dependency counseling.

  (24) "Life Skills Training" is a structured program of training, based upon a written curriculum and provided by qualified staff designed to help offenders with social competencies, such as communication and social interaction, stress management, problem solving, decision making, and management of daily responsibilities.

  (25) "Primary Counselor" is an individual working directly with and responsible for the treatment of the offender.

  (26) "Qualified Credentialed Counselor (QCC)" is a licensed chemical dependency counselor or one of the practitioners listed below who is licensed and in good standing in the state of Texas as defined by the DSHS:

    (A) Licensed professional counselor;

    (B) Licensed master social worker;

    (C) Licensed marriage and family therapist;

    (D) Licensed psychologist;

    (E) Licensed physician (MD or DO);

    (F) Licensed physician's assistant;

    (G) Certified addictions registered nurse; or

    (H) Licensed psychological associate; and

    (I) Nurse practitioner recognized by the Board of Nursing as a clinical nurse specialist or nurse practitioner with specialty in psyche-mental health.

  (27) "Responsivity" is matching the characteristics of the offender with the program modality, and the knowledge, skills, and abilities of the staff. It includes offender's learning style and readiness for treatment; the quality of the treatment relationship; and the staff's therapeutic approach, cultural competency, use of reinforcement, and modeling.

  (28) "Screening" is the initial stage of a process when it is determined whether an offender has a chemical dependency problem that may require further assessment or evaluation.

  (29) "Senior Counselor, Unit Manager, or Unit Supervisor" is a supervisory staff member who directs, monitors, and oversees the work performance of subordinate staff members.

  (30) "Special Needs Populations" are offenders who have significant problems in the areas of mental health, diminished intellectual capacity, or medical needs.

  (31) "Structured Activity" is a planned, interactive, scheduled event that is overseen by staff in which participants actively take part in an activity related to recovery, health, life skills, or interpersonal skills.

  (32) "Supportive Outpatient Treatment" is an outpatient treatment program that delivers no less than two hours per week of chemical dependency counseling.

  (33) "Treatment" is a planned, structured, and organized program, either residential or nonresidential, designed to initiate and promote an offender's chemical free status or to maintain the offender free of illegal drugs. It includes, but is not limited to, the application of planned procedures to identify and change patterns of behavior related to or resulting from chemical dependency that are maladaptive, destructive, or injurious to health, or to restore appropriate levels of physical, psychological, or social functioning lost due to chemical dependency.

  (34) "Treatment Team" is the team consisting of at least the offender, the offender's counselor, and a CSO or residential CSO when appropriate.

(b) Compliance. Compliance with TDCJ CJAD substance abuse treatment standards is required of all programs that provide substance abuse treatment and are funded directly or indirectly or managed by the TDCJ CJAD. Programs and facilities providing only substance abuse education are not subject to these standards.

(c) Accreditation of Personnel and Staff Development. The employer shall ensure that employees acquire and maintain any credentials, licensing, certifications, or continuing education required to perform their duties, with copies kept in their personnel files.

(d) Admissions and Removals.

  (1) Eligibility. Programs shall have written eligibility criteria specific to the services and mission of the program. Offenders may be admitted into a program only by order of the court and only if they meet the minimum eligibility criteria as outlined in the program policies, licensure, or CJAD approved program design. Offenders found to be ineligible for admission within 10 days of arrival at the program shall not be counted in program admissions.

  (2) Specific admission criteria and procedures shall be documented. Offenders are eligible for substance abuse treatment programs if:

    (A) There is responsivity between the treatment services provided by the program and the offender's criminogenic risks and needs;

    (B) A court orders the offender into the program and the subsequent assessment indicates the need for treatment services; or

    (C) The program allows readmissions and the offender meets the admission criteria.

  (3) For offenders placed in treatment programs who do not meet admission or eligibility criteria, a mechanism or procedure shall be developed for offender removal. A review and justification explaining the reason the offender does not meet admission criteria shall be required with copies kept in the offender's file. Offenders who do not meet eligibility criteria will be considered ineligible and shall not be counted as discharged.

(e) Intake. There shall be written policies and procedures establishing an intake process to determine eligibility for offenders entering a substance abuse treatment program. The intake process must be completed within 10 working days of an offender's arrival in a program.

(f) Initial Assessment Procedures. Acceptable and recognized assessment tools shall be used in all substance abuse treatment programs within 10 working days from date of admission. Assessment policies and procedures shall require the use of approved clinical measurements and screening tests. If the screening identifies a potential mental health problem, the facility shall obtain a mental health assessment and seek appropriate mental health services when resources for mental health assessments and services are available internally or through referral at no additional cost to the program. Assessment procedures shall include the following:

  (1) Identification of strengths, abilities, needs, and substance preferences of the offender;

  (2) Summarization and evaluation of each offender to develop individual treatment plans; and

  (3) Assessments completed by a QCC or a CI. If the assessor is a CI, the documentation must be reviewed and signed by a QCC.

(g) Assessments. The assessment shall include:

  (1) A summary of the offender's alcohol or drug abuse history including substances used, date of last use, date of first use, patterns and consequences of use, types of and responses to previous treatment, and periods of sobriety;

  (2) Family information, including substance use and abuse by family members and supportive or dysfunctional relationships;

  (3) Vocational and employment status, including skills or trades learned, work record, and current vocational plans;

  (4) Health information, including medical conditions that present a problem or that might interfere with treatment;

  (5) Emotional or behavioral problems, including a history of psychiatric treatment;

  (6) Educational achievement level;

  (7) Intellectual functioning level;

  (8) Responsivity analysis; and


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