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RULE §343.340Suicide Prevention Plan

(a) The facility shall implement a written suicide prevention plan, developed in consultation with a mental health provider. Consultation with the mental health provider shall be verified on documentation containing:

  (1) the date;

  (2) the provider's name, title, and professional credentials/licensing designation (e.g., LPC, LMSW, etc.); and

  (3) the provider's signature or other means of verifying the provider's identity (e.g., email from the provider's email account).

(b) The suicide prevention plan shall include:

  (1) definitions of moderate and high risk for suicidal behavior;

  (2) a listing of the facility-specific criteria associated with each of the two risk classifications and the identification of staff with the authority and responsibility for assigning or determining a resident's risk classification;

  (3) identification of the suicide screening instrument to be used and the personnel responsible for conducting the screening;

  (4) policies and procedures for suicide screening, including:

    (A) conducting a screening within two hours after a resident's admission into the facility;

    (B) conducting suicide screenings upon any indication a resident previously screened may now be at moderate or high risk for suicidal behavior or at other times during a resident's stay;

    (C) assessing risk when a resident refuses or is unable to cooperate with the screening process; and

    (D) using information from the screening to determine a resident's risk for suicidal behavior;

  (5) policies and procedures for written and/or verbal communication among facility staff; mental health providers; the resident's juvenile probation officer; the resident; and the resident's parent, legal guardian, or custodian, including:

    (A) communication about staff concerns that a resident previously screened may now be at moderate or high risk for suicidal behavior;

    (B) communication about a resident's past or current classification as moderate or high risk for suicidal behavior;

    (C) procedures for referring residents classified as moderate or high risk for suicidal behavior to a mental health provider as required by §343.346 of this title; and

    (D) identification of which types of information must be communicated, who is responsible to initiate the communication, who is required to receive the information, and how the information is communicated (e.g., direct contact, telephone, email, etc.);

  (6) level of supervision for residents assigned to moderate or high risk for suicidal behavior;

  (7) policies and procedures for intervening in suicide attempts, including:

    (A) staff responsibilities for administering first aid, contacting outside emergency medical services, and notifying other staff for assistance;

    (B) the process by which emergency medical services personnel will gain access to the facility and how they be guided to the resident;

    (C) identification and location of life-saving and emergency equipment (e.g., first aid kit, mask resuscitator, rescue tools, ladder, etc.) that is available for staff to use; and

    (D) identification of personnel responsible for maintaining, issuing, and using the life-saving and emergency equipment;

  (8) reporting of resident suicides and attempted suicides, in accordance with any applicable state law, administrative rule, or local policy or ordinance, including:

    (A) reporting a resident's death to local law enforcement and TJJD as required by §358.600 of this title;

    (B) reporting the death of an incarcerated resident to the Texas Attorney General's office as required by §358.640 of this title and Texas Code of Criminal Procedure Article 49.18(b); and

    (C) reporting a resident's attempted suicide to TJJD as required by §358.300 of this title;

  (9) policies and procedures for training all juvenile supervision officers on the contents and implementation of the suicide prevention plan, including:

    (A) identification of the training topics and curriculum; and

    (B) a timeline for the initial training and any follow-up training;

  (10) housing of residents classified as moderate or high risk for suicidal behavior, including removal of any dangerous objects such as clothing and bedding items from the resident; and

  (11) policies and procedures for conducting mortality reviews for suicides, including:

    (A) identification of the person or position that is responsible for leading the mortality review and identification of any other review team members;

    (B) identification of how the findings and recommendations will be recorded and relayed to the facility's governing board;

    (C) a requirement that the mortality review shall be:

      (i) designed to review the specific circumstances that occurred before, during, and after the suicide to determine if there is a need for modifications to policies, procedures, or the physical plant; and

      (ii) separate and distinct from any and all formal investigations such as investigations conducted by the facility, law enforcement, or TJJD.

Source Note: The provisions of this §343.340 adopted to be effective January 1, 2010, 34 TexReg 7095; amended to be effective September 1, 2013, 38 TexReg 4387; amended to be effective January 1, 2015, 39 TexReg 9243

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