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

   1. (1) Admission--The administrative process and procedure performed to accept an offender into a treatment program or facility.
   2. (2) Aftercare--Counseling and community based support services that are designed to provide continued support for treatment delivered in a residential or outpatient program
   3. (3) Aftercare Caseloads--Supervision and support services for offenders who have completed a substance abuse treatment program.
   4. (4) Assessment--A process conducted by a qualified credential counselor (QCC) trained to administer a structured interview 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/needs will be assessed and incorporated into the individual treatment plan.

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

      1. (A) validated treatment assessments that include criminogenic risks/need factors;
      2. (B) a treatment regimen that focuses on changing criminogenic risks/needs, behaviors, and thinking patterns;
      3. (C) a treatment regimen that includes a specific, cognitive-behavioral program that has been recognized in professional criminal justice journals;
      4. (D) responsivity in addressing offenders' needs and employment of qualified staff; and
      5. (E) measurable outcomes to reduce substance abuse, dependency or addiction and other criminogenic risks/needs.
   6. (6) Chemical Dependency--Substance-related disorders as that term is used in the most recent published edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
   7. (7) Continuum of Care--A system that provides for the uninterrupted provision of essential services from initial assessment through completion of treatment.
   8. (8) Counseling--Face-to-face interactions between offenders and counselors to help offenders identify, understand, and resolve their personal issues and problems related to their substance abuse or chemical dependency. Counseling may take place in groups or in individual meetings.
   9. (9) Counselor--A qualified credentialed counselor, graduate or counselor intern working towards licensure that would qualify them to be a qualified credentialed counselor (QCC).
   10. (10) Counselor Intern--An advanced student or graduate in a professional field gaining supervised professional experience.
   11. (11) Criminogenic Risk/Needs--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/hostility; poor self-management skills; inadequate social skills; poor attitude toward work/school; and poor family dynamics.
   12. (12) Detoxification--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. (13) Direct Care Staff--Staff responsible for providing treatment, care, supervision, or other direct client services that involve face-to-face contact with an offender.
   14. (14) Discharge--Formal, documented termination of services.
   15. (15) Discharge Summary--A written report of the offender's progress and participation while in treatment, including a discharge plan that provides an aftercare/supervision plan designed to sustain progress for offenders successfully completing treatment.
   16. (16) Education--Educational instruction; a planned, structured presentation of information which is related to substance abuse or chemical dependency. Education is not considered counseling.
   17. (17) Emergency--A situation requiring immediate attention and action to treat or prevent physical or emotional harm or illness.
   18. (18) Evaluation--A process conducted by a CSO trained to administer the TDCJ-CJAD Substance Abuse Evaluation (SAE) 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 risk/needs will be assessed and incorporated into the individual treatment plan.
   19. (19) Facility--The physical location of the treatment program operated by, for, or with funding from the TDCJ-CJAD. Some locations may be secured facilities for in-patient treatment; other programs may be offered at locations as outpatient treatment.
   20. (20) Graduate--A counselor intern who has successfully completed education and work experience requirements prior to licensure by the Texas Department of State Health Services (formerly Texas Commission on Alcohol and Drug Abuse).
   21. (21) Grievance--A formal complaint limited to matters affecting the complaining offender personally and limited to matters that the facility/program has the authority to remedy.
   22. (22) Intake--The process of gathering information to determine if an offender is eligible and appropriate for services, and providing information to the offender about a program's services and rules.
   23. (23) Life Skills Training--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.
   24. (24) Primary Counselor--An individual working directly with and being responsible for the treatment of the offender.

   25. (25) Qualified, Credentialed Counselor (QCC)--A licensed chemical dependency counselor (LCDC) or one of the following professionals:

       1. (A) licensed professional counselor (LPC);
       2. (B) licensed master social worker (LMSW);
       3. (C) licensed marriage and family therapist (LMFT);
       4. (D) licensed psychologist;
       5. (E) licensed physician (MD or DO);
       6. (F) licensed physician's assistant;
       7. (G) certified addictions registered nurse (CARN); or
       8. (H) licensed psychological associate; and
       9. (I) nurse practitioner recognized by the Board of Nurse Examiners as a clinical nurse specialist or nurse practitioner with specialty in psyche-mental health (APN-P/MH).
   26. (26) Responsivity--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.
   27. (27) Screening--The initial stage of a process in which it is determined if an offender has a chemical dependency problem that may require further assessment or evaluation.
   28. (28) Senior Counselor/Unit Manager/Unit Supervisor--A supervisory staff member who directs, monitors, and oversees the work performance of subordinate staff members.
   29. (29) Special Needs Populations--Offenders who have significant problems in the areas of mental health, diminished intellectual capacity, or medical needs.
   30. (30) Structured Activity--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.
   31. (31) Treatment--A planned, structured, and organized program, either residential or non-residential, 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.
   32. (32) Treatment Team--The treatment team shall consist of at least the offender, the offender's counselor, a CSO and/or residential CSO (when appropriate).
2. (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 TDCJ-CJAD. Programs and facilities providing only substance abuse education are not subject to these standards.
3. (c) Personnel & Staff Development/Accreditation. 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.

4. (d) Admissions and Removals.

   1. (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. (2) There shall be documentation of specific admission criteria and procedures. Offenders are eligible for substance abuse treatment programs if:

      1. (A) there is responsivity between the treatment services provided by the program and the offender's criminogenic risks/needs;
      2. (B) a court orders the offender into the program and the subsequent assessment indicates the need for treatment services; or
      3. (C) the program allows readmissions and the offender meets the admission criteria.
   3. (3) For offenders who are 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."
5. (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 ten working days of an offender's arrival in a program.

6. (f) Initial Assessment Procedures. Acceptable and recognized assessment tools shall be used in all substance abuse treatment programs within ten 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. (1) identification of strengths, abilities, needs and substance preferences of the offender;
   2. (2) summarization and evaluation of each offender to develop individual treatment plans;
   3. (3) assessments completed by a QCC, or if the assessor is a Counselor Intern, then the documentation must be reviewed and signed by a QCC.

7. (g) Assessments. The assessment shall include:

   1. (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. (2) family information, including substance use and abuse by family members and supportive or dysfunctional relationships;
   3. (3) vocational and employment status, including skills or trades learned, work record, and current vocational plans;
   4. (4) health information, including medical conditions that present a problem or that might interfere with treatment;
   5. (5) emotional or behavioral problems, including a history of psychiatric treatment;
   6. (6) educational achievement level;
   7. (7) intellectual functioning level;
   8. (8) responsivity analysis; and
   9. (9) a diagnostic summary signed and dated by a QCC.
8. (h) Orientation. Each program shall establish written policies and procedures for the orientation process. Orientation shall be provided at the onset of treatment and in accordance with the level of treatment to be provided. The orientation shall relay information concerning program rules, the grievance procedure, and the steps necessary for offenders to complete treatment successfully.
9. (i) Offender Rights. The offender's basic rights shall be respected and protected, free from abuse, neglect, exploitation, and discrimination. Each provider shall have written policy and procedure to ensure protection of the offender's rights according to federal and state guidelines.
10. (j) Release of Information. There shall be written policies and procedures for protecting and releasing offender information that conforms to federal and state confidentiality laws. The staff shall follow written policies and procedures for responding to oral and written requests for offender-identifying information.

11. (k) Offender Records. There shall be written policies and procedures regarding the content of offender treatment records. Residential programs shall maintain separate individual treatment records for defendants. Case records, whether residential or outpatient, shall include the following information at a minimum:

    1. (1) court order placing the offender into the program;
    2. (2) initial intake information form;
    3. (3) referral documentation;
    4. (4) case information from referral source, if applicable;
    5. (5) release of information forms;
    6. (6) relevant medical information;
    7. (7) case history and assessment including risk and needs assessment and Strategies for Case Supervision if required;
    8. (8) individual treatment plan;
    9. (9) evaluation and progress reports; and
    10. (10) discharge summary.
12. (l) Offender Records Review Policy. There shall be written policies and procedures to govern the access of offenders to their own substance abuse treatment records in accordance with Texas Health & Safety Code and 42 CFR part 2 (Code of Federal Regulations). This access does not apply to criminal justice records. Restrictions to access treatment records shall be specified and explained to offenders upon request. Exceptions must involve the potential for harm to the offender or others.

13. (m) Treatment Planning and Review. Initial individual Treatment Plans will be completed by the counselor collaborating with the offender within ten working days from the date of an offender's admission to a Community Corrections Facility (CCF), County Correctional Center (CCC) or any other substance abuse treatment program or through a similar process approved by the Community Supervision and Corrections Department (CSCD). Substance abuse treatment shall be based on substance abuse, chemical dependency or addiction and other criminogenic risks/needs identified through assessments and revised according to the offender's successful resolution of those substance abuse, chemical dependency or addiction and other criminogenic risks/needs. Treatment plans shall include criteria for discharge that are based on the achievement of treatment plan goals and shall be reviewed at timely intervals with a minimum of once each month or when major changes occur (e.g., change in stage). The treatment planning and review process shall ensure that:

    1. (1) the primary counselor meets with the offender as needed to review the treatment plan, evaluating goal progress and revisions;
    2. (2) all revised treatment plans are signed and dated by the counselor and the offender; and
    3. (3) results of the review are documented and placed in the treatment file, with a copy to the CSO.
14. (n) Treatment Progress Notes. There shall be written policies and procedures to require all programs to record and maintain progress notes on all offender case records, document counseling sessions, and to summarize significant events that occur throughout the treatment process. Progress notes shall be documented at a minimum of once each week.
15. (o) Changes in Treatment Stages. Each treatment program shall develop written criteria based on achievement of treatment plan goals for an offender to advance or regress from a stage of treatment. An offender must meet the criteria for a change in the stage of treatment before such a change or a discharge is implemented. The treatment team shall confer when the offender is subject to a major setback in the program and prior to discharge.

16. (p) Discharges from Treatment. Discharge from a program shall be according to one of the following criteria:

    1. (1) Successful Discharge--the offender has made sufficient progress towards meeting the objectives of the Treatment Plan, including addressing criminogenic risks/needs and program requirements;
    2. (2) Administrative Discharge--the offender has satisfied a period of placement as a condition of community supervision, the offender is removed by order of the court, or the offender is removed by operation of law for conduct occurring prior to admission into the program;
    3. (3) Unsuccessful Discharge--the offender has demonstrated non-compliance with the program criteria or court order, including absconding from the program; or
    4. (4) Medical Discharge--the offender manifests a medical or psychological problem, including death, that prohibits participation or completion of the program requirements.

17. (q) Discharge Plan. The treatment team shall adopt a discharge plan for each offender prior to successful discharge. The discharge plan shall be sent to the offender's supervision officer within seven days after discharge and provide a summary of:

    1. (1) clinical problems at the onset of treatment and original diagnosis;
    2. (2) the problems or needs and strengths or weaknesses identified on the master treatment plan;
    3. (3) the goals and objectives established;
    4. (4) the course of treatment;
    5. (5) the outcomes achieved; and
    6. (6) a continuum of care/relapse plan for aftercare treatment, which must be prepared with the offender and a family member or significant other, if appropriate and available.
18. (r) Discharge Summary. A Discharge Summary shall be prepared for all offenders who leave the program as an unsuccessful, administrative or medical discharge. The summary shall include elements (1) - (6) of the Discharge Plan.

19. (s) General Program Services Provisions. Specific services shall be required of all substance abuse treatment programs. Written policies and procedures shall ensure the following standards are met:

    1. (1) All substance abuse services shall be delivered according to a written treatment plan that has been developed from the offender's assessment;
    2. (2) Group counseling sessions are limited to a maximum of sixteen offenders. Group education and life skills training sessions are limited to a maximum of thirty-five offenders. These limits do not apply to multi-family educational groups, seminars, outside speakers, or other events designed for a large audience.
    3. (3) All programs shall employ a QCC.
    4. (4) All counselor interns shall work under the direct supervision of a QCC.
    5. (5) Chemical dependency counseling must be provided by a QCC, graduate or counselor who has the specialized education, training, or expertise in the subject matter to be delivered. Chemical dependency education shall be provided by counselors or individuals who have the specialized education, training, or expertise in the subject matter to be delivered.
    6. (6) Direct care staff shall be awake and alert on site during all hours of program operation.
    7. (7) Residential programs shall have at least one counselor on duty at least eight hours a day, five days a week.
    8. (8) Offenders in residential programs shall have an opportunity for eight continuous hours of sleep each night. Staff shall conduct and document at least three checks while offenders are sleeping.
    9. (9) The program shall include a culturally diverse curriculum applicable to the population served and shall be evidenced through demonstrated, appropriate counseling and instructional materials.
    10. (10) Members of the offender treatment team shall demonstrate effective communications and coordination, as evidenced in staffing, treatment planning and case-management documentation.

    11. (11) There shall be written policies and procedures regarding the delivery and administration of prescription and nonprescription medication which provide for:

        1. (A) conformity with state regulations; and
        2. (B) documentation of the administration of medications, medication errors, and drug reactions.
    12. (12) Chemical dependency education and life skills training shall follow a course outline that identifies lecture topics and major points to be discussed. All educational sessions shall include offender participation and discussion of the material presented.
    13. (13) The program shall provide education about the health risks of tobacco products and nicotine addiction.
    14. (14) The program shall provide HIV, Hepatitis B and C and Tuberculosis education based on the Model Workplace Guidelines for Direct Service Providers developed by the Texas Department of State Health Services.

    15. (15) Offenders shall have access to HIV counseling and testing services directly or through referral, as follows:

        1. (A) HIV services shall be voluntary, anonymous, and not limited by ability to pay.
        2. (B) counseling shall be based on the model protocol developed by the Texas Department of State Health Services.
        3. (C) in all TDCJ-CJAD funded facilities, testing, as well as pre- and post-test counseling, is to be provided by the medical department or contracted medical provider.

    16. (16) The program shall make testing and information, for tuberculosis and sexually transmitted diseases available to all offenders, unless the program has access to test results obtained during the past year, as follows:

        1. (A) services may be made available directly or through referral.
        2. (B) if an offender tests positive for tuberculosis or a sexually transmitted disease, the program shall refer the offender to an appropriate health care provider and take appropriate steps to protect offenders and staff.
        3. (C) a community corrections facility shall report to the local health department the release of an offender who is receiving treatment for tuberculosis.

    17. (17) The program shall:

        1. (A) refer pregnant offenders who are not receiving prenatal care to an appropriate health care provider and monitor follow-through; and
        2. (B) refer offenders to ancillary services (such as mental health services) necessary to meet treatment goals.

    18. (18) CSCDs that contract for services shall give preference to available programs that include the following elements of "Best Practices" in criminal justice treatment. CSCDs that conduct their own programs are required to incorporate the following elements of "Best Practices" in criminal justice treatment:

        1. (A) validated treatment assessments that include substance abuse, dependency or addiction and other criminogenic risks/needs factors;
        2. (B) a treatment regimen that focuses on changing substance abuse, dependency or addiction and other criminogenic risks/needs, behaviors, and thinking patterns;
        3. (C) a treatment regimen that includes a specific, cognitive-behavioral program that has been recognized in professional criminal justice journals; and
        4. (D) responsivity in addressing offenders' needs and in employment of qualified staff.
    19. (19) CSCDs that place offenders in substance abuse treatment programs shall ensure that offenders are referred to available aftercare services, giving preference to programs that incorporate "Best Practice" elements.
20. (t) Stages of Treatment. All CCFs providing substance abuse treatment shall designate in the current facility's Community Justice Plan (CJP) program proposal stages of treatment to be provided as described in subsections (v) through (y) below.
21. (u) Detoxification. Offenders being referred to detoxification services must be referred to appropriately licensed service providers.

22. (v) Intensive Residential Treatment. Written policies and procedures shall ensure the following:

    1. (1) All offenders admitted to Intensive Residential Treatment shall have written justification to support their admission, be medically stable, and able to participate in treatment.
    2. (2) The program shall provide adequate staff for close supervision and individualized treatment with counselor caseloads not to exceed ten offenders.
    3. (3) There shall be direct care staff alert and on site during all hours of operation. There shall be an appropriate number of direct care staff to provide all required program services, maintain an environment that is conducive to treatment, and ensure the safety and security of the offenders, according to the design of the facility and with the approval of the funding source.
    4. (4) Program counselors shall complete a comprehensive offender assessment and individual treatment plan within ten working days of admission.

    5. (5) The facility shall deliver not less than twenty-five hours of structured activities per week for each offender, including:

       1. (A) ten hours of chemical dependency counseling using a cognitive-behavioral approach with no less than one hour of individual counseling;
       2. (B) ten hours additional education, counseling, life skills, or rehabilitation activities; and
       3. (C) five hours of structured social or recreational activities.
    6. (6) Counseling and education schedules shall be submitted to the funding entity for approval.
    7. (7) Each offender shall have an opportunity to participate in physical recreation at least weekly.
    8. (8) Program staff shall offer chemical dependency education or services to identified significant others.

    9. (9) The program shall provide each offender with opportunities to apply knowledge and practice skills in a structured, supportive environment. Cognitive behavioral programs shall have a published curriculum identified by the authors to contain cognitive, social and behavioral elements. Anyone facilitating a cognitive curriculum must be trained in that specific curriculum. All direct care staff must receive training on the principles of a cognitive behavioral model as it relates to their job duties. This curriculum shall be approved by TDCJ-CJAD and implemented as designed. Components of the cognitive program shall at a minimum include:

       1. (A) ways to identify thinking patterns; and
       2. (B) a social skills training component.

23. (w) Supportive Residential Treatment. Written policies and procedures shall ensure the following:

    1. (1) All offenders admitted to Supportive Residential Treatment shall have written justification to support their admission, be medically stable, and able to function with limited supervision and support, and be able to participate in work release or community service/restitution programs.
    2. (2) The program shall have adequate staff to meet treatment needs within the context of the program description, with counselor caseloads not to exceed twenty offenders, unless the program can provide research-based evidence in writing to justify a higher caseload size based on the program design, characteristics, and needs of the population served, and any other relevant factors.
    3. (3) There shall be direct care staff alert and on site during all hours of operation. There shall be an appropriate number of direct care staff to provide for the safety and security of the offenders, according to the design of the facility and with the approval of the funding source.
    4. (4) Counselors shall complete a comprehensive offender assessment and individualized treatment plan within ten working days of admission for all offenders.
    5. (5) The program shall deliver no less than six hours per week of chemical dependency counseling with a cognitive-behavioral approach (one hour per month of which shall be individual counseling) for each offender.
    6. (6) Counseling and education schedules shall be submitted to the funding entity for approval.

    7. (7) The program design and application shall include increasing levels of responsibility for offenders and frequent opportunities for offenders to apply knowledge and practice skills in structured and unstructured settings. Cognitive behavioral programs shall have a published curriculum identified by the authors to contain cognitive, social and behavioral elements. This curriculum shall be approved by TDCJ-CJAD and implemented as designed. Anyone facilitating a cognitive curriculum must be trained in that specific curriculum. All staff must receive training on the principles of a cognitive behavioral model as it relates to their job duties. Components of the cognitive program shall at minimum include:

       1. (A) ways to identify thinking patterns; and
       2. (B) a social skills training component.

24. (x) Outpatient Treatment. Written policies and procedures shall ensure the following:

    1. (1) All offenders admitted to Outpatient treatment programs shall be medically stable, and have appropriate support systems in the community to live independently with minimal structure.
    2. (2) The program shall have adequate staff to provide offenders support and guidance to ensure effective service delivery, safety, and security. Staffing patterns shall be submitted to the funding entity.
    3. (3) The program shall set limits on counselor caseload size to ensure effective, individualized treatment and rehabilitation. Criteria used to set the caseload size shall be documented and approved by the funding entity.
    4. (4) Didactic groups shall not exceed thirty-five offenders in a group.
    5. (5) Therapeutic groups shall not exceed sixteen offenders in a group.
    6. (6) For offenders in supportive outpatient programs, counselors shall complete a comprehensive offender assessment within thirty calendar days of admission for all offenders.
    7. (7) For offenders in intensive outpatient programs, counselors shall complete a comprehensive offender assessment within ten calendar days of admission for all offenders.
    8. (8) Intensive outpatient programs shall deliver no less than six hours per week of chemical dependency counseling with a cognitive behavioral approach.
    9. (9) Supportive outpatient programs shall deliver no less than two hours per week of chemical dependency counseling.
    10. (10) Counseling and education schedules shall be submitted to the funding entity for approval.
    11. (11) The program design and application shall include increasing levels of responsibility for offenders and frequent opportunities for offenders to apply knowledge and practice skills in structured and unstructured settings.
    12. (12) The outpatient treatment stages may be utilized for residents in the work release phase of any residential substance abuse treatment program.

25. (y) Special Needs Populations. Written policies and procedures shall ensure the following:

    1. (1) Programs that address the special mental health, intellectual capacity, or medical needs of offenders must provide appropriate treatment either by program staff or through contracted services.
    2. (2) Admission to a special needs program must be based on a documented mental health, intellectual capacity, or medical need.
    3. (3) When the assessment process indicates that the offender has coexisting disabilities/disorders, the Treatment Plan shall specifically address those issues that might impact treatment, recovery, relapse, and/or recidivism.
    4. (4) Personnel qualified in the treatment of coexisting disabilities/disorders shall be available.
    5. (5) Within ninety-six hours of admission to a special needs residential program, offenders shall be administered a medical and psychological evaluation.
    6. (6) Within ten days of admission to a residential program for special needs offenders, the program administrator or designee shall contact the Texas Correctional Office on Offenders with Medical or Mental Impairments (TCOOMMI) regarding the offender's status. As soon as discharge date is projected, TCOOMMI shall be notified in writing of plans for a continuum of care after discharge, regardless of whether or not the discharge is for successful completion of the program.

    7. (7) Residential facilities providing services for special needs populations shall have procedures to provide access to health care services, including medical, dental, and mental health services, under the control of a designated health authority. When this authority is other than a physician, final medical judgments must rest with a single designated responsible physician licensed by the state.

       1. (A) Services/treatment shall be directed toward maximizing the functioning and reducing the symptoms of offenders.

       2. (B) There shall be written policies and procedures regarding the delivery and administration of prescription and nonprescription medication which provide for:

          1. (i) conformity with state regulations;
          2. (ii) documentation of the rationale for use and goals of service/treatment consistent with the individual plan of treatment;
          3. (iii) documentation of the administration of medications, medication errors, and drug reactions; and
          4. (iv) procedures to follow in case of emergencies.
    8. (8) There shall be procedures for documenting that the offender has been informed of medication management procedures.
    9. (9) Offenders shall be actively involved in decisions related to their medications.
    10. (10) Programs for special needs offenders must follow the same staffing for treatment levels as the levels for other offenders, except all residential programs shall maintain caseloads of no greater than sixteen offenders for each counselor.
    11. (11) Programs operating in residential facilities shall ensure that offenders will have no less than ten days of appropriate medication for use after discharge.
26. (z) Use of Force. The CSCD director and Facility director shall ensure that a residential treatment program has written policies, procedures, and practices that restrict the use of physical force to instances of self-protection, protection of offenders or others, or prevention of property damage. In no event is the use of physical force against an offender justifiable as punishment. A written report shall be prepared following all uses of force, and all such written reports shall be promptly submitted to the CSCD director and Facility director for review and follow-up. The application of restraining devices, aerosol sprays, chemical agents, etc. shall only be accomplished by an individual who is properly trained in the use of such devices and only in an emergency by any individual in self-protection, protection of others or other circumstances as described previously.

Source Note:The provisions of this §163.40 adopted to be effective October 4, 1998, 23 TexReg 9775; amended to be effective June 20, 2002, 27 TexReg 5220; amended to be effective April 17, 2003, 28 TexReg 3065; amended to be effective April 21, 2005, 30 TexReg 2234.