37 Tex. Admin. Code § 380.8767 - Crisis Stabilization Unit
(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
chapter.
(2) Psychiatric
Provider--has the meaning assigned by §
380.9187 of this
chapter.
(c) References.
(1) For due process procedures for mental
health status reviews, see §
380.9571 of this
chapter.
(2) For emergency mental
health placements, see §
380.8771 of this
chapter.
(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 the youth's 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
chapter.
(3) 72-Hour Admission
Review Process. A mental-health-status review hearing must be held for each
youth within 72 hours after arrival at the unit. If the 72-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, the youth 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, the youth 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 the youth's 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 chapter, 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 the youth's 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 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.
Notes
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