(a) Purpose. The purpose of this rule is to establish the process by which youth committed to the Texas Juvenile Justice Department (TJJD) are assessed and treated for specialized treatment needs. The purpose of all provisions in this rule is to promote successful youth reentry and reduce risk to the community by addressing individual specialized treatment needs through programs that are designed to reduce risk to reoffend.
(b) Definitions. Except as indicated in this subsection, see §380.8501 of this chapter for definitions of terms used in this rule.
  (1) Intensive Treatment Program--a high-intensity treatment program designed to address youth with a high need for specialized treatment. Treatment is generally delivered in specialized groups by licensed or appropriately trained staff.
  (2) Psycho-educational Program--a low-intensity program delivered by appropriately trained staff that is designed to address youth with a low need for specialized treatment.
  (3) Sex Offense--a reportable adjudication as defined in Article 62.001 of the Texas Code of Criminal Procedure.
  (4) Mental Health Professional--see definition in §380.9187 of this chapter.
  (5) Moderate-Intensity Treatment Program--a program designed to address youth with a moderate need for specialized treatment. Treatment is generally delivered in specialized groups by licensed or appropriately trained staff.
(c) General Provisions.
  (1) Youth with one or more specialized needs will have these needs addressed while under TJJD jurisdiction. Youth may have specialized needs addressed while in a high- or medium-restriction facility or on parole status.
  (2) If a youth cannot be provided the type(s) of specialized program designated in this rule for the youth's assessed need level, the youth will be provided with the most appropriate alternate form of intervention for that treatment need.
(d) Treatment Planning.
  (1) Upon admission to TJJD, comprehensive assessments are conducted to determine if a youth has any specialized treatment needs and to identify the type of specialized program that is best suited to address those needs. For each youth assessed as having a specialized treatment need, an initial plan documenting all specialized treatment needs and recommended programs is developed as soon as possible.
  (2) In addition to the initial plan, a comprehensive plan is developed for each youth with specialized treatment needs. The comprehensive plan must:
    (A) include individually tailored statements regarding treatment goals and objectives;
    (B) include the tentative sequence and start dates for each specialized program;
    (C) be developed with input from the youth; and
    (D) be documented in the youth's individual case plan.
  (3) The sequence and start dates for specialized programs are based on individual youth needs, facility schedules, and program openings, with consideration given to the youth's minimum length of stay or minimum period of confinement.
  (4) The comprehensive specialized treatment plan is reviewed, reevaluated, and modified in accordance with rules for the review and modification of the individual case plan, as set forth in §380.8701 of this chapter. The plan is also modified following each reassessment of a youth's specialized treatment needs.
  (5) Specialized treatment needs may be reassessed at any time during a youth's stay in TJJD.
(e) Specialized Treatment Needs. The areas of specialized treatment need are set forth in paragraphs (1) - (6) of this subsection, with each area given priority for placement and treatment based on urgency of need.
  (1) Medical. Each youth is provided comprehensive medical and dental examinations. Based on the results of these examinations, each youth is assigned a need level for medical or dental services. Non-compliance with treatment may cause any youth to be designated as higher need than the underlying condition would typically warrant.
    (A) High Need--includes youth who require medical, surgical, or dental services of an intense/acute nature. The youth has a serious acute condition, experiences an exacerbation of a chronic medical or dental condition, sustains a serious injury, and/or may require hospitalization. The youth's condition is unstable or unpredictable, and recovery requires 24-hour nursing care or supervision beyond the scope of normal infirmary services. The youth's medical needs, until resolved, take precedence over other therapeutic interventions and temporarily prevent active participation in programming.
    (B) Moderate Need--includes youth who are diagnosed with a medical or dental condition that is moderate to serious in severity and that may require frequent access to clinical and/or hospital services for symptom exacerbation.
    (C) Low Need--includes youth who are diagnosed with a condition that is mild to moderate in severity and does not require ongoing treatment or monitoring. The youth may be temporarily restricted from an activity due to an accident, injury, or illness of mild to moderate severity.
    (D) None--includes youth with no medical or dental diagnosis requiring ongoing attention.
  (2) Mental Health. The mental health needs assessment is provided by mental health staff through comprehensive psychological and/or psychiatric evaluation using the most current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Based on this assessment, each youth is assigned a need level for mental health treatment services.
    (A) High Need - Level 1.
      (i) This level of treatment need includes youth who:
        (I) are diagnosed with a mental disorder. As a result of the disorder, there is disorganized, bizarre, and/or grossly inappropriate behavior in one or more of the following areas: social or interpersonal interactions, educational or vocational participation, or the ability to manage daily living requirements;
        (II) have an assessment of adaptive functioning that is consistent with the level of impairment noted;
        (III) cannot meaningfully participate in programming until the underlying disorder is stabilized; and/or
        (IV) are an imminent danger to themselves or others as a result of the mental disorder.
      (ii) This level of impairment is not the result of a conduct disorder, oppositional defiant disorder, or similar impulse control/behavioral disorders and is not the result of intoxication or withdrawal from drugs.
      (iii) Youth with this level of impairment require a protective environment during this phase of the disorder and are treated at an agency-operated crisis stabilization unit or a psychiatric hospital with psychiatric care as the highest priority.
    (B) High Need - Level 2.
      (i) This level of treatment need includes youth who:
        (I) are diagnosed with a mental disorder. As a result of the disorder, there is moderate to severe impairment in one or more of the following areas: social or interpersonal interaction, educational or vocational participation, or the ability to manage daily living requirements despite receiving psychiatric care and clinical support services;
        (II) have an assessment of adaptive functioning that is consistent with the level of impairment noted; and/or
        (III) are having a difficult time maintaining stability and program participation despite receiving psychiatric services and local clinical support.
      (ii) This level of impairment is not the result of a conduct disorder, oppositional defiant disorder, or similar impulse control/behavioral disorders and is not the result of intoxication or withdrawal from drugs.
      (iii) Youth with this level of treatment need are placed in an intensive mental health treatment program with structured interventions and enhanced clinical support services in addition to regular psychiatric services.
    (C) Moderate Need.
      (i) This level of treatment need includes youth who:
        (I) are diagnosed with a mental disorder. As a result of the disorder, behavior is mildly impaired by signs and symptoms of the mental disorder in one or more of the following areas: social or interpersonal interaction, educational or vocational participation, or ability to manage daily living requirements with regular psychiatric care and/or psychological intervention;
        (II) have an assessment of adaptive functioning that is consistent with the level of impairment noted; and/or
Cont'd...