(a) Purpose. This rule provides guidelines for using psychopharmacotherapy as part of an established treatment plan for Texas Juvenile Justice Department (TJJD) youth exhibiting symptoms of mental illness, mental disorder, or emotional distress.
(b) General Provisions. Under no circumstances are tranquilizers, psychostimulants, or other psychotropic medications administered:
  (1) for discipline, security, or control purposes;
  (2) for experimental research; or
  (3) as a sleep aid (unless sleep disturbance is related to a primary mental health diagnosis).
(c) Prescribing Psychotropic Medication.
  (1) TJJD strives to ensure that prescribing psychotropic medication is a collaborative effort among the psychiatric provider, the youth, and the parent/guardian when feasible. All discussions and/or notifications to the youth and/or the parent/guardian regarding treatment objectives, medication disadvantages, available alternatives, consequences of not following the recommended treatment plan, and potential medication side effects are documented in the youth's medical record. During the intake and assessment process, the psychiatric provider may continue the medication after reviewing the youth's medical record and/or conducting a psychiatric evaluation. Indication for the psychopharmacotherapy must be documented in the youth's medical record.
  (2) Psychotropic medication may be prescribed only as part of an established treatment plan after a youth has received nursing, medical, and mental health screenings and evaluations. A previously prescribed medication may be continued upon TJJD admission or transfer to promote continuity of care in accordance with subsection(c)(1) of this section.
  (3) Psychotropic medication is prescribed only to a youth who exhibits symptoms that meet criteria in the current Diagnostic and Statistical Manual for a psychiatric disorder.
  (4) The schedule and dosage of prescribed psychotropic medication are consistent with established community standards of care and nationally accepted practice guidelines. If the schedule and dosage differ from these standards or guidelines, the psychiatric provider must clearly document his/her rationale.
  (5) Standing orders will not be utilized for prescribing psychotropic medication. The use of standing orders shall comply with applicable state regulations.
  (6) Psychotropic medication is prescribed in accordance with disease management guidelines and the formulary adopted for use by TJJD and the University of Texas Medical Branch-Correctional Managed Care (UTMB). The guidelines and formulary are developed and revised as needed by the TJJD/UTMB Pharmacy and Therapeutics Committee, consisting of psychiatrists, pharmacists, nurses, the TJJD medical director, and the UTMB mental health directors.
(d) Psychotropic Medication Administration.
  (1) Psychotropic medication is administered orally unless specific contraindications have been documented.
  (2) Psychotropic medication may not be administered against the will of a youth except in a psychiatric emergency as specified in §380.9192of this title.

Source Note: The provisions of this §380.9191 adopted to be effective December 31, 1996, 21 TexReg 12185; amended to be effective February 20, 1998, 23 TexReg 1115; amended to be effective July 31, 2001, 26 TexReg 4728; amended to be effective September 19, 2011, 36 TexReg 5943; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended to be effective April 15, 2015, 40 TexReg 1976