37 TAC §91.99
The Texas Youth Commission (the commission) proposes an amendment
to §91.99, concerning Medical Admissions for Al Price State Juvenile
Correctional Facility. The amendment to the section will allow for youth whose
medical condition no longer warrants placement in the Medical Recovery Dorm
to be transferred to a facility other than the facility from which they were
originally referred.
Robin McKeever, Assistant Deputy Executive Director for Financial Support,
has determined that for the first five-year period the section is in effect
there will be no fiscal implications for state or local government as a result
of enforcing or administering the section.
Neil Nichols, General Counsel, has determined that for each year of the
first five years the section is in effect the public benefit anticipated as
a result of enforcing the section is avoiding the transfer of a youth back
to a facility which may be experiencing an overpopulation condition. There
will be no effect on small businesses. There is no anticipated economic cost
to persons who are required to comply with the section as proposed. No private
real property rights are affected by adoption of this rule.
Comments on the proposal may be submitted within 30 days of the publication
of this notice to DeAnna Lloyd, Chief of Policy Administration, Texas Youth
Commission, 4900 North Lamar, P.O. Box 4260, Austin, Texas 78765, or email
to deanna.lloyd@tyc.state.tx.us.
The amendment is proposed under the Human Resources Code, §61.045,
which provides the commission with the authority to make rules appropriate
to the proper accomplishment of its functions.
The proposed rule affects the Human Resources Code, §61.034.
§91.99.Medical Admissions for Al Price State Juvenile Correctional Facility.
(a)
Purpose. The purpose of this rule is to establish criteria
and procedures for medical admission of youth to the Al Price State Juvenile
Correctional Facility (APSJCF) Medical Recovery Dorm (MRD). The MRD is a
male-only
[
male only
] dorm for Texas Youth Commission (TYC)
youth who have chronic illnesses requiring frequent monitoring by medical
staff or youth with acute conditions
requiring
[
that require
] frequent care. Youth may be referred to the MRD from TYC-operated
institutions or high restriction contract care programs.
(b)
Applicability. When a youth is placed in the MRD for medical
reasons, this policy must be read in conjunction with:
(1)
§91.81 of this title (relating to Medical Consent).
(2)
§91.83 of this title (relating to Criteria for Health
Care).
(3)
§91.85 of this title (relating to Medical Care).
(4)
§91.92 of this title (relating to Psychotropic Medication-Related
Emergencies).
(5)
§87.1 of this title (relating to Case Planning).
(c)
Explanation of Terms Used.
(1)
Admission Review Team--is a team that reviews referrals
for medical admission to the MRD. At a minimum, the admission review team
consists of a program administrator (PA), facility nurse manager or designee,
primary service worker (PSW), juvenile corrections officer VI (JCO) and a
psychologist.
(2)
Phase Assessment Team (PAT)--is responsible for monitoring
and assessing a youth’s progress through the Resocialization program.
At a minimum, the PAT consists of the PA or designee, PSW, JCO, facility nurse
manager or designee and designated education staff.
(d)
Admission Criteria. Youth from a residential setting [
or Marlin Orientation and Assessment Unit (MOAU)
] may be eligible for
placement to the MRD for medical reasons according to the following criteria:
(1)
youth with a chronic condition who need more frequent health
counseling to manage their disease upon release, youth whose chronic condition
is uncontrolled, or youth whose condition requires frequent medical monitoring.
Examples [
of conditions
] include, but are not limited to, uncontrolled
diabetes, hepatitis B or C, sickle cell disease or multiple sclerosis; or
(2)
youth with acute conditions that require more frequent
care. Examples [
of conditions
] include, but are not limited to,
severe fractures or post-operative care. These youth would be considered to
be in need of transitional care; or
(3)
youth requiring frequent trips to University of Texas Medical
Branch (UTMB) for any reason. Examples include, but
are
not limited
to, extensive diagnostic testing or chemotherapy.
(e)
Admission Process.
(1)
Youth may be referred from the
Marlin Orientation
and Assessment Unit (MOAU)
[
MOAU
] or from another facility
or high restriction contract care program to the MRD. If referred from another
facility or high restriction contract care program, the action is considered
an administrative transfer under §85.45 of this title (relating to Movement
Without Program Completion). Youth may contest such a transfer by filing a
complaint under §93.31 of this title (relating to Complaints Resolution
System).
(A)
A referral packet is completed and forwarded with the appropriate
signature from the sending superintendent or the quality assurance administrator
to the MRD admissions review team at APSJCF.
(B)
The admission review team will review the referral packet
to determine if the MRD placement is appropriate for the youth.
(2)
Emergency Referrals. If an emergency exists, the sending
superintendent or the quality assurance administrator may request of the APSJCF
superintendent immediate placement in the MRD.
(f)
[
General
] MRD Requirements.
(1)
The MRD focus will be on the coordination and provision
of health care services.
(2)
Health care services will be provided in the MRD[
,
] and the APSJCF infirmary, whichever is most appropriate.
(3)
Parents or guardians of youth under the age of 18 will
be notified of all movements to or from the MRD, any significant change in
medical condition
,
or if their child is on psychotropic medication.
Youth 18 or older must give consent to disclose any of the information listed
above to parents or guardians.
[
(g)
MRD Requirements.
]
(4)
[
(1)
]
An
Individual Case
Plan (ICP) reflecting treatment goals shall be developed for and with each
youth. Refer to §87.1 of this title.
(5)
[
(2)
] The facility nurse manager
or designee will provide updates at the monthly PAT meeting regarding medical
treatment goals and objectives. The PSW will incorporate the medical treatment
goals and objectives into the youth’s ICP.
(6)
[
(3)
] The PAT shall conduct a review
of the youth’s progress at least every 30 days in conjunction with the
ICP review until the youth’s placement in the MRD has ended. The review
must:
(A)
find that the admission criteria continue to be met;
(B)
find that the treatment needs are appropriate;
and
(C)
update the ICP to include reasons for continued stay in
the MRD.
[
(4)
Upon a determination by the
PAT that the youth has met program completion criteria, the youth will be
released or transferred under the appropriate rule:]
[
(A)
§85.55 of this title (relating to Program
Completion for Other Than Sentenced Offenders).]
[
(B)
§85.59 of this title (relating to Program
Completion for Sentenced Offenders Under Age 19).]
[
(C)
§85.61 of this title (relating to Program
Completion for Sentenced Offenders Age 19 or Older).]
[
(D)
§85.69 of this title (relating to Program
Completion for Sentenced Offenders Adjudicated for Capital Murder).]
[
(E)
§85.41 of this title (relating to Maximum
Length of Stay for Other Than Type A Violent and Sentenced Offenders).]
(g)
[
(h)
]
Transition,
Release
or Transfer
from the MRD.
A youth can be transitioned, released
or transferred from MRD because the youth’s medical condition no longer
warrants continued placement or the youth has otherwise qualified for transition,
release or transfer according to the appropriated rules listed below.
(1)
Youth’s Medical Condition No Longer
Warrants MRD Placement.
(A)
[
(1)
] Upon a determination by the
youth’s physician[
,
] that the youth’s medical condition
is stable enough to be [
released,
] transitioned[
,
] or
transferred from the MRD, the PAT recommends to the APSJCF superintendent
the [
release,
] transition or [
administrative/TDCJ
] transfer
of a youth from the MRD. [
The facility’s physician will be consulted
when questions arise regarding the release, transition or transfer. The TYC
medical director may be consulted before making final decisions regarding
the release, transition or transfer of youth from the MRD.
]
(B)
The APSJCF superintendent consults
with the facility nurse manager or designee when medical questions arise regarding
the transition or transfer.
(C)
The APSJCF superintendent must
approve the transition or transfer of youth from the MRD. The TYC medical
director may be consulted before making final decisions regarding the transition
or transfer of youth from the MRD.
(D)
If the youth has not met transition,
release or transfer criteria according to paragraph (2) of this subsection,
the youth will be returned to his/her originally assigned facility. If the
youth was referred from MOAU or APSJCF to the MRD and a general population
bed at APSJCF is unavailable at the time of the youth’s transfer from
the MRD, the youth may be placed at another facility by the CPU. This is considered
an administrative transfer pursuant to §85.45 of this title.
(2)
Youth Who Meet Criteria for
Transition to Medium Restriction, Release to TYC Parole or Transfer to Texas
Department of Criminal Justice (TDCJ).
(A)
Upon a determination by the PAT that the youth
has met release or transfer criteria, the youth will be released or transferred
under the appropriate rule:
(i)
§85.55 of this title (relating to Program
Completion for Other Than Sentenced Offenders).
(ii)
§85.59 of this title (relating to Program
Completion for Sentenced Offenders Under Age 19).
(iii)
§85.61 of this title (relating to Program
Completion for Sentenced Offenders Age 19 or Older).
(iv)
§85.69 of this title (relating to Program
Completion for Sentenced Offenders Adjudicated for Capital Murder).
(B)
Upon a determination by the PAT that the youth
meets criteria pursuant to §85.41 of this title (relating to Maximum
Length of Stay), the youth will be released to TYC parole (home or home substitute).
(C)
Upon a determination by the PAT that the youth
meets criteria pursuant to §85.45 of this title (relating to Movement
Without Program Completion), the youth may be transitioned to a medium restriction
placement if appropriate.
[
(2)
The admission review team
may recommend the youth to remain at the APSJCF.]
[
(3)
The APSJCF superintendent
must approve the release, transition, or transfer of youth from the MRD.]
[
(4)
If the youth has not completed
the program completion criteria, the youth will be returned to his/her originally
assigned facility. This is considered an administrative transfer as described
in §85.45 of this title, unless the original assignment was APSJCF. This
movement is considered a dorm change.]
(3)
[
(5)
] When a youth is [
released,
] transitioned,
released, or transferred,
[
or administrative
transferred or transferred to TDCJ,
] the PSW will ensure that a summary
of pertinent medical information and required follow-up care is included in
the transition ICP in the special needs section.
(h)
[
(i)
] Transportation.
(1)
The referring facility will make the transportation arrangements
to APSJCF for initial admission referrals.
(2)
When a youth is medically released and needs to be transported,
APSJCF will request transportation through statewide transportation. See §117.7
of this title (relating to Terminations/Discharges (Article VII, NAJCA).
(3)
When required by a youth’s condition, the APSJCF
medical van will be used to transport the youth to and from APSJCF.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 16, 2005.
TRD-200501964
Dwight Harris
Executive Director
Texas Youth Commission
Earliest possible date of adoption: July 3, 2005
For further information, please call: (512) 424-6014