Texas Register, Volume 23, Number 31, Pages 7663-7938, July 31, 1998 Page: 7,743
7663-7938 p. ; 28 cm.View a full description of this periodical.
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(B) In outpatient programs, direct care staff shall be
awake and on site whenever an offender is on site. Offenders shall
have access to on-call staff 24 hours a day.
(4) If the program accepts offenders with acute detoxifi-
cation symptoms or a history of acute detoxification symptoms, the
program shall have:
(A) a licensed vocational nurse or registered nurse on
duty during all hours of operation;
(B) a physician on-call 24 hours a day.
(5) Level of observation shall be based on medical rec-
ommendations and program design, or not less than that described in
paragraph (2)(A) of this subsection.
(6) A physician shall approve all medical policies, proce-
dures, guidelines, tools, and forms, which shall include:
(A) screening instruments (including a medical risk
assessment) and procedures;
(B) treatment protocol or standing orders for each
chemical the program is prepared to address in detoxification; and
(C) emergency procedures.
(7) The clinical supervisor shall be a physician, physician
assistant, advanced practice nurse, or registered nurse.
(8) The program shall:
(A) ensure continuous access to emergency medical
care;
(B) provide offenders access to mental health evalua-
tion and linkage with mental health services when indicated;
(C) use written procedures to encourage offenders to
seek appropriate treatment after detoxification.
(9) Direct care staff shall complete detoxification training
provided by a physician, physician assistant, advanced practice nurse,
or registered nurse that includes instruction in the following areas
listed in subparagraphs (A)-(E) of this paragraph:
(A) signs of withdrawal;
(B) pregnancy-related complications (if the program
admits females of child-bearing age);
(C) observation and monitoring procedures;
(D) appropriate intervention; and
(E) complications requiring transfer.
(10) Staff shall assist each offender in developing an indi-
vidualized post-detoxification plan that includes appropriate referrals.
(t) Relapse/Intensive Residential Treatment. Written policies
and procedures shall ensure the following listed in paragraphs (1)-
(11) of this subsection.
(1) All offenders admitted to relapse intensive residential
treatment shall be medically stable, and able to participate in
treatment.
(2) The program shall provide adequate staff for close
supervision and individualized treatment with counselor caseloads
not to exceed ten offenders.
(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 sources.
(4) Counselors shall complete a comprehensive offender
assessment within three working days of admission.
(5) An individualized treatment plan shall be completed
for all offenders within five working days of admission.
(6) The facility shall deliver not less than 20 hours of
structured activities per week for each offender, including:
(A) ten hours of chemical dependency counseling,
with no less than one hour of individual counseling;
(B) seven hours additional education, counseling, life
skills, or rehabilitation activities; and
(C) three hours of structured social or recreational
activities.
(7) Counseling and education schedules shall be submit-
ted to the funding entity for approval.
(8) Each offender shall have an opportunity to participate
in physical recreation at least weekly.
(9) Program staff shall offer chemical dependency educa-
tion or services to identified significant others.
(10) The program shall provide each offender with op-
portunities to apply knowledge and practice skills in a structured,
supportive environment.
(11) If the program utilizes a Modified Therapeutic Com-
munity modality of treatment it shall include the following listed in
subparagraphs (A)-(E) of this paragraph as minimal components:
(A) a Structure Board;
(B) encounter, counseling and family groups;
(C) utilization of a three phase process. (Offenders
shall transition from Phase 1, to Phase 2, to Phase 3, by meeting
objectives and program goals);
(D) graduated treatment sanctions for incidents of non-
compliance in coordination with the Transitional Treatment Team;
and
(E) other peer-support groups.
(u) Primary Care/Modified Therapeutic Community Treat-
ment. Written policies and procedures shall ensure the following
listed in paragraphs (1)-(12) of this subsection.
(1) All offenders admitted to modified therapeutic com-
munity treatment shall be medically stable, and able to participate in
treatment.
(2) The program shall provide adequate staff for close
supervision and individualized treatment with counselor caseloads
not to exceed 20 offenders.
(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.
(4) Counselors shall complete a comprehensive offender
assessment within five working days of admission for all offenders
admitted to a therapeutic community program.PROPOSED RULES July 31, 1998 24 TexReg 7743
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Texas. Secretary of State. Texas Register, Volume 23, Number 31, Pages 7663-7938, July 31, 1998, periodical, July 31, 1998; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth113850/m1/82/: accessed June 21, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.