State Supported Living Centers Statewide Policy & Procedures

Transcription

1 State Supported Living Centers Statewide Policy & Procedures Policy Number: Effective: DRAFT Replaces: 051 POLICY: PURPOSE: High-Risk Determination and Classification of Alleged Offender Residents The purpose of the policy is to establish operational criteria, procedures, and processes for determining whether individuals who are alleged offenders are at risk of inflicting substantial physical harm to another person, along with the hearing processes and the transfer issues related to the high-risk determination. APPROVED BY: Joe Vesowate Assistant Commissioner State Supported Living Centers APPLIES TO: All employees, agents, and contractors of State Supported Living Centers operated by Texas Department of Aging and Disability Services (DADS) and the ICF-IID component of Rio Grande State Center operated by the Department of State Health Services, collectively referred to as state centers. DISTRIBUTION: The State center must ensure the policy, all exhibits, and forms are distributed to applicable staff, contractors, and agents and to any individual requesting a copy. CONTACT: Eric Moorad Policy/Rules Coordinator (512) EXHIBITS AND FORMS: SSLC 051A: Instructions for High Risk Determination Report SSLC 051B: High Risk Determination Report SSLC 051C Notice of Appeal of High- Risk Alleged Offender Resident Determination and Classification SSLC 051D Notice of Appeal of High- Risk Alleged Offender Resident Determination, Classification, and Transfer REFERENCES: Texas Administrative Code (TAC), Title 40, Part 1, Chapter 2, Subchapter F TAC, Title 1, Part 15, Chapter 357, Subchapter I Texas Health and Safety Code (THSC), Chapter 555 THSC, Chapter 591 Texas Code of Criminal Procedure, Chapter 46B Texas Family Code, Chapter 55

2 Definitions Alleged offender resident: An individual with a developmental disability who: 1) was committed or transferred to a state supported living center (SSLC) under Chapter 46B or 46C Code of Criminal Procedure as a result of being charged with or convicted of a criminal offense; or 2) is a child committed to or transferred to a SSLC under Chapter 55, Family Code as a result of being alleged by petition or having been found to have engaged in delinquent conduct constituting a criminal offense. (See Texas Health and Safety Code (THSC) (1)) State center or facility: A state supported living center (SSLC) or the ICF-IID component of the Rio Grande State Center. (See THSC (2) and 40 TAC 3.101)) Direct support professional: An unlicensed employee who directly provides services to an individual. (See 40 TAC 3.101) Forensic center: The state supported living center designated in THSC Chapter 555 to provide for the care, apart from other clients and residents, of high-risk alleged offender residents. (See THSC ) High-risk alleged offender resident: An alleged offender resident who has been determined under THSC to be at risk of inflicting substantial physical harm to another. (THSC (10)) High-Risk Determination Report: A summary report completed by the interdisciplinary team (IDT) that details the findings, documentation, and evidence used to make a high-risk determination for the alleged offender resident. Details on the report are provided in Form SSLC 051A: Processing the High- Risk Determination Report. (See THSC (c)) Individual: A person with a developmental disability receiving services from a facility. The term individual is synonymous with the term resident. (40 TAC 3.101) Interdisciplinary team (IDT): An interdisciplinary team with the active participation of the individual and LAR, that is responsible for assessing the individual's treatment, training, and habilitation needs and making recommendations for services based on the personal goals and preferences of the individual using a person-directed planning process, including recommendations on whether the individual is best served in a facility or community setting. (40 TAC 3.101) Legally authorized representative (LAR): A person authorized by law to act on behalf of an individual, including a parent, guardian, or managing conservator of a minor individual, or a guardian of an adult individual. (40 TAC 3.101) Minor individual: An individual under 18 years of age who is not and has not been married or who has not had disabilities of minority removed for general purposes. (See THSC (15)) Risk determination process: The interdisciplinary team s (IDT s) determination process of whether an individual poses a risk of inflicting substantial physical harm to another based on known risk factors the individual presents. The results of this process are reported in the High-Risk Determination Report. The risk determination process includes a review and documentation of relevant information from the following sources: unusual incident reports; observation notes; integrated progress notes; behavioral data; relevant results of psychiatric assessments and consultation; applicable information provided by counselors or other therapists providing services; interviews with staff who have worked with the individual, legal authorized representatives (LARs), or family members; and direct observations. Information provided by the completion of the START and the HCR-20 is also presented. To help aid in the coordination of efforts in planning for potential transfers, the state office must receive the preliminary findings of the IDT. The preliminary findings are completed using the High Risk 2

3 Determination Report (form SSLC 51A) completed in accordance with instructions (form SSLC 51B), and marked as Preliminary. The process concludes with a final High-Risk Determination Report in which the IDT makes a determination and classification of the alleged offender resident as high risk for inflicting substantial physical harm to another or not high risk.. SSLC: A state supported living center. (See 40 TAC 3.101) Transfer: The movement of a resident between centers or residences, with the intent of relocation and reassignment within the Texas Department of Aging and Disability Services (DADS) service delivery system. I. Responsibilities of a Forensic Center The Forensic Center must ensure consistent and effective implementation of this policy, the attached forms, THSC Chapter 555, and THSC Subchapter B, Chapter 594 by: 1. Providing placement for an alleged offender resident who has been newly committed or transferred to the Forensic Center and for whom there has not been a high-risk determination; 2. Ensuring that the risk screening process to determine whether the individual is a high-risk alleged offender resident is completed no later than 30 days after the date an alleged offender resident is civilly committed to the Forensic Center pursuant to Texas Code of Criminal Procedure, Chapter 46B, Subchapters E and F. See THSC (a). This requirement does not apply to a commitment for restoration to competency under Article 46B.073, Texas Code of Criminal Procedure, or to a 90-day placement under Section 55.33, Texas Family Code; 3. Ensuring that a high-risk determination is completed for all alleged offender residents who have not been previously determined or classified as a high-risk alleged offender resident; 4. Ensuring that another high-risk determination is completed for all high-risk alleged offender residents residing at the Forensic Center at least annually, by the anniversary of the date of the individual s high-risk determination. See THSC (a); 5. Ensuring that an offender determined and classified as a high-risk alleged offender resident is placed in a separate home at the Forensic Center, based upon whether the individual is an adult or a person younger than 18 years of age and male or female. See THSC (b)(2); 6. Accepting the transfer of a high-risk alleged offender resident from another state center to the Forensic Center. See THSC (b)(1); 7. Making arrangements for the transfer of an alleged offender resident residing at the Forensic Center who does not have a high-risk determination and classification if the alleged offender resident requests a transfer. The transfer will be in accordance with THSC Subchapter B, Chapter 594. See THSC (c); 8. Notifying an alleged offender resident of his or her right to request a transfer to another state center in accordance with THSC Subchapter B, Chapter 594 if he or she has not been determined and classified as a high-risk alleged offender resident under THSC See THSC (c); 9. Notifying non-alleged offender residents at Mexia State Supported Living Center of their right to request a transfer. See THSC (b)(4); 3

4 10. Notifying an individual who has been determined and classified as a high-risk alleged offender resident of the opportunity to pursue an administrative hearing with the Health and Human Services Commission to contest that determination and classification. See THSC (d); 11. Not carrying out any requested transfers while any appeals are in progress; and 12. Not moving the individual to a home designated as high-risk pending outcome of the appeal if any individual has been determined and classified as a high-risk alleged offender resident, and a timely appeal has been filed. II. Responsibilities of State Centers Not Designated as Forensic Centers The state centers not designated as forensic centers must ensure consistent and effective implementation of this policy, the attached forms, THSC Subchapter B, Chapter 594 by: 1. Ensuring that a high-risk determination and classification is completed for all alleged offender residents currently residing at the state center and to initiate the transfer of an alleged offender who is classified as a high-risk alleged offender resident to a forensic center. See THSC (b)(1) and (a); 2. Notifying an individual who has been determined and classified as a high-risk alleged offender resident of the opportunity to pursue an administrative hearing with the Health and Human Services Commission to contest that determination and classification. See THSC (d); 3. Making arrangements for a transfer of an alleged offender residing at the forensic center who does not have a high-risk determination if the alleged offender requests a transfer. The transfer will be in accordance with THSC Subchapter B, Chapter 594. See THSC (b) (4) and (c); 4. Not carrying out any requested transfers while any appeals are in progress; and 5. If any individual has been determined and classified as a high-risk alleged offender resident, and a timely appeal has been filed, not moving the individual to a home designated as high risk pending outcome of the appeal. III. Determination and Classification of High-Risk Alleged Offender Status A. The assigned psychologist prepares the HCR-20 and the START prior to the IDT meeting. B. The IDT must determine whether the alleged offender resident is at current risk of inflicting substantial physical harm to another and should be classified or remain classified as a high-risk alleged offender resident. C. To help aid in the coordination of efforts in planning for potential transfers, the state office must receive the preliminary findings of the IDT. The preliminary findings are completed using the High Risk Determination Report (form SSLC 51A) in accordance with instructions (form SSLC 51B) and marked as Preliminary. D. In making the final determination, the IDT must document and review the evidence provided through the risk determination process, and must summarize the determination and classification in a High 4

5 Risk Determination Report (form SSLC 51A) completed in accordance with the instructions in form SSLC 51B. The final report must include reference to documents that were completed or reviewed by the IDT, notes regarding the deliberations held by the IDT during the meeting or meetings regarding this determination, and a signature sheet signed by all the IDT members indicating their agreement or reasons for disagreement regarding the classification. E. For those determined and classified as high-risk, the final High-Risk Determination Report and the evidence collected are provided to: 1. The state office of DADS; 2. The director of the state center; 3. The independent ombudsman; 4. The alleged offender resident or the alleged offender resident s parent if the resident is a minor individual; and 5. The alleged offender resident s legally authorized representative (LAR), if any. IV. Request for an Appeal The request for an appeal of a high-risk alleged offender resident determination and classification or transfer will be governed by Texas Administrative Code, Title 1, Part 15, Chapter 357, Subchapter I, entitled Hearings under the Administrative Procedure Act. V. Transfer Requirements A. Alleged offender residents of state centers for which a risk screening process has resulted in a highrisk determination and classification must be transferred to the forensic center. See THSC (b)(1) and (a). B. Alleged offender residents of the forensic center must remain at the forensic center until a risk screening process has been completed and a determination is made as to whether the alleged offender resident is at risk of inflicting substantial physical harm to another. All individuals at the forensic center, other than those determined and classified as high-risk alleged offenders, may request a transfer from the forensic center. See THSC (b)(4). VI. Data Collection and Reporting A. Data Collection DADS must collect data regarding the commitment of alleged offender residents to state supported living centers. See THSC (e). The data must include: 1. Any offense with which an alleged offender resident is charged; 2. The location of the committing court; 3. Whether the alleged offender resident has previously been in the custody of the Texas Youth Commission or the Department of Family and Protective Services; and 5

6 4. Whether the alleged offender resident receives mental health services or previously received any services under a Section 1915C waiver program. B Annual Report An annual report summarizing these data is completed by the DADS state office and submitted to the governor, the lieutenant governor, the speaker of the house of representatives, and the standing committees of the legislature with jurisdiction over state supported living centers. The report will not contain personally identifiable information. See THSC (e). VII. Quality Assurance Each state center must establish a system to assess the implementation of this policy. This system must include at least the following: 1. A current list of any alleged offender residents, including the demographic information required for the annual report; 2. A current list of the age, gender, and location of any alleged offender residents determined and classified as high-risk alleged offender residents; 3. A current list of alleged offender residents with the dates of the completion of the risk determination process; 4. A current list of appeals on high-risk determination and classification and the results; and 5. A tracking system for each alleged offender resident that shows where the alleged offender resident is in the high-risk determination process. 6

7 INSTRUCTIONS FOR PROCESSING THE HIGH-RISK DETERMINATION REPORT The assigned psychologist or assigned psychologist s designee completes each part of Sections I-III using the instructions below and shares the completed Sections I-III with the interdisciplinary team (IDT) prior to the IDT meeting. Based on deliberations in the IDT meeting, the IDT may add information to Sections I-III and completes Section IV and the signature sheet. Section I General Information Attach a copy of the alleged offender resident s commitment order to the report. Describe the circumstances that precipitated this risk screening. List any current legal offense information. Section II Information Reviewed by the IDT in the Risk Determination Process Specify sources of information, including documents reviewed, persons interviewed, and personal observations. Minimally, sources of information should include relevant unusual incident reports, observation notes, integrated progress notes, behavioral data, relevant results of psychiatric assessments and consultation, applicable information provided by any counselor providing services, interviews with direct support professionals and home supervisors who have worked with the individual, and direct observations. Attach relevant copies of the documents mentioned above as evidence. Provide a brief developmental and family history, and a summary of relevant medical information, psychiatric history, substance abuse history, criminal/legal history, interpersonal skills and relationships, and violence characteristics and frequency (including likely precipitating factors). Specify information provided by the completion of the START and the HCR-20. Section III Identified Risk Factors for Violence to Others Describe any identified events that make violence toward others more likely, including contextual variables. Describe any relevant behavioral observations and the alleged offender resident s mental status. Indicate the alleged offender resident s psychiatric diagnoses and the relationship to violence. Specifically address the alleged offender resident s history of significant previous violence SSLC 051A High Risk Determination Report Instructions (February, 2013

8 toward others, aggressive threats toward others, history of the use of weapons in aggressive episodes, regard for the rights and welfare of others, impulsiveness, stability of relationships with others, access to others as potential victims, and response to treatment. Section IV Appraisal of Risk and Recommendations Document the IDT s deliberation regarding the identified risk factors for violence toward others. Indicate the current level of support needed to ensure the safety of the alleged offender resident and others. Indicate the IDT s determination of whether the alleged offender resident is at risk of inflicting substantial physical harm to another. Recommend transfer if applicable, and document whether the family or correspondent supports or opposes the transfer. SSLC 051A Instructions for Processing High Risk Determination Report (February, 2013) 2

9 [NAME] STATE SUPPORTED LIVING CENTER HIGH RISK DETERMINATION REPORT INTERDISCIPLINARY TEAM MEETING MEETING DATE: Name of alleged offender resident: [First and Last Name] Case #: [0000] MPI# [ ] «PATID» [ ] The purpose of this IDT meeting is to evaluate the evidence and determine whether the alleged offender resident is at high risk of inflicting substantial physical harm to another. Complete Sections I IV and the Signature Sheet in accordance with the SSLC 051A Instructions for Processing the High Risk Determination Report, the High Risk Determination Statewide Policy, and any statewide operational procedures. Section I. General Information Section II. Information Reviewed by the IDT in the Risk Determination Process Section III -- Identified Risk Factors for Violence to Others Section IV. Appraisal of Risk and Recommendations [Name of Alleged Offender Resident] is/is not at high- risk of inflicting substantial physical harm to another. DRAFT SSLC 051B High Risk Determination Report (February, 2013

10 Signature Sheet It is the determination of this IDT that [Name of Alleged Offender Resident] is/is not at high-risk of inflicting substantial physical harm to another. IDT Member Printed Name and Title IDT Member Signature IDT Member Comments 2 SSLC 051B High Risk Determination Report (February, 2013)

11 NOTICE OF APPEAL OF HIGH-RISK ALLEGED OFFENDER RESIDENT DETERMINATION AND CLASSIFICATION I,, a resident of the [name SLLC] State Supported Living Center, hereby acknowledge receipt of the following: (1) Notice that my interdisciplinary team (IDT) has determined I should be classified as a highrisk alleged offender resident; (2) Notice of my right to representation; (3) Receipt of the applicable statutes and DADS policy concerning high-risk alleged offender resident designation; (4) Receipt of the findings, documentation, and evidence relied upon by my IDT to make its high-risk alleged offender resident designation; and, (5) Receipt of the HHSC hearings rule. I wish to appeal the IDT s high-risk alleged offender resident determination and classification and request an administrative hearing in accordance with Texas Health and Safety Code, Section (d). Signature or Mark of Resident Date IF THE RESIDENT IS UNABLE TO SIGN THEIR NAME: Signature of CCSSLC Staff or Representative who witnessed the Resident s Mark Date Form SSLC 051H (February, 2013)

12 NOTICE OF APPEAL OF HIGH-RISK ALLEGED OFFENDER RESIDENT DETERMINATION AND CLASSIFICATION I,, a resident of the [name SLLC] State Supported Living Center, hereby acknowledge receipt of the following: (1) Notice that my interdisciplinary team (IDT) has determined I should be classified as a highrisk alleged offender resident; (2) Notice that [name SSLC] proposes to transfer me to Mexia State Supported Living Center. (3) Notice of my right to representation; (4) Receipt of the applicable statutes and DADS policy concerning high-risk alleged offender resident designation; (5) Receipt of the findings, documentation, and evidence relied upon by my IDT to make its high-risk alleged offender resident designation; and (6) Receipt of the HHSC hearings rule. I wish to appeal the IDT s high-risk alleged offender determination and classification and the proposed transfer to Mexia State Supported Living Center and request an administrative hearing in accordance with Texas Health and Safety Code, Section (d). Signature or Mark of Resident Date IF THE RESIDENT IS UNABLE TO SIGN THEIR NAME: Signature of CCSSLC Staff or Representative who witnessed the Resident s Mark Date Form SSLC 051I (February, 2013)